Mucin as possible cause of early adhesional intestinal obstruction

Objectives: To report the case of a 24 year old female undergraduate who presented with bowel obstruction, three weeks following the excision of a mucinous ovarian cyst .Patient and methods: The records of the patients past and recent medical history laboratory and imaging studies were reviewed.Results: Clinical findings of a distended and a plain abdominal radiogram showing distended loops of bowel (Figure 2) were in keeping with acute bowel obstruction. This was confirmed by the intraoperative finding of fibrous encasement of small bowel. This was excised, and 12 months thereafter, patient has remain in good health.Conclusion: Early and absolute adhesional bowel obstruction from abdominal surgery is failing conservative management rate. We attributed this to the ruptured mucinous cyst in our earlier operation. We therefore suggest that should a rupture cyst of this type occurs during a surgical procedure, any of the preventive methods discussed should be tried as a prophylactic measure.Key words: Ruptured mucinous cyst; adhesional intestinal obstruction; literature review

Neurofibromas as bilateral cystic chest wall swellings.

A 35 year old male farmer presented with soft bilateral posterior chest wall swellings. He had no similar swellings elsewhere. There were no associated symptoms, except cosmetic deformity and discomfort when he lies on his back. A clinical diagnosis of posterior chest wall lipomata was made. However at surgery, the two tumours were completely cystic. Following total excision, histology of the two tumours revealed cystic degeneration of neurofibromas. His postoperative recovery was uneventful. The importance of this report is to emphasize the need for histological examinination of all excised human tissues, which is not always the case in most of our rural areas and to document the discovery of such a rare clinical entity in our centre. This rare entity should be borne in mind when considering the differential diagnosis of benign cystic chest wall tumours.Key words: neurofibromatosis, cystic swelling, posterior, chest, wall

Prevalence Of Dog Bites In A Rural Community: A 15 Year Review Of Cases In Okoyong, Cross River State, Nigeria

This retrospective study was undertaken to assess the prevalence of dog bites in Comprehensive Health Centre, Okoyong south-south Nigeria. Eleven cases of dog bite were recorded out of a total of 25,000 patients seen during a fifteen- year period (1990-2004). This gives a prevalence of 44 per 100,000 population. The age of the patients ranged from 16 to 43 years, with a mean of 27.1+ 8.3. Male to female ratio was 1:0.8. The treatment of patients consisted of analgesics, antibiotics, tetanus toxoid and antitetanus serum. We did not have any recorded case of rabies, in spite of the fact that none of the patients had rabies vaccination nor antirabies immunoglobulin. All the patients reported late to hospital, the mean duration before presentation being 10.23 days. The follow up was extremely poor as most patients never reported for follow up after the initial treatment as outpatient or discharge following admission. We conclude that the prevalence of dog bites in this health centre is low (0.04%).We recommend more comprehensive community-based studies to adequately assess the burden of this problem. Current regulations on the management of dog bites should be strictly followed by the attending medical personnel. KEY WORDS: Okoyong, Dog bites, Prevalence

Approximate Query Processing over Static Sets and Sliding Windows

Indexing of static and dynamic sets is fundamental to a large set of applications such as information retrieval and caching. Denoting the characteristic vector of the set by B, we consider the problem of encoding sets and multisets to support approximate versions of the operations rank(i) (i.e., computing sum_{j = i}) queries. We study multiple types of approximations (allowing an error in the query or the result) and present lower bounds and succinct data structures for several variants of the problem. We also extend our model to sliding windows, in which we process a stream of elements and compute suffix sums. This is a generalization of the window summation problem that allows the user to specify the window size at query time. Here, we provide an algorithm that supports updates and queries in constant time while requiring just (1+o(1)) factor more space than the fixed-window summation algorithms

Plasmacytoma of the Breast: A Report of a Rare Disease

BACKGROUND: Extramedullary plasma cells tumours are rare. Much more rarer is their occurance in the breast tissue. Our aim is to report a single case of this very rare lesion (at least from an African  perspective) that we incidentally diagnosed histopathologically as a primary extramedullary lesion in a 53 year old woman.CASE DEATILS: Clinical records of a 53 year old postmenopausal woman was referred from a secondary health centre to our clinic with a three weeks’ history of right breast lump were reviewed. There was no associated pain, nipple discharge, weight loss or systemic symptoms nor was there a previous history of  trauma or surgery to the breast. On examination: two discrete lumps measuring 3x2 and 2 x 1.5cm in the upper medial quadrant of the right breast were identified. The lumps were firm, irregular in shape, not  attached to the skin or underlying tissues. Tentative diagnosis of adenocarcinoma of the breast was  made, with a differential as fat necrosis. A wide excision biopsy was done four days later for histology,  after an inconclusive cytological examination of smear of which the result revealed plasmacytosis. The  liver function test, Plasma proteins electrophoresis, electrolytes, urea, creatinine, bicarbonate and pelvic X-rays, and abdomino-pelvic ultrasonography were normal. Bence Jones proteins were negative in urine. Histology of bone marrow aspirate revealed scanty plasma cells.RESULTS: She received 20mg dexamethasone, 20mg adramycin, and 2mg vincristine intravenously and 200mg of alloperinol daily by mouth for three days before leaving by the 4th treatment day against medical advice for personal reasons.CONCLUSION: This rare lesion should sometimes be considered as a differential diagnosis of a breast lump, as it does not differ from the common lesions clinically, especially in older women.KEYWORDS: Extramedullary, plasmacytoma, primary, breast, lesio

Management of Lower Urinary Retention in a Limited Resource Setting

Background: There is a projected increase in lower urinary tract obstruction by 2018, especially in the developing economies of Asia and Africa. However in many of these countries, the problems encountered both by the patients and the clinicians are not well documented. Our aims are, to prospectively analyse the management of urinary retention, the associated difficulties, and complications in our setting, where access to investigative modalities such as Computerize Tomography and Magnetic Resonance Imaging are not available.Patients and Methods: The study was approved by the University Of Calabar Teaching Hospital ethical committee. A validated Proforma was used to collect data from all patients who were clinically diagnosed with urinary retention based on history, and physical examination, from July 2009 to June 2010. Data collected from the 1st of July 2009 to the 30th of June 2010, include demographics, findings on physical examination, previous medical history and co-morbid conditions. The results of investigations done such as: urinalysis, full blood count, electrolytes, urea and creatinine, intravenous urography, trans- abdominal ultrasonography, chest X-ray and histology of trans-rectal biopsies of the prostate . The total number of new patients seen, including those with urinary retention during the study was documented. The retentions were also classified into acute and chronic. All the patients were followed up throughout the study. The data was analysed using Epi-Info statistical program version 3.4 of 2007 to analyse the data, estimating averages, mean, median and percentages. Results: The total number of new patients seen, including those with urinary retention was Seventy thousand, one hundred and thirty nine (70,139).Of this number, hundred and fifty nine (0.23%), presented with urinary retention; 145 (91.2%) were acute, and14 (8.8%) were chronic. The male: female ratio was 39:1.The patients ages ranged from 4 to 94 years, with a mean of 53.7±11.2. Seventy seven [48.4%] of them were in the 6th and 7th decades of life. The common causes were; prostatic diseases [BPH and cancer of the prostate] 77.0%, infections 75.8%, trauma 12.1%, and congenital 12.1%. Urinary retention was relieved by: indwelling urethral catheterization [IUC] 120 patients (75.5%), supra- pubic cystostomy [SC] 34 (21.4%) and intermittent urethral catheterization [IC] 5 (3.1%). The most frequently encountered complications include pyuria (18.2%), pericatheter sepsis 17.5%, and haemorrhage during change of catheter 16.8% [figure 2].Conclusion: Lower urinary retention is common in our environment. The management is appropriate and standard. The man power and facilities are inadequate, and requires urgent improvement.Keywords: Urinary retention; management; limited resource

TeAAL: A Declarative Framework for Modeling Sparse Tensor Accelerators

Over the past few years, the explosion in sparse tensor algebra workloads has led to a corresponding rise in domain-specific accelerators to service them. Due to the irregularity present in sparse tensors, these accelerators employ a wide variety of novel solutions to achieve good performance. At the same time, prior work on design-flexible sparse accelerator modeling does not express this full range of design features, making it difficult to understand the impact of each design choice and compare or extend the state-of-the-art. To address this, we propose TeAAL: a language and compiler for the concise and precise specification and evaluation of sparse tensor algebra architectures. We use TeAAL to represent and evaluate four disparate state-of-the-art accelerators--ExTensor, Gamma, OuterSPACE, and SIGMA--and verify that it reproduces their performance with high accuracy. Finally, we demonstrate the potential of TeAAL as a tool for designing new accelerators by showing how it can be used to speed up Graphicionado--by $38\times$ on BFS and $4.3\times$ on SSSP.Comment: 14 pages, 12 figure

Trauma death in a resource constrained setting: Mechanisms and contributory factors, the result of analysing 147 cases

Aims and objectives: The objective of the following study is to analyze the trauma type (causes), injury pattern and factors that may have contributed to death within 72 h of admission into our emergency department (E.D).Materials and Methods: An 18 month prospective observational study, done from April 2009 to September 2010. All the patients were that  admitted for 72 h following a full assessment by the attending clinician were enlisted for the study. The demographic data of each patient, time of arrival at the E.D, type of injury sustained, time of incident, previous care at any peripheral hospital, clinical state of the patient, Glasgow coma scale (GCS), Injury severity score (ISS) and treatment offered before death were entered into a Proforma.Data Analysis: This was done using EPI-Info statistical programme version 3.4.3 of 2007(by CDC Atlanta Georgia , USA).Results: A total of 4011 patients were seen in the E.D during the period. 1943 (48.4%), were trauma emergencies, with a (147; 41.4%) mortality. Their ages ranged from 4 to 87 years, with an average of 34.5 years. The male:female ratio was 7:1. The assessed GCS ranged from 6 to 15, with an average of 9.1, the ISS ranged from 9 to 75 with an average of 31.3. Road traffic accidents (RTAs) accounted for 118 (80.3%) of the deaths, assaults 14.3%, falls from height 4.0% and gunshot injuries 1.4%. The overall mortality was 17.1%.Conclusion: The major source of trauma death was RTA; The most  frequently injured part of the body was head, with death resulting clinically hemorrhage. The 17.1% mortality is multifactorial: The late presentation (in some cases occasioned by interference by persons not knowledgeable in the basics of trauma care) lack of trained personnel and the systemic deficiencies.Key words: Causes, factors contributory to death, mechanism of trauma, pattern of injuries, trauma deat