An unusual cause of gastric outlet obstruction during percutaneous endogastric feeding: a case report

<p>Abstract</p> <p>Introduction</p> <p>The differential diagnoses of acute abdomen in children include common and rare pathologies. Within this list, different types of bezoars causing gastrointestinal obstruction have been reported in the literature and different methods of management have been described. The aim of this article is to highlight a rare presentation of lactobezoars following prolonged percutaneous endoscopic gastrostomy feeding and its successful surgical management.</p> <p>Case presentation</p> <p>A 16-year-old boy was admitted to a paediatric ward with abdominal distension and high output from his permanent gastrostomy feeding tube, with drainage of bilious fluids. The clinical, radiological and endoscopical examinations were suggestive of partial duodenal obstruction with multiple bezoars in the stomach and duodenum. Gastrojejunostomy was performed after the removal of 14 bezoars. The child had an uneventful postoperative course and was discharged on the sixth postoperative day in a stable condition.</p> <p>Conclusion</p> <p>Lactobezoars should be included in the differential diagnosis of acute abdominal pain in patients with percutaneous endogastric feeding. Endoscopy is important in making the diagnosis of this surgical condition of the upper gastrointestinal tract in a child.</p

Understanding the impact of droughts in the Yarmouk Basin, Jordan: monitoring droughts through meteorological and hydrological drought indices

This article assesses drought status in the Yarmouk Basin (YB), in northern Jordan, using the Standardized Precipitation Index (SPI), the Standardized Water-Level Index (SWI), and the Percent Departure from Normal rainfall (PDNimd) during the years 1993–2014. The results showed that the YB suffers from frequent and irregular periods of drought as variations in drought intensity and frequency have been observed. The SPI results revealed that the highest drought magnitude of − 2.34 appeared at Nuaimeh rainfall station in 1991. This station has also experienced severe drought particularly in years 1995, 1999, 2005, and 2012 with SPI values ranging from − 1.51 to − 1.59. Some other rainfall stations such as Baqura, Ibbin, Khanasiri, Kharja, Mafraq police, Ramtha, Turra, and Umm Qais have also suffered several periods of drought mostly in 1993. The SWI results show the highest extreme drought events in 2001 in Souf well while other extreme drought periods were observed at Wadi Elyabis well in 1994 and at Mafraq well in 1995. As compared to SPI maps, our SWI maps reflect severe and extreme drought events in most years, negatively impacting the groundwater levels in the study area

Brain Deletion of Insulin Receptor Substrate 2 Disrupts Hippocampal Synaptic Plasticity and Metaplasticity

Diabetes mellitus is associated with cognitive deficits and an increased risk of dementia, particularly in the elderly. These deficits and the corresponding neurophysiological structural and functional alterations are linked to both metabolic and vascular changes, related to chronic hyperglycaemia, but probably also defects in insulin action in the brain. To elucidate the specific role of brain insulin signalling in neuronal functions that are relevant for cognitive processes we have investigated the behaviour of neurons and synaptic plasticity in the hippocampus of mice lacking the insulin receptor substrate protein 2 (IRS-2)