The role of multislice computed tomography (MSCT) in the direction of traumatic intra abdominal injury : our experience in Hospital Tengku Ampuan Afzan(HTAA), Kuantan, Pahang

Introduction: Blunt abdominal trauma can cause multiple injuries and these injuries are often difficult to be accurately evaluated via clinical assessment. Currently, multislice computed tomography (MSCT) scan is the imaging modality of choice in assessing clinically stable patients with blunt abdominal trauma. This study assessed the role of MSCT in the detection of traumatic intra abdominal injury and correlates the findings with subsequent patient’s management. Methodology This is a retrospective study approved by our institutional review board. All cases of CT scan performed to rule out traumatic intra abdominal injury from January 2008 until December 2009 was traced from the registration book. CT scan images were retrieved and reviewed. Analysis of findings was done and organ injuries were graded according to AAST (American Association of Surgery and Trauma). Case notes and surgical findings were reviewed for correlation with CT findings. Results There were 151 cases included in this study. Positive scan were seen in 130 patients (86.1%). Liver, spleen and renal injuries were seen in 40.8%, 33.8% and 26.2% of cases respectively. Laparotomies were performed in 42 patients from 130 positive scans (32.3%) and in 3 patients who had negative scan. Out of 45 patients who had undergone laparotomies, 10 patients had significant surgically injuries that were missed on CT scan findings. The injuries were bowel perforation (n=4), serosal tear of bowel (n=1), mesenteric injuries (n=2), spleen injury (n=1), liver injury (n=1) and laceration of broad ligaments with oozing of blood from ovarian artery (n=1). Conclusion CT scan is a useful tool in the evaluation of blunt abdominal injuries in haemodynamically stable patients especially in the detection of solid organ injuries and retroperitoneal haematoma. However assessment of bowel and mesenteric injury was not similarly effective in our study

Continuous Production of Carbon Nanotubes - A Review.

Carbon nanotubes (CNTs) up to now are the most researched materials of the 21st century with an international intention of growing industrial quantities due to their superior properties for use in many applications. Thus far large quantities of carbon nanotube scan be grown in a continuous manner by both arc as well as chemical vapour deposition methods. In this paper, an innovative approach of feeding gases, a carbon precursor (solid or gases) and a catalyst into the reaction zone is reviewed. This is followed by a study of the reaction process concerning how the method is initiated, the effect of growth environment and catalyst on CNTs as well as the discharging mechanism for the final carbon products. A study of the arc method consists of a novel way of growing CNTs in a liquid solution from an arc discharge generated by carbon rods, by growing CNTs in a plasma zone using carbon gases or solid carbon and a more direct method of using carbon tape as the anode for the synthesized source are also reported. In the case of the chemical vapour deposition (CVD) method, some use a horizontal reactor and some use a vertical reactor with all having different installed devices for use in continuous feeding and discharging of resources and products respectively. Additionally, problems regarding the CNT yield and some issues that have not been taken into consideration by others, are discussed. At the end of the review, an additional mechanism to integrate catalyst preparation and carbon nanotube purification into the current research synthesizing process for future study is proposed for a highly productive continuous CNT synthesis process

Spectrum of breast asymmetries: a pictorial essay

Introduction: Asymmetric breast tissue is a relatively common mammographic finding and is usually benign. It might be due to a normal variation, postoperative changes or hormone replacement therapy. However, an asymmetric area may indicate a developing mass or an underlying cancer. Method: We collected random cases of asymmetric breast densities on mammography, and present examples of the four types according to the recent ACR BIRADs classification. The four types are global asymmetry (previously known as asymmetric breast tissue), asymmetry (previously known as density seen on one projection), focal asymmetry (previously known as focal asymmetric density) and a developing asymmetry (replacing architectural distortion). The final diagnoses are given, confirmed on further investigations such as biopsy and FNAC or supplementary imaging. Conclusion: Accurate interpretation of breast asymmetry found on a mammogram may needs additional imaging studies such as supplementary views, ultrasonography or magnetic resonance imaging. Radiologist should be aware of this condition and further assessment should be carried out in a logical work flow for optimum patient care

Disseminated histoplasmosis presenting with chronic ulcerative tongue lesions in a patient with diabetes

We describe a case of chronic tongue ulceration with systemic symptoms in a patient with poorly controlled diabetes. A biopsy of a lesion from the posterior third of the tongue showed features typical of histoplasmosis. A CT of the thorax and abdomen revealed a diffuse reticulonodular pattern bilaterally.The intra-abdominal organs were normal

CT imaging of blunt splenic injury: a pictorial essay

Nonsurgical management has become the standard care for hemodynamically stable patients with splenic injury from blunt abdominal trauma. To attempt nonsurgical management, it is important to identify and characterize not only the splenic injury but also the concurrent injury to solid viscera, bowel and mesentry, or retroperitoneum that may require surgery. The ability of multi-detector row computed tomography (MDCT) to obtain high resolution images has made MDCT the primary imaging modality for the evaluation of these patients. The CT features of splenic injury include lacerations, subcapsular or parenchymal hematomas, active hemorrhage and vascular injuries. A variety of CT grading systems have been proposed to grade splenic injury following trauma. Radiologists should be familiar with the splenic injury grading system to facilitate communication with the managing surgical team and for research purposes. In Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, from January 2008 to December 2009 there were 42 cases of splenic injuries out of 154 cases of blunt abdominal trauma, which underwent CT assessment. We reviewed all 42 cases of splenic injury and illustrated the spectrum of CT findings based on American Association for the Surgery of Trauma (AAST) classification

Penyediaan tempat tinggal golongan asnaf menurut skim bantuan agihan zakat: cadangan penggunaan tanah wakaf

Islam adalah agama sejahtera yang mengatur tatacara hidup manusia (Al Maidah:3)1. Ini jelas dalam matlamat syara’ (maqasid al-syari’ah) itu sendiri di mana sesuatu perkara adalah dituntut supaya diadakan (daruriyyat) sekiranya ketiadaannya boleh menjejaskan norma-norma kehidupan manusia. Justeru itu dapat difahami bahawa tempat tinggal, pakaian dan makanan adalah keperluan bagi menjamin kelangsungan hidup manusia. Oleh itu, kertas kerja ini membincangkan penyediaan tempat tinggal bagi golongan asnaf yang berkelayakan menurut skim bantuan agihan zakat yang digariskan oleh Jabatan Wakaf, Zakat dan Haji (JAWHAR), Jabatan Perdana Menteri, Malaysia. Melalui sorotan literatur dan perbincangan dengan ahli akademik, kertas kerja ini mencadangkan penggunaan tanah wakaf sebagai tapak pendirian rumah-rumah tersebut. Sudah pasti ianya tertakluk kepada syarat-syarat tertentu, contohnya seperti yang diputuskan oleh Jawatankuasa Perunding Hukum Syara’ Negeri Selangor tahun 1999 mengenai pelaburan harta zakat. Melalui hubung jalin antara zakat dan tanah wakaf, adalah diharapkan keperluan tempat tinggal bagi golongan asnaf dapat ditingkatkan sekaligus mengurangkan jurang ekonomi dan sosial antara golongan ini dengan masyarakat lain. Ini bagi menjamin kehidupan muhibbah sesama manusia melalui perkongsian nikmat Allah di muka bumi

Dementia secondary to a potentially treatable cause - role of GPs

Dementia is tragic mind-wrecking disease, defined as a multifaceted decline in cognitive function severe enough to interfere with activities of daily life. We present herein two patients who presented with loss of memory and altered behaviour. The purpose of these case reports is to alert the health professionals, especially general practitioners, in detection of “potentially treatable " cases of dementia that can be treated effectively to restore normal or nearly normal intellectual function

Experimental investigation of the size effects of SiO2 nano-particles on the mechanical properties of binary blended concrete

In the current study, the size effects of SiO2 nano-particles on compressive, flexural and tensile strength of binary blended concrete were investigated. SiO2 nano-particles with two different sizes of 15 and 80 nm have been used as a partial cement replacement by 0.5, 1.0, 1.5 and 2.0 wt.%. It was concluded that concrete specimens containing SiO2 particles with average diameter of 15 nm were harder than those containing 80 nm of SiO2 particles at the initial days of curing. But this condition was altered at 90 days of curing. Also from the viewpoint of free energy, it can be concluded that the C–S–H gel formation around the particles with average diameter of 15 nm was more at the primary days of curing. This can be as a result of more nucleation sites that causes acceleration in early age strength. On the other hand, the growth probability of C–S–H gel around the 80 nm particles was more at 90 days of moist curing. This is due to the fact that the nucleus of strengthening gel could simply reach to the critical volume of nucleation that causes increase in the strength

The effects of lime solution on the properties of SiO2 nanoparticles binary blended concrete

In this study, the effects of SiO2 nanoparticles on both mechanical properties (compressive, split tensile and flexural strength) and physical properties (water permeability, workability and setting time) of binary blended concrete have been investigated. SiO2 nano-particles have been used as a partial cement replacement by 0.5, 1.0, 1.5 and 2.0 wt.%. Curing of the specimens has been carried out in water and lime solution for 7, 28 and 90 days after casting. For the specimens cured in water, the optimal replacement level of cement by SiO2 nanoparticles for producing concrete with improved strength, was set at 1.0 wt.%. However, by curing the specimens in lime solution, Portland cement could be advantageously replaced by 2.0 wt.% of SiO2 nanoparticles. It was concluded that the SiO2 nanoparticles can improve the filler effect and its ultra high pozzolanic activity causes more C–S–H gel formation when cured in lime solution. Although curing in the lime solution can reduce the strength of control concrete, Curing the specimens containing SiO2 nanoparticles in lime solution causes faster setting time together with higher strength and residence to water absorption

Contribution of rice husk ash to the properties of mortar and concrete: a review

In the last decade, the use of supplementary cementing materials has become an integral part of high strength and high performance concrete mix design. These can be natural materials, by-products or industrial wastes, or the ones requiring less energy and time to produce. Some of the commonly used supplementary cementing materials are fly ash, Silica Fume (SF), Ground Granulated Blast Furnace Slag (GGBFS) and Rice Husk Ash (RHA) etc. RHA is a by-product material obtained from the combustion of rice husk which consists of non-crystalline silicon dioxide with high specific surface area and high pozzolanic reactivity. It is used as pozzolanic material in mortar and concrete, and has demonstrated significant influence in improving the mechanical and durability properties of mortar and concrete. This paper presents an overview of the work carried out on the use of RHA as partial replacement of cement in mortar and concrete. Reported properties in this study are the mechanical, durability and fresh properties of mortar/concrete