haemolytic anaemia, splenomegaly and jaundice, admitted in Chettinad hospital and research institute during one year period from January 2019 to January 2020. Surgical intervention is indicated for selected patients with hereditary spherocytosis with haemolytic anaemia and jaundice to abate the hemolytic process after correction of anaemia with blood transfusion. Pigmented gallstones are seen in more than 50% cases for which incidence increases with severity of hemolysis and with age. Complications include aplastic anemia (most common after parvovirus B19 infection), haemolytic crisis during inter-current infection, megaloblastic crisis – during folic acid deficiency, cardiomyopathy, hematological malignancies.
This research paper investigates the microstructure, microsegregation and mechanical behaviour of Ni-based superalloy 59 which is an important candidate in the pollution control application. The weld joints were produced with continuous current gas tungsten arc welding (CCGTAW) and pulsed current gas tungsten arc welding (PCGTAW) by applying both autogenous mode and filler wire ERNiCrMo-13. Weld flaws and weld aspect ratio of weld joints were identified using a macro analysis. An optical microscope (OM) and scanning electron microscope (SEM) were used to examine the microstructure of the welded joints. PCGTA weldments exposed refined grain structure, reduced heat-affected zone and narrow weld bead compared to CCGTAW. Microsegregation of the alloying elements at the weld center (WC) and weld interface (WI) was examined using Energy Dispersive X-ray spectroscopy (EDS). The findings of the metallurgical characterisation proved that the PCGTA weldments offer minimal microsegregation at the interdendritic region in comparison to CCGTA weldments. X-Ray Diffraction (XRD) examination reveals that there is a 16.7% enhancement in grain refinement in the autogenous mode and a 17.4% improvement in the filler wire ERNiCrMo-13 when switching from CCGTA to PCGTA welding. Tensile, Charpy impact and microhardness tests were used to assess the strength, toughness and hardness of the weld joints. Weld joints fabricated by PCGTAW offers higher tensile strength ( ̴ 1.4 to 1.6%), higher toughness ( ̴ 4.4 to 5.4%), and higher hardness ( ̴ 4.8 to 7.7%) than CCGTAW weld joints.
Background and Objectives: AIHPS (adult idiopathic hypertrophic pyloric stenosis) is an uncommon but clear cut condition in adults, with only 200-300 case reports are recorded in the articlesso far, now A case report of AIHPS treated in our hospital is discussed, as well as a review of the literature.
Methods and Results: The patient had upper abdominal discomfort that started suddenly and was accompanied by nausea, vomiting, and anorexia. The pylorus showed a distinct "cervix sign" during an esophagogastroduodenoscopy (EGD). He next had a partial distal gastrectomy with a Billroth II gastrojejunostomy, which resulted in significant alleviation in his symptoms.
Conclusion: Adult idiopathic hypertrophic pyloric stenosis (AIHPS) is an uncommon condition as it were underreported owing to diagnostic difficulties. After food nausea, vomiting, early satiety, and epigastric discomfort are the most prevalent symptoms of AIHPS, as shown in our case.Endoscopy impression reveals a distinct sign characterised by a fixed, constricted pylorus with a smooth border also known as cervix sign which is in diagnostic favour for AIHPS. Endoscopic dilatation, pyloromyotomy with forethought pyloroplasty, and gastrectomy with a BillrothII gastrojejunostomy have all been recommended as therapies for AIHPS. There is currently no proof that one surgical method is better than another. Before one approach can be established as the standard of care, more study on AIHPS is required.
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