Appendicitis is a common surgical emergency. When present in an abnormal subhepatic location, it can pose a challenge in its diagnosis and management. Subhepatic appendicitis is a rare phenomenon, especially in the pediatric age group. Herein, we present a rare case of subhepatic appendicitis in an 11-year-old boy with delayed presentation but managed successfully.
Background: Minigastric bypass is gaining popularity worldwide as an effective bariatric surgery which has fewer complications than RYGB. There is raising concerns about biliary refl ux and its effect on gastric mucosa. In this study we tried to fi nd the link between the presence of bile in the stomach and the incidence of gastritis after MGB. including 40 patients. All patients underwent MGB with a 12-month follow-up, UGI endoscopy was performed 9 months after MGB for all patients, where multiple biopsies and gastric aspirate were obtained for bilirubin level.Results: Mean age at operation was 32 years (18-60) and preoperative BMI 44.31 kg/m2. The mean operative time was 95 (± 18 min), Mean % EWL was 81.2% at 12 months. Complete resolution occurred of hypertension in 8 patients (80%) and of Diabetes type 2 in 11 patients (84.2%). Level of bilirubin in gastric aspirate was elevated in 8 patients (20%) all of them had different levels pouch gastritis confi rmed by histopathological examination. Conclusion:Biliary refl ux reached about 20% after MGB, the severity of biliary gastritis is related to the elevation of bilirubin level in the gastric aspirates, this results need to be confi rmed by further studies on the MGB.
Plexiform schwannoma is a rare neurogenic tumor, arising from skin and subcutaneous tissue. The presence of multiple schwannomas suggests a possible association with neurofibromatosis type 2 (NF2). A 50-year old male patient presented with multiple papulo-nodular cutaneous lesions on both arms and forearms. Histopathological examination revealed a dermal multinodular pattern of well-circumscribed masses of closely packed cells, with peripheral myxoid tissue, well-encapsulated in a thin collagenous capsule. S-100 immunohistochemical staining was diffusely and strongly positive. Neuron-specific enolase was positive, confirming a neural tissue tumor. An audiogram and Magnetic Resonance Imaging (MRI) of cerebro-pontine angle showed no detected abnormality, excluding acoustic neuroma. Thus, we present a case of multiple bilateral isolated cutaneous plexiform schwannomas, not associated with NF2. Multiple plexiform schwannomas is a very rare entity, distinct from neurofibromatosis (NF), and being confined to the dermis is even more rarely reported.
Atmospheric Boundary Layer (ABL) height (h) is one of the basic criteria for describing its structure. ABL measurements, parameters and predictions have numerous practical and theoretical implementations as forecast of pollutant concentrations, surface temperature, expansion of disturbance measurements or in climate models and numerical weather prediction. The height of the mixing layer is difficult to be measured; therefore, mathematical methods are introduced to calculate this layer and different FORTRAN programs have been developed to define the height of ABL on an hourly basis through the year. The analysis of the results showed that the variation of the height of the mixing layer for different seasons depends on the type of the dominant stability class and the value of wind speed, where the rise of the mixing layer in winter and autumn months may be related to increased frequency of stability conditions in the unstable and slightly unstable atmosphere On the other hand, when the stable conditions are dominant, the height of the mixing layer remains smaller. The boundary layer ozone is a standard contaminant because of its harmful effects on living organisms and plants. It also has an active role in atmospheric chemistry and climate change; therefore, monthly and seasonal variation of the surface ozone O 3 concentration and its effects on the atmospheric boundary layer are measured for the first time at a coastal site in Egypt in the year 2013.
Objective: This study was conducted to evaluate the safety, and complications of bilateral simultaneous endoscopic thoracic sympathectomy by resection of T3/T4 sympathetic ganglia in treatment of primary palmar and axillary hyperhidrosis.Patients and methods: This prospective study was conducted in General Surgery Unit at Ain Shams University Hospitals in the period from May 2012 to June 2014 on twenty patients. All cases underwent thoracoscopic sympathectomy of T 3, 4 ganglia on the right &left sides at the same setting. In this prospective interventional study, we had 20 patients with severe primary hyperhidrosis with failed medical treatment who underwent bilateral simultaneous Endoscopic Thoracic Sympathectomy (ETS).Results: Of 20 patients there were 13 males (65%) and 7 females (35%). The mean age was 23.9 ±7.8. The mean operating time was 76.2 min. ± 21.4 min. all cases were completed laparoscopically and there were no serious intraoperative complications.The average length of hospital stay was 2.8 days (range: 2-5 days). The average postoperative follow-up period was 14.6 months (range: 6-20 months).Residual pneumothorax occurred in 3 patients (15%), Surgical emphysema on either side was seen in the early postoperative period in 3 patients (15%).The postoperative intercostal pain was observed in all cases (100%). most patients (19/20: 95% of patients) experienced compensatory sweating of varying degrees in other parts of the body, which was bilateral and symmetrical, most commonly at the lower back.Excessive hand dryness was reported in 8 patients (40%), one of them had to use moisturizing hand cream daily.Patients' Satisfaction with the overall results of the operation were assessed .Only one patient (5%) stated that they were 'dissatisfied' and regretted having undergone the operation Conclusion: ETS with T3/T4 ganglia resection is a safe method for patients complaining of severe palmar or combined palmar and axillary hyperhidrosis . From the results of this study, we recommend using smaller ports and performing a more limited approach (T3 or T4) to patients with moderate primary hyperhidrosis symptoms to avoid dissatisfaction due to severe compensatory sweating and palmar overdryness.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.