A 34-year-old man presented with chronic worsening left-sided retrosternal chest pain. Following a negative cardiac work up he was found, on cross-sectional imaging, to have a cystic mass measuring 9.6×11.8×9 cm related to his left diaphragmatic crus. The patient underwent an exploratory laparotomy with complete resection of the cystic mass. Histopathological examination of the mass confirmed it as being a bronchogenic cyst. His pain resolved following excision of the mass and at follow-up he was asymptomatic with no evidence of recurrence on imaging.
Polyarteritis Nodosa (PAN) is a rare systemic necrotising vasculitis of medium and small-sized arteries. Patients typically present with systemic symptoms. Obstructive intestinal symptoms are described but usually resolve with treatment of the underlying vascular disease. We report a case of a one year old boy with multiple ischemic small bowel strictures secondary to infantile PAN, who was treated with resection of the affected segments by single port laparoscopy.
The purpose of the study was to assess strategies for enhancing the integration of cultural practices into the teaching and learning of chemistry in secondary schools. The study adopted a descriptive survey research design and the population of the study comprised 19,920 respondents. Two research questions and two hypotheses guided the study. The instrument used for data collection was “Strategies Enhancing Integrating Cultural Practices Questionnaire (SEICPQ)” developed by the researchers. Mean and standard deviation were used to answer the research questions and t-test statistic was used to test the null hypotheses at 0.05 significance. The result revealed that incorporation of cultural practices into the chemistry curriculum content and adequate training of teachers on the integration of cultural practices in teaching chemistry and among others were identified as strategies that could enhance the integration of cultural practices. Non-incorporation of cultural practices into the chemistry curriculum content among others were identified as factors affecting the integration of cultural practices. The results also revealed that teachers and students do not significantly differ on their responses on strategies enhancing as well as the factors militating against the integration of cultural knowledge and practices into teaching of chemistry. Necessary conclusions were made.
Mitochondrial diseases are rare and devastating, with a wide spectrum of clinical presentations and systemic symptoms. The majority of the published literature focuses on the neuromuscular manifestations and genetic components of this mitochondrial cytopathy, however, cardiac, renal, endocrine and gastrointestinal manifestations may also be present. The authors report a case detailing a 56-year-old woman's final hospitalisation from the gastrointestinal sequelae of mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) (Co Q10 deficiency variant). She presented with abdominal pain and distension associated with lactic acidosis, and was shown on imaging to have a colon perforation. This resulted in emergent surgery at which a necrotic colon secondary to a sigmoid colon was identified. Following four subsequent operations, and the development of multiorgan failure, care was eventually withdrawn. Practitioners of patients with MELAS should be cognisant of the rare but devastating gastrointestinal consequences of mitochondrial diseases.
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