Bronx Health Link

Background: Intestinal stomas are often constructed in emergency abdominal surgeries, when primary repair of bowel carries high risk of anastomotic leakage due to peritoneal contamination or inflamed bowel or in hemodynamically unstable patient, such as typhoid ulcer perforation, trauma (penetrating or blunt), rectal or colonic injury, appendicular perforation etc. During this time stoma carries with it a lot of morbidity making the quality of life poor. That’s why some author suggested early closure of the stoma. Other mentioned early closure is not safe. But there is no established guideline to indicate the optimal timing for reversion. Aim: The aim of the study is to compare the surgical outcomes and complication rates associated with early and delayed loop ileostomy closure Methods: This was conducted in surgery department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh between January 2021 to June 2022. A total of 60 patients with loop ileostomy were included in this study in two groups, of them 30 patients in early closure group where reversal was done between 14 days to 28 days and other 30 patients in delayed closure group where reversal was done after 12 weeks. Data were collected from the patients, admitted in different unit of surgery for ileostomy reversion, using a semi structured case record form. Data were analyzed using SPSS (Statistical Package for Social Sciences) software (version 26.0) and findings were presented in the form of tables and graphs with due interpretation. Recorded data finally were analyzed by unpaired t-test and chi-square/fisher exact test and p value <0.05 was considered as a level significance. Results: The mean age was found 39.9±7.17 years and 40.6±6.7 years in early closure group and delayed closure group respectively with male predominance in both groups. Most common indication for ileostomy procedure in both groups was enteric perforation. Stoma related complications significantly higher in delayed closure group (p=0.015). Mean operation time for ileostomy closure was significantly higher in delayed closure group (59.3±9.2 mins vs 72.7±10.4 mins, P <0.001). The postoperative wound infection was higher in early closure group (10.0% vs 6.7%, p=0.640. On the other hand, paralytic ileus and anastomotic leakage were higher in delayed closure group but not statistically significant. Mean hospital stay was significantly higher in delayed closure group compare to early closure group (6.73±1.46 days vs 8.20±2.62 days, p=0.01). Mortality was not found statistically significant in both groups (0% vs 3.3%, p>0.05). Conclusion: The current study demonstrates stoma related complications, mean operation time and length of hospital stay were significantly lower in the early than in the delayed closure group.

Abstract Once highlighted for having significant shale gas resource potential, the Bowland Basin has been at the centre of both scientific and political controversy over the last decade. Previous shale gas resource estimates range from 10 3 to 10 1 TCF. Repeated events of induced seismicity following hydraulic fracturing operations led to an indefinite government moratorium and abandonment of operations across the mainland UK. We use apatite fission-track analyses to investigate the magnitude and timing of post-Triassic uplift and exhumation. Results indicate that maximum palaeotemperatures of 90–100°C were reached in the stratigraphically younger Sherwood Sandstone. We combine palaeotemperature predictions to constrain palaeo heat flow and erosion in regional basin models for the first time. Our results indicate variable maximum Late Cretaceous palaeo heat flow values of 62.5–80 mW m −2 and the removal of 800–1500 m of post-Triassic strata at wells across the basin. Regional 2D basin modelling indicates a gas-in-place estimate of 131 ± 64 TCF for the Bowland Shale. This reduces to a resource potential of 13.1 ± 6.4 TCF, assuming a recovery factor of 10%. These values are significantly lower than previous resource estimates and reflect the highly complex nature of the Bowland Basin and relatively unknown history of post-Triassic uplift, exhumation and erosion.

We investigate a class of rapidly growing emission line galaxies, known as\n"Green Peas", first noted by volunteers in the Galaxy Zoo project because of\ntheir peculiar bright green colour and small size, unresolved in SDSS imaging.\nTheir appearance is due to very strong optical emission lines, namely [O III]\n5007 A, with an unusually large equivalent width of up to ~1000 A. We discuss a\nwell-defined sample of 251 colour-selected objects, most of which are strongly\nstar forming, although there are some AGN interlopers including 8 newly\ndiscovered narrow Line Seyfert 1 galaxies. The star-forming Peas are low mass\ngalaxies (M~10^8.5 - 10^10 M_sun) with high star formation rates (~10\nM_sun/yr), low metallicities (log[O/H] + 12 ~ 8.7) and low reddening (E(B-V) <\n0.25) and they reside in low density environments. They have some of the\nhighest specific star formation rates (up to ~10^{-8} yr^{-1}) seen in the\nlocal Universe, yielding doubling times for their stellar mass of hundreds of\nMyrs. The few star-forming Peas with HST imaging appear to have several clumps\nof bright star-forming regions and low surface density features that may\nindicate recent or ongoing mergers. The Peas are similar in size, mass,\nluminosity and metallicity to Luminous Blue Compact Galaxies. They are also\nsimilar to high redshift UV-luminous galaxies, e.g., Lyman-break galaxies and\nLyman-alpha emitters, and therefore provide a local laboratory with which to\nstudy the extreme star formation processes that occur in high-redshift\ngalaxies. Studying starbursting galaxies as a function of redshift is essential\nto understanding the build up of stellar mass in the Universe.\n