Ridge Lea Hospital

Aim: To study acute intestinal obstruction as complication of Meckel’s diverticulitis in rural area. Case Presentation: A 13-year-old boy presented with diffuse abdominal pain, nausea, vomiting, and abdominal distension persisting for four days. The abdominal X-ray revealed dilated bowel loops and air-fluid levels, indicating obstruction. During exploratory laparotomy, a mesodiverticular band compressing the ileum was identified, along with a perforated Meckel’s diverticulum approximately 100 cm proximal to the ileocecal junction. The trapped intestinal loop was released, and the diverticulum was resected. The procedure included peritoneal lavage and drain placement. The patient was closely monitored postoperatively, with further management tailored according to clinical progress and histopathological findings. Conclusion: This case underscores the importance of early diagnosis and individualized surgical strategies in complicated Meckel’s diverticulum, particularly in resource-limited settings. Open laparotomy remains the preferred method for severe cases involving perforation or obstruction

The worsening problem of antimicrobial drug resistance requires a nuanced approach. Since the conventional drug pipeline is unlikely to be sufficient to avoid massive increases in mortality by the mid-twenty-first century, other methods of antisepsis will be required. These might be used either in place of (allowing conservation) or together with conventional agents. Of such approaches, locally applied protocols involving photo-antimicrobials suggest themselves, particularly as early intervention, e.g. in bacterial tonsillitis, would be curative without recourse to conventional drugs, and would thus prevent the development of more serious diseases such as pneumonia or meningitis. However, given the pharmaceutical industry's lack of investment in such approaches, support would be required from other areas of bioscience, such as the biomed or biotech sectors.

Research into students’ conceptions is inherently challenged with appropriately transferring profound research questions into suitable research instruments. This applies in particular, but not exclusively, to studies with primary school students. In order to investigate individuals’ conceptions, besides linear-linguistic questionnaire procedures, classically guided interviews are used, also triangulated with each other or further sub-instruments (e.g. concept mapping techniques). For this latter purpose, seek-and-find-drawings offer a good opportunity, both paper based and digital. This paper presents research on primary school students’ conceptions of computers in everyday objects and illustrates a methodical opportunity regarding the use of seek-and-find-drawings in Computer Science Education research. In the presented study, 60 primary school children were presented with a seek-and-find-drawing depicting several everyday encounter situations with computing systems. According to the results, primary school students understand not only personal computers, smartphones, tablets, video gaming consoles and (video) cameras, but in few cases also refrigerators, air conditioners and cars as systems containing (embedded) computers. The experience from the presented paper based hidden objects study can be used especially for future research projects.

A 61-year-old woman presented with chronic anterior pain and stiffness in the distal left thigh. Examination revealed swelling and tenderness immediately proximal to the patella. Radiographs showed opacities in the distal anterior thigh whilst MRI identified enlargement of the distal quadriceps tendon with splayed fibres separated by solid conglomerates. Dystrophic calcification of the quadriceps tendon was diagnosed. Blood tests revealed no systemic abnormalities in calcium handling. Arthroscopy of the left knee identified calcific deposits in the supra-patella pouch with surrounding synovitis. An open debridement of the tendon was performed; biopsy of the excised tendon showed chronic tenosynovitis with dystrophic calcification without evidence of malignancy. Post-operatively her knee was braced in extension enabling progressive flexion over 4 weeks. Anterior knee pain diminished post-operatively and 10 months following surgery the patient was pain free, able to walk normally and scored 99/100 on the Fulkerson modification of the Lysholm score.

Chronic venous disease is a term that covers a wide spectrum of conditions ranging from cosmetic problems to limb threatening venous ulceration. Venous conditions are very common throughout the population in Europe and represent a significant burden on healthcare systems. However, recent advances in the assessment and treatment of deep and superficial venous conditions particularly with regard to endovascular techniques have renewed interest in the field.

Crude oil produced water characterization is important because its disposal or reuse is difficult: environmental impacts (high salinity and toxic components) or risk of obstruction on the production columns (crust formation).

Deep and complex anatomic situation of the hip joint makes the establishment of arthroscopic portals more difficult and risky than in other joints. We describe a new technique to improve the efficiency and the safety of establishing standard hip arthroscopy portals (anterolateral, anterior +/− posterolateral portals): the extra-articular approach. Although special techniques and specialized instruments have been developed to make the hip arthroscopic procedure safer and easier, surgeons still need to use an image intensifier to guide the approach. However, this procedure has several disadvantages, including exposure to radiation (surgeon and patients). In addition, fluoroscopy provides only 2-dimensional images for the surgeon, especially because it is not convenient to change the C-arm machine position during the operation which can lead to potential damage to nerves, vessels, or cartilage during the approach.

In 1931, Michael Burman wrote that ‘visualisation of the hip joint is limited to the intracapsular part of the joint. It is manifestly impossible to insert a needle between the head of the femur and acetabulum’ [1]. This was following extensive cadaver experimentation using an early arthroscope design. He did not, however, attempt to distract the hip, and also states that ‘we have found it difficult to move the joint because of rigor mortis fixing the joint solidly’. Despite this statement, arthroscopic access to the central compartment of the hip, otherwise known as the part of the hip medial to the acetabular labrum and including the acetabulum and articular surface of the femoral head has been practiced since the late-1970s [2].

To our knowledge, there is no report in the orthopaedic literature that correlates the duration of hip pain with the results of hip arthroscopic surgery. The aim of this study was to compare the modified Harris Hip Score (mHHS) with patient satisfaction in a prospective study over a two year period. We present a prospective single-surgeon series of 525 consecutive patients undergoing hip arthroscopy for a labral tear, femoroacetabular impingement (FAI), or a chondral lesion. Modified HHS was recorded for all patients at the time of surgery and at six weeks, six months and one, two and three years after hip arthroscopy. At the time of surgery, patients were divided into three groups based on duration of preoperative symptoms: group A, under 6 months; group B, six months to three years; group C, over three years. Mean age was 39 years. There were significantly better outcomes for patients who underwent surgery within six months of symptom onset compared with those who waited longer. Patients who had symptoms for over 3 years by the time of surgery had a significantly poorer result than those with a shorter symptom duration and a higher chance of requiring revision surgery. We recommend that patients with a diagnosis of labral tear, FAI or a chondral lesion should undergo hip arthroscopic surgery within six months of symptom onset. Patients with persistent symptoms for over three years should be made aware of the poorer outcome after hip arthroscopy.