scholarly journals EP.WE.117Colovaginal fistula from neglected vaginal pessary; Fallouts from the COVID-19 pandemic

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ahmed Tawfik ◽  
Bankole Oyewole ◽  
Ahmed Elzaafarany ◽  
Catherine Gilbert ◽  
Tim Campbell-Smith
Keyword(s):  
Rectovaginal Fistula ◽  
Uterine Prolapse ◽  
White Cell Count ◽  
Recurrent Utis ◽  
Vaginal Pessary ◽  
Intravenous Antibiotics ◽  
End Colostomy ◽  
History Of

Abstract An 86 year old lady was admitted with a one week history of feeling unwell, polyuria, dysuria, urinary and faecal incontinence. She had previously been treated for recurrent UTIs by her GP. On examination she had suprapubic tenderness but no peritonism. Observations revealed tachycardia of 122bpm with a temperature of 36.3*C. Inflammatory markers were raised with a white cell count of 22.0x106/L and CRP 129 mg/L. Urine cultures grew Pseudomonas aeruginosa. She was managed for urosepsis with intravenous antibiotics. Past medical history included vaginal pessary for uterine prolapse, congestive cardiac failure, hypertension, polymyalgia and osteoporosis. She lived alone with no package of care. On admission she improved with intravenous antibiotics however she had a perineal examination due to ongoing faecal and urinary incontinence and was noticed to be passing faeces per vaginam. A colo-vaginal fistula was suspected and she was reviewed by the gynaecologist who noted her pessary had been in-situ for up to a year and her routine appointment to have it changed was cancelled due to the COVID-19 pandemic. An MRI Pelvic scan confirmed a 3x2cm rectovaginal fistula. She was reviewed by the general surgery team and the decision was made for her to be defunctioned to prevent her episodes of recurrent UTIs and improve her quality of life. She successfully had a laparoscopic end colostomy with an uneventful post-operative period. This case highlights the harms caused from the cancellation of appointments and demonstrates a rare cause of rectovaginal fistula.

scholarly journals 719 Colovaginal Fistula from Neglected Vaginal Pessary; Fallouts from the COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
B Oyewole ◽  
A Elzaafarany ◽  
A Tawfik ◽  
T Campbell-Smith
Keyword(s):  
Rectovaginal Fistula ◽  
Uterine Prolapse ◽  
White Cell Count ◽  
Recurrent Utis ◽  
Vaginal Pessary ◽  
Intravenous Antibiotics ◽  
End Colostomy ◽  
Colovaginal Fistula ◽  
History Of

Abstract An 86-year-old lady was admitted with a one-week history of feeling unwell, polyuria, dysuria, urinary and faecal incontinence. She had previously been treated for recurrent UTIs by her GP. On examination she had suprapubic tenderness but no peritonism. Observations revealed tachycardia of 122bpm with a temperature of 36.3*C. Inflammatory markers were raised with a white cell count of 22.0x106 /L and CRP 129 mg/L. Urine cultures grew Pseudomonas aeruginosa. She was managed for urosepsis with intravenous antibiotics. Past medical history included vaginal pessary for uterine prolapse, congestive cardiac failure, hypertension, polymyalgia and osteoporosis She lived alone with no package of care. On admission she improved with intravenous antibiotics however she had a perineal examination due to ongoing faecal and urinary incontinence and was noticed to be passing faeces per vaginam. A colo-vaginal fistula was suspected, and she was reviewed by the gynaecologist who noted her pessary had been in-situ for up to a year and her routine appointment to have it changed was cancelled due to the COVID-19 pandemic. An MRI Pelvic scan confirmed a 3x2cm rectovaginal fistula. She was reviewed by the general surgery team and the decision was made for her to be defunctioned to prevent her episodes of recurrent UTIs and improve her quality of life. She successfully had a laparoscopic end colostomy with an uneventful post-operative period. This case highlights the harms caused from the cancellation of appointments and demonstrates a rare cause of rectovaginal fistula.

S7-13 Detecting Voids in Tendon Ducts of Post-Tensioned Bridge Girders

2013 ◽  
Vol 639-640 ◽  
pp. 1015-1020
Author(s):  
Gui Hua Dai ◽  
Xian Yan Zhou
Keyword(s):  
Frequency Domain ◽  
Data Interpretation ◽  
Bridge Girders ◽  
Impact Echo ◽  
Condition Evaluation ◽  
Load Carrying ◽  
History Of ◽  
Post Tensioned

The tendon ducts in post-tensioned bridge girders must be grouted fully so as to prevent water and oil stain from entering the ducts, which will decrease the durability and load-carrying capacity of post-tensioned bridges badly. This paper describes the motivations for and recent history of Impact-Echo (IE) scanning applications to internal grout condition evaluation of tendon ducts in post-tensioned girders. The tendon ducts’ internal injection quality of a railway bridge in Yichang city was evaluated using IE technology. During the in-situ testing, the IE signals were collected firstly, then the transformation from the time to the frequency domain was carried out using the principles of the fast Fourier transform, data interpretation was much simpler and quicker in the frequency domain. The grout condition of tendon ducts could be determined according to the frequency analysis, poorly grouted sections can be differentiated from the well-grouted sections within the tendon ducts. Results show that the IE method can be employed to detect voids in the grouted tendon ducts of many types of post-tensioned structures.

scholarly journals Neglected doughnut pessary in the uterine cavity

2019 ◽  
Vol 12 (4) ◽  
pp. e228415 ◽  
Author(s):  
Chutimon Asumpinwong ◽  
Pichai Leerasiri ◽  
Pattaya Hengrasmee
Keyword(s):  
Pelvic Organ Prolapse ◽  
Rectovaginal Fistula ◽  
Uterine Cavity ◽  
Abdominal Hysterectomy ◽  
Pelvic Organ ◽  
Healthcare Personnel ◽  
Vaginal Pessary ◽  
Adjacent Structures

Vaginal pessary is a practical and effective tool for pelvic organ prolapse management. Nevertheless, serious complications can occur in neglected patients such as vesicovaginal and rectovaginal fistula, erosion and impaction in adjacent structures. We report a case of neglected pessary found in the uterine cavity. The patient was treated with abdominal hysterectomy with in situ doughnut pessary. Proper pessary care and regular follow-up should be emphasised among patients, caregivers and related healthcare personnel to early detect as well as to avoid complications.

Probiotics in gastroenterology – from a different angle

2013 ◽  
Vol 154 (8) ◽  
pp. 294-304 ◽  
Author(s):  
György Miklós Buzás
Keyword(s):  
Side Effects ◽  
Beneficial Effect ◽  
Analytical Data ◽  
Well Being ◽  
Gastrointestinal Diseases ◽  
Convincing Evidence ◽  
Probiotic Treatment ◽  
History Of ◽  
Irritable Bowel

After a short overview of the history of probiotics, the author presents the development of human intestinal microflora based on the newest genetic data and the microbiological features of main probiotics. The indications of probiotic administration have been defined and extended in recent years. The author reviews significant results of probiotic treatment in some gastrointestinal diseases based on meta-analytical data. Probiotics are useful in preventing and treating diarrhoea caused by antibiotics and Clostridium difficile caused diarrhoea. In the treatment of Helicobacter pylori infection, preparations containing certain Lactobacillus,Bifidobacterium strains or Saccaromyces boulardii could enhance by 5–10% the rate of successful eradication and reduce the incidence and severity of the side effects. Some symptoms of irritable bowel syndrome and thus the quality of life can be improved by probiotics. Their beneficial effect in ulcerative colitis was proven, while in Crohn’s disease has not yet been defined. The use of probiotics is not included in guidelines, with the exception of the Maastricht IV/Florence consensus. For each disease it is advisable to use probiotics containing strains only with proven beneficial effect. The efficiency of preparations containing mixed strains has not yet been properly investigated. The author reviews the rare but potentially serious side effects of probiotics. In Hungary, there are many probiotic preparations available which can be purchased in pharmacies without prescription: their use is more empirical than evidence-based. The European Food Safety Authority has recently rejected claims for probiotics to be classed as medicines given the lack of convincing evidence on the effects of probiotics on human health and well-being. Clearly, further research is needed to collect evidence which could be incorporated into the international guidelines. Orv. Hetil., 2013, 154, 294–304.

Pengaruh Jenis Co-Solvent terhadap Rendemen dan Mutu Biodiesel secara Transesterifikasi In Situ Menggunakan Radiasi Gelombang Mikro

2016 ◽  
Vol 10 (2) ◽  
pp. 119-126
Author(s):  
Mahlinda Mahlinda ◽  
Fitriana Djafar
Keyword(s):  
Catalyst Concentration ◽  
Maximum Yield ◽  
Acid Value ◽  
Experimental Result ◽  
In Situ Transesterification ◽  
Yield And Quality ◽  
Solvent Type ◽  
Biodiesel Quality

The main purpose of this research was to observer effect co-solvent type (n-Hexane, chloroform and without co-solvent)  toward yield and quality of biodiesel via in situ transesterification process using microwave irradiation. The process was studied at microwave power 450 watt, reaction time 4 minutes, methanol to seed ratio 25:1 and catalyst concentration 5%. The physicochemical parameters of the biodiesel produced such as viscosity, density and acid value were analysed and compared with the SNI 7182-2012 standard. The experimental result showed the maximum yield biodiesel 78,32% obtained by using co-solvent chloroform.Test result of physicochemical properties (viscosity, density and acid value) of biodiesel products using co solvent n-Hexane, chloroform and without co solvent showed that these products conform to the SNI 7182-2012 standars. The type of co-solvent only affectedon biodiesel yield dan not affected on biodiesel quality (viscosity, density and acid value).  ABSTRAKTujuan penelitian ini adalah untuk mempelajari pengaruh jenis co-solvent (n-Hexane, chloroform dan tanpa co-solvent) terhadap rendemen dan mutu biodiesel secara trasesterifikasi in situ menggunakan radiasi gelombang mikro. Proses dilakukan pada daya gelombang mikro 450 watt, waktu reaksi 4 menit, perbandingan berat metanol terhadap bahan baku 25:1 dan jumlah katalis 5%. Parameter fisiko kimia dari produk biodiesel seperti viskositas, densitas dan angka asam di analisa dan dibandingkan dengan standar SNI 7182-2012 tentang biodiesel. Hasil penelitian menunjukkan rendemen maksimum biodiesel sebesar 78,32% diperoleh dengan menggunakan co-solvent chloroform. Hasil pengujian  karakteristik fisiko kimia (viskositas, densitas dan angka asam) dari produk biodiesel menggunakan co-solvent n-Hexane, chloroform dan tanpa co-solvent menunjukkan bahwa semua parameter ini masih memenuhi standar SNI 1782-2012 tentang biodiesel. Jenis co-solvent hanya berpengaruh pada rendemen biodiesel dan tidak berpengaruh terhadap mutu biodiesel (viskositas, densitas dan bilangan asam).Kata kunci: co-solvent, in situ transesterifikasi, microwave, rendemen, mutu   

EXPLORING HEALTHCARE ARCHITECTURE THROUGH THE MEDIUM OF FILM: Motives and Techniques

2014 ◽  
Vol 8 (1) ◽  
pp. 29
Author(s):  
Stephen Verderber
Keyword(s):  
Real World ◽  
The Real ◽  
Healthcare Settings ◽  
Interdisciplinary Field ◽  
Body Of Knowledge ◽  
Behavior Setting ◽  
Physical Environments ◽  
Scant Attention ◽  
History Of

The interdisciplinary field of person-environment relations has, from its origins, addressed the transactional relationship between human behavior and the built environment. This body of knowledge has been based upon qualitative and quantitative assessment of phenomena in the “real world.” This knowledge base has been instrumental in advancing the quality of real, physical environments globally at various scales of inquiry and with myriad user/client constituencies. By contrast, scant attention has been devoted to using simulation as a means to examine and represent person-environment transactions and how what is learned can be applied. The present discussion posits that press-competency theory, with related aspects drawn from functionalist-evolutionary theory, can together function to help us learn of how the medium of film can yield further insights to person-environment (P-E) transactions in the real world. Sampling, combined with extemporary behavior setting analysis, provide the basis for this analysis of healthcare settings as expressed throughout the history of cinema. This method can be of significant aid in examining P-E transactions across diverse historical periods, building types and places, healthcare and otherwise, otherwise logistically, geographically, or temporally unattainable in real time and space.

РАССКАЗЫ В.ШУКШИНА И ПРОБЛЕМЫ ПЕРЕВОДА ИХ НА КЫРГЫЗСКИЙ ЯЗЫК

2020 ◽  
pp. 77-81
Author(s):  
Джээнбүбү Бегеева
Keyword(s):  
Key Words ◽  
Russian Literature ◽  
Main Task ◽  
Stylistic Variation ◽  
Psychological Feature ◽  
Translation Analysis ◽  
History Of ◽  
The Creation ◽  
Problems Of Translation

Аннотация. В статье анализируется качество переводов рассказов В.Шукшина, осуществленных в середине 70-х годов С. Наматбаевым. Переводоведческий анализ вывил многочисленные стилевые расхождения между оригиналом и переводом. При переводе одного из лучших рассказов Шукшина «Чудик» искажения стиля не передали психологические тонкости рассказа. При переводе рассказа «Дядя Ермолай» философский аспект рассказа выпал, так как переводчик исказил жанровую специфику. Перевод рассказа «Два письма» оказался более качественным по сравнению с предыдущими. Переводчик рассказа «Два письма» сумел приблизиться к оригиналу, расшифровать его основную тональность, воспроизвести атмосферу напряженных поисков истины героем рассказа Николаем Иванычем. Этот перевод оказался более качественно выполненным по сравнению с предыдущим рассказом «Дядя Ермолай». Причину переводческого успеха можно объяснить, прежде всего, доступностью содержания рассказа, да и сам герой не столь сложная и глубокая личность, как повествователь в рассказе о дяде Ермолае. В целом, переводы С.Наматбаева являются своеобраз- ным этапом в переводческом деле. В настоящее время необходимо более полное и глубокое восприятие творчества В.Шукшина и создания новых адекватных переводов. Ключевые слова: качество переводов, стилевые расхождения, психологические тонкости, философский аспект, этапом. Аннотация. Макалада В.Шукшиндин аңгемелеринин кыргыз тилине которуудагы сапаты каралат, котормолор 1970-жылдары котормочу С.Наматбаев аркылуу жаралган. Котормонун сапатына талдоо жүргүзгөндө көпчүлүк каталар табылган, алардын эң олуттуусу стилдердин айырмасы, негизги чыгарма менен котормонун ортосунда. Мисалы, “Чудик” деген аңгеменин психологиялык мүнөздөмөсү жоголуп кеткен. “Ермолай байке” деген аңгемеде жанрдын туура эмес берилишинен жазуучунун негизги ою жоголуп кеткен. “Эки кат” деген аңгеме беркилерге караганда сапаттуу которулган. Котормочу " Эки кат" деген аңгемени оригиналга жакындатып которгон. Башкы каарман Николай Иванычтын изденүүлөрүн, ойлорун, чындыкты табууга аракеттерин Шукшинден кем эмес окуучуларга жеткирген. Котормочунун жетишкендиги аңгеменин түшүнүктүү мазмуну менен түшүндүрсө болот, жана Николай Ивановичтин жөнөкөйлүгү менен. С.Наматбаевдын котормолору каталарына карабастан котормочулук иште алдыга жылуу болгон. Бирок, азыркы заманда сапаттуу котормо жаратууда мезгил келди. Түйүндүү сөздөр: которуудагы сапаты, стилдердин айырмасы, психологиялык мүнөздөмөсү, негизги ою жоголуп. Annotation. The quality of translation of the Shukshins stories is analyzed in the Middle 70- years. By S.Namatbaev. The translation analysis had idenh hed numerous style discrepancies between the original and the translation. The psychological feature of the compasihion were not be hansfered by the translation one the bestand famous story by. V.Shukshin due to distorhion of the style. By the translation of the story “The uncle Ermolai” had full a phisichal aspect of the story, because the translator had distorted the genre specifics. The translation of the stories “Two letters” was wade more qualitative comparated with another stories. Generally, the Namatbaevs translation are a sui generis stage in the translatiobs. We need currently more total and profound perception of the creation by V.Shukshin. The create of the new adeavate translation is the main task. The head of the theory and history of Russian literature department. V. Shukshin’s stories and problems of translation them into Kyrgyz language. This article is analysed the quality of translation of V. Shukshin’s stories, which were written in 70 th with S. Namatbaev. Translation analyse deduced many stylistic variations between translated version and original. There is a misrepresentation, was not transmitted psychological subtleties of the story in translation of one of the best V. Shuk- shin’s story “Wierdo”. Metaphysical dimension is disappeared in translation of the story “Uncle Ermolai”, since translator destort the genre specificity. The translation of the story “Two letters” has been more qualitative in comparison with previous translations. In common, S. Namatbaev’s translation is a genius stage in translation. It needs more full and deep comprehension of S. Shukshin’s work and to establish new suitable translation. Key words: Quality of translation, stylistic variation, psychological subtleties, metaphysical dimension, stage.

Estudio del proceso de lavado de contenedores para eliminar tiempos y movimientos innecesarios, caso: Wash Containers S.A de C.V.

2020 ◽  
pp. 25-36
Author(s):  
Juan Alfredo Lino-Gamiño ◽  
Carlos Méndez-González ◽  
Eduardo José Salazar-Araujo ◽  
Pablo Adrián Magaña-Sánchez
Keyword(s):  
Business Process ◽  
Value Chain ◽  
Process Management ◽  
Core Business ◽  
The Core ◽  
Washing Process ◽  
Overall Performance ◽  
The Times

In the value chain it is important to keep in mind the core business of the company, since it depends largely on the competitiveness of the company and its overall performance, bearing in mind that all business indicators depend on it. In this work we will study the washing process within the company WASH CONTAINERS SA DE CV, to improve the washing processes and in this way reduce times and movements in the process leading the company to reduce costs considerably within the operations company daily, having a more competitive operation and with greater profit margin in its business process. Goals: It Improve the logistics of the movement of containers for washing and with it the core business of the company. Methodology: The action research will be applied applying Business Process Management for the improvement of processes in situ, it will be developed in a certain period of time and with that it will establish an improvement projection. Contribution: The improvement of the times for the disposal of the containers and their subsequent use, allows a better competitiveness and with it the income of the company, on the other hand, the transport companies improve in performance in quantity, quality of disposition and with it their income.

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