scholarly journals Transanal endoscopic operation for rectocutaneous fistula after low anterior resection: a case report

2021 ◽  
Author(s):  
Yu-Jen Chen ◽  
Ta-Wei Pu ◽  
Gang-Hua Lin ◽  
Nung-Sheng Lin ◽  
Jung-Cheng Kang ◽  
...  
Keyword(s):  
Anterior Resection ◽  
Low Anterior Resection ◽  
Transanal Endoscopic Operation ◽  
Anastomosis Site ◽  
Major Operation ◽  
History Of ◽  
Recent Diagnosis ◽  
Endoscopic Operation ◽  
The Right ◽  
First Time

Introduction: Enterocutaneous fistulas (ECFs) can be caused by abscess formation at the site of anastomotic leakage (AL) after surgery. Rectocutaneous fistula following low anterior resection (LAR) is rare, and medical management of ECFs is usually the initial treatment. We report a case of rectocutaneous fistula after laparoscopic LAR, which was successfully treated, for the first time, with a transanal endoscopic operation (TEO). Case Presentation: A 58-year-old man presented with a history of hypertension, benign prostatic hyperplasia, peptic ulcer, and recent diagnosis of rectal cancer. The patient underwent laparoscopic LAR with coloanal anastomosis complicated with AL. He then underwent transanal repair of the anastomosis site and laparoscopy with ileostomy. Six months later, he complained of a painful mass lesion over the right buttock that relieved after passing purulent fluid and feces. Colonoscopy and imaging revealed a fistula for which he received antibiotics and wound incision and drainage. He also underwent TEO repair of the rectal fistula, recovered well, and was discharged from hospital. On follow-up 7 months later, there was no recurrence or sign of localized infection. Conclusion: TEO repair may be an effective method for managing rectocutaneous fistula after LAR complicated with AL instead of a major operation.

Remitting seronegative symmetric synovitis with pitting edema (RS3PE) with painful erythematous nodules

2020 ◽  
Vol 13 (4) ◽  
pp. e234197
Author(s):  
Nicholas Kevin Laidler ◽  
Thomas Delaney
Keyword(s):  
Tertiary Hospital ◽  
Acute Onset ◽  
General Malaise ◽  
Metastatic Adenocarcinoma ◽  
Cutaneous Manifestations ◽  
Hands On ◽  
History Of ◽  
Recent Diagnosis ◽  
The Right ◽  
Pitting Edema

Remitting seronegative symmetric synovitis with pitting edema (RS3PE) is an uncommon syndrome characterised by acute onset severe synovitis of the radiocarpal and small joints of the hands, with associated pitting edema. Discussed here is the case of a 69-year-old man who presented to the emergency department of a tertiary hospital with acute bilateral hand swelling. This was on a background of a recent diagnosis of metastatic adenocarcinoma of the caecum and subsequent hemicolectomy. There was a history of general malaise, fever and lethargy for 5 days prior to the swelling of the hands. On examination, the upper limbs were swollen to the elbow bilaterally. Painful erythematous nodules were noted on the dorsal and palmar aspects of the hands and violaceous periungual discolouration was observed on the right fourth and fifth fingers. Prednisolone was commenced resulting in a dramatic resolution of the articular and cutaneous manifestations within 3 weeks.

scholarly journals Management of Shoulder Dislocation by Prakash Method

2021 ◽  
Vol 8 (1) ◽  
pp. 21-24
Author(s):  
Ihsan Ullah ◽  
Samir Khan Kabir ◽  
Khalid . ◽  
Mohammad Inaam ◽  
Gul Hassan ◽  
...  
Keyword(s):  
Success Rate ◽  
Shoulder Dislocation ◽  
Recurrent Dislocation ◽  
Study Data ◽  
Posterior Shoulder ◽  
Fracture Dislocations ◽  
History Of ◽  
The Right ◽  
First Time ◽  
Anterior Posterior

OBJECTIVES: The objective of the study is to evaluate the effectiveness and safety of shoulder reduction developed by Prakash. METHODOLOGY: This descriptive study was carried out at Rehman Medical and Surgical Center District Buner and Naseer Teaching Hospital Peshawar from June 2017 to December 2019. All patients with a history of trauma to either shoulder were subjected to anterior-posterior shoulder radiograph. Those having shoulder dislocation were enrolled in the study. Data including age, gender, previous dislocation history, duration of dislocation and associated fracture, and fracture type were recorded in patient case sheet. Patients having recurrent dislocation, polytrauma, low GCS, fracture-dislocations, and more than a week history of dislocation were excluded from the study. RESULTS: This study was performed on 30 patients. The mean age of the patients was 36.46±11.58 years. Among them, 83.3% (n=25) were male and 16.7% (n=5) were female. While dislocation occurred on the right shoulder in 63.3% (n=19) and in 36.7% (n=11) on the left side. All the patients have dislocation for the first time. The reduction was performed using Prakash’s method. The success rate was 90% (n=27) and 10% (n=3) the reduction failed, which was then reduced under anesthesia using the Hippocratic method. CONCLUSION: The Prakash's method for reducing anterior shoulder dislocation requires minimum assistance with no anesthesia, it is safe, less time consuming, has a high success rate, less pain, and has minimal complications.  

scholarly journals Cure the Incurable? Recent Breakthroughs in Immune Checkpoint Blockade for Hepatocellular Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 5295
Author(s):  
Pei-Yi Chu ◽  
Shih-Hsuan Chan
Keyword(s):  
Clinical Trials ◽  
Kinase Inhibitors ◽  
Systemic Treatment ◽  
Immune Checkpoint Blockade ◽  
Checkpoint Blockade ◽  
Combination Regimen ◽  
Advanced Hcc ◽  
History Of ◽  
The Right ◽  
First Time

HCC usually arises from a chronic inflammation background, driven by several factors including fatty liver, HBV/HCV viral infection and metabolic syndrome. Systemic treatment for advanced HCC remains disappointing due to its strong resistance to chemotherapy and even to tyrosine kinase inhibitors (TKIs). Recently, the use of ICI therapy has revolutionized the systemic treatment of advanced HCC. For the first time, clinical trials testing ICIs, anti-CTLA-4 and anti-PD1/PDL1 reported a survival benefit in patients with sorafenib resistance. However, it took four more years to find the right combination regimen to use ICI in combination with the anti-angiogenic agent bevacizumab to substantially prolong overall survival (OS) of patients with advanced HCC after sorafenib. This review provides a comprehensive history of ICI therapy in HCC, up-to-date information on the latest ICI clinical trials, and discusses the recent development of novel ICIs that would potentially lead to a new checkpoint blockade therapy for advanced HCC.

scholarly journals On Disabilities

1970 ◽  
pp. 2
Author(s):  
Nawaf Kabbara
Keyword(s):  
The Political ◽  
Parliamentary Election ◽  
People With Disability ◽  
History Of ◽  
Right To Vote ◽  
The Right ◽  
Political Right ◽  
First Time ◽  
Disability Movement ◽  
Political Scene

The Lebanese parliamentary election was a very decisive moment in the country’s history. As a result of this election, a new parliamentary majority and discourse dominated the political scene. The election was also peculiar concerning the disability cause in Lebanon. For the first time in the history of Lebanon’s elections, disability became an issue. In fact, the Lebanese disability movement succeeded in launching two different but complementary campaigns during the election. The first one was engineered by both the Lebanese Physical Handicapped Union and the Youth Blind Association. Under the title “Haqqi” or “My Right,” the campaign focused on the right of people with disability to practice one of their most important rights: the political right to vote.

scholarly journals Acute blue finger syndrome: a rare benign cause of acute digit discolouration

2019 ◽  
Vol 12 (1) ◽  
pp. e223365
Author(s):  
Kiran Dhaliwal ◽  
Colin Thomas Brewster ◽  
Sivarajasingham Pakeerathan
Keyword(s):  
Rapid Assessment ◽  
Middle Finger ◽  
X Rays ◽  
Benign Condition ◽  
Volar Aspect ◽  
History Of ◽  
The Right ◽  
Digital Ischaemia ◽  
First Time

Acute blue finger syndrome is a rare benign condition that mimics digital ischaemia. We discuss the case of a 32-year-old woman who presented with a 6hour history of blue discolouration of the middle finger of the right hand, associated with pain and swelling. There was no history of trauma and this was the first time that the patient had experienced these symptoms. Examination found blue discolouration of the digit primarily on the volar aspect with associated swelling. All investigations, including blood tests, X-rays and Doppler scanning, were normal. The symptoms resolved spontaneously within 48 hours. There were no recurrent episodes or long-term sequelae. Patients presenting with an acutely blue finger need rapid assessment to exclude digit ischaemia. Knowledge of this rare benign condition may prevent unnecessary distress, invasive investigations and potentially harmful treatment of a healthy patient.

scholarly journals The earliest Fellows of the Royal Society

1950 ◽  
Vol 7 (2) ◽  
pp. 172-192 ◽  
Keyword(s):  
Royal Society ◽  
History Of ◽  
The Right ◽  
Almost All ◽  
First Time

The Royal Society was granted its first charter of incorporation on 15 July 1662, its second on 22 April 1663. Both charters name the President and the members of the Council of the Society; the second empowers the President and Council within the two months immediately succeeding the grant to admit into the Society as Fellows such persons as they (or a specified majority of them) shall think fit; after the two months have elapsed the right of admitting new Fellows is to belong to the President, Council, and existing Fellows. In accordance with this grant ninety-four Fellows were admitted on 20 May 1663 and four more on 22 June 1663 ; these ninety-eight are known as ‘Original Fellows‘. The Council consisted of twenty members apart from the President. The Society had originated in a group of scientists who first met about 1645. This group held informal meetings and apparently kept no records. On 28 November 1660 its members (or some of them) determined to hold their meetings more regularly and to form themselves into an association for doing so. The association, which for convenience may be called the Philosophical Society, drew up rules, provided for funds, and kept records. The last, so far as they are adequate, show who were admitted as members and when they were admitted. The President, the members of the first and second Councils, and the Original Fellows of the Royal Society, had almost all been members of the Philosophical Society; the dates when they became members of the Philosophical Society are therefore of greater interest, both for the history of the Society and for their individual biographies, than the dates of their appearance as Fellows of the Royal Society. The first of the following lists gives these dates, which are here brought together for the first time. In the course of compilation a few names were found of members or apparent members of the earlier society who did not become Fellows of the later one until after 22 June 1663 ; these names have been brought together in a second list. A third list contains the names of those members of the Philosophical Society who never became Fellows of the Royal Society as constituted under the Second Charter.

scholarly journals Diagnosis and Management of Macular Holes Traumatic

2019 ◽  
Vol 2 (1) ◽  
pp. 38-45
Author(s):  
Reny Violeta ◽  
AK Ansyori ◽  
Ramzi Amin
Keyword(s):  
Macular Hole ◽  
Blunt Trauma ◽  
Internal Limiting Membrane ◽  
Photoreceptor Layer ◽  
Macular Holes ◽  
Younger Age ◽  
History Of ◽  
Amsler Grid ◽  
The Right ◽  
First Time

Introduction. Macular hole is a defect in the retina involving the macula and fovea, in the form of damage to full thickness from the internal limiting membrane (ILM) to the outermost part of the photoreceptor layer . It was more often found in women. In patients with myopia disorders can be found at a younger age. In this case we report the macular hole caused by blunt trauma, as was the first time a macular hole case was discovered. Case Presentation. A man 24-year-old, Mr. C, came to Palembang RSMH eye clinic on August 15, 2014 with complaints of blurred right eye vision. Main Complaints: Right eye blurred. History Disease: Right eye blurred for about 3 months before entering the hospital. Blur is felt after the patient had a motorcycle accident 3 months ago. At that time the collision sufferer avoided the truck, the right eye hit the motorcycle handlebar, the patient then fell from the motorcycle and hit the highway head. A history of frequent headaches is denied, nausea, vomiting is denied, history of seeing in tunnels is denied. Supporting examination is Amsler Grid Oculi Dextra: there is a black hole in the middle of the image. differential diagnosis is Traumatic Macular Hole OD, Lamellar Macular Hole OD, work diagnosis is Traumatic Macular Hole stage 3 OD. Conclusion. Traumatic macular holes can occur immediately after blunt trauma to the eyeball, the accuracy of the diagnosis and the speed of the timing for surgery, greatly determining the prognosis. Vitrectomy and combined with internal limiting membrane peeling have been shown to provide excellent results in macular surgery in macular hole cases.

scholarly journals THE FOURTH BASTION OF SEVASTOPOL: ARCHAEOLOGICAL DISCOVERY OF 2019

2021 ◽  
pp. 79-94
Author(s):  
В. Л. Мыц ◽  
С. Л. Соловьев ◽  
А. Ф. Покровская ◽  
Н. Ф. Соловьева
Keyword(s):  
Material Culture ◽  
Reliable Data ◽  
Crimean War ◽  
Adaptive Use ◽  
History Of ◽  
Characteristic Features ◽  
The Right ◽  
First Time ◽  
The City ◽  
Insight Into

В 2018-2019 гг. основным объектом исследований Севастопольской экспедиции ИИМК РАН стали оборонительные сооружения, расположенные на Историческом бульваре г. Севастополя. Археологические раскопки Четвертого бастиона позволили проследить историю его строительства. Впервые были получены достоверные данные о местоположении, характере и конструкции основных элементов фортификации правого фланга 4-го бастиона: валганга, горжи, эскарпа и контрэскарпа. Открыты орудийные дворики, части бруствера с орудийными амбразурами, вспомогательные площадки для размещения боеприпасов, погреба для хранения пороха и бомб, блиндажи для личного состава. Во рву обнаружены вырубленные в скале навесы-убежища и 14 входов в контрминные галереи, потайной ход для скрытного перемещения войск. В ходе раскопок собрана представительная археологическая коллекция предметов войны и быта защитников бастиона и их противников, достойная пополнить экспозиции музеев Севастополя, посвященных его обороне в годы Крымской войны. В 2019 г. специалистами ИИМК РАН и Эрмитажа разработана и представлена в Министерство культуры РФ концепция музеефикации и приспособления для современного использования выявленных сооружений в районе правого фаса 4-го бастиона на Мемориальном комплексе памятников обороны города в 1854-1855 гг. «Исторический бульвар» (г. Севастополь). In 2018-2019 defensive fortifications located in the Istoricheskiy (Historical) Boulevard of Sevastopol (Fig. 1) became the main object of excavations carried out by the Sevastopol expedition of the Institute for the History of Material Culture (RAS). The archaeological excavations of the fourth bastion provide an insight into the history of its construction. Reliable data on location, characteristic features and technical design of the key fortification elements of the bastion right flank such as terreplein, neck line, escarp and counterscarp were obtained for the first time. The excavations revealed gun positions, parts of breastwork with gun ports, auxiliary areas for ammunition storage, a magazin for gun powder and bombs, dugout shelters for manpower. Shelter awnings cut out in rock and 14 entries into countermine galleries as well as a secret passage for surreptitious movements of troops (Fig. 3; 4) were identified. A representative archaeological assembly of war items and paraphernalia of bastion defenders and their enemy was collected during the excavations. It will replenish expositions of the Sevastopol museums dedicated to its defense in the Crimean war (Figs. 5-8). In 2019 specialists of the Institute for the History of Material Culture prepared a concept note for museification and adaptive use of constructions discovered in the right side of the fourth bastion at the 1854-1855 Memorial Ensemble of the City Defense Sites known as ‘the Historical Boulevard' (Sevastopol). The concept note was forwarded to the Russian Ministry of Culture.

scholarly journals Inspection of the Monastic Hegumens of Lviv Union Eparchy in 1724

2021 ◽  
pp. 93-103
Author(s):  
Andrii Pavlyshyn ◽  
Keyword(s):  
Xviii Century ◽  
History Of ◽  
Monastic Communities ◽  
The Right ◽  
Relationship Of ◽  
Historical Methods ◽  
First Time ◽  
The Relationship ◽  
The Church ◽  
Real State

The aim of the research is to introduce an important source of the history of the church, in particular the monasticism of the Lviv Union eparchy of the first half of the XVIII century into scientific circulation – “Inspection of the hegumens of the Lviv eparchy in 1724”. The methodology of the researchis based on the principles of historicism, analytical and synthetic critique of sources. Comparative and typological general historical methods are also used.The scientific noveltyis in the introduction of the source, which most fully reflects the real state of monasticism of the Lviv eparchy in the first quarter of the XVIII century into wide circulation for the first time. Conclusions: As a result of archival searches, a historical source “Inspection of the hegumens of Lviv eparchyin 1724”was discovered and put into scientific circulation. It is the first complete description of the existing monasteries of the Lviv dioceseand allows to recreate their detailed network at the first quarter of the XVIII century. For the first time, the document also reliably outlines the number of monastic communities in the eparchy. Onthebasisofinspection it can be stated that the Lviv Union diocesein 1724 had 62 monasteries with 341 monks. The source also allows us to trace the power of bishops over monasteries, in particular the mechanism of hegumens subordination to bishops. The document contains valuable information about the relationship of monasteries, in particular the subordination of smaller monastic communities to larger ones. No less important are the sources about the economic situation of the monasteries.In 1724, only 34 out of 62 monasteries, showed documents for the right to own some land plots, which allows us to speak of a relatively modest monastic farming. “Inspection of the hegumens of the Lviv eparchy in 1724”, is a key source that allows us to characterize not only the state of monasteries, but also the Lviv eparchy in general in the first decades after the adoption of the Brest Union by the diocese.

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