Incidental diagnosis of Herlyn-Werner-Wunderlich Syndrome in a nulliparous woman: a case report in Bhutan

Herlyn-Werner-Wunderlich syndrome (HWWS) is a rare congenital syndrome with features of uterus didelphys, ipsilateral absent kidney and obstructed hemivagina. Ultrasound findings of absent kidney or abnormalities in the kidney should alert the clinicians about the syndrome. Complications like endometriosis, infertility and pelvic inflammation occurs with late diagnosis.A 42-yearold nulliparious married woman who presented with right sided abdominal pain to the National Referral Hospital was diagnosed to have HWWS. The diagnosis was supported by ultrasound, CT and MRI findings. Patient was treated for endometriosis and had symptomatic improvement. The diagnosis of the syndrome is challenging as it is rare but clinicians should suspect the syndrome in women who present with infertility. Ultrasound scan is the basic investigation to screen the syndrome which is available in most hospitals.

Giant Amoebic Liver Abscess: A Rare Diagnosis in a Rural Setting of Sub-Saharan Africa

Background. Extraintestinal amoebiasis is an uncommon complication of Entamoeba histolytica infection, occurring in about 5-10% of patient. Prompt diagnosis and management is essential to prevent complications. However, diagnosis and management in resource-limited settings is very challenging owing to limited diagnostic tools and nonspecific clinical symptoms. Therefore, our case report underscores the role of incisive clinical evaluation, basic investigation, and nonsurgical management of giant amoebic abscess in resource-limited settings. Case Presentation. A 13-year-old female Cameroonian presented with subacute onset of upper abdominal pain, high fever, and chest pain for one week. Before presentation, she had been on treatment at a local traditional practitioner during which her symptoms worsen. After clinical evaluation and basic investigation, she was diagnosed with a giant amoebic liver abscess. She was resuscitated and placed on nonsurgical management. Follow-up after 1 month was significant for complete recovery. Conclusion. Amoebic liver abscess is a rare complication of Entamoeba histolytica infection with devastating complications. The diagnosis of this disease requires high index of suspicion in resource-limited settings. Good clinical evaluation and timely nonsurgical therapy can provide recovery to some patients.

Structural Characterization of a Biogenic Secretion Extracted from the Tendon or Ligament in Rabbits for Artificial Ligament Formation

Thus far, our research group has conducted a basic investigation for the development of an artificial ligament, which was performed by utilizing a biogenic secretion that was derived from the Achilles tendon in mice; this was achieved using the film model method. In this study, an attempt has been made to derive a biogenic secretion from the Achilles tendon (tendon gel) and the medial collateral ligament (ligament gel) in rabbits. Subsequently, a discussion was carried out on the possibility of forming a ligament-like structure that was based on the structural, mechanical, and spectroscopic investigations. The tendon gel was successfully formed from a parent tendon that was preserved in vivo for 3, 5, 10, and 15 d. Further, an aligned collagen fiber emerged in the tendon gel, which was subjected to tension on every preservation date. Further, the mechanical behavior of the tendon gel specimens was classified in two groups. The values of the Young's modulus of the specimens preserved for 10 and 15 d were higher than those of the specimens preserved for 3 and 5 d. Within the range of this experimental condition, the aligned collagen fiber structure was formed by applying a tension of approximately greater than 0.05 N. Conversely, only a 10-d preservation period yielded a sufficient amount of ligament gel for the experiment. Notably, the volume of ligament gel was less than that of the tendon gel. In the ligament gel specimen without the synovial membrane, the collagen fiber structure was formed by applying a tension, which was similar to that experienced by the tendon gel specimen. However, the cross-linking and growth of collagen fibers in the ligament gel samples were insignificant as compared with those of the tendon gel samples.

Systemic genre-and-style relations in the english-language student academic essay: paradigmatics, sintagmatics, epidigmatics

This work is focused on the problem of genre specificity within the English language academic discourse of today. The goal of the research is to reveal and analyze system relations regularly and steadily showing themselves within one definite genre of the student essay, their significance and role in the official university communicative space. The abovesaid relations can be found at both the structural level, i.e. in the special text arrangement of essays, and at the conceptual level of the genre. The basic investigation methods are: interpretation and classification of the material; linguistic observation and description; componential analysis of dictionary definitions; comparison and contrasting; linguistic, functional and stylistic, genre analysis of the text; context and discourse analysis; argumentative illustration tool. The practical value can be viewed as a possibility to apply the investigation results in teaching; e.g. during the courses of English, language culture studies, linguadidactics, cross-cultural pragmatics. The authors conclude that student essay text demonstrate closely interweaving paradigmatic, syntagmatic and epidigmatic links. Paradigmatics is represented by semantic and conceptual categories of systemity, integrity, cohesion and closeness. Discourse syntagmatic categories are characterized by linguosemantic consistency, linearity, remoteness, parallelism. Epidigmatic systemity can be traced as the availability of derivative words.

PELAKSANAAN INVESTASI SEKTOR PARIWISATAPULAU-PULAU KECIL DI KABUPATEN PESISIR SELATAN

Indonesia as a developing country is doing a lot of activities in Pesisir Selatan that is being actively growing. In this skripsi, the formulation of the problem are: a) how the government of Kab.Pesisir Selatan manage the investation in tourism of small islands. b) what is the government challange involved in investment in tourism of small Islands in Kab. Pesisir Selatan. Research methods used are juridical empirical, that is the existing approach with an understanding positif law of an object and how reality in the field. Then analyzed qualitatively and described descriptively. The results showed that: a) The basic investigation in Kab.Pessel has been implemented in accordance with UU Penanaman Modal and UU Kepariwisataan. In practice it finds one investment company and more than 12 domestic investors who invest in insland tourism. Activity that involved in investing in small islands tourism are tourist attraction transportation, tourism and travel agency, food and beverage, providing accommodatin and other tourism bussiness activity. b) in the implementation there is obstacles such as: whether unregistered land, potential investors who do not meet the requirements, lack of people awareness about investation commonly in tourism field, and low in facility in Pesisir Selatan. The government's ongoing solution is to counseling and coaching local communities to register their land, take care of permits and be open to investing activities and tourism, make it easier permit service and non permit service and coordinating inter-sectoral services to improve facilities.