scholarly journals Prolapse of the Small Intestine from the Uterine Perforation at Dilatation and Curettage

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Shigeki Matsubara ◽  
Akihide Ohkuchi ◽  
Hiroaki Nonaka ◽  
Homare Ito ◽  
Alan T. Lefor
Keyword(s):  
Developing Countries ◽  
Small Intestine ◽  
Adverse Events ◽  
Intestinal Resection ◽  
Uterine Wall ◽  
Uterine Perforation ◽  
Missed Abortion ◽  
Developed Country ◽  
Dilatation And Curettage ◽  
Tertiary Center

Dilatation and curettage (D&C) sometimes causes uterine perforation, which usually does not cause a serious problem. Here, we report uterine perforation caused by D&C, in which the small intestine prolapsed from the uterus, requiring intestinal resection. D&C was performed for missed abortion at 9 weeks. After dilating the cervix, forceps grasped tissue that, upon being pulled, resulted in the intestine being prolapsed into the vagina. Laparotomy revealed a perforation at the low anterior uterine wall, through which the ileum had prolapsed. The mesentery of the prolapsed ileum was completely detached and the ileum was necrotic, which was resected. The uterus and the intestine were reconstructed. Although intestinal prolapse is considered to be caused by “unsafe” D&C performed by inexperienced persons or even by nonphysicians in developing countries, this occurred in a tertiary center of a developed country. We must be aware that adverse events such as uterine perforation with intestinal prolapse can occur even during routine D&C.

scholarly journals Morbidly Adherent Placenta in Mid Trimester Abortion - A Case Report

2017 ◽  
Vol 31 (1) ◽  
pp. 50-53
Author(s):  
Kamrun Nahar ◽  
Quorrate Eynul Farhad ◽  
Suraiya Apsara ◽  
Jereen Afsana
Keyword(s):  
Advanced Maternal Age ◽  
Uterine Wall ◽  
Placenta Praevia ◽  
Missed Abortion ◽  
Trimester Abortion ◽  
Morbidly Adherent Placenta ◽  
Decidua Basalis ◽  
Uterine Surgery ◽  
Adherent Placenta ◽  
Dilatation And Curettage

Morbidly adherent placenta (MAP) occurs when there is abnormally firm attachment of placental villi to the uterine wall with the absence of the normal intervening decidua basalis and nitabuch’s layer. There are several risk factors of this condition including previous uterine surgery like myomectomy, dilatation and curettage operation, placenta praevia following previous caesarean section, advanced maternal age, multiparity and tobacco use. A diagnosis of MAP can be confirmed with tissue histology; however, medical imaging can be effective diagnostic tool. USG can detect the presence of accreta (80% sensitivity) and absence of accreta (95% specificity). This condition is presented here as a 20 weeks pregnancy with missed abortion with morbid adherent placenta (MAP).Bangladesh J Obstet Gynaecol, 2016; Vol. 31(1) : 50-53

scholarly journals Biodistribution of the radiophamarceutical sodium pertechnetate (Na99mTcO4) after massive small bowel resection in rats

2007 ◽  
Vol 22 (6) ◽  
pp. 430-435 ◽  
Author(s):  
Dâmaso de Araújo Chacon ◽  
Irami Araújo-Filho ◽  
Arthur Villarim-Neto ◽  
Amália Cínthia Meneses Rêgo ◽  
Ítalo Medeiros Azevedo ◽  
...  
Keyword(s):  
Small Intestine ◽  
Short Bowel Syndrome ◽  
Intestinal Mucosa ◽  
Intestinal Resection ◽  
Small Bowel Resection ◽  
Control Group ◽  
Short Bowel ◽  
Massive Resection ◽  
Mucosal Thickness ◽  
Misleading Interpretation

PURPOSE: To evaluate the biodistribution of sodium pertecnetate (Na99mTcO4) in organs and tissues, the morphometry of remnant intestinal mucosa and ponderal evolution in rats subjected to massive resection of the small intestine. METHODS: Twenty-one Wistar rats were randomly divided into three groups of 7 animals each. The short bowel (SB) group was subjected to massive resection of the small intestine; the control group (C) rats were not operated on, and soft intestinal handling was performed in sham rats. The animals were weighed weekly. On the 30th postoperative day, 0.l mL of Na99mTcO4, with mean activity of 0.66 MBq was injected intravenously into the orbital plexus. After 30 minutes, the rats were killed with an overdose of anesthetic, and fragments of the liver, spleen, pancreas, stomach, duodenum, small intestine, thyroid, lung, heart, kidney, bladder, muscle, femur and brain were harvested. The biopsies were washed with 0.9% NaCl.,The radioactivity was counted using Gama Counter WizardTM 1470, PerkinElmer. The percentage of radioactivity per gram of tissue (%ATI/g) was calculated. Biopsies of the remaining jejunum were analysed by HE staining to obtain mucosal thickness. Analysis of variance (ANOVA) and the Tukey test for multiple comparisons were used, considering p<0.05 as significant. RESULTS: There were no significant differences in %ATI/g of the Na99mTcO4 in the organs of the groups studied (p>0.05). An increase in the weight of the SB rats was observed after the second postoperative week. The jejunal mucosal thickness of the SB rats was significantly greater than that of C and sham rats (p<0.05). CONCLUSION: In rats with experimentally-produced short bowel syndrome, an adaptive response by the intestinal mucosa reduced weight loss. The biodistribution of Na99mTcO4 was not affected by massive intestinal resection, suggesting that short bowel syndrome is not the cause of misleading interpretation, if an examination using this radiopharmaceutical is indicated.

scholarly journals SAT0176 THERAPEUTIC APHERESIS DURING PREGNANCY IN RHEUMATIC DISEASES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1029.2-1030
Author(s):  
A. Colpo ◽  
P. Marson ◽  
T. Tison ◽  
A. Zambon ◽  
A. La Rosa ◽  
...  
Keyword(s):  
High Risk ◽  
Adverse Events ◽  
Rheumatic Diseases ◽  
Therapeutic Option ◽  
Cardiac Activity ◽  
Successful Outcome ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Total N ◽  
Tertiary Center

Background:Therapeutic apheresis (TA) represents a therapeutic option in pre-existing conditions or rheumatic diseases that occur during gestation. Although pregnancy is not a contraindication itself, due to the lack of evidence-based guidelines and the alleged risk of maternal and/or fetal adverse events, there is general resistance to its application during pregnancy.Objectives:In this observational study we aimed to evaluate the efficacy and safety of TA in high-risk pregnancies in patients with rheumatic diseases, followed over a decade in a tertiary Center.Methods:Between January 2005 and April 2019, 843 TA procedures were performed during 51 pregnancies in 43 patients: 745 plasma exchange sessions and 98 immunoabsorption sessions. TA was performed in 29 (57%) pregnancies of 21 (48.8%) patients with antiphospholipid antibody syndrome (APS), in 20 (39.2%) pregnancies of 20 (46.5%) patients with congenital heart block (CHB), in 1 (1.9%) pregnancy of 1 (2.3%) patient with systemic sclerosis (SSc) and 1 (1.9%) pregnancy of 1 (2.3%) patient affected by lupic nephritis (SLE).Results:During the period considered, apheresis sessions applied to pregnant women were 7.1% of the total (n = 13.251). The average age at the first treatment was 33 years (range 24-43). The mean management age at the first apheretic treatment was 21 weeks (range 4-32). Twelve (1.4%) apheresis sessions were complicated by adverse events, none required or prolonged hospitalization. There were 44 (86.3%) live births, 3 (5.9%) spontaneous abortions and 2 (3.9%) voluntary terminations of pregnancy, 2 (3.9%) lost to follow-up. The average gestational age at birth was 35 weeks (range 24-37) and cesarean section was performed in 41 (80.4%) cases. TA was added to conventional therapy in 24/29 (82.7%) patients with APS, to the detection of fetal cardiac activity, while in 5/26 (17.3%) it was introduced when the first signs of pregnancy complications such as mild preclampsia, HELLP and IUGR were detected. TA was started within 24 hours of atrioventricular block (AVB) detection; 10/20 (50%) mothers with CHB were diagnosed with 2nd degree AVB, 9/20 (45%) with 3rd degree AVB and one (5%) with sinus bradycardia and endocardial fibroelastosis. The patient with SSc was treated with TA twice a week from the 32nd SG until delivery, which occurred at the 36th SG, due to severe IUGR and oligohydramnios. The patient with SLE complicated by lupic nephritis was treated with TA twice a week, from the 26th SG until the birth, which took place at the 31st SG.Conclusion:Our data have shown that TA in pregnancy is well tolerated. Close collaboration between rheumatologist, obstetrician and specialist in TA is essential to ensure a successful outcome of high-risk pregnancies.Disclosure of Interests: :Anna Colpo: None declared, Piero Marson: None declared, Tiziana Tison: None declared, Alessandra Zambon: None declared, Annalisa La Rosa: None declared, Ermella Zanetti: None declared, Amelia Ruffatti: None declared, Giustina De Silvestro: None declared, Ariela Hoxha Speakers bureau: Celgene, UCB, Novartis, Sanofi, Werfen

scholarly journals Forward Rate Bias in Developed and Developing Countries: More Risky Not Less Rational

Econometrics ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 43
Author(s):  
Michael D. Goldberg ◽  
Olesia Kozlova ◽  
Deniz Ozabaci
Keyword(s):  
Developing Countries ◽  
Forward Rate ◽  
Currency Markets ◽  
Developed Country ◽  
Slope Coefficient ◽  
Break Points ◽  
Time Periods ◽  
The Stability ◽  
Widespread View ◽  
Shed Light

This paper examines the stability of the Bilson–Fama regression for a panel of 55 developed and developing countries. We find multiple break points for nearly every country in our panel. Subperiod estimates of the slope coefficient show a negative bias during some time periods and a positive bias during other time periods in nearly every country. The subperiod biases display two key patterns that shed light on the literature’s linear regression findings. The results point toward the importance of risk in currency markets. We find that risk is greater for developed country markets. The evidence undercuts the widespread view that currency returns are predictable or that developed country markets are less rational.

Adverse events following immunization: Easily preventable in developing countries

2011 ◽  
Vol 7 (9) ◽  
pp. 989-991 ◽  
Author(s):  
Ramesh Verma ◽  
Pardeep Khanna ◽  
Mohan Bairwa ◽  
Suraj Chawla ◽  
Shankar Prinja ◽  
...  
Keyword(s):  
Developing Countries ◽  
Adverse Events

Use of Oral Fluid Therapy and Posttreatment Feeding Following Enteritis in Children in a Developed Country

PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 358-361
Author(s):  
Keyword(s):  
Developing Countries ◽  
Fluid Therapy ◽  
Oral Fluid ◽  
Electrolyte Solutions ◽  
Oral Hydration ◽  
Developed Country ◽  
Oral Rehydration ◽  
Young Infants ◽  
Life Threatening ◽  
Cotransport System

The 1982-1983 report by the United Nations Children's Fund (UNICEF) on the State of the World's Children recommended widespread implementation of oral rehydration as one of the four strategies projected to save the lives of 20,000 children each day.1 In the developing countries, oral rehydration has been shown to be an effective, simple, and inexpensive therapy for dehydration caused by severe enteritis in infants.2-8 The modern concepts of oral fluid therapy for diarrheal diseases evolved in part from the clinical observation that orally administered glucose-electrolyte solutions can replace diarrheal fluid losses in cholera. Previous laboratory investigation had demonstrated the presence of a cotransport system of sodium with glucose or other actively transported small organic molecules in the small intestine in animals and in man. Clinical studies suggest that this sodium-glucose cotransport system remains intact not only when the pathophysiologic agent is an enterotoxin, such as that elaborated by Vibrio cholerae or enterotoxigenic strains of Escherichia coli, but also with inflammatioion such as that associated with rotavirus, Campylobacter jejuni, E coli, and Yersinia enterocolitica.4-8 These observations have provided a physiologic rationale for an appropriately efficient ratio of sodium to glucose in formulating solutions to be used in the developing countries for oral therapy in the treatment of infants with life-threatening diarrheal dehydration. The question we address in this commentary is that of the appropriate implementation of oral hydration therapy in a developed country. Pediatricians and others concerned with the health of children in this country are not usually confronted with the problem of obtaining uncontaminated water nor with the management of large numbers of severely malnourished young infants with multiple health problems.

Recurrent large uterine fundal dehiscence during cesarean section after hysteroscopic uterine septum resection with uterine perforation

2016 ◽  
Vol 5 (2) ◽  
pp. 85-87
Author(s):  
İbrahim Alanbay ◽  
Mustafa Öztürk ◽  
Mustafa Ulubay ◽  
Uğur Keskin ◽  
Emre Karaşahin
Keyword(s):  
Cesarean Section ◽  
Uterine Rupture ◽  
Late Complication ◽  
Uterine Wall ◽  
Elective Cesarean Section ◽  
Uterine Perforation ◽  
Elective Cesarean ◽  
Uterine Septum ◽  
Uterine Fundus ◽  
Previous Cesarean

Abstract Septum resection using hysterescopy is safe, rapid and efective, but some late complication of it may be seen as uterine rupture or dehiscence of uterine wall during pregnancy due to myometrial damage. We present a case of recurrent large uterine fundal dehiscence conscecutive to cesarean section in a patient who had previously undergone a uterine septum resection. The patient was a 35-year-old who presented at 39 weeks of gestation (Gravida 2, Parity 1) and was admitted for an elective cesarean section. Her reproductive history included a septum resection which resulted in uterine perforation, and one previous cesarean section in which a large fundal defect was found and repaired. Then the examination had shown an aproximately 5 cm large uterine fundus defect including all three layers of uterus which had been repaired. Perforation or excessively deep incision of uterine fundus during hysteroscopic metroplasty may cause chronic weakness of the uterine wall especially at fundal localization. Our case was an incidental uterine wall dehiscence during cesarean section. Patients with an uterine septum resection history should be followed up carefully for uterine rupture during pregnancy.

Street Level Flood Monitoring and Warning System, a conceptual model using IoT: A Case of Surat City

2021 ◽  
Vol 14 (12) ◽  
pp. 55-65
Author(s):  
Anant Patel ◽  
Sanjay Yadav
Keyword(s):  
Developing Countries ◽  
Water Level ◽  
Warning System ◽  
Water Levels ◽  
Mitigation Measures ◽  
Developed Country ◽  
River Bank ◽  
Street Level ◽  
Flood Warning ◽  
Flood Monitoring

Most of the natural disasters are unpredictable, but the most frequent occurring catastrophic event over the globe is flood. Developing countries are severely affected by the floods because of the high frequencies of floods. The developing countries do not have good forecasting system compared to the developed country. The metro cities are also settled near the coast or river bank which are the most vulnerable places to floods. This study proposes plan for street level flood monitoring and warning system for the Surat city, India. Waterlogging happens in the low lying area of the Surat city due to heavy storm and heavy releases from the Ukai dam. The high releases from upstream Ukai dam and heavy rainfall resulted into flooding in the low lying area of the Surat city. This research proposed a wireless water level sensor network system for the street water level flood monitoring. The system is proposed to monitor the water levels of different areas of city through the wireless water level sensors as well as to capture live photos using CCTV camera. This will help authority not only to issue flood warning but also to plan flood mitigation measures and evacuation of people.

Short Bowel Syndrome

2015 ◽  
Author(s):  
Robert Burakoff ◽  
Alison Goldin
Keyword(s):  
Small Intestine ◽  
Short Bowel Syndrome ◽  
Average Length ◽  
Intestinal Failure ◽  
Clinical Manifestations ◽  
Intestinal Resection ◽  
Intestinal Atresia ◽  
Congenital Defects ◽  
Short Bowel ◽  
Vascular Insufficiency

Short bowel syndrome (SBS) is a state of malabsorption resulting from physical or functional loss of large portions of the small intestine, and is the most common cause of intestinal failure. The average length of a human’s small intestine is between 3 and 8 m, depending on the type of measurements made (surgical, radiologic, or autopsy); SBS occurs when less than 200 cm of small bowel remains. SBS may be congenital (intestinal atresia) or acquired. Physical losses usually occur from surgical resection for Crohn disease (CD), vascular insufficiency, radiation, malignancy, trauma, or volvulus. The site of intestinal resection helps to determine the degree of intestinal capacity. Functional losses, on the other hand, are less common and occur in the setting of a nonfunctioning, but intact, small intestine. Examples include radiation enteritis, congenital defects, and inflammatory bowel disease (IBD). This review addresses the epidemiology, pathophysiology and pathogenesis, clinical manifestations, treatment, complications, and prognosis of SBS. A figure shows sites of intestinal nutrient absorption. A table lists potential complications of SBS in patients receiving parenteral nutrition (PN). This review contains 1 highly rendered figure, 1 table, and 67 references. 

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