Johnsonclapp9054

INTRODUCTION Intussusception of the appendix occurs when part of the appendix passes the part next to it or the whole appendix to the cecum. It is classified as primary or secondary, or can be classified to partial or complete. Most cases are secondary and partial. Patients usually presents with right lower abdominal pain and most cases are diagnosed during surgery. CASE PRESENTATION A 27-year-old female presented with right iliac fossa pain and nausea for 2 days. Abdominal examination showed tenderness, guarding, and rebound tenderness at the right iliac fossa. The WBC count was 11,000 c/mm and the urinalysis was normal. At surgery, there was intussusception of the vermiform appendix in its middle part with palpable mass attached to its wall. Appendicectomy was performed successfully. The result of the histopathology was consistent with mucinous cystadenoma of the appendix with no evidence of malignancy. CONCLUSION Surgery is the main form of treatment as most of the cases are diagnosed during surgery, the operation type may include appendicectomy or more extensive surgery is required such as right hemicolectomy depending on the cause. Surgery can be performed laparoscopically. Trials of colonoscopic reduction are not recommended. INTRODUCTION Laparoscopic cholecystectomy for patients with acute cholecystitis and liver cirrhosis is associated with increased risk. We present an obese patient with acute cholecystitis and liver cirrhosis caused by nonalcoholic steatohepatitis (NASH), who was successfully managed with laparoscopic cholecystostomy and a low-carbohydrate diet with exercise. PRESENTATION OF CASE A 61-year-old woman presented with right upper quadrant abdominal pain. Ultrasonography and computed tomography were consistent with acute cholecystitis with multiple stones and cirrhosis. The patient had no history of alcohol intake, and serologic tests were negative. The patient's body mass index was 39 kg/m2 (154 cm, 93 kg) and NASH was suspected. Percutaneous transhepatic drainage was impossible because of the anatomic position of the gallbladder. Emergency laparoscopic cholecystostomy was performed initially for drainage. A low-carbohydrate diet and exercise were started for weight loss and her weight reduced by 19 kg over three months. this website Open cholecystectomy was performed uneventfully, and liver biopsy suggested NASH. DISCUSSION Laparoscopic cholecystostomy is a reasonable temporary alternative to cholecystectomy in patients with acute cholecystitis and increased surgical risk. Weight loss with diet and exercise can be effective in patients with NASH. A low-carbohydrate diet is a reasonable treatment for NASH, because glucose is converted to triglycerides and stored as lipid in the liver. CONCLUSION Laparoscopic cholecystostomy was effective in this obese patient with acute cholecystitis and NASH cirrhosis. Using a low-carbohydrate diet with exercise, her weight decreased, and subsequent open cholecystectomy was uneventful. In this study, nanoscale zero-valent iron (NZVI) modified by ethylene glycol (EG), and then an aluminum hydroxide (Al(OH)3) film was wound on it to make a new material (EG-NZVI@Al(OH)3), it is used to remove sulfides in water and it has greatly improved the performance of sulfide removal. At different pH values, Al(OH)3 film can effectively improve the adsorption of sulfide by EG-NZVI @Al(OH)3. Al(OH)3 film can also enhance suspension stability and reduce NZVI corrosion in water. The scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR) and X-ray photoelectron spectroscopy (XPS) characterization methods were used to prove that the NZVI was successfully modified by EG and coated by Al(OH)3, achieved the role of protecting NZVI from being oxidized during preparation and drying, and enhanced suspension stability, chemical reactivity and longevity. The removal of sulfides in water by NZVI is mainly through the formation of surface complexes, iron mercapto oxide (FeOSH) and the precipitates of iron sulfide (FeS, FeS2, FeSn) adsorbed on the surface of NZVI. Al(OH)3 film is positively charged It will cause electrostatic adsorption and adsorption on sulfur ions. EG-NZVI@Al(OH)3 is used to remove sulfide from 2.5-50 mg/L aqueous solution. It shows the highest adsorption capacity is 175.5 mg/g. And the mechanism of adsorption is speculated. Peroxymonosulfate (PMS) activation by heterogeneous catalysts has been widely investigated to remove organic contaminants. Nevertheless, the technology is restricted to the bench-scale batch system. For practical applications, a supported catalyst design based on a reactor configuration with catalyst recovery is the need for future development. In this study, Mn3O4 nanodots-g-C3N4 nanosheets (Mn3O4/CNNS) composites were prepared via a facile hydrothermal method. The micro-structures and compositions of composites were investigated by a series of characterization methods. It was found that the Mn3O4 nanodots (5-10 nm) were distributed uniformly over the CNNS. When the added amount of CNNS was 150 mg during the synthesis process, a composite named as Mn3O4/CNNS-150 was obtained, which exhibited the best performance on PMS activation for 4-chlorophenol (4-CP) removal. The Mn3O4/CNNS-150@PTFE membrane was synthesized by facile vacuum filtration. The catalytic membrane was applied in filtration experiments for the degradation of different contaminants. The stability tests revealed excellent stability of the catalytic membrane. The redox circles of Mn(IV)/Mn(III)/Mn(II) on the Mn3O4 surface were the main source of activated PMS and a possible activation mechanism in the reaction system was provided. This study is of great significance for the development of novel catalytic membranes with PMS activation. Wastewater is a significant environmental and public health concern which management is a constant challenge since antiquity. Wastewater research has increased exponentially over the last decades. This paper provides a global overview of the exponentially increasing wastewater research in order to identify current challenges and paradigm shifts. Besides households, hospitals and typical industries, other sources of wastewater appear due to emerging activities like hydraulic fracturing. While the composition of wastewater needs constant reassessment to identify contaminants of interest, the comprehensive chemical and toxicological analysis remains one of the main challenges in wastewater research. Moreover, recent changes in the public perception of wastewater has led to several paradigm shifts i) water reuse considering wastewater as a water resource rather than a hazardous waste, ii) wastewater-based epidemiology considering wastewater as a source of information regarding the overall health of a population through the analysis of specific biomarkers, iii) circular economy through the implementation of treatment processes aiming at harvesting valuable components such as precious metals or producing valuable goods such as biofuel.