One of the main causes of proximal bowel obstruction in neonates is congenital duodenal obstruction. It can be grouped by intrinsic and extrinsic factors and the presentation may differ depending on whether the obstruction is complete or partial. The intrinsic factors include duodenal atresia, duodenal stenosis, or duodenal web. The extrinsic factors include malrotation with Ladd's band, annular pancreas, anterior portal vein, and duodenal duplication. Malrotation may present with or without midgut volvulus. We are sharing a rare presentation of congenital duodenal obstruction with combined intrinsic and extrinsic causes, namely, duodenal stenosis with gastrointestinal malrotation in a neonate. The patient underwent successful exploratory laparotomy, corrective Kimura's procedure (duodenostomy), Ladd's procedure, and appendicectomy. Early recognition of signs and symptoms, prompt corrective surgery, and adequate optimization of metabolic components post-operatively are important to determine the decreased morbidity and mortality of neonates.
Congenital pulmonary airway malformation (CPAM) together with oesophageal atresia and tracheoesophageal fistula (TOF) is a very rare condition in neonates. We presented a case of an infant with Gross type C oesophageal atresia with TOF coexisting with Stocker Type III CPAM in our centre. It is interesting to know that TOF associated with type III CPAM has never been reported in the literature. The child was delivered through caesarean section, and because of respiratory distress post-delivery, endotracheal intubation was carried out immediately. CPAM was diagnosed by a suspicious finding from the initial chest X-ray and the diagnosis was confirmed through computed tomography scan of the chest. The patient was initially stabilised in a neonatal intensive care unit (NICU), and after the successful ligation of fistula and surgical repair of TOF, lung recruitment was started by high flow oscillatory ventilation. The patient recovered well without complications and able to maintain good saturation without oxygen support through the stay in the neonatal unit. Early recognition of this rare association is essential for immediate transfer to NICU, the intervention of any early life-threatening complications, and for vigilant monitoring in the postoperative period.
Biodegradable polymers are gaining attention as alternatives to non-biodegradable plastics to address environmental issues. With the rising global demand for plastic products, the development of non-toxic, biodegradable plastics is a significant topic of research. Aliphatic polyester, the most common biodegradable polyester, is notable for its semi-crystalline structure and can be synthesized from fossil fuels, microbial fermentation, and plants. Due to great properties like being lightweight, biodegradable, biocompatible, and non-toxic, aliphatic polyesters are used in packaging, medical, agricultural, wearable devices, sensors, and textile applications. The biodegradation rate, crucial for biodegradable polymers, is discussed in this review as it is influenced by their structural properties and environmental conditions. This review discusses currently available biodegradable polyesters, their emerging applications, and the challenges in their commercialization. As research in this area grows, this review emphasizes the innovation in biodegradable aliphatic polyesters and their role in advancing environmental sustainability.
The use of nanomaterials as a means of recovering heavy and light oil from petroleum reservoirs has increased over the preceding twenty years. Most researchers have found that injecting a nanoparticle dispersion (nanofluids) has led to good results and increased the amount of oil that can be recovered. In this research, we aim to imitate the three-dimensional hexagonal prism in the existence of SiO2 and Al2O3 nanoparticles for better oil recovery. Porosity (0.1≤φ≤0.4), mass flow rate (0.05mL/min≤Q≤0.05ml/min), nanoparticle concentration (0.01≤ψ≤0.04), and the effect of relative permeability (kr) on oil and water saturation in the presence of gravity under different time durations are all investigated. The result obtained for the model is verified with existing experimental data. The results indicated that the infulence of nanoparticle volume fraction (VF) is significant in enhancing the oil recovery rate. It is also observed that at low porosity values the oil recovery is maximum. The maximum oil recovery is attained at low values of mass flow rate in the 3D hexagonal prism in the presence of silicon and aluminium nanoparticles It is also observed that the use of SiO2 gives a better oil recovery rate than Al2O3. It is also observed that maximum oil recovery is obtained at 99% at a flow rate of 0.05 mL/min in the presence of silicon injection.
Preeclampsia patients have frequently been found to experience hyperuricaemia and this may result in poor outcomes compared to those with normal uric acid levels. This study aimed to determine the relationship of hyperuricaemia in pre-eclampsia patients with foetal and maternal outcomes. This prospective cohort study involved 79 patients in a tertiary centre from year 2016 to 2018. Blood samples were taken antenatally and at the 6th week, post-delivery for renal function including serum uric acid level. Our findings indicate that there was a higher incidence of poor maternal and foetal outcomes in the hyperuricaemia group than the normal uric acid group. Serum uric acid has been shown to be a significant predictor for low birth weight and premature delivery in preeclampsia patients. It was also found that there was a significant negative correlation between uric acid level and antenatal creatinine clearance (rs = -0.338, p = .002). The assessment of the serum uric acid level seems to be important to ensure better outcomes in patients with preeclampsia.Impact statementWhat is already known on this subject? Preeclampsia is a serious pregnancy-related complication and remains as one of the most important cause of maternal and foetal morbidity and mortality, affecting 2-8% in all pregnancy. Many studies have established the association between hyperuricaemia and preeclampsia. Besides, numerous studies have found that hyperuricaemia contributed to adverse maternal and foetal outcomes.What the results of this study add? There was a significant increase in adverse foetal and maternal outcomes in the hyperuricaemia group compared to the normal uric acid group. This study revealed that serum uric acid remains a significant predictor for low birth weight and premature delivery in preeclampsia patients.What the implications are of these findings for clinical practice and/or further research? Hyperuricaemia does not merely become an indicator for the severity of disease in preeclampsia patients but also indicates adverse foetal outcomes. Large population-based studies are required to establish the absolute maternal and foetal outcomes in patients with hyperuricaemia. Besides, further studies are recommended on long-term implication of hyperuricaemia which is not limited to only during antenatal period.
The emergence of nosocomial multidrug-resistant Klebsiella pneumoniae is an escalating public health threat worldwide. The prevalence of nosocomial infections due to K. pneumoniae was recorded up to 10%. In this systematic review and meta-analysis, which were conducted according to the guidelines of Preferred Reporting Items for Systematic Review and Meta-Analysis, 1092 articles were screened from four databases of which 47 studies fulfilled the selected criteria. By performing a random-effect model, the pooled prevalence of nosocomial multidrug-resistant K. pneumoniae was estimated at 32.8% (95% CI, 23.6-43.6), with high heterogeneity (I2 98.29%, p-value < 0.001). The estimated prevalence of this pathogen and a few related studies were discussed, raising awareness of the spread of multidrug-resistant K. pneumoniae in the healthcare setting. The emergence of nosocomial multidrug-resistant K. pneumoniae is expected to increase globally in the future, and the best treatments for treating and preventing this pathogen should be acknowledged by healthcare staff.