Approximation in scour depth around spur dikes using novel hybrid ensemble data-driven model.

The scouring process near spur dikes poses a threat to riverbank stability, making it crucial for river engineering to accurately calculate the maximum scour depth. However, determining the maximum scour depth has been challenging due to the intricacy of scour phenomena surrounding these structures. This research introduces a reliable ensemble data-driven model by hybridizing random tree (RT) using additive regression (AR), bagging (B), and random subspace (RSS) for predicting scour depths around spur dikes.

Incomplete Kawasaki Disease in an Adult South Asian Patient.

Kawasaki disease is an acute multisystemic vasculitis occurring predominantly in children and rarely in adults, with sequelae of potentially life-threatening coronary artery aneurysms. "Incomplete" Kawasaki disease is a novel concept and considered a diagnosis of exclusion as it alludes to patients with fever lasting ⩾5 days and 2 or 3 clinical criteria without another reasonable explanation for the illness. The multidisciplinary team should be vigilant for this oligosymptomatic clinical presentation, specifically within this subgroup despite age and ethnicity, and the syndrome should be considered as a differential diagnosis in challenging cases presenting as infectious or autoimmune disease.

A Novel Treatment With Obinutuzumab-Chlorambucil in a Patient With B-Cell Prolymphocytic Leukemia: A Case Report and Review of the Literature.

We report the case of a patient with B-cell prolymphocytic leukemia who was successfully treated with the novel humanized monoclonal antibody obinutuzumab. This patient was previously treated with the combination of rituximab and bendamustine and had recurrent infusion reactions. Her treatment with rituximab and bendamustine was discontinued when she developed disease progression after 3 cycles of therapy.

Large cell neuroendocrine carcinoma of the rectum presenting with extensive metastatic disease.

Introduction. Rectal large cell neuroendocrine carcinoma (LCNEC) is a poorly differentiated neoplasm that is very rare and belongs within the poorest prognostic subgroup among primary colorectal neoplasms. Here, we describe a case of LCNEC of the rectum, which highlights the aggressive clinical course and poor prognosis associated with this disease.

An Unusual Case of Anti-GBM Antibody Elevation in HIV-Associated Nephropathy.

Introduction. The most commonly seen glomerular disease in HIV infected patients is HIV-associated nephropathy (HIVAN); however, a multitude of other nephropathies can occur in HIV infection with an almost equal cumulative frequency. We report an unusual case of a patient with clinical and histological evidence of HIVAN in which the diagnosis was initially confounded by the finding of an elevated serum anti-glomerular basement membrane (anti-GBM) antibody.

Lupus nephritis in a patient with sickle cell disease.

Introduction. The diagnosis of systemic lupus erythematosus (SLE) in patients with sickle cell disease (SCD) can be difficult to establish because the musculoskeletal, central nervous system, and renal manifestations are similar in both diseases. In the presented case, we highlight the diagnostic challenge that can evolve in patients with a concurrence of both diseases and we establish the importance of early recognition and treatment of lupus nephritis in patients with SCD.

Role of suture material and technique of closure in wound outcome following laparotomy for peritonitis.

Background: There are no accepted guidelines for the closure of laparotomy incisions in patients of peritonitis. As these patients differ from the patients undergoing elective abdominal surgery, the same recommendations for closure may not be applicable in both groups.

Aim: To compare wound outcome parameters following closure of the laparotomy incision with absorbable and non-absorbable suture material using the continuous and interrupted techniques in patients of peritonitis.

Physiological cost index in cerebral palsy: its role in evaluating the efficiency of ambulation.

The study was undertaken to evaluate whether the Physiological Cost Index (PCI) can be used as a reliable index of efficiency of gait and as an outcome measure in cerebral palsy (CP). Physiological Cost Index was calculated in normal subjects by recording the heart rate manually and with electrocardiograph recording, and the values compared. In another group of subjects, PCI was calculated after they walked 3 different distances (50, 100, and 150 m).

Evaluation of intestinal mucosal permeability function in patients with acute pancreatitis.

This study aims to evaluate the intestinal mucosal permeability in patients with acute pancreatitis. The lactulose:mannitol (L:M) ratio was used to assess permeability. It is an inexpensive and quite reliable method.

Lateral sacral meningomyelocele as a gluteal swelling--an unusual presentation.

Paravertebral meningoceles are rare examples of craniospinal dysraphism. A young boy presented with a cystic swelling over left gluteal region with lumbosacral scoliosis. On exploration, he was found to have a laterally placed sacral meningomyelocele.

Early enteral feeding by nasoenteric tubes in patients with perforation peritonitis.

Malnutrition is well recognized as a potential cause of increased morbidity and mortality in surgical patients. Early postoperative enteral nutrition through a feeding jejunostomy has been shown to improve results in patients undergoing major resections for gastrointestinal malignancies, trauma, and perforation peritonitis. We conducted a prospective study to assess the feasibility and short-term efficacy of early enteral feeding through a nasoenteric tube placed intraoperatively in patients with nontraumatic perforation peritonitis with malnutrition.

Improving outcome in patients of high output small bowel fistula.

Early and effective control of sepsis is the most important factor determining the outcome in patients with enterocutaneous fistulae (ECF). From a retrospective analysis of the hospital records (published data), ongoing contamination of the peritoneal cavity by the faecal stream was the most important factor leading to sepsis and occurred in 75% of patients. The mortality figure in patients with high-output ECF was 54.

Hindgut duplication--case report and literature review.

Colonic duplication is a rare congenital abnormality that can present diagnostic difficulties. A case of duplication of the entire large bowel and terminal ileum is presented, and a framework for diagnostic work-up and treatment options in these patients is discussed.

Ureteric stricture with a perirenal urinoma treated by ureteric replacement with appendix.

Appendix has routinely been utilized by the urologists as an intermittent catheterization route to empty a continent urinary reservoir. However it is utilized very rarely for ureteric substitution. We present here our experience with the use of an appendicular conduit for substitution of a complete ureteric stricture and discuss the implications of its use for ureteric reconstruction.

Hydronephrotic obstructed kidney mimicking a congenital multicystic kidney: case report with review of literature.

Objective: To report a case of obstructed hydronephrotic kidney mimicking a multicystic kidney and to review the literature regarding differentiation of the hydronephrotic variant of multicystic kidney from the obstructed hydronephronic kidney. To suggest a possible algorithm in distinguishing them.

Methods: We have reported a case of a 35-year-old male who presented with dull aching pain and a palpable right-sided cystic flank mass of several years duration.

Effect of partial ileal bypass on the lipid profile in the hyperlipedemic rabbits.

The hypocholesterolemic effect of partial ideal bypass was studied in two groups of healthy albino rabbits. Both groups of rabbits were made hypercholesterolemic by feeding them cholesterol suspended in groundnut oil (1 ml/kg bw) at a dose of 100 ml/kg bw/day for one week. Group I rabbits were subjected to partial ileal bypass and group II rabbits were sham operated.

Histopathological assessment of the liver in cholelithiasis with cholecystitis.

Liver function and histology were studied in 62 patients undergoing elective cholecystectomy. Data from 50 of the cases was subsequently analyzed. Liver function was assessed by biochemical parameters and histological examination of intraoperatively obtained core and wedge liver biopsy.

Massive amebic liver abscess--an unusual presentation.

A 40-year-old woman presented with a huge lump in the right half of the abdomen and irregular menses. Ultrasonography showed a cystic lump with septations, extending from the upper abdomen to the pelvis; the right ovary was not seen. On exploration, there was a large cyst arising from the right lobe of the liver; the aspirate was bilious.

Review of a hospital experience of enterocutaneous fistula.

A retrospective analysis of records of 46 patients with enterocutaneous fistulas treated over a period of three and half years has been done. There were 28 males and 18 females, with 80% of patients being in age group of 25-35 years. Forty-five patients were postoperative and in one patient fistula occurred spontaneously.

Chronic calcific pancreatitis associated with osteomalacia and secondary hyperparathyroidism.

A 22-year-old woman with chronic calcific pancreatitis had dramatic relief of pain after pancreaticojejunostomy. Four years later, she presented with steatorrhea with osteomalacia and secondary hyperparathyroidism, a rare occurrence in chronic pancreatitis. She improved with pancreatic enzyme supplementation and calcium and vitamin D therapy.

Malignant carcinoid tumor of the gallbladder: a case report and review of literature.

Carcinoid of the gallbladder and bile ducts is a rare tumor. Till date 20 cases have been reported. Here we report one more case and review all 21 cases collectively.