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Assessment of Extent and Severity of Pellet Induced Abdominal Injuries, a Rare Variant of Weapon Violence: A Prospective Study  [PDF]
Azher Mushtaq, Atif Naeem Raja, Hilal Ahmad Wani, Shaukat A. Jeelani, Nazia Hilal, Ishfaq Ahmed Gilkar
Surgical Science (SS) , 2016, DOI: 10.4236/ss.2016.710064
Abstract: Background: The use of a Pellet gun, a form of short gun used for mob control in many conflict zones, has posed a serious challenge to the surgeons in assessing the extent of trauma caused by these pellets. Objectives: To study the role of conventional available investigations for trauma like ultrasonography and computed tomography scans in assessing the severity of the injuries caused by the pellets. Methodology: 50 patients having pellet injuries predominantly in abdomen without other associated trauma were included in the study. The decision for surgery was taken on the basis of clinical and CECT (Contrast Enhanced Computed Tomography) findings and these findings were then compared with intra-operative findings. Results: 30/50 patients were decided to be operated on the basis of Clinical and CECT findings. On exploration, it was observed that 18/33 patients really needed exploration while as 15/33 patients could have been managed conservatively. This was observed in next 20/50 patients who were put on conservative management with similar CECT findings. Of these 20 patients, 17 did well while as 3 were explored later in view of developing peritonitis and were found to have small bowel perforations. Conclusion: Conventional investigations for trauma like FAST and CECT abdomen are not ideal for assessing the severity of pellet induced abdominal visceral injuries which result in high rate of unnecessary laparotomies. Also the abdominal pellet trauma patients can be well managed conservatively until hemodynamically stable even though CT scan shows pellet penetration into peritoneal cavity or bowel lumen.
Open Underlay Mesh Reinforced Large Incisional Hernia Repair—Prospective Observational Hospital Based Study  [PDF]
Umer Mushtaq, Ishfaq Ahmad Gilkar, Javid Ahmad Peer, Shaukat Jeelani, Asgar Aziz, Farzanah Nowreen, Yaser Hussain Wani, Yaqoob Hassan, Drjavidahmad Peer
Surgical Science (SS) , 2019, DOI: 10.4236/ss.2019.103013
Introduction: Incisional hernias frequently complicate abdominal surgeries with a varied incidence as reported to be 2% - 20%. The risk factors of development of incisional hernias include immunocompromised state, diabetes mellitus, smoking, obesity, wound infection at the index surgery, emergency surgery. Materials and Methods: The study design was prospective and included 62 patients with incisional hernias. The patients were evaluated preoperatively on OPD basis with history, clinical examination, baseline investigation, ultrasound abdomen and computed tomogram. Results: The mean age was 48.9 years with male:female ratio of 1:1.4. Mean BMI was 30.1 kg/m2. Out of 62 patients in the study 61.2% had concomitant hypertension and were on treatment for the same. 30.6% were clinically hypothyroid, 38.7% were diabetic and 54.8% were smokers. There were multiple factors present in patients in the current study which were observed to be possible to have risked the patients to incisional hernias after an abdominal surgery. 21 patients had defect size ranging from 5 to 10 cm and 41 patients were bearing a hernia of the defect size of 10 cm or more. The mean operative time was 221.7 minutes. Conclusion: Incisional hernias are a part of surgical practice that would probably glue to it to the end of time. A progression from primitive suture repair with recurrence rates of over 65% to modern day mesh reinforced repairs with recurrences aimed at 0% is always welcome. But still then the placement of mesh in different positions or layers of abdominal wall yields different results.
The Impact of Traffic Emission on Air Quality in an Urban Environment  [PDF]
Hesham A. Al-Jeelani
Journal of Environmental Protection (JEP) , 2013, DOI: 10.4236/jep.2013.42025

Study of the impact of traffic emissions on air quality around the Haram Mosque in Makkah, Saudi Arabia, was conducted experimentally, numerically and statistically. Experimental study was performed to measure existing air quality. Numerical study was done to model the extent of air movement and pollutant dispersion within and around the Haram area. Statistical study was conducted to determine correlation coefficients, auto-correlation and time lags of each pollutant. Pollutant measurements were carried out using an air quality mobile laboratory at three sites. Numerical calculations were made using an ISC-AERMOD dispersion model. Concentrations of traffic emissions including nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), ozone (O3) and airborne particulate material under 10 μm diameter (PM10) are presented and analyzed. The calculated concentrations are validated by comparing with observed values at the three sites. The results indicate good agreement between calculated concentrations and observed values, which demonstrate satisfactory model performance. Results show that the Haram area is experiencing high concentrations of dust. High buildings around the Haram Mosque act as flow obstacles. Mean pollutant dispersion was toward the south and southeast during January and June. Highest mean concentrations were observed in January and June.

Diurnal and Seasonal Variations of Surface Ozone and Its Precursors in the Atmosphere of Yanbu, Saudi Arabia  [PDF]
Hesham A. Al-Jeelani
Journal of Environmental Protection (JEP) , 2014, DOI: 10.4236/jep.2014.55044

Surface ozone (O3) and its precursor’s gases (nitrogen monoxide (NO), nitrogen dioxide (NO2), nitrogen oxides (NOx), carbon monoxide (CO), methane (CH4) and non-methane hydrocarbons (NMHCs), and sulfur dioxide (SO2) were measured in Yanbu, Saudi Arabia from January 2004-December 2004. The annual average concentrations of O3, NO, NO2, NOx, SO2, CO, CH4, TNMHCs and THC were 22.51 ppb, 15.58 ppb, 17.25 ppb, 23.84 ppb, 6.66 ppb, 165.13 ppb, 3.44 ppm, 0.56 ppm and 3.88 ppm, respectively. The SO2/NOx and SO2/NO2 concentration ratios during the period of study indicate that the mobile emissions are the predominant sources in yanbu. The diurnal cycles of O3 concentrations revealed highest levels in the daytime and lowest levels in night time. The diurnal variations of NO, NO2, NOx, SO2, CO, NMHCs

Impact of Remote and Local Sources on Particulate Matter in Urban Environment  [PDF]
Hesham A. Al-Jeelani
Journal of Environmental Protection (JEP) , 2016, DOI: 10.4236/jep.2016.75064

In this paper, the impact of natural and anthropogenic sources on particulate matter with diameter less than 10 μm (PM10) was investigated in Jeddah urban area, Saudi Arabia to identify and quantify the major particle pollution source classes. Hourly data of PM10 and other gaseous pollutants (NOx, CO, SO2 and O3) and meteorological factors (temperature, relative humidity, atmospheric pressure, wind speed and wind direction) were collected at two air quality monitoring sites for the period of March 2008 to February 2009. The air mass origin was determined using 5-day backward trajectories arriving to Jeddah by using HYSPLIT model. Results show that the PM10 Daily Limit Value was exceeded. The most frequent air masses entering Jeddah and thereby influencing PM10 concentrations come from the East, specifically the SE and NE directions, 84% of the trajectories were originated over the Arabian Peninsula including Saudi Arabia mainland and the Arabian Gulf. The Mediterranean Sea and southern Europe were the origin source of 8% of the air mass trajectories, another 8% were originated from North Africa and Sahara Desert. The majority of PM10 episodes were attributed to the intrusion of dust to Jeddah urban air.

The Professional Medical Journal , 2010,
Abstract: Objectives: To analyze the rate of Pneumothorax after CT guided TNAB of lung masses , and correlating it with the size of thelesion. Design: Descriptive study. Setting: Department of Radiology Mayo Hospital, Lahore. Period: From June 2002 to April 2003, Patientsand method: Seventy patients underwent CT guided FNA of the chest masses. Results: Out of Seventy, 18 patients i.e.; 26 % developedPneumothorax. Lesion less than 1 cm , out of 6 patients 3 developed pneumothorax ( 50 %), lesions 1-2 cm 5 out of 11 developedpneumothorax(45%), lesions with size of 2-3 cm 5 out of 14 patients developed pneumothorax ( 35%), lesions between 3-4 cm 2 out of 8developed pneumothorax (25%), lesion sized 4-5 cm 1 out of 15 developed pneumothorax (6%), and lesion with more than 5 cm size 1 out of 16 developed pneumothorax ( 6%) . Conclusion: The study shows that the rate of Pneumothorax after CT guided TNAB of Lung Massesincreases as the size of the lesion decreases.
The Professional Medical Journal , 2010,
Abstract: Objective: To know the findings of MDCT in cases of Abdominal Tuberculosis. Patients and Methods: Fifty eight patients withsuspicion of abdominal tuberculosis were scanned and the findings were evaluated. All the patients received IV and oral contrast. The patients were referred from the medical and surgical departments of Shalamar Hospital, Lahore. Toshiba 4 Slice Aquilion was used for scanning. The exclusion criterion was patients on Anti tuberculous drugs and urogenital tuberculosis. Results Following 6 findings were observed in 47 abnormal scans, Out of other 11 scans 9 had other diseases like diverticulitis, Appendicitis and Bowel Lymphoma. 2 were normal. Close medical and Surgical follow up was obtained in all cases. Ascites = 35, Omental / Mesenteric Thickening / Involving = 27, Small Bowel wall thickening = 07, Large bowel wall thickening including Caecal wall thickening = 06, Abdominal Lymphadenopathy= 26, Solid Organ Involvement, Liver=01, Spleen=02. Conclusion: Ascites was the most common finding in Patients with Abdominal Tuberculosis and Involvement of liver being the least common finding amongst the group.
Basic Minimal Dominating Functions of Quadratic Residue Cayley Graphs
B Jeelani, B Maheswari
Momona Ethiopian Journal of Science , 2012,
Abstract: Domination arises in the study of numerous facility location problems where the number of facilities is fixed and one attempt to minimize the number of facilities necessary so that everyone is serviced. This problem reduces to finding a minimum dominating set in the graph corresponding to this network. In this paper we study the minimal dominating functions and basic minimal dominating functions of quadratic residue Cayley graphs and results on these functions have been obtained.
Robotic Assisted Surgery for Endometriosis—“Is the Way Forward?”  [PDF]
Rooma Sinha, Madhumathi Sanjay, Rupa Bana, Fozia Jeelani, Samita Kumari
Open Journal of Obstetrics and Gynecology (OJOG) , 2016, DOI: 10.4236/ojog.2016.62011
Abstract: Endometriosis is a chronic and progressive gynecologic disorder that affects 10% - 50% of women of reproductive age worldwide. Chronic pain and infertility are the most debilitating problems associated with it requiring both medical and surgical treatment. Laparoscopy is considered the gold standard for diagnosis and treatment. However, a 10% rate of conversion to laparotomy has been reported when performed by skilled laparoscopic surgeons and much higher in low volume less skilled surgeons. To improve surgical outcomes, robotic assistance is the logical next step in performing minimally invasive gynecological surgeries, especially in complex endometriosis cases. Enhanced 3D visualization and 10× magnification along with Endowrist instruments with seven degrees of freedom facilitates precise and careful dissection. Firefly technology using ICG green dye can improve detection of small and invisible lesions. Robotics is useful in deep infiltrating disease manifesting as lesions deeper than the superficial tissues of rectovaginal septum, vaginal fornix, pelvic sidewalls, parametrium, bowel or ureter and bladder. Trials show no increase in surgical time, blood loss, or intra- or postoperative complications and similar clinical outcome when robotics is compared with laparoscopy. At present, it is more appropriate to compare it with laparotomy rather than laparoscopy. Robotics can be used to manage recurrence of endometriosis after hysterectomy. Surgeons experienced in conventional laparoscopy can utilize robotic platform for deep infiltrating endometriosis for performing complex surgical dissection and achieving the surgical goals in mind and reduce conversions to open surgery. Robotic assistance can bridge the gap in performance of laparoscopic surgery in advanced endometriosis.
The Professional Medical Journal , 2006,
Abstract: Objective: To evaluate the role of chemical sphincterotomy in the treatment of chronic anal fissure.To compare the effects of xylocaine gelly 5% with GTN 0.2%. Design: Comparative study. Setting: Outdoor andEmergency Department of Surgical unit II and III of Sir Ganga Ram Hospital Lahore Period During the year 2004Methods and materials: 40 patients of chronic anal fissure were included in study and was divided in a randomizedmanner into two groups and the effects, out come and side effects of the Xylocaine 5% and GTN 0.2% were noted,while treating the patients of chronic anal fissure. Results: At 4 weeks only 2 patients of Group A (xylocaine 5%)showed healing evidence while 8 patients of Group B (GTN 0.2%) had shown the healing of the anal fissure. At the endof the 6 weeks a total of 4 patients of Group A showed healing while in case of Group B 14 patients had shown thehealing of the anal fissure. Conclusion: Our study suggests that topical GTN produces successful chemicalsphincterotomy. It not only helps in relieving pain but also promotes healing of fissure. Lignocaine may help in relievingpain but it is not effective in healing of fissure.
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