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Search Results: 1 - 2 of 2 matches for " Abdelrahmen Abdelbar "
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Isolated Pulmonary Infective Endocarditis with Septic Pulmonary Embolism Complicating a Right Ventricular Outflow Tract Obstruction: Scarce and Devious Presentation
Abdelrahmen Abdelbar,Raed Azzam,Kok Hooi Yap,Ahmed Abousteit
Case Reports in Surgery , 2013, DOI: 10.1155/2013/746589
Abstract: We present a case of a fifty-three-year-old male who presented with severe sepsis. He had been treated as a pneumonia patient for five months before the admission. Investigations revealed isolated pulmonary valve endocarditis and septic pulmonary embolism in addition to undiagnosed right ventricular outflow tract (RVOT) obstruction. The patient underwent surgery for the relief of RVOT obstruction by substantial muscle resection of the RVOT, pulmonary artery embolectomy, pulmonary valve replacement, and reconstruction of RVOT and main pulmonary artery with two separate bovine pericardial patches. He was discharged from our hospital after 6 weeks of intravenous antibiotics. He recovered well on follow-up 16 weeks after discharge. A high-suspicion index is needed to diagnose right-side heart endocarditis. Blood cultures and transesophageal echocardiogram are the key diagnostic tools. 1. Introduction Infective endocarditis involving the right side of the heart is an uncommon condition, which often involves the tricuspid valve [1]. It is even rarer to see isolated pulmonary valve endocarditis. This has led to the absence of definite guidelines to aid the management. In this particular case, pulmonary valve endocarditis was predisposed by undiagnosed right ventricular outflow tract (RVOT) obstruction. This had led to delayed diagnosis and, therefore, treatment. 2. Case Presentation A fifty-three-year-old man was referred to the cardiothoracic surgical team for consideration of surgery. Five months earlier he was diagnosed and treated by his general practitioner for what was thought to be pneumonia. He did not completely recover after a course of antibiotics. The patient’s symptoms deteriorated and were resistant to antibiotics. He was therefore admitted to a local hospital. Early during the hospital stay, ongoing sepsis led to vasculitic rash in both lower limbs. He was transferred to a tertiary hospital for further workup and treatment plan. Past history included a spontaneously healed ventricular septal defect (VSD) during childhood but no further follow-up was done. He remained septic despite being on intravenous (IV) antibiotics. Successive blood cultures were negative which were thought to be the results of response to antimicrobial treatment. Antibiotics were changed according to the microbiology team advice, but the patient deteriorated after a brief response. Transesophageal echocardiogram (TOE) confirmed the diagnosis of pulmonary valve endocarditis with RVOT obstruction. The decision was made to operate on the patient to remove the source of sepsis.
Alpha-Beta Pruning and Alth?fer’s Pathology-Free Negamax Algorithm
Ashraf M. Abdelbar
Algorithms , 2012, DOI: 10.3390/a5040521
Abstract: The minimax algorithm, also called the negamax algorithm, remains today the most widely used search technique for two-player perfect-information games. However, minimaxing has been shown to be susceptible to game tree pathology, a paradoxical situation in which the accuracy of the search can decrease as the height of the tree increases. Alth?fer’s alternative minimax algorithm has been proven to be invulnerable to pathology. However, it has not been clear whether alpha-beta pruning, a crucial component of practical game programs, could be applied in the context of Alh?fer’s algorithm. In this brief paper, we show how alpha-beta pruning can be adapted to Alth?fer’s algorithm.
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