Herniation of the Anterior Wall of the Stomach into a Congenital Postdiaphragmatic Space: An Unusual Complication following Laparoscopic Nissen Fundoplication

Postoperative herniation of the stomach into potential spaces is a rare but serious complication of Nissen fundoplication. We report a 55-year-old female who presented with persistent vomiting shortly following laparoscopic Nissen fundoplication. At laparotomy, the anterior wall of the stomach was noted to be herniating into a congenital space behind the diaphragm. Anterior gastropexy was performed following the reduction of the herniating gastric segment. A high index of suspicion followed by aggressive and timely intervention is necessary to diagnose and manage postoperative gastric herniation and reduce the subsequent morbidity and mortality

The effect of organisational absorptive capacity on business intelligence systems efficiency and organisational efficiency

Purpose: Business intelligence (BI) systems (i.e. technology and procedures that transform raw data into useful information for managers to enable them to make better and faster decisions) have enormous potential to improve organisational efficiency. However, given the high expenditure involved in the deployment of these systems, the factors that will enable their successful integration should be thoroughly considered and assessed before these systems are adopted. Absorptive capacity (ACAP) is the ability of organisations to gather, absorb and strategically influence new external information, and as such, there is a strong theoretical connection between ACAP and BI systems. This research aims to empirically investigate the relationship between the dimensions underpinning ACAP (i.e. acquisition, assimilation, transformation and exploitation) and whether and how they affect the efficiency of BI systems, which, in turn, can enhance organisational efficiency. Design/methodology/approach: This study formulates five hypotheses addressing the effect of ACAP dimensions on BI systems efficiency and the effect of BI systems efficiency on organisational efficiency. It synthesises previous qualitative work and current research to derive sets of measures for each of the key constructs of the study. It follows a quantitative methodology, which involves the collection of survey data from senior managers in the telecommunications industry and the analysis of the data using partial least squares – structural equation modelling (PLS-SEM). Findings: The results of the analysis confirmed the validity of the constructs and proposed measures and supported all five hypotheses suggesting a strong positive relationship between the ACAP dimensions, acquisition, assimilation, transformation and exploitation and the efficiency of BI systems and a strong effect of BI systems efficiency on organisational efficiency. Practical implications: The study offers a comprehensive model of ACAP and BI systems efficiency. The set of measures that underpin these constructs could help researchers understand how ACAP dimensions are practically implemented and could contribute to their efforts to develop ACAP measurement instruments. At the same time, the model can help managers assess the readiness of their firms to adopt BI systems and identify which areas should be further developed, before committing to the substantial financial investment associated with BI systems. It also provides a set of practical solutions that could be implemented to enable a more robust ACAP and support a better integration of BI systems. Originality/value: Following an empirical approach, this study refines one’s theoretical and practical understanding of ACAP as an organisational dynamic capability and its dimensions; it provides an account on how each dimension affects different aspects of BI systems efficiency, which, in turn, may contribute to the improvement of organisational efficiency. Moreover, the study reframes ACAP measures as a set of requirements that can be practically assessed and followed before attempting to purchase BI systems

Medicinal plants used by women in Mecca: urban, Muslim and gendered knowledge

Background: This study explores medicinal plant knowledge and use among Muslim women in the city of Mecca, Saudi Arabia. Ethnobotanical research in the region has focused on rural populations and male herbal healers in cities, and based on these few studies, it is suggested that medicinal plant knowledge may be eroding. Here, we document lay, female knowledge of medicinal plants in an urban centre, interpreting findings in the light of the growing field of urban ethnobotany and gendered knowledge and in an Islamic context. Methods: Free-listing, structured and semi-structured interviews were used to document the extent of medicinal plant knowledge among 32 Meccan women. Vernacular names, modes of preparation and application, intended therapeutic use and emic toxicological remarks were recorded. Women were asked where they learnt about medicinal plants and if and when they preferred using medicinal plants over biomedical resources. Prior informed consent was always obtained. We compared the list of medicinal plants used by these Meccan women with medicinal plants previously documented in published literature. Results: One hundred eighteen vernacular names were collected, corresponding to approximately 110 plants, including one algae. Of these, 95 were identified at the species level and 39 (41%) had not been previously cited in Saudi Arabian medicinal plant literature. Almost one half of the plants cited are food and flavouring plants. Meccan women interviewed learn about medicinal plants from their social network, mass media and written sources, and combine biomedical and medicinal plant health care. However, younger women more often prefer biomedical resources and learn from written sources and mass media. Conclusions: The fairly small number of interviews conducted in this study was sufficient to reveal the singular body of medicinal plant knowledge held by women in Mecca and applied to treat common ailments. Plant availability in local shops and markets and inclusion in religious texts seem to shape the botanical diversity used by the Meccan women interviewed, and the use of foods and spices medicinally could be a global feature of urban ethnobotany. Ethnobotanical knowledge among women in Islamic communities may be changing due to access to mass media and biomedicine. We recognise the lack of documentation of the diversity of medicinal plant knowledge in the Arabian Peninsula and an opportunity to better understand gendered urban and rural knowledge

The Effects of Pitfall Trap Spacing on Ant Richness (Hymenoptera: Formicidae), Abundance, and Composition in Dinder National Park, Sudan

Ants play an important role in Sudanese biodiversity and environmental impact assessments, Although baiting is easy and cheap to implement, several considerations, such as the spacing among bait, can affect the estimation of the abundance and richness of ants species. In this study, we evaluated the effects of bait spacing on abundance and the number of ant species. We also demonstrate which distance between baits showed the best relationship between costs and the number of ant species sampled. We sampled 30 transects of 100 m with bait spacing ranging (2.5; 3.3; 5; 6.7; 10 and 20 m), spread over 1 km² into three different type of ecosystems (Wooded grass land, Riverine ecosystem and Maya ecosystem), at DNP located in Sudan. The bait spacing did not affect the ant diversity estimative. Regardless bait spacing, the number of species collected every five baits was around 8, and the average abundance was approximately 50 individuals. However, the number of species per bait was higher in transects with a larger gap between baits. Transects with bait spans of 20 and 10 m captured 50% more species per bait than transects with baits 2.5 and 3.4 m apart. Our study suggest that the most efficient sampling design using only baits in the park would be, to place 450 baits every 10 m and 20 m

Computer vision syndrome among Al-Rayan Medical Colleges students, Madinah, Saudi Arabia

Background: Digital devices now become a part of university student’s life, and with prolonged use, they may experience some ocular problems like dryness, headache, eye strain, and pain. These symptoms and others constitute computer vision syndrome (CVS). Our study aimed to assess CVS among Al-Rayan medical college students and to evaluate students’ behaviors related to preventing CVS. Methods: A cross-sectional, questionnaire-based study was performed among the students of Alrayan Medical College from the period from November to December 2022, with a sample size of 270 cases. Data were collected using (CVS-Q) questionnaire. Results: Near half of the participants (53.7%) were suffering from CVS. The most reported symptoms included headache (43.3%), tearing (42.9%), burning (39.3%), and blurred vision (35.1%). The most significant measures applied to minimize the impact of electronic devices were putting the digital device at enough distance (p value=0.001) and adjusting the screen brightness of the digital device (p value=0.004). Conclusions: This study disclosed that CVS is a common problem among medical students. The manifestation of CVS was affected by the frequency and duration of electronic device use

Variation in the rates of biomass removal by soil macro-fauna in different land uses at Rashad, South Kordofan, Sudan

One of the main implications of reducing biodiversity is the loss or decline of ecosystem function. We have previously seen in the Rashad location that agricultural practices have a lower effect on ant biodiversity. However, how they affect the environmental services, they provide is unclear. The main objective of this study was to evaluate whether the conversion of native areas into agricultural systems affects the removal of biomass carried out by ants, an important ecosystem function linked to decomposition and predation. We sampled three transects from (the Rashad district). Each sampling plot consisted of a grid of 12 pitfall traps filled with sardine baits (simulating animal organisms) and bananas (as attractive vegetable resources). In addition, grass seeds (Sorghum bicolor) were applied in both natural (Campo, Kubos, and forest) and agricultural settings (soy monoculture, pastures, and organic agriculture). The Results showed that ant’s removal was highest in sardine with an average of 87.3g (σ ± 23.8), followed by banana (average of 70.5g, σ ± 31.5) and lowest in the seed (mean of 7.8g, σ ± 7.3) (highest p = 0.017). Only the soy monoculture regions showed the lowest levels of sardine removed, indicating an effect associated with the kind of land use. Because little biomass is eliminated in both natural and agricultural settings, no effect of the seeds bait has been observed. As for the banana bait, the data suggested a redundancy effect with another group of macro-fauna). Our results suggest that there is a redundancy effect with another group of macrofauna. However, macrofauna biomass (excluding ants) does not explain this biomass removal. In addition, it detected no impact of ant species composition on removed biomass. The reduction of sardine and banana biomass was correlated with ant richness, indicating that the effects on ecosystem function depend on the particularities of each evaluated role (such as resource type), the type of land use, and the ant richness in the study area

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics

Plasmodium vivax cerebral malaria in an adult patient in Sudan

BackgroundPlasmodium vivax infection is rising in sub-Saharan Africa, where Plasmodium falciparum is responsible for more than 90% of malaria cases. While P. vivax is identified as a major cause of severe and cerebral malaria in South east Asia, the Pacific and South America, most of the severe and cerebral cases in Africa were attributed to P. falciparum. Cases of severe malaria due to P. vivax are emerging in Africa. A few severe P. vivax cases were reported in Eastern Sudan and they were underestimated due to the lack of accurate diagnosis, low parasitaemia and seldom use of rapid diagnostic tests (RDTs).Case presentationA 60-year-old Sudanese male presented to the Al Kuwaiti hospital in the Sudan capital Khartoum. On admission, the patient was complaining of fever (measured temperature was 38 °C), sweating, chills, vomiting and confusion in the past 2 days prior to his admission. He rapidly deteriorated into a coma state within 48 h of the admission, with significant neck stiffness. He was admitted to the intensive care unit and was suspected of meningitis. Lumbar puncture was not performed since the patient was suffering from spinal cord disc. Brain CT scan was unremarkable. Several biochemical, haematological tests, and blood film for malaria were performed. The results of the laboratory tests were within the normal range except of mild elevation of the total white blood cell count and a significant decrease in the platelets count. Malaria parasites were seen in the blood film with high parasitaemia (quantified as 3 +++). The patient was diagnosed as P. vivax cerebral malaria based on the positive blood film and the amplification of P. vivax specific 499 bp amplicon using Plasmodium multi-species multiplex Polymerase Chain Reaction (PCR). The patient was treated with quinine 10 mg/kg body weight for 10 days followed by primaquine 15 mg/days PO for 2 weeks. The symptoms subsided within 48 h and the patients was cured and released from the hospital.ConclusionsPlasmodium vivax is an emerging cause of cerebral malaria in adults in Sudan and should be considered in the differential diagnosis of cerebral malaria for proper management of patients