Typhoid intestinal perforation: 24 perforations in one patient.

Intestine perforation is one of the most dreaded and common complication of typhoid fever remarkably so in developing world; it usually leads to diffuse peritonitis, requiring early surgical intervention. Despite various measures such as safe drinking water supply and safe disposal of waste, intestinal perforation from salmonellosis remains the most common emergency surgery performed. The incidence continues to rise, so also the mortality, despite new antibiotics and improvement in surgical technique. More disturbing is that we now see increasing number of ileal perforations and colonic involvement. We hereby present a case report of 35-year-old male with multiple (24) intestinal perforation in the Ileum and Cecum.

Epidemiological and entomological aspects of an outbreak of chikungunya in Lakshadweep Islands, India, during 2007.

Since 2006, the Indian state of Kerala has reported outbreaks of chikungunya (CHIK). During July-August 2007, an unusual increase in the incidence of fever was noticed in Kadmat, Amini and Kavaratti Islands in the Union Territory of Lakshwadeep, a group of Indian islands adjacent to the Kerala coast inthe Arabian Sea.The populations affected as per the primary health centre (PHC) records of three islands, viz. Kadmat,Amini and Kavaratti, was 85%, 1.4% and 0.15% respectively. Entomological surveys revealed very highlarval indices of Aedes albopictus only in the three surveyed islands. Aedes aegypti, the classical vectorof dengue, was not detected. The maximum breeding of Ae. albopictus was found in coconut shells(57%), tyres (9%), metal containers (9%) and plastic containers (8%). The breeding was also detected intree holes and rat-bitten coconuts on top of the trees. The House Index for Ae. albopictus rangedbetween 95.4% in Kavaratti to 79% in Amini. Kadmat island which was the worst affected, recording the maximum Container Index of 90%, compared with 40% in Amini island. The CHIK outbreak seemed to have been caused by importation of the virus from Kerala, because of heavy movement of the islanders to the mainland.

Catalytic effects of carbon sorbents for mercury capture

Activated carbon sorbents have the potential to be an effective means of mercury control in combustion systems. Reactions of activated carbons in flow systems with mercury and gas stream components were investigated to determine the types of chemical interactions that occur on the sorbent surface. The effects of carbon type, particle size, temperature, and reactive gases were studied. Sorption kinetics and capacities for lignite- and bituminous-based carbons were compared with those for catalytic carbons at temperatures of 107 degrees C, 150 degrees C, and 163 degrees C. In the air and baseline gas studies, the catalytic carbons exhibited far better sorption than the lignite- and bituminous-derived carbons. With the catalytic carbons, the greater sorption kinetics and capacity in an air stream or baseline gas composition compared with nitrogen provides a clear demonstration that O(2) is required in the gas stream for higher reactivities and capacities. Thus, a catalytic chemisorption mechanism predominates for the sorption of mercury at these conditions. The reaction kinetics are inversely proportional to the temperature, indicating that a preliminary physisorption step with mercury associating with a surface site is rate-determining. In synthetic flue gas streams containing HCl (50 ppm), the sorption kinetics of the catalytic carbon are slightly inferior to those of lignite-based carbon. Thus, the reaction is dominated by a different interaction, where HCl reacts with mercury on the carbon surface and the oxidation sites on the catalytic carbon apparently have no advantage. Granular and fine-particle carbons gave similar results in flue gas streams.