Emergency chest wall reconstruction in open pneumo-thorax from gunshot chest: A case report.

Chest trauma, penetrating or blunt is common in this era of motor vehicle accidents, violence and terrorism in South Asia. Islamabad is the capital of Pakistan but there is no dedicated chest surgery unit in any government sector hospitals. Gunshot chest, is therefore managed by general surgery team in our tertiary care setting i.e. Federal Government Polyclinic Hospital and Post Graduate Medical Institute, Islamabad. We report a case of gunshot chest with lung contusion and open pneumothorax with a chest wall defect of 10 x 15 cm. in March 2015, this young man presented in emergency department of Federal Government Polyclinic Hospital (FGPC), Post Graduate Medical Institute (PGMI) Islamabad in shock after self-inflicted point blank suicidal gunshot to his left anterolateral chest. After primary resuscitation, the patient was shifted to OR, and a left anterolateral thoracotomy performed. Lung contusion was repaired and chest drain placed. The challenging task of closing the huge chest wall defect was performed by rotating the left latissimus dorsi muscle flap. The patient was shifted to ICU and remained stable postoperatively.

Differential mobilization and metal uptake versus leaching in multimetal soil columns using EDTA and three metal bioaccumulators.

Tannery waste is a major environmental concern that needs proper management. Tannery solid waste (TSW) can be added to the soil as an organic amendment but needs metal removal. Chelant-assisted phytoremediation hastens the process of metal removal but also poses risk of leaching at the same time. This research evaluates Ethylenediaminetetraacetic acid (EDTA)-assisted phytoextraction and associated leaching hazard using metal-tolerant plants. Greenhouse trials were carried out with sunflower, spinach, and marigold using columns of uniform diameter packed with field soil and multimetal contamination of TSW (5% and 10%) with four EDTA doses. The amounts of metal absorbed or leached conformed to amounts in the soil amendment and the dose of EDTA. The mobilization of metals by EDTA was however metal-specific. The metals that were extracted in greater amounts by the plants were leached less compared to Cr and Cu. A significant amount of other metals was leached down and thus less amount was phytoextracted by the plants e.g. Cd and Ni. A high correlation was observed between the amount of metal absorbed by the plant and the amount in leachate except for Cr in all the plants. Antioxidant activities like SOD and catalase were also found to be high in sunflower and spinach.