The development of sustainable IoT E-waste management guideline for households.

The introduction of new technology, such as the Internet of Things (IoT), entails a growth in digital devices, which could ultimately result in a high amount of electronic trash (e-waste) production if they are not appropriately managed. Apart from that, the regulation on possible "IoT E-waste" generation is yet to be regulated, probably due to the new development and implementation of IoT globally. Hence, this paper proposed a Sustainable IoT E-waste Management guideline for households. This guideline could assist government agencies and policymakers in their strategies, planning, development, and implementation of a sustainable household IoT e-waste management initiatives in Malaysia. This study is an exploratory study that adopts a qualitative case study research method. The guideline was developed based on the Integrated Sustainable Waste Management (ISWM) Model. This guideline contributes to Malaysia's sustainability agenda in reducing carbon emissions intensity towards 2030 by 45 percent.

Vimentin positive acantholytic penile squamous cell carcinoma with rhabdoid features.

Acantholytic variant of penile squamous cell carcinoma (SCC) is an exceedingly rare and associated with bad prognosis. Histologically it mimics angiosarcoma due to pseudovascular spaces. Vimentin immunopositivity in such cases represent epithelial to mesenchymal transition manifested by cellular discohesion. We describe a case of vimentin positive acantholytic penile SCC in a 55-year-old patient.

Laparoscopic CBD Exploration.

Laparoscopic CBD exploration (LCBDE) is a cost effective, efficient and minimally invasive method of treating choledocholithiasis. Laparoscopic Surgery for common bile duct stones (CBDS) was first described in 1991, Petelin (Surg Endosc 17:1705-1715, 2003). The surgical technique has evolved since then and several studies have concluded that Laparoscopic common bile duct exploration(LCBDE) procedures are superior to sequential endolaparoscopic treatment in terms of both clinical and economical outcomes, Cuschieri et al. (Surg Endosc 13:952-957, 1999), Rhodes et al. (Lancet 351:159-161, 1998). We started doing LCBDE in 1998.Our experience with LCBDE from 1998 to 2004 has been published, Gupta and Bhartia (Indian J Surg 67:94-99, 2005). Here we present our series from January 2005 to March 2009. In a retrospective study from January 2005 to March 2009, we performed 3060 laparoscopic cholecystectomies, out of which 342 patients underwent intraoperative cholangiogram and 158 patients eventually had CBD exploration. 6 patients were converted to open due to presence of multiple stones and 2 patients were converted because of difficulty in defining Calots triangle; 42 patients underwent transcystic clearance, 106 patients had choledochotomy, 20 patients had primary closure of CBD whereas in 86 patients CBD was closed over T-tube; 2 patients had incomplete stone clearance and underwent postoperative ERCP. Choledochoduodenosotomy was done in 2 patients. Patients were followed regularly at six monthly intervals with a range of six months to three years of follow-up. There were no major complications like bile leak or pancreatitis. 8 patients had port-site minor infection which settled with conservative treatment. There were no cases of retained stones or intraabdominal infection. The mean length of hospital stay was 3 days (range 2-8 days). LCBDE remains an efficient, safe, cost-effective method of treating CBDS. Primary closure of choledochotomy in select patients is a viable & safe option with shorter operative time and length of stay. LCBDE can be performed successfully with minimal morbidity & mortality.

Laparoscopic repair of a right para duodenal hernia.

Para duodenal hernia is among the uncommon and rare causes of intestinal obstruction, but it is the most common type of internal hernia in abdomen and accounts for more than half of cases that do occur. Here, we are reporting a case of right Para duodenal hernia, reduced and repaired laparoscopically. This thirteen year old girl presented to us with features of small bowel obstruction of two days duration. Plain abdominal X-ray showed multiple fluid levels confined to right side of abdomen. A diagnostic laparoscopy was done under General Anaesthesia. Right Para duodenal hernia was found with small bowel confined to the right side between the ascending colon and hepatic flexure of colon. Laparoscopic reduction of contents of the hernia was done starting from the Ileocaecal junction. Hernial opening was closed laparoscopically with nonabsorbable suture. Patient is quite well till date and has had no recurrence of symptoms.