Institute of Chartered Accountants of Nigeria

About: Institute of Chartered Accountants of Nigeria is a based out in . It is known for research contribution in the topics: Population & Adipose tissue. The organization has 528 authors who have published 579 publications receiving 18688 citations.

Just the tip of the iceberg: difficulties in assessing and managing extreme obesity in routine clinical care.

Abstract: As obesity prevalence increases worldwide, healthcare professionals are often faced with challenging cases associated with massive obesity. A 33-year-old woman (weight 342 kg, body mass index = 100 kg/m²) presented with respiratory failure, limb edema and ascites. Abdominal CT scan became feasible after initial weight loss and showed a large pelvic mass in contact with the left ovary. The surgical removal performed despite a high-risk profile led to the diagnosis of a giant mucinous borderline tumor whose growth was due to delayed care and responsible for multiple severe complications: sepsis, anemia, esophagitis, constipation, anorexia due to mechanical compression, undernutrition, sarcopenia and lower limb edema contributing to a severe disability. After 7 months under specialized care, her weight decreased to 180 kg, complications were treated and disability improved. This case, showing that, despite barriers, a multidisciplinary approach makes quality of care possible even in massively obese patients, is an educational example to reduce stigma.

The care pathway in weight loss surgery

Abstract: Weight loss surgery requires multidisciplinary preparation and support. The risks of a failure in the follow-up and complications are significant. Consequently, caregivers and patients must follow a more clearly defined pathway which involves both and takes account of their expectations.

Supraspinatus pocket: An alternative pacemaker location for patients with no prepectoral access.

Abstract: Case report We report the case of a 55-year-old man with a history of oral cancer treated by surgery and radiotherapy who presented with recurrent syncope due to sinus node dysfunction and complete atrioventricular (AV) block after extensive neck and face reconstructive surgery. Surgeons had previously removed all pectoral muscles for facial reconstruction. During this reconstructive surgery, the patient experienced cardiac asystoles due to carotid sinus hypersensitivity secondary to vagus nerve injury. After the surgery, repeated 15to 30-second episodes of asystole due to sinus dysfunction and complete AV block occurred in the intensive care unit, requiring permanent pacing. However, because of the removal of all pectoral muscles and skin damage secondary to recent surgery and previous radiation therapy, the implantation of the generator in the standard subclavicular position was not possible. We thus decided to implant a singlechamber pacemaker in a right supraspinatus subcutaneous pocket. The patient was positioned in left decubitus to allow access to the right supraspinatus muscle, and a single ventricular lead was introduced through the right internal jugular vein (details in Supplementary Figure 1). We then performed a subcutaneous tunneling of the lead between the jugular access and the supraspinatus pocket and connected the ventricular lead to a KORA SR 100 generator (Sorin Group) (Figure 1). The can was inserted in the subcutaneous pocket and fixed to the muscle. Six months later, the patient did not feel any pain, the scar was clean, and the position of

Surface plasmon coupled chemiluminescence during adsorption of oxygen on magnesium surfaces.

Abstract: The dissociative adsorption of oxygen molecules on magnesium surfaces represents a non-adiabatic reaction exhibiting exoelectron emission, chemicurrent generation, and weak chemiluminescence. Using thin film Mg/Ag/p-Si(111) Schottky diodes with 1 nm Mg on a 10-60 nm thick Ag layer as 2π-photodetectors, the chemiluminescence is internally detected with a much larger efficiency than external methods. The chemically induced photoyield shows a maximum for a Ag film thickness of 45 nm. The enhancement is explained by surface plasmon coupled chemiluminescence, i.e., surface plasmon polaritons are effectively excited in the Ag layer by the oxidation reaction and decay radiatively leading to the observed photocurrent. Model calculations of the maximum absorption in attenuated total reflection geometry support the interpretation. The study demonstrates the extreme sensitivity and the practical usage of internal detection schemes for investigating surface chemiluminescence.