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River bank protection is vital in hydraulic river engineering to preserve natural rivers, lands, and critical constructions such as bridges. Spur dikes are erosion-protective structures that protrude outward from the river bank in different orientations to deflect the flow away from the riverbank. The present experimental study provides insight into the temporal variation in bed morphology and scours around rectangular-shaped spur dikes with different orientations, such as 60º, 90º, and 120º. Also, maximum scour depth (MSD) is developed compared to the condition when downward seepage is applied. The experiments examined the suitability of various spur dike orientation configurations and the scour development over time, specifically at intervals of 2, 12, and 24 hours, and compared with 24 hours (Seepage). Results showed that the orientation angle of 90º generated the highest scour depth, while the least scour depth was found with an orientation angle of 120º. The downward seepage intensifies the motion of sediment particles and leads to an escalated particle detachment, resulting in deeper scour depressions. The development of scour depth is initiated from the spur dike tip and reaches its maximum there. The deposition of sand particles shifted downstream, and a dune-like structure formed near the second spur dike.

Helicobacter pylori (H. pylori) infection is a widespread global health issue with a varying prevalence influenced by geography, socioeconomic status, and demographics. In the U.S., the prevalence is lower, though certain groups, such as older adults and immigrants from high-prevalence regions, show higher rates. The decrease in infection rates in developed countries is due to improved sanitation, antibiotics, and healthcare, whereas developing countries continue to experience high rates due to poor living conditions. H. pylori infection can be asymptomatic or cause symptoms like dyspepsia, abdominal pain, bloating, nausea, and loss of appetite. Pathophysiologically, H. pylori contribute to conditions such as gastritis, peptic ulcers, and gastric cancer through mechanisms including urease production and the release of virulence factors, leading to chronic inflammation and an increased cancer risk. Diagnostic methods for H. pylori have progressed significantly. Non-invasive techniques, such as serological assays, stool antigen tests, and urea breath tests, are practical and sensitive. Invasive methods, including endoscopic biopsy and molecular diagnostics, are more definitive but resource intensive. Recent advancements in diagnostic technology, including matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), biosensor technology, and next-generation sequencing (NGS), promise improved speed, accuracy, and accessibility. These innovations are expected to enhance the detection and management of H. pylori, potentially reducing the global disease burden. This review aims to discuss these diagnostic modalities with a focus on further advances under investigation. [ABSTRACT FROM AUTHOR]

Enoxaparin, a form of low-molecular-weight heparin, can cause a rare, underreported, and often reversible form of hepatocellular injury. This report describes a case of enoxaparin-induced hepatotoxicity in a 61-year-old male diagnosed with pulmonary embolism. Elevations of liver enzymes were noted within 1 week of starting the drug, followed by a dramatic improvement upon its discontinuation, with subsequent normalization in the following days.

Introduction. The occurrence of acute respiratory failure as a result of esophageal bezoars is a rare phenomenon. We present a patient who failed initial endoscopic intervention. Successful resolution was achieved through a novel approach involving a combination of Creon and Coca‐Cola. Subsequently, the patient was diagnosed with achalasia, a condition that potentially contributed to the formation of the esophageal bezoar. Case Description. An 82‐year‐old man presented with respiratory distress, necessitating endotracheal intubation for airway protection. A chest computed tomogram (CT) showed pneumonia and a distended esophagus compressing the trachea, raising the possibility of an esophageal food bolus. Endoscopy revealed a severely dilated esophagus containing a significant amount of food and a phytobezoar in the lower esophagus. He failed various endoscopic techniques to remove the obstruction. Given the patient's poor surgical candidacy, he was started in a thrice‐daily regimen of Creon dissolved in 165 mL of Coca‐Cola, over a 4‐day period. A subsequent endoscopy revealed no discernible evidence of food or bezoar. The patient was weaned from mechanical ventilation. A high‐resolution esophageal manometry identified type 1 achalasia. Conclusion. Esophageal food impaction leading to respiratory failure is rare. Endoscopy remains the mainstay approach. Surgical interventions carry significant risks. This case emphasizes the potential for noninvasive management in patients with esophageal bezoars and also underscores the significance of contemplating esophageal pathologies when addressing cases of respiratory failure. The use of Coca‐Cola and Creon emerges as a safe, effective, and cost‐efficient treatment, providing a feasible option when endoscopy proves unsuccessful before considering more aggressive interventions. [ABSTRACT FROM AUTHOR]