BACKGROUND: A vitello-intestinal duct connects the developing mid-gut to the yolk sac and regresses by the ninth week of gestation. In approximately 2% of cases, this duct remains patent. While usually detected in infancy or early childhood, it can occasionally present in adults, causing small bowel obstruction (SBO), which can result in significant morbidity and mortality. CASE PRESENTATION: A 28-year-old male presented to the Emergency Department with an 8-day history of severe abdominal pain, vomiting, and abdominal distention. Physical examination revealed a distended abdomen with generalized tenderness. Ultrasonography and contrast-enhanced computed tomography (CECT) of the abdomen indicated multiple adhesions and marked circumferential wall thickening involving bowel loops, suggesting SBO. Emergency exploratory laparotomy revealed a 9 cm tubular structure enclosing the ileum, diagnosed as a patent vitello-intestinal duct upon histopathological examination. The patient recovered uneventfully post-surgery. CONCLUSIONS: Acute SBO is a common surgical emergency that necessitates prompt diagnosis and treatment to prevent severe complications such as intestinal gangrene and peritonitis. While most cases of SBO are due to adhesions, tumors, or infections, a patent vitello-intestinal duct, although rare, should be considered, especially in cases without a clear etiology. Literature reports indicate that a patent vitello-intestinal duct can present as an umbilical sinus, polyp, or cause SBO due to fibrotic bands or adhesions, often requiring surgical intervention. Acute SBO can have severe outcomes if not promptly treated. Surgeons should include a patent vitello-intestinal duct in the differential diagnosis during exploratory laparotomy to enhance surgical care and improve patient outcomes.
BACKGROUND: The emergence of antibiotic-resistant bacteria has created a significant burden on humanity in terms of combating illnesses that were usually responding to classical antibiotics. Therefore, there is a growing focus and effort trying to investigate and develop new therapeutic agents with higher efficacy. Metallic nanoparticles are one of the promising choices. METHODS: We tried to investigate the silver nanoparticles (AgNPs) utilizing green synthesis techniques and an alcoholic Barberry (Berberis vulgaris L.) fruit extract. After synthesizing them, we tested their antibacterial properties on antibiotic-resistant Pseudomonas aeruginosa biofilms. It is a cross-sectional study on 6 isolates antibiotic resistant P. aeruginosa. Moreover, their optical properties, structure, and morphology have been studied using a variety of advanced methods, including energy-dispersive X-ray (EDX) analysis, scanning electron microscopy (SEM), and atomic force microscopy (AFM). The antibiotics investigated are cefepime, amikacin, aztreonam, piperacillin, levofloxacin, gentamycin, ciprofloxacin, and tobramycin. RESULTS: Barberry extract-derived nanoparticles have shown action against clinical isolates of antibiotic-resistant P. aeruginosa. CONCLUSIONS: Silver nanoparticles are an effective and promising choice that could be implemented in the treatment of antibiotic-resistant bacteria. Further studies are essential to prepare these nanoparticles for commercial use.
BACKGROUND: Sleep plays an important role in memory consolidation, habits, cognitive, and skills especially in medical students that learning and memory is important that they deal with health of the human beings and treated ill patients, improve problems solving, creative thinking, and all these will achieve via enough and good quality of sleep. To assess the effect of sleep duration, quality, and factors affecting sleep on memory consolidation and learning among medical students. METHODS: A cross-sectional study design was used to describe the impact of sleep on memory consolidation among 323 medical students in Al-Kindy College of Medicine-University of Baghdad, Baghdad, Iraq, during the period from November 1, 2023, to November 6, 2023 using Online Google Form Questionnaire distributed via social media to them after explaining to them the study. RESULTS: The study included 323 medical students (74.3%) of them were more than 20 years of age, 69.7% of them were females and the rest were males. About 62.5% of them went to bed at 1.00 a.m. and 61.3% of them got up at 6.00 a.m. Most of them (83.9%) slept less than 7 hours. A weekly nonlinear regression between total sleep hours and the time needed to fall asleep at bedtime showed an R2 of 0.0026, meaning that only 0.26% of the variation in sleep hours can be explained by changes in the time it takes to fall asleep. CONCLUSIONS: This study showed that sleep quality and deprivation affect the performance of the students regarding age and gender.
BACKGROUND: This case report describes the clinical management of a male patient with both triple-negative breast cancer (TNBC) and a suspicious lung mass, a rare and complex oncological scenario. TNBC, accounting for less than 1% of all male breast cancers, is aggressive and does not respond to hormonal therapies, requiring chemotherapy. CASE PRESENTATION: The patient, initially diagnosed with TNBC, later presented with a lung lesion, raising concerns about whether it was a metastasis from the breast cancer or a primary lung carcinoma. The diagnostic process involved imaging studies, PET scans and biopsies, which revealed elevated PD-L1 expression, suggesting responsiveness to immunotherapy. CONCLUSIONS: The treatment combined neoadjuvant chemotherapy (carboplatin and gemcitabine) and pembrolizumab, an anti-PD-1 immunotherapy. After three cycles, the breast tumor responded well, achieving complete pathological response, but the lung lesion showed only partial reduction. Surgical interventions, including mastectomy and lung lobectomy, were performed, and both specimens revealed no residual tumors. This case emphasizes the importance of a multidisciplinary approach, the potential for immunotherapy in treating TNBC, and the challenges of managing multiple primary cancers. The patient remains under close follow-up.
BACKGROUND: The aims of this study were to determine the most appropriate mini-implant placement location based on cortical bone thickness and investigating any potential differences concerning how thick the male and female bones were at the same sites. METHODS: A total of 116 cone beam computed tomography (CBCT) scans were chosen built upon specific criteria of including as well as excluding. The sample was divided into two groups: 53 males and 63 females. All CBCT scans were taken from patients aged 18 to 30 who had fully erupted second premolars as well as the first molar and the second molar. The cortical bone thickness was measured at two sites and three vertical levels from the alveolar crest in both maxillary quadrants by using the Myray 3D Imaging Suite with an Implant Library. RESULTS: The results indicated that the cortical bone thickness was higher at 6 mm and lesser at 2 mm in both regions. The cortical bone thickness for male samples was higher than those for females at most sites, except for one site between first and second molar at 4 mm level to the right side where female was higher. CONCLUSIONS: The results indicated that at the level of 6 mm from the alveolar bone crest, the highest thickness of bones was observed, followed by the 4 mm level to a lesser extent. The males exhibited greater cortical bone thickness compared to females.
BACKGROUND: This study aimed to investigate and profile miRNAs expression using next-generation transcriptome sequencing, and its influence on palatal soft tissue healing following rhEGF administration, highlighting the potential involvement of novel miRNAs in soft tissue healing. METHODS: Twelve 10-week-old C57BL6 mice were divided into two groups: the test and control groups. The test group received 5 mu g of rhEGF injected into the palatal tissues, repeated every 7 days for a total of four doses. Palatal soft tissues were harvested for miRNA analysis following total RNA extraction. Novel miRNA prediction was performed using mirDeep2 with trained mouse-miRNA sets. RESULTS: A total of 220 miRNAs were identified in the 24 samples. The top 10 predominantly expressed known miRNAs were assessed, and mmu-miR-148a-5p was found to be the most abundantly expressed among the novel miRNAs amongst in all samples both at 30 days and 60 days. The significantly upregulated and downregulated miRNAs and their putative targets were predicted and subjected to GO annotation for functional analysis. CONCLUSIONS: This study revealed miRNA expression profiles between the test and control groups, with the majority of miRNAs being upregulated in the rhEGF group. Notably, novel miRNAs, including miR-148a-5p and miR-26a-5p, which have been previously associated with cancer cell signaling pathways, were markedly overexpressed in the test group. These findings suggest that these novel miRNAs might play a pivotal role in promoting soft tissue healing, and thus, miRNAs might be crucial soft tissue healing modulators, potentially enhanced by rhEGF.
BACKGROUND: Coronavirus a large family of viruses named (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) and was discovered in 2019 in Wuhan, China. Azithromycin is an antibiotic belonging to azalides group. It shows direct and indirect anti-viral effects at bronchial epithelial cells in addition to its effect against a wide range of bacteria so it can be used in treatment of patients with COVID-19. The primary objective in this study was to evaluate azithromycin effect and conservatives on COVID-19 symptoms. METHODS: Cross-sectional study. Eighty patients selected from different age groups in Al-Kindy teaching hospital and number of patients that were not admitted to hospital. The inclusion criteria were patients infected with COVID-19. Questionnaires were filled with by the researchers while interviewing the patients. Analysis of data was carried by using SPSS version 21.0 (SPSS Inc., Chicago, IL, USA). RESULTS: Patients who took azithromycin as a treatment showed the following symptoms (78% fever, 84.7% cough, 81.4% headache, 62.7% shortness of breath, 37.3% nausea and vomiting, 44.1% sneeze, 30% insomnia, 44% anxiety, 28% depression, and 46% irritability). Patients who took supplements and herbal as a treatment the symptoms were (65% fever, 70% cough, 75% headache, 60% shortness of breath, 40% nausea and vomiting, 35% sneeze, 20% insomnia, 30% anxiety, 20% depression, and 46% irritability). CONCLUSIONS: Azithromycin and conservative treatments both help to improve the symptoms of COVID-19 infection, but conservative treatments showed more positive results compared to azithromycin and more appropriate treatments and drugs are required for further improvement.
BACKGROUND: Teleconsultation has become a routine component of clinical practice. Given its widespread use, questions have been raised regarding the reliability of teleconsultation. The reliability of teleconsultation in fracture cases has been the subject of numerous studies. The aim of this study was to evaluate the accuracy of fracture diagnoses made by teleconsultation in patients referred from the emergency department of a secondary state hospital with a preliminary diagnosis of fracture. METHODS: A retrospective study was conducted on radiologic images of 1150 patients who were diagnostically classified by two experienced orthopedic surgeons. Inter-and intraobserver analyses were performed and diagnostic decisions were based on two forms of evaluation: direct analysis of images from the picture archiving and communication system (PACS) and analysis of images taken from the PACS computer screen and sent via WhatsApp. RESULTS: For diagnoses, interclass correlation coefficient (ICC) values for interobserver WhatsApp (0.65, 95% CI: 0.62-0.67), interobserver PACS (0.77, 95% CI: 0.73-0.81), and interobserver WhatsApp vs. PACS (0.85, 95% CI: 0.84-0.86) were strong for interobserver WhatsApp and interobserver PACS and excellent for WhatsApp vs. PACS. CONCLUSIONS: The reliability of teleconsultation in the evaluation of radiologic trauma patients with a preliminary diagnosis of fracture has been found to be high. However, it is clear that these consultations cannot replace a comprehensive evaluation of the patient as a whole. We suggest that teleconsultation, due to its strong diagnostic ability and rapidity, can be used as a consultation technique in trauma patients in whom direct communication with an orthopedic and traumatology specialist is difficult.
BACKGROUND: Precocious puberty is characterized by an early onset of puberty and appearance of secondary sexual characteristics in girls aged less than eight years and boys aged less than nine years. The aim of the study was to find out the effect of clinical determinants on psychosocial/behavioral problems among patients with precocious puberty. METHODS: A cross-sectional study was conducted through 4 months period in 2023. Data of 116 children were collected from patients aged 6-12 years with precocious puberty, by using the child behavior check list (CBCL). RESULTS: The mean age of patients was 8.79 +/- 1.3 years, 93.1% of them were females, 23% of patients had increased weight. More than half of the patients had Tanner stage 3. The highest means of the CBCL subscale were 65.13 +/- 5.19 for other problems. The highest means of the scales was for externalizing problems 64.45 +/- 4.50. According to CBCL scales, 42.2% of patients with internalizing problems had clinical symptoms, 45.7% of patients with externalizing problems had clinical symptoms and 35.3% of patients' total problems had clinical symptoms. CONCLUSIONS: Increasing Body Mass Index (BMI) is associated with increased emotional, behavioral problems. While, increasing duration of treatment may decrease psychosocial, behavioral problems in children.
BACKGROUND: There are some reports of malignancies masquerading as abscesses. Carcinoma, lymphoma, and sarcoma can mimic chronic inflammatory conditions. The tumor necrosis may mimic pus. Percutaneous aspiration may yield diagnostic material in case of abscess. But adequate tissue sampling is required for malignancies. The imaging diagnosis of abscess can delay the treatment for malignancy. We are reporting a case of sarcoma that masqueraded as a tuberculous abscess. CASE PRESENTATION: A 64-year-old male patient presented with pain in right upper back and arm for 6 months and a swelling for 2 weeks. There was a fluctuant and tender swelling in right paraspinal region of size 4 & times;3 cm. Contrast enhanced MRI scan showed altered intensity of D3 vertebral body and disc and enhancing epidural collection compressing the spinal cord. There was a thick-walled collection involving the paraspinal muscle extending along the rib into the pleura. Ultrasound-guided aspiration was done as per the request of the patient. The sample was sent for Cartridge Based Nucleic AcidAmplification Test. But the sample was inadequate. He was started on empirical antituberculosis treatment. He came after 11 days with tachypnea and paraparesis. Blood counts showed leukemoid reaction. Laminectomy and removal of epidural and chest wall collections were done. The histopathology and immunohistochemistry reports came as high-grade sarcoma. He was referred to oncology for treatment. CONCLUSIONS: This report emphasizes the need for adequate biopsy of necrotic lesions presenting as chronic inflammations. Some may be malignancies.
BACKGROUND: Thalassemia, an inherited hemolytic disorder characterized by defective hemoglobin synthesis, poses a significant public health challenge globally, with a particularly high prevalence in the Middle East. Despite the availability of preventive measures, effective community awareness and acceptance remain critical for reducing the incidence of thalassemia major. The aim of this study was to evaluate the level of community awareness regarding thalassemia prevention in Iraq. Specifically, it seeks to assess general knowledge about thalassemia, understanding of its genetic transmission, awareness of preventive strategies, identification of prevalent misconceptions, and the influence of demographic factors on awareness levels. METHODS: A cross-sectional study was conducted in Iraq using an online questionnaire distributed nationwide from March 2024 to January 2025. The population consisted of 723 Iraqi individuals aged 18 and above from various governorates. Convenience sampling was used for broad participation. Data was collected using Google Forms and analyzed using SPSS version 23. Descriptive statistics summarized demographic characteristics and awareness levels, while Pearson chi 2 tests examined associations between demographic variables and awareness domains. RESULTS: The study revealed a high general awareness of thalassemia, with 81.7% of participants having heard of the disease. A majority (66.3%) correctly identified thalassemia as a hereditary disorder, and 63.5% understood that two carriers can have a child with thalassemia major. However, significant knowledge gaps were identified, including misconceptions about the transmission of thalassemia through food (7.6%) and its classification as an infectious disease (7.6%). Additionally, only 36.1% were aware that thalassemia can be diagnosed at birth, and 34.4% recognized thalassemia as preventable. Demographic analysis indicated that higher education levels and urban residency were associated with greater awareness and understanding of thalassemia prevention. Notably, misconceptions and lack of knowledge were prevalent among lower socioeconomic groups and those residing in rural areas. CONCLUSIONS: While overall awareness of thalassemia is relatively high in Iraq, significant gaps and misconceptions persist, particularly regarding genetic transmission, preventability, and diagnostic methods. These findings highlight the need for comprehensive, targeted educational programs that address specific knowledge deficits and cultural barriers. Enhancing community awareness through genetic counseling, premarital screening initiatives, and public health campaigns is essential for effective thalassemia prevention and reducing the socioeconomic burden of the disease in Iraq. Future interventions should prioritize accessibility and cultural sensitivity to ensure broad-based participation and acceptance across diverse demographic segments.
BACKGROUND: Lobular carcinoma in situ (LCIS) increases breast cancer risk, but its clinical significance when diagnosed with invasive breast cancer remains unclear. This study evaluates the prevalence of LCIS in patients undergoing breast-conserving surgery (BCS) and its association with ipsilateral breast tumor recurrence (IBTR) and contralateral breast cancer (CBC) risk. METHODS: This retrospective study included women treated for stage I-III breast cancer between 2010 and 2024. Patients were divided into two groups: group 1 had invasive breast cancer only, and group 2 had concurrent LCIS and invasive cancer. Demographics, tumor characteristics, hormone receptor status, treatments, and follow-up outcomes were analyzed statistically. RESULTS: A total of 1138 patients underwent BCS, with 1103 in group 1 and 35 in group 2. The mean follow-up was 7.6 years for group 1 and 7.2 years for group 2 patients. No significant differences were found in age, family history, tumor features, or adjuvant treatments between the groups. LCIS presence did not significantly affect IBTR rates (LCIS+ 5.71% vs. LCIS-2.17%, P=0.8401). However, CBC incidence was significantly higher in LCIS-positive patients (14.29% vs. 1.36%, P=0.0214). CONCLUSIONS: LCIS does not significantly impact IBTR rates and should not influence BCS decisions. However, due to increased CBC risk, close clinical and radiological surveillance is necessary for patients with LCIS. (Cite this article as: Yilmaz M, Kuyucuo & gbreve;lu U, & Ouml;zcan C, Da & gbreve; A, & Ccedil;olak T. Clinical impact of lobular carcinoma in situ in patients undergoing breast-conserving surgery: risk of contralateral breast cancer without increased ipsilateral recurrence. Chirurgia 2026;39:172-6. DOI: 10.23736/S0394-9508.25.05973-X)
BACKGROUND: Investigate the degree of changes in body image impairment in burn patients and identify its influencing factors. Analyze the relationship between body image impairment and Quality of Life (QoL) in burn patients. METHODS: This study used convenience sampling method to select burn inpatients who visited the The 904(th) Hospital of the Joint Logistics Support Force of the PLA from January 2022 to January 2023 as the survey subjects. According to the follow-up study design, questionnaire surveys were conducted at two time points: T0 (1-2 days before normal discharge) and T1 (30 +/- 2 days after discharge). Evaluate the patient's general information and disease condition, body image disorder (BID), sleep, emotions, social support, and QoL separately. Analyze the degree of change in BID and their influencing factors; Analyze the relationship between body image impairment and QoL in burn patients. RESULTS: At T0, a total of 301 questionnaires were collected, and at T1, 288 questionnaires were collected. The patient's body image impairment score increased from 2.44 +/- 1.45 at T0 to 2.54 +/- 1.45 at T1, with statistical significance (t=4.873, P<0.001). The difference between T0 and T1 was 0.10 +/- 0.35 (-1.57 similar to 2.71), with 71 burn patients (24.7%) showing an increase in scores, 204 patients (70.8%) remaining unchanged, and 13 patients (4.5%) showing a decrease in scores. Binary logistic regression analysis showed that residential type, monthly income, burn area, degree of itching, and anxiety had statistical significance (P<0.05). The scores of body image impairment and QoL in patients at T0 and T1 were negatively correlated (P<0.01); The QoL Score of patients at T0 was positively correlated with the QoL Score at T1 (P<0.05). CONCLUSIONS: As burn patients progress through treatment, some may experience worsening of their body image impairment levels, influenced by factors such as residence type, monthly income, burn area, degree of itching, and anxiety. The level and degree of physical image impairment in burn patients are closely related to their QoL.
