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This study evaluated possible predictors of long-term opioid usage among patients with ureteric stones who received ureteroscopy (URS) or shockwave lithotripsy (SWL). We also assessed opioid usage characteristics of URS and SWL recipients.This retrospective study used IQVIA PharMetricsThe study population consisted of opioid naive individuals having a diagnosis of a kidney stone who underwent URS (N = 9407) or SWL (N = 4894). About 6.7% (N = 964) of study subjects were long-term opioid users. Unadjusted bivariate associations showed that compared to non-long-term opioid users, long-term opioid users had significantly greater total days' supply, total morphine milliequivalents (MME) supplied, and claims per month. A similar trend was observed for URS (vs. SWL) recipients. However, compared to SWL recipients, URS recipients had 14.3% (1.2-25.6%; p = 0.034) lower odds of becoming long-term users. Total days' supply (OR: 1.041 (95% CI 1.030-1.052; p 0.001) and total MME supplied (OR 1.001 (95% CI 1.000-1.001; p 0.001) were significantly associated with long-term usage.Higher total days' supply and total MME supplied as well as SWL were identified as risk factors for becoming long-term opioid users.

Background The coronavirus disease 2019 (COVID-19) disrupted the delivery of elective surgery in children. We introduced guidance to mitigate this impact. By reviewing the outcomes for inguinal herniotomies, we aimed to determine if this guidance has enabled us to prevent an increase in the elective surgery wait time and therefore the need for emergency surgery for incarcerated hernias. This report aims to share our learnt lessons about responding to a crisis limiting accessibility to elective surgery. Results We performed a retrospective review of all elective and emergency herniotomies performed between April 1 and September 30, 2019 (pre-COVID-19) and the same period in 2020 (post-COVID-19). We compared the data on wait time from referral to clinic review/elective surgery and incarceration rates. During the study period in 2019, 76 elective herniotomies were performed compared to 46 in 2020. We did not observe a simultaneous increase in emergency herniotomies in 2020 (27 [2020] vs 25 [2019], OR [95% CI] = 1.53 [0.79–2.9]; p = 0.2). The median time from referral to elective surgery in 2019 compared to 2020 did not differ (56 vs 59 days, respectively; p = 0.61). In 2020, 72% of children that required emergency surgery had not been previously referred to our service and the median age (interquartile range) at which they presented with an incarcerated hernia was 2.8 months (2.1–13.7 months). Conclusion By adhering to local guidelines for resumption of elective activity, the pandemic did not result in children waiting longer to be seen by a surgeon for a suspected inguinal hernia. As a result, we did not perform more emergency herniotomies. Urgent prioritisation of hernias in infants, from birth up to 3 months old, was a beneficial strategy. Public health education on childhood hernias will improve outcomes.

Bioenergy is one of several renewable energy options derived from biomass that can help satisfy our energy needs. Anaerobic digestion is a viable method for producing bioenergy in the form of biogas from biomass. The anaerobic digestion process is challenged with low biogas recovery, and low-quality effluent or CO2 emission, which contribute to environmental pollution and the carbon footprint in the atmosphere. Computational process modelling and simulation can provide realistic information for dealing with the technological challenges involved with anaerobic digestion. In this study, modeling and simulation of the simplified anaerobic digestion process were done using SuperPro Designer software fed with biomass feedstock containing carbohydrates, proteins, and fats, as well as yeast, at 37 °C mesophilic temperature. The anaerobic digestion process yielded 89.655% of CH4 and 10.345% of CO2 and confirmed that the carbohydrate feedstock produces more CH4 composition in the biogas. Mineralization of CO2 using MgO yielded 0.23% MgCO3, consuming > 99% of the CO2 produced during the anaerobic digestion process. Environmental impact assessment of the effluent discharge yielded 0.142 kg Slds/L volatile solid with 6.01% COD reduction per batch of the anaerobic digestion process in an anaerobic digester with 90% (1.925 kg/batch) feedstock dosage. The data indicate that single-batch effluent cannot be discharged into the environment, hence indicating the possible recycling for multiple anaerobic digestion processing. The results are a significant guide for the realistic scalable production of high-quality biogas for bioenergy application, CO2 mineralization, and environmental remediation.

Acetaminophen (APAP) is a worldwide antipyretic as well as an analgesic medication. It has been extensively utilized during the outbreak of coronavirus 2019 (COVID-19). APAP misuse would lead to liver injury. Diacerein (DIA), an anthraquinone derivative, has antioxidant and inflammatory properties. Hence, this study attempted to evaluate the impact of DIA treatment on liver injury induced by APAP and its influence on nuclear factor-κB (NF-κB) /toll-like receptor 4 (TLR4)/high mobility group box-1(HMGB-1) signaling as well as the expression of peroxisome proliferator-activated receptor-gamma (PPAR-γ) expression.Male albino rats received 25 as well as 50 mg/kg/day DIA orally for seven days. One hour after the last administration, rats received APAP (1gm/kg, orally). For histopathological analysis, liver tissues and blood were collected, immunohistochemical (IHC) assay, biochemical assay, as well as quantitative real-time polymerase chain reaction (qRT-PCR).DIA markedly reduced liver injury markers and ameliorated histopathological changes. Moreover, DIA dose-dependently alleviated oxidative stress status caused by APAP administration along with inflammatory markers, including the level of interleukin-1 beta (IL-1β), myeloperoxidase (MPO), tumor necrosis factor-alpha (TNF-α), and interleukin 6 (IL-6). Furthermore, DIA downregulated protein levels as well as mRNA of HMGB-1, TLR4, NF-κB p65 expression, and enhanced PPAR-γ expression. Moreover, DIA ameliorated apoptotic (Bax) and caspase-3 expressions and increased the anti-apoptotic (Bcl2) expression.This study demonstrated that DIA exerts anti-apoptotic, anti-inflammatory, and antioxidant properties against liver injury induced by APAP that is attributed to inhibition of the HMGB1/TLR4/NF-κB pathway, besides upregulation of the expression of PPAR-γ.

Escherichia coli, as a global source of antimicrobial resistance, is a serious veterinary and public health concern. The transmission of pathogenic multidrug-resistant (MDR) E. coli within diarrheic calves and its correlation with Musca domestica and milk strains have been investigated. In total, 110, 80, and 26 E. coli strains were obtained from 70 rectal swabs from diarrheic calves, 60 milk samples and 20 M. domestica, respectively. Molecular pathotyping of E. coli revealed the presence of pathogenic E. coli with a higher percentage of shigatoxigenic strains within diarrheic calves and M. domestica at 46.4% and 34.6%, respectively. Phenotypic antimicrobial resistance revealed higher β-lactams resistance except for cefquinome that exhibited low resistance in M.domestica and milk strains at 30.8% and 30%, respectively. The extended-spectrum cephalosporin (ESC) resistant strains were detected within fecal, M. domestica, and milk strains at 69.1%, 73.1%, and 71.3%, respectively. All E. coli strains isolated from M. domestica exhibited MDR, while fecal and milk strains were harboring MDR at 99.1% and 85%, respectively. Molecular detection of resistant genes revealed the predominance of the bla

Schistosomiasis is one of the most important parasitic diseases in tropical and subtropical areas. Its prevalence is associated with the distribution of freshwater snails, which are their intermediate hosts. Thus, control of freshwater snails is the solution to reduce the transmission of this disease. This will be achieved by understanding the relationship between the snails and their habitats including natural enemies and associated aquatic plants as well as the factors affecting their distribution. In this study, Maximum Entropy model (MaxEnt) was used for mapping and predicting the possible geographic distribution of Bulinus truncatus snail (the intermediate host of Schistosoma haematobium), Odonata nymph (predatory aquatic insect), and Ceratophyllum demersum (the associated aquatic plant) in Egypt based on topographic and climatic factors. The models of the investigated species were evaluated using the area under receiver operating characteristic curve. The results showed that the potential risk areas were along the banks of the Nile River and its irrigation canals. In addition, the MaxEnt models revealed some similarities in the distribution pattern of the vector, the predator, and the aquatic plant. It is obvious that the predictive distribution range of B. truncatus was affected by altitude, precipitation seasonality, isothermality, and mean temperature of warmest quarter. The presence of B. truncatus decreases with the increase of altitude and precipitation seasonality values. It could be concluded that the MaxEnt model could help introducing a predictive risk map for Schistosoma haematobium prevalence and performing better management strategies for schistosomiasis.

Head and neck cancers commonly require radiation as part of treatment. Irradiated patients suffer from severe salivary gland impairment. In this study, we investigated the role of silver nanoparticles (AgNPs) in preventing radiation-induced changes in Albino rats’ submandibular glands (SMG). Thirty adult male Albino rats were divided into three groups ten rats each; group I (control) and group II (irradiated group (IR)) received a single dose of 15 Gray (Gy), and group III (AgNPs + IR) received 150 µg/kg of AgNPs and a single dose of 15 Gy. Sialochemical analysis of salivary function has been evaluated. Salivary levels of 8 hydroxydeoxyguanosine (8-OHdG), nitric oxide (NO), and total antioxidant capacity (TAC) have been measured. Histological and ultrastructural examinations of the salivary gland have been assessed. Immunohistochemical expression of malondialdehyde (MDA), superoxide dismutase (SOD), and inducible nitric oxide synthetase (iNOS) were detected. The results showed a significant decrease in salivary gland function and total protein levels in the IR group, contrary to group III. The 8-OHdG and NO levels and the immunohistochemical expression of MDA and iNOS were significantly increased in the IR group. However, the levels of TAC and SOD were significantly decreased. IR group showed atrophy of acinar cells with signs of degeneration, wide intercellular spaces, and cytoplasmic vacuolizations in addition to apoptotic cells. The results of group III showed protection of the submandibular salivary gland from radiation. We concluded that silver nanoparticles could have a protective role against radiotherapy through their antioxidant activity and scavenging of reactive oxygen species (ROS).

Background Fatal blast injuries are generally reported as a consequence of explosions, mainly in terrorist events, work-related detonations, or domestic settings. Although quite rare, blast injuries of high kinetic energy can be seen in tyre blowouts and are very dangerous and potentially lethal because of their unpredictability. This phenomenon is rarely reported in the existing forensic literature. The aim of this study was to report two cases of fatal truck tyre bursts and to discuss the mechanisms leading to the burst and the pattern of injuries. Case presentations Case 1 was of a 58-year-old truck driver man who was standing nearby a detached tyre that was being inflated in a repair shop when the burst occurred. The tyre struck him in the face and threw him. The medicolegal autopsy showed a right periorbital haematoma, a large wound of the left parietal scalp, a diffuse subarachnoid haemorrhage, an atlanto-occipital dislocation, a fracture of the hyoid bone, multiple rib fractures, and lacerations of the ascending aorta and the pulmonary arteries. Case 2 involved a young man of 24-year-old, a worker in a tyre repair shop, who was inflating a truck’s tyre when it burst violently. The injuries sustained included bleeding from the right ear, fractures of the facial bones, a left hemispheric subdural haematoma associated with the fracture of the skull base, a rib fracture, and diffuse areas of contusions to the lungs. Toxicological analyses were negative in both cases. Conclusion Fatalities related to tyre blowout accidents are uncommon. The mechanisms leading to a blowout can be mechanical or chemical in origin, and the main danger of a burst often occurs when air enters the tyre during inflation. Internal damage caused by the pressure waves of the blast often exceeds what would be expected based on external signs alone.

Microcystis aeruginosa produces an abundant cyanotoxin (microcystins (MCs) in freshwater supplies. MCs have adverse health hazards to animals and humans. Microcystin-leucine-arginine (microcystin-LR or MC-LR) is the most studied among these MCs due to their high toxicity. So, this study was designed to evaluate the possible therapeutic role of the natural algal food supplement, Spirulina platensis (SP), against MC-LR-induced toxic effects in male Wistar rats. Forty rats were randomly divided into five groups. Control and SP groups orally administered distilled water and SP (1000 mg/kg/daily), respectively, for 21 days. MC-LR group was intraperitoneally injected with MC-LR (10 μg/kg/day) for 14 days. MC-LR-SP500 and MC-LR-SP1000 groups were orally treated with SP (500 and 1000 mg/kg, respectively) for 7 days and concomitantly with MC-LR for 14 days. MC-LR induced oxidative hepatorenal damage, cardiotoxicity, and neurotoxicity greatly, which was represented by reduction of reduced glutathione content and the activities of glutathione peroxidase, catalase, and superoxide dismutase and elevation of concentrations of nitric oxide and malondialdehyde in renal, hepatic, brain, and heart tissues. In addition, it increased serum levels of urea, creatinine, tumor necrosis factor-alfa, interleukin-1beta and interleukin-6 and serum activities of alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, creatine kinase, and creatine kinase-MB. However, S. platensis restored normal levels of measured serum parameters, ameliorated MC-LR-induced oxidative damage, and normalized tissue antioxidant biomarkers. In conclusion, SP alleviated MC-induced organ toxicities by mitigating oxidative and nitrosative stress and lipid peroxidation.

Parasitic gastroenteritis (PGE) is one of the most important parasitic diseases that causes economic losses and health problems in ruminants. PGE causes a drop in milk, meat, and wool production in addition to decreasing animal fertility and sometimes leading to animal death. Conventional anthelmintics used for animal treatment are expensive, especially for farmers in developing countries. Moreover, the concern of anthelmintic resistance to these synthetic drugs is rising. Therefore, this study aimed to evaluate the anthelmintic activity of plant extract pomegranate (Punica granatum L) peel extract (PPE) against PGE infestations among ruminants. A total of 120 ruminants of different species (20 cattle, 12 buffalos, 68 sheep, and 20 goats) were examined for PGE eggs in their fecal samples. The animals under experiment were divided into four groups: the first group (negative control) was not given any drugs, the second group was given ivermectin (0.5 ml/25 kg bwt) (positive control 1), the third group was given albendazole (2.5 mg active principle/kg bwt) (positive control 2), and the fourth group was given PPE (200 mg/kg bwt). Fecal egg count (FEC) was performed on day 0 prior to the 1st dose of treatment. On day 15, an additional treatment (with the same doses) was administered and FEC was performed on days 7 and 21. Our results showed that on the 7th day of the experiment, there was an increase in FEC in the negative control group by 5%, while in the second, third, and fourth groups, there was a decrease in FEC with 95%, 90%, and 85% respectively. On the 21st day (7 days from the second dose), there was an increase in FEC in the control group by a 10% and 100% reduction in FEC in both the second and third groups. While in the fourth group, there was a decrease in FEC by 97%. In conclusion, PPE could be used as a safe, cheap, and effective natural anthelmintic against PGE.

The direct/indirect responsibility of the gut microbiome in disease induction in and outside the digestive tract is well studied. These results are usually from the overpopulation of certain species on the cost of others, interaction with beneficial microflora, interference with normal epigenetic control mechanisms, or suppression of the immune system. Consequently, it is theoretically possible to cure such disorders by rebalancing the microbiome inside our bodies. This can be achieved by changing the lifestyle pattern and diet or by supplementation with beneficial bacteria or their metabolites. Various approaches have been explored to manipulate the normal microbial inhabitants, including nutraceutical, supplementations with prebiotics, probiotics, postbiotics, synbiotics, and antibiotics, or through microbiome transplantation (fecal, skin, or vaginal microbiome transplantation). In the present review, the interaction between the microbiome and epigenetics and their role in disease induction is discussed. Possible future therapeutic approaches via the reestablishment of equilibrium in our internal micro-ecosystem are also highlighted.

Background Congenital diaphragmatic hernia (CDH) is a congenital malformation of the diaphragm, resulting in the herniation of the abdominal organs into the thoracic cavity. If not properly diagnosed before or at birth, CDH represents a life-threatening pathology in infants and a major cause of death. We present a fatal case of congenital diaphragmatic hernia corresponding to Bochdalek hernia, discovered incidentally during a sudden death’s autopsy of an infant. To achieve a better view of the range of these anomalies, we also conducted a literature review on this subject describing the pathogenesis, manifestations, diagnosis, and autopsy contribution to addressing these CDH. Case presentation The case involved a 4-month-old female infant who presented sudden respiratory difficulties after breastfeeding. External examination found marked cyanosis with no evidence of trauma. Upon opening the chest cavity, the stomach, markedly distended, was occupying much of the left pleural cavity. The left lung was compressed and displaced superiorly, and the heart was also compressed and deviated to the right. This mediastinal deviation was due to an ascension of the stomach into the chest cavity through a 2 × 1.5 cm defect in the posterior left hemidiaphragm. Further examination remarked an ecchymotic appearance of the stomach portion entrapped in the hernia defect suggesting recent strangulation of the stomach. The lungs showed atelectasis with signs of pulmonary infection in the histology study. Conclusions CDH might be considered uncommon and not always mentioned in the list of sudden death in infant causes. Forensic pathologists should know of this malformation in order to apply the best autopsy techniques and thus allow positive feedback to pediatricians considering the possible legal implications.

Background Benign paroxysmal positional vertigo (BPPV) is the most frequent vestibular disorder with significant morbidity, psychosocial impact, and medical costs. This multi-center study work aimed to review BPPV clinical features, treatment, and outcomes. Methods After a detailed history, clinical examination, audiological assessment, and position provocation tests to diagnose BPPV type, the suitable repositioning maneuver was done. BPPV was diagnosed according to the criteria developed for this study through piloting and validation in a specialized dizziness clinic. The main outcome measures were patient demographics, comorbidities, canal involvement, response to treatment, and incidence of recurrence. Results Within included 114 patients, the affected canal was 93% posterior semicircular canal, 3.5% horizontal semicircular canal, and 3.5% anterior semicircular canal. The response after repositioning maneuver was (86%) after one session and 100% after the second session. Conclusion Meticulous BBPV assessment with choosing appropriated provocation test help to diagnose and identify the type of BPPV and so applying appropriated suitable repositioning maneuver.

Background Colorectal Cancer is found one of the most profound type of cancer around globe, affecting men and women with different ethnic and racial groups. Insulin-like growth factor 1 is known as peptide growth factor found to increase the proliferation of cell and prevent apoptosis. Insulin pathway might have linked with progression of colorectal cancer. Methods This study conducted on total 160 subjects, including 80 patients with colorectal cancer with 80 age and gender match controls. Clinical parameters were compared between the control group and Colorectal cancer group. Blood serum IGF-1 was quantified by using ELISA and IGF-1 rs6214(C/T) variations were investigated using TaqMan allelic discrimination assay. Results Blood serum level of Insulin growth factor-I (ng/ml) showed substantial association concerning groups while IGF-1 rs6214(C/T) genotype distribution observed increased in colorectal cancer patients as compared to controls with significant association. The variant TT and CT genotype frequency observed more common in cases as compared to control. However, the wild type CC genotype were common in cases used to compared with controls. The Odds Ratio reveal the risk of variant IGF-1 rs6214 T allele to increase 3 times compared to wild type allele. Conclusion The homozygous TT genotypes and T variant allele of IGF-1 rs6214(C/T) showed association with high serum Insulin growth factor level 1, may increase susceptibility to the colorectal cancer. This work will use to investigate the associations between Insulin-like growth factor 1 and rs6214(C/T) gene variant and blood serum level with the vulnerability to treat Colorectal. In summary, we have investigated the relationship between Insulin growth factor level hormone and colorectal cancer. Further studies are required to understand the association between colorectal cancer and polymorphism. However, this study can be serve as an informative study to uncover mechanisms behind main cause of colon cancer. Therefore, the genomic profiling of Insulin-like growth factor-1 can be helpful to treat colorectal cancer patients.

International audience; Coronavirus disease 2019 (COVID-19) has become a challenging public health catastrophe worldwide. The newly emergeddisease spread in almost all countries and infected 100 million persons worldwide. The infection is not limited to the respiratorysystem but involves various body systems and may lead to multiple organ failure. Tissue degenerative changes result from directviral invasion, indirect consequences, or through an uncontrolled immune response. Severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2) spreads to the brain via hematogenous and neural routes accompanied with dysfunction of theblood–brain barrier. The involvement of the central nervous system is now suspected to be among the main causes of death. Thepresent review discusses the historical background of coronaviruses, their role in previous and ongoing pandemics, the way theyescape the immune system, why they are able to spread despite all undertaken measures, in addition to the neurologicalmanifestations, long-term consequences of the disease, and various routes of viral introduction to the CNS.

Acrylamide (AA) is a hazardous chemical that is widely used in industrial practices. Spirulina platensis (SP) is a blue green alga that is rich in bioactive compounds with many medicinal benefits. The aim of the present study was to evaluate the ameliorative effect of SP against AA toxicity in rats. Animals were divided into six groups: Group (1) was normal rats, groups (2) and (3) received SP at 500 and 1000 mg/kg BW orally respectively for 21 days, group (4) was administered 20 mg/kg BW AA daily for 14 days, while groups (5) and (6) were given orally SP at the same doses of groups (2) and (3), then AA at similar dose of group (4). Rats that received AA alone displayed markedly increased serum levels of liver enzymes (ALT, AST, and ALP), kidney function parameters (urea and creatinine), DNA damage marker (8-OHdG), and proinflammatory cytokines (IL-1β, IL-6, and TNF-α), compared to control rats. Furthermore, tissue analysis revealed marked increases in hepatic, renal, and brain MDA and NO, as well as marked reductions in the antioxidant biomarkers (GSH, GSH-Px, SOD, and CAT) in acrylamide-intoxicated rats. Spirulina ameliorated the alterations in serum biochemical parameters and reduced MDA and NO, as well as improved antioxidant biomarkers in AA-intoxicated rats in a dose-dependent manner. Our results show that SP has a powerful protective effect on serum biochemistry and liver, kidney, and brain antioxidant machinery in AA-intoxicated rats.

Global warming is one of the major challenges facing humanity. The increase in the Earth’s temperature and thawing of ancient ice release viable viruses, bacteria, fungi, and other microorganisms which were trapped for thousands and millions of years. Such microorganisms may belong to novel microbial species, unknown genotypes of present pathogens, already eradicated pathogens, or even known pathogens that gained extremely robust characteristics due to their subjection to long-term stress. These worries drew more attention following the death of a child by ancient anthrax spores in Siberian in 2016 and the reconstruction of smallpox and Spanish flu genomes from ancient frozen biological samples. The present review illustrates some examples of recently recovered pathogens after being buried for millions of years, including some identified viable ancient viruses, bacteria and even other forms of life. While some pathogens could be revived, genomes of other ancient pathogens which could not be revived were re-constructed. The present study aims to highlight and alarm the hidden aspect of global warming on the international public health, which represents future threats from the past for humanity.

Escherichia coli field isolates from calves were characterized and categorized into the most significant diarrheagenic pathotypes using polymerase chain reaction (PCR) assays with different specific primers. The used PCR systems were designed to detect sequences representing the group-specific virulence genes encoding fimbriae f5 (K99), Shiga toxins (stx1 and stx2), heat-stable enterotoxins (st), heat-labile enterotoxins (lt), intimin (eae), hemolysin (hylA), and EAEC heat-stable enterotoxin (astA). In the present work, a total of 150 E. coli field isolates were recovered from 150 fecal swabs collected from 100 diarrheic and 50 apparently healthy in-contact cattle and buffalo calves under 3 months old. Out of these 150 isolated E. coli, 106 isolates from 77 diarrheic and 29 in-contact calves harbored one or more of the investigated virulence genes. The pathotyping of the isolates could classify them into shigatoxigenic E. coli (STEC), enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC), and enteroaggregative E. coli (EAEC) with a 30.7, 2.7, 12.7, and 7.3% distribution, respectively. Meanwhile, the detection rates of f5, stx1, stx2, st, lt, eae, hylA, and astA genes were 17.3, 27.3, 6.7, 10, 37.3, 17.7, 9.3, and 20.7%, respectively. These virulence genes were found either single or in different combinations, such as stx/eae, stx/st/f5, eae/st/f5, or st/lt/f5. Four attaching-effacing shigatoxigenic E. coli isolates (AE-STEC) harboring stx/eae were retrieved from diarrheic calves. Although none of the stx-or eae-positive isolates was verified as O157:H7, STEC isolates detected in apparently healthy calves have potential pathogenicity to humans highlighting their zoonotic importance as reservoirs. Atypical combinations of ETEC/STEC and ETEC/EPEC were also detected in percentages of 14.7 and 2.7%, respectively. Most of these atypical combinations were found more in buffalo calves than in cattle calves. While STEC and EPEC isolates were detected more in cattle calves than in buffalo calves, ETEC isolates were the same in the two species. The pathogenic E. coli infection in calves was recorded to be higher in the first weeks of life with the largest numbers of virulence factor-positive isolates detected at the age of 4 weeks. Histopathological examination of five intestinal samples collected from four dead buffalo calves revealed typical attaching and effacing (AE) lesion which was correlated with the presence of intimin encoding virulence gene (eae). Other lesions characterized by hemorrhagic enteritis, shortening and fusion of intestinal villi and desquamation of the lining epithelium of intestinal mucosa had also been detected.

We sought to discuss the updates in the 8th edition (8E) of The American Joint Committee on Cancer (AJCC) staging for penile cancer and to provide relevant evidence associated with the major changes that occurred. A comprehensive search of PubMed® and Web of Science® was performed for relevant English language articles from 2004 through 2019. Literature resulting from this search were reviewed and articles pertinent to penile cancer staging changes were included. Modifications were observed in the tumor and nodal staging. In the 8E AJCC, Ta disease indicates noninvasive localized squamous cell carcinoma, which allows for inclusion of other historical variants. T1 is subcategorized into T1a and T1b according to existence of lymphovascular invasion, perineural invasion and high-grade tumor. This subcategorization demonstrates different risks for lymph node (LN) metastases and will affect decision strategy when opting for inguinal lymphadenectomy. Urethral invasion is no longer a differentiator between T2 and T3 disease, as T2 includes invasion of the corpus spongiosum and T3 involves invasion of the corpus cavernosum. For nodal staging, pN1 has been increased from a single LN metastases to two unilateral inguinal LN metastases, while pN2 has been modified to three or more inguinal LN metastases. This change was evidenced by demonstrating no significant difference in disease specific mortality between the previous edition’s pN1 and pN2. The 8E penile cancer staging provides several modifications that have relevant clinical implications in the management of penile cancer. Nevertheless, it requires refinements that allow for better staging of penile tumors.

Ocimum, commonly known as Tulsi, is a huge genus within family Lamiaceae, comprising about 64 species of annual to perennial aromatic medicinal herbs with a long history of traditional uses. The aromatic plants of the genus Ocimum have long been used as flavouring agents, as well as diverse medicinal applications. Our comprehensive review covers the published literature through the period from 1961 to April 2019 and provides a complete survey of nearly all the studied species up to date. Additionally, all related taxonomic data, geographical distribution as well as different traditional uses are discussed here in details. The major chemical classes within the genus Ocimum include flavonoids, phenolic acids and terpenes. The bioactivities of various extracts or individual compounds, both in vitro and in vivo, include antimicrobial, cytotoxic, antinociceptive, anti-inflammatory, antihyperglycemic and antioxidant. This comprehensive review will serve as a database for future research and drug development from the genus Ocimum.

Global warming and the associated climate changes are predictable. They are enhanced by burning of fossil fuels and the emission of huge amounts of CO2 gas which resulted in greenhouse effect. It is expected that the average global temperature will increase with 2–5 °C in the next decades. As a result, the earth will exhibit marked climatic changes characterized by extremer weather events in the coming decades, such as the increase in temperature, rainfall, summertime, droughts, more frequent and stronger tornadoes and hurricanes. Epidemiological disease cycle includes host, pathogen and in certain cases intermediate host/vector. A complex mixture of various environmental conditions (e.g. temperature and humidity) determines the suitable habitat/ecological niche for every vector host. The availability of suitable vectors is a precondition for the emergence of vector-borne pathogens. Climate changes and global warming will have catastrophic effects on human, animal and environmental ecosystems. Pathogens, especially neglected tropical disease agents, are expected to emerge and re-emerge in several countries including Europe and North America. The lives of millions of people especially in developing countries will be at risk in direct and indirect ways. In the present review, the role of climate changes in the spread of infectious agents and their vectors is discussed. Examples of the major emerging viral, bacterial and parasitic diseases are also summarized.

The present investigation was oriented to the discovery of chemical compounds from the Red Sea sponge Amphimedon sp., as a source of active agents against Trypanosoma brucei, the causal agent of human sleeping sickness. Dereplication analysis of the active fraction from Amphimedon sp. using liquid chromatography coupled with high-resolution mass spectrometry revealed the chemical richness of this sponge with diverse alkaloidal classes such as purine, manzamine, bis-piperidine, and pyridine. Activity-guided fractionation of the total extract showed the antitrypanosomal activity concentrated in the ethyl acetate fraction (IC50 = 3.8 μg/ml). In silico modelling was carried out on the dereplicated compounds to provide an insight into their antitrypanosomal mechanism of action with docking study on eight trypanosomal proteins. Molecular dynamics was run for the complex of zamamidine D and ornithine decarboxylase, which illustrated that zamamidine D has the highest affinity to the ornithine decarboxylase enzyme. These results highlight the valuable chemical profile of Amphimedon sp., as a lead source for antitrypanosomal natural products.

Background Plantar fasciitis due to calcaneal spur is a common cause of heel pain and functional disability, and its management presents a huge challenge for clinicians which results sometimes in unpleasant clinical outcomes. The efficacy of extracorporeal shock wave therapy (ESWT) as an alternative therapeutic option to surgical management after failure of conservative treatment has been addressed. Our aim was to evaluate the efficacy of ESWT in the treatment of plantar fasciitis in calcaneal spur patients using ultrasonography. Results The mean plantar fascia (PF) thickness was statistically significantly higher in the calcaneal spur patient group (5.66 ± 1.14 mm) than in the healthy control group (2.40 ± 0.35 mm), (P = 0.001). Significant PF thickness reduction, visual analog scale (VAS), and Roles and Maudsley score (RMS) improvement were observed (P < 0.001) after 4 sessions of ESWT. Conclusion PF thickness increases significantly in calcaneal spur patients and responds to treatment. ESWT decreases the thickness of the PF and improves pain and function significantly.

BackgroundIn some localities of the Mediterranean coast and the Nile land region, the gall midgeSchizomyia buboniaeFrauenfeld, 1859 (Diptera: Cecidomyiidae) induce small barrel-shaped galls on the stem ofDeverra tortuosa(Desf.) DC. (Family: Apiaceae). Host plants interact with several insects in a different manner. The current work studies the interaction ofS. buboniaewithD. tortuosa. Furthermore, the present work predicted the distribution ofS. buboniaeand its host plantD. tortuosain Egypt by using MaxEnt modeling, in addition to the effect of elevation and vegetation cover on its distribution.ResultsThe predominance ofS. buboniaeoccurred during late winter to spring. TheS. buboniaelarvae are occasionally attacked by endoparasitoids of the genusInostemma(Platygastridae). There was a significant positive correlation between the number of galls per plant and the plant cover within the study localities. Meanwhile, there was no significant correlation between the number of galls per plant and the altitude within the study localities. Also, the high temperature and altitude were the most important predictors for the habitat distribution ofS. buboniaeand its host plantD. tortuosa. The predicted distribution range size forS. buboniaeis less than the total predicted distribution range size forD. tortuosa.ConclusionsThe current study suggests that the gall inducer prefers large plants more than small ones. The present study suggests that the habitat distribution patterns ofS. buboniaeand its host plantD. tortuosain Egypt can be modeled using a small number of occurrence records together with environmental variable layers for the study area through the maximum entropy modeling technique.

Six geological studied sections from the Ouled Maallah region (Dahra) allow the identification of lacustrine deposits, sandwiched between Messinian gypsum and Mio-Pliocene blue marls. The gypsum followed by white micritic limestones deposits is correlated with the “Terminal Carbonated Complex” subsequent to the coral platforms (Oran, Melilla, Sorbas). Correlated to the Lago Mare 1 episode, which is slightly older than 5.60 Ma, the lacustrine deposits tend to cover a large extension area, both on the southern margin of the Dahra and on the Beni Chougrane northern slopes. Subsequently, the early Messinian-Zanclean deposits fossilize the Messinian Erosional Surface and indicate the post-Messinian Crisis marine reflooding. They are characterized by two microfossiliferous successions: (i) the presence of Sphaeroidinellopsis subdehiscens, Globorotalia margaritae (foraminifers), Ceratolithus acutus, Reticulofenestra zancleana (calcareous nannofossils) indicating the latest Messinian to earliest Zanclean, followed by an association with (ii) G. puncticulata, G. bononiensis, G. aff. crassaformis and Helicosphaera sellii, Discoaster asymmetricus, and D. tamalis, indicating a late Zanclean age up to an early Piacenzian one. The regional correlations reveal large subsiding sedimentary depocentres built along the Chelif Valley. Likewise, the Mio-Pliocene sedimentation seals folded tectonics active during the latest Messinian, individualized by the tilted gypsum and Lago Mare deposits of Ouled Maallah. This deformation has resulted from gravity tectonics responsible for the “olistolite” made or reworked materials within the geological series located at the Chelif Valley and the Beni Chougrane Mounts. This testifies to a large-scale, compressive deformation that would correspond to a restructuring of paleogeographic spaces associated with the Tellian Massif uplifts.

This review will address the current literature available regarding complications after intravesical Bacillus Calmette-Guerin (BCG) therapy for bladder cancer. Topics include intravesical BCG therapy–related complications, role of BCG therapy in immunosuppression, and future directions in the context of BCG-related complications. There are several new reviews and case reports discussing unique complications following intravesical BCG therapy that should raise awareness of possible short-term and long-term effects after using this common treatment modality in bladder cancer patients. Since intravesical BCG is a common treatment option for non-muscle invasive bladder cancer and can cause a variety of complications, it is important to recognize this aspect of the patient’s history when evaluating patients who present with symptoms similar to the ones discussed in this review. This will allow for prompt delivery of treatment as well as preventing unnecessary morbidity and mortality.

Organ-sparing surgery (OSS) for the kidney and adrenals has emerged as the need for preservation of function is paramount in patients with poor functional reserve. As reports increasingly showed that oncological outcomes were equivalent to radical excision, elective OSS became a viable alternative in patients with otherwise normal reserve. In this review, we summarize the current knowledge of OSS for adrenal and renal tumors. PubMed, Web of Science and Cochrane Library Central Search were searched for recently published articles up to December 2017. The following keywords were used; “partial adrenalectomy”, “adrenal sparing”, “partial nephrectomy”, “nephron sparing”, “kidney/renal cancer”. Partial adrenalectomy became an attractive alternative to total adrenalectomy avoiding adrenal insufficiency. Both minimally invasive surgery and ablative techniques were increasingly reported for adrenal OSS with adequate residual adrenal function and excellent oncological outcome. Radical nephrectomy remained for many years as the gold standard of treatment for organ-confined renal cell carcinoma. As the need to reduce the impact on renal function, more conservative approaches were utilized. Soon, the non-inferiority of nephron-sparing surgery to that of radical excision became evident and elective partial nephrectomy was gaining ground as the standard of care for small renal masses in patients with normal contralateral kidneys. Herein, we present a comprehensive review of the current status of OSS in renal and adrenal tumors.