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Background: Worldwide, stroke is the most common cause of death after coronary artery disease (CAD). The risk factor stratification and prognostication of stroke patients are vital in planning and allocating health-care resources. Methods: We conducted a prospective, comparative observational study. Fifty age- and sex-matched cases each of ischemic stroke (IS) and intracerebral hemorrhage (ICH) stroke were enrolled, and baseline demographic, risk factor profile, Glasgow Coma Scale, modified Rankin scale (mRS), and Barthel Index (BI) were recorded, and the cases were followed up for 90 days or till death. We looked at the risk factors associated with IS and ICH and functional outcome of IS vis-à-vis ICH using mRS and BI at 90 days postenrollment. We also compared the mortality of IS vis-à-vis ICH. Results: The presence of hypertension (100% vs. 88%) and smoking (50% vs. 26%) was significantly higher in ICH (P < 0.05). The presence of diabetes mellitus (40% vs. 18%) and CAD (12% vs. 2%) was significantly more in IS cases (P < 0.05). Consumption of alcohol was more prevalent in ICH patients compared to IS patients (30% vs. 24%). Based on mRS and BI at 90 days, ICH cases had significantly poorer functional outcome compared to IS cases (P < 0.0001). Mortality of IS cases (4%) was also significantly less compared to ICH cases (30%). Conclusions: A combination of hypertension, smoking, and history of alcohol consumption had a higher predilection for the occurrence of ICH, whereas a combination of hypertension, diabetes mellitus, and CAD favored the occurrence of IS. The functional outcome of cases of ICH 90 days poststroke was significantly poorer compared to IS cases. The most important factors for poor outcome of ICH cases were more stroke severity at baseline compared to IS cases and the presence of intraventricular hemorrhages in some cases. Mortality was also found to be more in patients with ICH compared to IS.

Background: The dilation and torsion of testicular veins in the plexus pampiniformis causes Varicocele, which is asurgically repairable cause of male infertility. This study assessed the impact of varicocelectomy on semen characteristics,total motile sperm count (TMSC) and sperm DNA integrity in patients with severe oligoasthenoteratozoospermia(OAT).Materials and Methods: In this prospective study, semen samples of 360 men with severe OAT who underwentvaricocelectomy according to World Health Organization (WHO) criteria 2021 were studied (pre-operatively and at 6,12, and 18 months post-operatively).Results: The average age of our patients was 38.5 years. The mean spermatozoa concentration was found to be 1.60 ±0.83 million/ml pre-operatively, while the mean post-operative concentration was 5.17 ± 1.23 million/ml at 6 months,8.32 ± 0.98 million/ml at 12 months, and 13.51 ± 1.48 million/ml at 18 months (P

Cancer of the testis is the most common malignant tumor in men aged 14-44 years. Genetic and environmental factors contribute to the development of testicular cancer, for which cryptorchidism is the most common risk factor. It is potentially curable and has a long life expectancy, requiring long-term observation of survivors. Radical orchiectomy is the procedure for the diagnosis and treatment of these tumors. We report the case of a young man whose testicular tumor was discovered fortuitously by pyelonephritis because he did not consult us for the large bursa.

In Pakistan raw coal and a little quantity of waste plastics are burnt to sustain high temperature inside brick making kilns. The gaseous emissions of the kilns contain a considerable amount of darkish colored particulates. It is currently believed that the plastic burning produces these particulates. Advanced characterization instruments, such as a scanning electron microscope, energy dispersive spectroscopy, X-ray fluorescence, X-ray diffractometer, surface area analyzer using nitrogen gas adsorption isotherms, and thermogravimetric analyzer, were used to find out the chemistry and physics of the particulates. At a magnification of 30,000x, the SEM picture shows masses that are roughly roundish in shape and their size is in between 0.1 to 0.5 microns. The elements detected in these particles are carbon, oxygen, and sulfur (EDS analysis), or in other words, these elements are a typical composition of raw coal. This elemental analysis suggest that fine coal particles come out with usual combustion gases and these emitted particulates are not plastic combustion product. To strengthen this finding, the sample when calcined discarded a significant amount of sulphur oxides species, as determined in the XRF study by noticing a considerable decrease of sulphur content in the calcined particles, suggesting that the particles are actually a coal. The N2 isotherm graph reveals that the light weight flying coal particles has a very low surface area. Additionally, the XRD and TGA studies supports the conclusion that these dark colored particulate emissions are primarily fine coal particles (cenosphere).

Renal infarction is a rare pathology, which can be life-threatening for the kidney. Its low incidence and non-specific clinical manifestations make it difficult to diagnose, often resulting in delayed or misdiagnosis. Contrast-enhanced CT has a role to play in early positive diagnosis, enabling rapid and effective management. We report the case of a right renal infarction simulating renal colic, with a review of the literature.

Orchiepididymitis is a rare complication of acute pancreatitis and leads to misdiagnosis and unnecessary surgery.Abdominal pelvic CT and testicular Doppler ultrasound are the two key examinations in this situation.This is about a 38-year-old patient, seen in the emergency room in an initial picture of right orchiepididymitis secondary to a migration of pancreatic fluid collection treated with antibiotic therapy with monitoring.No consensus as to management has not been established so far.- According to the 2012 Atlanta Consensus: basic antibiotic therapy is recommended in case of suspected infection of these collections.

Summary: The tumor microenvironment (TME) presents cells with challenges such as variable pH, hypoxia, and free radicals, triggering stress responses that affect cancer progression. In this study, we examine the stress response landscape in four carcinomas—breast, pancreas, ovary, and prostate—across five pathways: heat shock, oxidative stress, hypoxia, DNA damage, and unfolded protein stress. Using a combination of experimental and computational methods, we create an atlas of stress responses across various types of carcinomas. We find that stress responses vary within the TME and are especially active near cancer cells. Focusing on the non-immune stroma we find, across tumor types, that NRF2 and the oxidative stress response are distinctly activated in immune-regulatory cancer-associated fibroblasts and in a unique subset of cancer-associated pericytes. Our study thus provides an interactome of stress responses in cancer, offering ways to intersect survival pathways within the tumor, and advance cancer therapy.

The management of locally advanced and metastatic breast cancer has evolved since 2021, with confirmation of the role of cell cycle inhibitors.The discovery of breast cancer is often the result of self-examination through the discovery of a nodule, but may also be due to symptoms at the metastatic site. The spinal cord is one of the rare sites of metastatic breast cancer involvement.We report the management of a rare case of metastatic breast cancer in the spinal cord, discovered following acute urinary retention.

Free fatty acid receptor 2 (FFAR2) is activated by short-chain fatty acids and expressed widely, including in white adipocytes and various immune and enteroendocrine cells. Using both wild-type human FFAR2 and a designer receptor exclusively activated by designer drug (DREADD) variant we explored the activation and phosphorylation profile of the receptor, both in heterologous cell lines and in tissues from transgenic knock-in mouse lines expressing either human FFAR2 or the FFAR2-DREADD. FFAR2 phospho-site-specific antisera targeting either pSer296/pSer297 or pThr306/pThr310 provided sensitive biomarkers of both constitutive and agonist-mediated phosphorylation as well as an effective means to visualise agonist-activated receptors in situ. In white adipose tissue, phosphorylation of residues Ser296/Ser297 was enhanced upon agonist activation whilst Thr306/Thr310 did not become phosphorylated. By contrast, in immune cells from Peyer’s patches Thr306/Thr310 become phosphorylated in a strictly agonist-dependent fashion whilst in enteroendocrine cells of the colon both Ser296/Ser297 and Thr306/Thr310 were poorly phosphorylated. The concept of phosphorylation bar-coding has centred to date on the potential for different agonists to promote distinct receptor phosphorylation patterns. Here, we demonstrate that this occurs for the same agonist-receptor pairing in different patho-physiologically relevant target tissues. This may underpin why a single G protein-coupled receptor can generate different functional outcomes in a tissue-specific manner.

Prostate-specific antigen (PSA) is a marker specific to the prostate gland, and it is, therefore, possible to observe an increase in PSA above 4 ng/mL in cases of benign prostatic hypertrophy and cancer. But according to studies, a very high PSA level is most likely synonymous with metastatic prostate cancer.Our rare case concerns the management of a localized prostatic adenocarcinoma despite a very high PSA level of over 3000 ng/mL, with an enormous volume of prostate without invasion or distant metastasis.A very high PSA level can probably be a sign of metastatic prostatic adenocarcinoma, but not necessarily.

Endoscopic pathological findings of the gastrointestinal tract are crucial for the early diagnosis of colorectal cancer (CRC). Previous deep learning works, aimed at improving CRC detection performance and reducing subjective analysis errors, are limited to polyp segmentation. Pathological findings were not considered and only convolutional neural networks (CNNs), which are not able to handle global image feature information, were utilized. This work introduces a novel vision transformer (ViT)-based approach for early CRC detection. The core components of the proposed approach are ViTCol, a boosted vision transformer for classifying endoscopic pathological findings, and PUTS, a vision transformer-based model for polyp segmentation. Results demonstrate the superiority of this vision transformer-based CRC detection method over existing CNN and vision transformer models. ViTCol exhibited an outstanding performance in classifying pathological findings, with an area under the receiver operating curve (AUC) value of 0.9999 ± 0.001 on the Kvasir dataset. PUTS provided outstanding results in segmenting polyp images, with mean intersection over union (mIoU) of 0.8673 and 0.9092 on the Kvasir-SEG and CVC-Clinic datasets, respectively. This work underscores the value of spatial transformers in localizing input images, which can seamlessly integrate into the main vision transformer network, enhancing the automated identification of critical image features for early CRC detection.

Introduction: Organic rice is a food product that is cultivated organically, does not contain chemicals and pesticides, and has a high nutrient and antioxidant content. This study aims to 1) find out the method used to collect data about consumers' willingness to pay for organic rice, 2) find out the method used to measure the level of willingness to pay for organic rice, 3) find out the factors that influence consumers' willingness to pay for organic rice. Methods: The method used in this study is the SLR (Systematic Literature Review) method with PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis). Results: The results showed that 1) the highest frequency in data collection techniques was carried out using questionnaires and interviews (460 respondents), 2) the highest frequency in data analysis was using the CVM (contingent valuation method), 3) the most frequent category of factors influencing WTP, namely price product. Conclusion and suggestion: The more research questions answered in published journals, the more data collection methods, methods of measuring WTP, and factors that influence WTP are often used in research.

Abstract Background Multiple sclerosis (MS) is the most frequent autoimmune neurological disease in the young population. Vesico-sphincter disorders are frequent in the course of the disease; it has been reported that 90% of MS patients will develop a lower urinary tract disorder within 18 years of the diagnosis. Methods The aim of this study is to identify the frequency, severity, diagnosis, and treatment of overactive bladder (OAB) in MS patients at the Mohammed VI hospital university in Oujda-Morocco. It is a cross-sectional study. The population was collected in neurology department of Mohammed VI hospital university in Oujda-Morocco. The population cohort consisted of patients diagnosed with multiple sclerosis, which were invited to the urology department where they underwent urinary screening and completed a form of questions regarding the frequency and severity of OAB and its influence on quality of life. Result In our study, the mean age of the patients was 43 years, and our sample was composed of 48% males and 52% females, and the most frequent lower urinary tract symptom was urgency (57%), followed by urinary frequency (29%) and urge incontinence (14%). The recurrent-remittent form was the most frequent (62%), followed by the primary progressive form (24%) and the secondary progressive recurrent form (14%). Among the patients, 33% presented a mild symptomatology, 48% moderate, and 19% severe. In this study, it was found that the intensity of urinary symptoms and the MS disability score were positively correlated with quality of life and disease duration. Conclusion The urgency was the major symptom of the lower urinary tract, and the MS disability score and the severity of OAB were associated with the quality of life of the patients. The urological evaluation of patients with multiple sclerosis should be performed routinely to identify OAB and to treat this condition appropriately.

Fournier's gangrene is a fast progressive necrotizing fasciitis of the perineum and external genitals, It is secondary to polymicrobial infection by aerobic and anaerobic bacteria with synergistic action. The origin of the infection is either cutaneous, urogenital or colorectal. There are age, diabetes and immunosuppression, are frequently present in affected patients. Fluid and electrolyte management, combined with broad-spectrum antibiotic therapy followed rapidly by surgical debridement, is the standard of treatment. we report in this article a very rare case of cancer of the penis manifested by fournier's gangrene.

The discovery of an adrenal myolipoma is often fortuitous, or due to the effects of hypersecretion of the adrenal gland. A large tumor can exert a mass effect on neighbouring organs, as in our case where the myolipoma leads to compression of the main bile duct and causes hepatic colic, which is rare to explain the discovery of an adrenal myolipoma on CT.

Neuromyelitis optica (NMO) is a rare autoimmune disorder of the central nervous system that can cause a variety of neurological symptoms, including urinary dysfunction. Here, we present the case of a 21-year-old male patient who was diagnosed with NMO after presenting with urinary retention.

Context: Diabetes mellitus (DM) is the most common endocrine disorder and is a significant cause of ocular morbidity, unstable refraction, corneal abnormalities, neovascular glaucoma, nerve palsies, and diabetic retinopathy (DR); it is being increasingly recognized that even the ocular surface is adversely affected in diabetic patients. Aims: The present study was undertaken to analyze the conjunctival surface changes by conjunctival impression cytology (CIC) and correlate them with glycosylated hemoglobin (HBA1c) levels. Settings and Design: Known cases of DM satisfying the inclusion criteria were included in this nonrandomized prospective study, which was undertaken after ethical clearance was obtained from our institutional ethical review board. Subjects and Methods: Eighty patients with DM who presented to the Department of ophthalmology at our center were included in the study; they were divided into Group 1 (HbA1c ≤6.5%) and Group 2 (HbA1c >6.5%). A detailed history, general physical examination, complete ophthalmological examination, and CIC were performed in all of the participants. Statistical Analysis Used: Data were analyzed using Chi-square test and statistical software EPI INFO Version 6 and Microsoft Excel. P < 0.05 was considered statistically significant. Results: CIC technique revealed that, after age and gender adjustment, there was a significantly higher percentage of uncontrolled diabetic patients (77.7%) who had lower goblet cell density and higher Nelson grades of conjunctival squamous metaplasia. This difference was significant for all age groups and both sexes (P < 0.001), and it was also significantly related to the duration of DM. In addition, there was a positive correlation between DR and decreased corneal sensation when associated with poor glycemic control (HbA1c >6.5%). Conclusions: Dry eye disease and ocular surface disorders are increasingly recognized in patients suffering from DM. The ocular surface evaluation must be included in the routine examination of all diabetic patients. CIC is a safe, minimally invasive procedure with no side effects and can serve as one of the diagnostic tools for the evaluation of the ocular surface.

Introduction: Knee osteoarthritis (OA) is a degenerative condition that is caused by the gradual wear and tear of the cartilage that cushions the bones of the knee. This study will find out the effectiveness of intra-articular hyaluronic acid (IAHA) and intra-articular corticosteroids (IACS) in the management of knee OA. Material & Methods: A randomized control trial was conducted in Hayatabad Medical Complex Peshawar and Pak Military Hospital Rawalpindi from March 2019 to June 2021. Total one eighty-two patients were randomly assessed in the study. Treatment group A received intra-articular hyaluronic acid (IAHA), while treatment group B received intra-articular corticosteroids for three months. This study has used Western Ontario and McMaster Universities Arthritis Index (WOMAC) to evaluate the effectiveness of treatment in both groups of knee OA. Results: The study participants mean age was 56.344 ± 7.25. Out of 182 patients, 2 of the patients reported as “loss to follow up” from IACS Tx group b. Treatment groups include 95 (52.7%) female patient while 85 (47.22%) were male patients. 96 (53.33%) received intra-articular hyaluronic acid (IAHA), while 84 (46.66%) received intra-articular steroids (IACS). The pre- and post-treatment mean difference in WOMAC scores in the hyaluronic acid group was 5.52 ± 4.756, while that in the corticosteroid group was 9.495 ± 1.24 (p value < 0.01). Conclusion: Intra-articular steroids (IACS) and hyaluronic acid (IAHA) alone reduces OA symptoms and pain significantly. Yet intra-articular steroids are more effective than intra-articular hyaluronic acid in reducing symptoms of OA at knee.

Colorectal cancer (CRC) is the most prevalent type of cancer affecting the gastrointestinal tract. The synchronous occurrence of CRC and renal cell carcinoma is rare, and even rarer when the renal cell carcinoma is of papillary origin, with only two cases reported in the literature. The synchronous detection of colon cancer and other primary tumors has been extensively studied and reported in the literature, either falling within the framework of well-defined clinical syndromes such as Lynch syndrome or occurring sporadically. This article aims to report and expose a literature review of the synchrony of colorectal cancer and renal carcinoma.

Metastatic cancers of the testis are rare. Metastatic disease in the testis from urothelial carcinoma is extremely rare. Usually, metastatic testicular cancers are from primitive prostate, lung, and gastrointestinal tumors.Testicular metastases from urothelial carcinoma should be suspected in patients with hematuria and testicular swelling.

Genitourinary tuberculosis is a rare form of extrapulmonary tuberculosis that affects the kidneys, ureters, prostate, vas deferens, seminal vesicles, testes, and epididymis.Testicular tuberculosis is a very unusual form, We report a rare case of unilateral testicular tuberculosis that manifested as orchi-epididymitis. The main treatment for urogenital tuberculosis is antituberculosis therapy, possibly combined with surgery.

Cancer-associated fibroblasts are transcriptionally rewired by signals from the cancer cells, resulting in heterogeneous populations. Here the authors show that loss of BRCA function in pancreatic cancer cells leads to HSF1–dependent accumulation of immune-regulatory clusterin-positive cancer associated fibroblasts.

Polycystic kidney disease (PKD) is a genetic disorder characterized by the formation of multiple cysts in the kidneys. We present a case of a 47-year-old male with PKD on dialysis who underwent bilateral renal artery embolization followed by bilateral nephrectomy via a median incision. The specimen weight was 5 kg for the left kidney and 8 kg for the right one. Renal artery embolization can be a useful tool in managing polycystic kidney disease in cases where nephrectomy is indicated. This case highlights the importance of timely intervention and the role of minimally invasive techniques in managing this rare condition.

Primary seminal vesicle adenocarcinoma is an extremely rare tumor. Accurate recognition of malignant neoplasms of the seminal vesicle is a crucial condition to establish a correct treatment that leads to improvement of long-term survival. Diagnosis of seminal vesicle carcinoma is based on many methods including imaging, biology, and pathological assessment, especially by means of immunohistochemistry. Herein, we report a case of primary mucinous adenocarcinoma of the seminal vesicle mimicking a benign congenital cyst in a 25-year-old patient, fortuitously discovered on a pelvic computer tomography scan.

Renal trauma is a serious condition that can result in significant morbidity and mortality, particularly in the case of Grade V injuries with complete avulsion of the renal artery and vein. We report a case of a 22-year-old male who sustained a Grade V renal injury in a motor vehicle accident resulting in total avulsion of the renal artery and vein. The patient underwent immediate surgical exploration with successful nephrectomy and ligation of the renal pedicle. This case reports aims to discuss the management strategies for severe renal injuries and the outcomes associated with this approach.

We report the rare case of a primary pelvic hydatid cyst in a 37-years old from a rural area. The diagnosis was suspected preoperatively based on the origin of the patient, and CT findings and it was confirmed intraoperatively by finding the typical cystic content. A total excision of the cyst without causing or contamination of the field was carried out by median incision. Our work aims to point to an unusual localization of hydatid disease, clinical and radiological characteristics, and above all to discuss the different ethnic-pathogenic theories and surgical treatment.

Inguinal bladder hernia is a very rare clinical form, representing 1–4% of inguinal hernias. More than 90% of cases are discovered intraoperatively, with iatrogenic bladder injury occurring in 16% of cases. We report the case of a 67-year-old patient with a history of left inguinal hernia, who presented with a strangulated inguinoscrotal hernia with a tense bursa, painful spontaneously and irreducible to palpation. The abdominopelvic CT scan revealed a giant inguinoscrotal bladder hernia. The bladder resection for a necrosis portion was indicated. This case presents interesting considerations and potential pitfalls when evaluating a patient with an inguinal hernia.