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Introduction Thoracic outlet syndrome (TOS) caused by superior mediastinal soft tissue mass has never been reported in the literature, the aim of this study is to discuss a case of TOS caused by a superior mediastinal mass in which the histopathological examinations of the mass showed vascular malformation.Case report A 45-year-old female presented with left upper limb pain and numbness for three months, associated with swelling and attacks of shortness of breath. Imaging studies showed soft tissue mass involving the superior mediastinum. The condition of the patient deteriorated and the signs and symptoms of TOS became clearer, all provocative tests and nerve conduction studies were positive. The patient underwent thoracic outlet decompression. The patient did not respond and the symptoms deteriorated further. After a multidisciplinary board discussion, the patient was prepared for median sternotomy under general anesthesia. A total resection of the mass was done. The patient was totally relieved a few hours after the operation.Discussion The etiology of TOS can be multifaceted. Several factors contribute to its onset, and these can be categorized as congenital or acquired. Congenital causes include anatomical anomalies such as a cervical rib, or an elongated transverse process of the cervical vertebrae. These anatomical deviations can reduce the size of the thoracic outlet and make it prone to compression.Conclusion Although it is rare, TOS could be due to superior mediastinal mass and the treatment of choice is total resection either through median sternotomy or thoracoscopic procedure.

We conducted genetic and morphological investigations on a snake specimen initially identified as the venomous species Walterinnesia morgani(Mocquard, 1905) from the family Elapidae, primarily based on its dark colouration. However, subsequent genetic analysis revealed a clear affiliation with the family Colubridae, specifically Hemorrhois nummifer(Reuss, 1834), which shares a partially sympatric distribution with the previously mentioned species in Iraq. This discovery represents the first documented record of such a coloured specimen of H. nummiferin Iraq, raising additional questions regarding possible mimicry and the possibility of confusion in species identifications.

In Iraq, the endangered Persian Leopard (Panthera pardus tulliana) is distributed in the northern part (Kurdistan Region) along the Zagros mountain steppe ecoregion, which includes the Bamo and Khoshk Mountains, where we carried out a field survey between October 2020 and November 2022 including camera trapping and interviews with local communities. At least five individuals were recorded during this study, including males, a female, and a family, given a population density of 1.25 indivuduals/100 km2. Bezoar Goat and Wild Boar are their key prey species in the area. Poaching and wildlife trafficking, decreasing natural water sources, overgrazing, minefields, and forest fires are identified as key threats facing the Persian Leopard population, their prey species, and their natural habitats in the Bamo and Khoshk Mountains. It is suggested to designate the study area as a national protected area or a transboundary conservation area between Iraq and Iran.

In the PATHWAY-2 study of resistant hypertension, spironolactone reduced blood pressure substantially more than conventional antihypertensive drugs. We did three substudies to assess the mechanisms underlying this superiority and the pathogenesis of resistant hypertension.

Acinar cell carcinoma (ACC) of the pancreas is a rare neoplasm which is mostly diagnosed in late adulthood. This study aims to report an incidental finding of ACC in a child who was treated successfully with operation. A 9-year-old male presented with signs of delayed growth. Physical examination revealed a swelling in the left upper abdomen, which was shown to be a pancreatic tumor on a CT scan. Total surgical excision of the neoplasm was performed and the histopathology report confirmed the diagnosis of ACC. Pancreatic ACC is very rarely reported in children and its signs and symptoms are non-specific. Its diagnosis needs a high index of suspicion and CT scan is a good imaging modality for detection. Resectable tumors are best managed with complete removal of the cancer, while unresectable neoplasms can be treated with chemotherapy. However, treatment guidelines and prognosis of pancreatic ACC are not clear in pediatric age groups due to scarcity of reports. Accidental finding of ACC involving the body and tail of the pancreas is extremely rare in children. Early detection and proper management provide an excellent outcome.

The effect of soil amended with stalks of sunflower (Helianthus annuusL.), alfalfa (Medicago sativaL.) and Hungarian vetch (Vicia pannonicaCrantz) on onion bulb rot caused byFusarium oxysporumSchlecht. f.sp.cepae(Hanz.) Snyder Hansen andAspergillus nigerv. Tieghem was tested in a soil naturally infested with the pathogens under field conditions. All treatments significantly reduced bulb rot incidence. The fungal and antibacterial populations varied among all of the amended tested soils. Heterotrophic fungal populations were more effective than heterotrophic bacterial populations in the suppression of disease. The highest population of fungal microflora was found in plots amended with sunflower stalks. The carbon-to-nitrogen ratio and available moisture content of amended soils have an indirect suppressive role on disease, by increasing the heterotrophic fungal population.

The coexistence of thyroid dysgenesis and resistance to thyroid hormone (RTH) is a very rare occurrence. The current study aims to report a unique case of thyroid agenesis with RTH in a pediatric patient.

and importance: Giant cell tumors of the tendon sheath in children have rarely been reported in the literature. This study aims to present a case of giant cell tumors of the tendon sheath on the big toe of a 5-year-old child.

Inflammatory pseudotumours of the liver are rare benign tumours of unknown origin, usually mistaken for malignant lesions. Two patients with Type 2 diabetes presented separately, unwell with fever, weight loss and hepatomegaly. Ultrasonography revealed 3–4 cm multiple lesions in the liver of the first case and a solitary 5 cm mass in the right lobe of the liver in the second. Biopsies revealed inflammatory pseudotumours in both cases. Both patients were treated with intravenous antibiotics and fluids. The clinical outcome was good and both patients had an uneventful recovery. We believe these to be the first two cases of inflammatory liver pseudotumours to be described in patients with diabetes mellitus.

A case of bleeding from angiodysplasia in association with aortic stenosis is presented. The particular interest in this patient is that the bleeding ceased immediately after the insertion of a bioprosthetic valve and recurred when the valve restenosed. Furthermore, the bleeding again promptly resolved when the valve was exchanged for a metallic prosthesis despite long‐term anticoagulation. The implications of these observations are discussed.

BackgroundIn lean healthy human beings, perivascular adipose tissue (PVAT) exerts an anticontractile effect on adjacent small arteries, but this is lost in obesity where there is evidence of adipocyte inflammation and increased oxidative stress. The aim of this study was to investigate the effects of bariatric surgery on small artery function and the underlying mechanisms.

Diabetes is a major public health problem that is approaching epidemic proportions globally. There is an urgent need for strategies to curb the rising prevalence of this disease, and prevention appears a logical approach. Lifestyle modifications with weight loss and moderate exercise can reduce the incidence of diabetes by >50% in patients with impaired glucose tolerance (IGT). The use of metformin, acarbose and other agents have been shown in randomized prospective trials to prevent type 2 diabetes in high-risk subjects with IGT. Other pharmacological interventions are currently being examined in large prospective studies. It is likely that one or a combination of these approaches could make diabetes prevention a reality in the near future.