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This case report presents a novel cause of rigid flatfoot caused by the entrapment of the Flexor Hallucis Longus (FHL) tendon within the subtalar joint. A 19-year-old male with chronic right ankle and foot pain diagnosed with rigid flatfoot deformity. MRI identified the FHL tendon entrapped within the subtalar joint, a condition to our knowledge never previously reported. This report highlights the importance of thorough clinical evaluation and advanced imaging techniques in diagnosing rare causes of rigid flatfoot and suggests that surgical options may still be valid for such rare presentations.

Introduction: Acute accidental poisoning in children remains a significant public health issue and a predictable cause of morbidity around the world. To take preventive measures, it is necessary to identify the pattern of this problem. Objective: To determine the extent and characteristics of paediatric poisoning, an epidemiological investigation specific to each country is required. The goal of our research was to determine the current pattern of acute poisoning in children between (0−5) years old in Jordan. Methods: This retrospective study performs a descriptive analysis of the Jordan University Hospital’s National Poison Information Center (NPIC) database and describes the epidemiology of acute poisoning in children between (0−5) years old during a period of two years (2018–2019). Results: Paediatric poisoning (0−5) years old accounts for approximately 88% of poisoning cases in Jordan between 2018 and 2019.Out of 3531 paediatric poisoning cases, 44.9% of cases were in children between (2−3) years old, 63.4% of subjects were male. 40.9% of calls were from governmental hospitals. Most cases occurred at home (98.7%) and were unintentional (98.6%). Medication poisoning was the commonest among cases (71.0%). Besides, 89.4% were asymptomatic at the time of call, and Central Nervous System (CNS) symptoms being the most common (3.6%) among the symptomatic cases. Conclusions: Most cases of paediatric poisoning handled by the NPIC was due to medications. To prevent or minimize these cases, it is necessary to educate parents and other caregivers about proper medication storage and use, and in case of poisoning, urgent referral to health facilities is required.

Urinothorax is one of the rare causes of pleural effusion of extra-vascular origin, commonly presents with a transudative pleural effusion due to obstruction, injury or trauma to the genitourinary tract. It is not a common cause which increases the likelihood of underdiagnosis or misdiagnosis. Herein, we are presenting a 65-year-old gentleman who presented with urinary symptoms found to have urinothorax secondary to urinary tract obstruction by benign prostatic hypertrophy. This case was further complicated by urinoma and pyelonephritis. We are reporting this case to highlight the importance of including this entity in the differential diagnosis in patients who have pleural effusion especially if they presented with obstructive urinary symptoms.

Lymphoma in the gastrointestinal tract most commonly occurs in the stomach, small intestine and around the ileocecal region. Usually gastrointestinal lymphoma occurs secondary to widespread nodal disease and is rarely found to be the primary site. Of the different types of lymphoma, diffuse large B-cell non-Hodgkin's lymphoma makes up the majority of lymphomas in the gastrointestinal tract. Primary colorectal lymphoma is even less common and accounts for 3% of all gastrointestinal lymphomas and to our knowledge, gastrointestinal lymphoma involving 2 different regions in the GI tract has not been discussed in the literature. Herein, we are presenting a rare case of diffuse large B-cell lymphoma presenting as a malignant mass in both the duodenum and ascending colon.

There are different sources of cerebral emboli, including cardiac embolism, extracranial arterial embolism, paradoxical embolism, trauma, and iatrogenic embolism. In rare cases, atypical sources should be ruled out. We are reporting a lady who presented with transient ischemic attack and had a fistula between the azygos to the pulmonary vein. (Level of Difficulty: Advanced.)

Ascending aortic is an uncommon site for arterial thrombosis and ascending aortic thrombosis is a very rare phenomenon with a high fatality rate. Marijuana is the most commonly used psychoactive drug in the United States and a few cases have been reported on the association of marijuana with vascular thromboembolism. However, the pathophysiology and exact mechanism are still not well studied. Herein, we present a case of a 44-year-old female with active marijuana use presented with ascending aortic thrombus associated with acute arterial occlusion of the right vertebral artery and bilateral renal artery. The unique part of this case is that the patient did not have the classical risk factors for vascular thromboembolic disease. The only risk factor was marijuana smoking. To our best knowledge, this is one of the unique cases of marijuana-associated with ascending aorta thrombosis.

This is a report of a very rare case of marginal zone lymphoma in a 15-years old male with Ataxia Telangiectasia. Besides being a rare diagnosis within the pediatric age group, this case exhibited a true challenge not only from diagnostic point of view but also regarding management plans. Marginal zone lymphoma is an indolent disease in which transformation is extremely rare particularly the pediatric subtype. However, there isn't enough data regarding marginal zone lymphoma in a sitting of immunodeficiency conditions had been published so far. The case described here showed some features pointing to more aggressive disease with massive bone marrow involvement and areas of focal transformation unlike the subtle pattern of infiltration that is usually seen in cases of marginal zone lymphoma. Another interesting finding in our case is the presence of a clone of CD4/CD8 double positive T-cells of moderate size (12%) with restricted expansion of Vb1 region. The significance of this clone is uncertain as it could be a transient reactive clone or a pre-malignant one. Keywords: Ataxia telangiectasia, Marginal zone lymphoma, Low grade lymphoma

Background: There is an increasing need to find natural bioactive compounds for pharmaceutical applications, because they have less harmful side effects compared to their chemical alternatives. Microalgae (MA) have been identified as a promising source for these bioactive compounds, and this work aimed to evaluate the anti-proliferative effects of semi-purified protein extracted from MA against several tumor cell lines. Methods: Tested samples comprised MA cell extracts treated with cellulase and lysozyme, prior to extraction. The effect of dialysis, required to remove unnecessary small molecules, was also tested. The anti-cancer efficacies of the dialyzed and undialyzed extracts were determined by measuring cell viability after treating four human cancer cell lines, specifically A549 (human lung carcinoma), MCF-7 (human breast adenocarcinoma), MDA MB-435 (human melanoma), and LNCap (human prostate cancer cells derived from a metastatic site in the lymph node). This was compared to the effects of the agents on the human BPH-1 cell line (benign human prostate epithelial cells). The t-test was used to statistically analyze the results and determine the significance. Results: Against LNCap and A549 cells, the performance of cellulase-treated extracts was better (with p-values 0.05, as compared to the control); however, they had similar effects against the other two tumor cell lines (with p-values mainly < 0.05, as compared to the control). Moreover, based on their effect on BPH-1 cells, extracts from lysozyme-treated MA cells were determined to be safer against the benign prostate hyperplasia cells, BPH-1 (with p-values mainly > 0.05, as compared to the control). After dialysis, the performance of MA extracts from lysozyme-treated cells was enhanced significantly (with p-values dropping to < 0.05, as compared to the control). Conclusions: The results of this work provide important information and could provide the foundation for further research to incorporate MA constituents into pharmaceutical anti-cancer therapeutic formulations.

Background: An increased incidence of non-Hodgkin’s lymphoma (NHL) has been reported in farmers and other occupational groups working with pesticides. In these individuals, an increased prevalence of the chromosomal translocation t(14;18)(q32;q21), one of the most common chromosomal abnormalities in NHL, has been detected in peripheral blood lymphocytes. This translocation juxtaposes the antiapoptotic BCL2 protein to the immunoglobulin heavy chain gene locus (IGH) leading to overexpression of BCL2. This causes an increase in cell survival, paving the way for malignant transformation. Aim of the study: The present study aimed to evaluate the association between the occurrence of the chromosomal translocation t(14;18) and occupational exposure to pesticides among a group of Jordanian farmers. Methods: A total of 192 male subjects including 96 agricultural workers and 96 control subjects participated in this study. BCL2-IGH t(14;18) fusions were detected by a nested polymerase chain reaction (PCR) assay targeting the major breakpoint region (MBR). Results: We found that occupational exposure to pesticides in open-field farming and insecticide used on animals increased the frequency of the chromosomal translocation t(14;18). Farmers occupationally exposed to pesticides and insecticide were 13.5 times more likely to harbor t(14;18). 63.5% (61 of 96) of farmers compared to 11.5% (11 of 96) of controls carried the translocation (odds ratio: 13.5; 95% confidence interval (CI) = 6.3–28.6). We ruled out the influence of possible confounding factors such as age, duration of sun exposure, alcohol intake, smoking, and use of personal protective equipment. Conclusion: Our results indicate that pesticides increased the frequency of chromosomal translocation in the 14q32 region. Accordingly, the presented data agrees with previous suggestions from the literature that pesticides might be involved in the development of NHL through the t(14;18) pathway. Keywords: Pesticides, Translocation t(14;, 18), Follicular lymphoma

Background and Study Aim: Helicobacter Pylori (H. pylori), a widespread gastric pathogen, can have a range of presentations necessitating population based tailored treatment strategies. We aimed to study the clinical and demographic profile of patients with H pylori in Qatar, to determine the best treatment strategy for Qatar's population., Patients and Methods: Retrospective data collection of all patients diagnosed with H pylori from January 2017 to December 2019 in Hamad Medical Corporation (HMC) and Primary Health Care Corporation (PHCC), Qatar was done. The demographic, clinical, endoscopic and histologic characteristics of patients and H. Pylori directed therapies were documented and compared. Pearson's Chi-square test, independent samples ttest or analysis of variance (ANOVA) was used as appropriate to compare various parameters between patients., Results: 2217 patients tested positive for H. Pylori over 3 yrs. of which 837 (37.8 %) were Qatari nationals. Dyspepsia was the most common indication for testing (44.6 % patients) which was positively associated with gastric erythema and atrophy on endoscopy (P = 0.000 and 0.004, respectively) and negatively associated with a normal endoscopy (p = 0.038). Most of the patients had chronic active gastritis (98.2 %). Other pre-malignancies were seen in only 85 (14.3 %) patients. Mean (SD) age of patients with premalignancies was significantly more than those without [ 53.25 (17.6) vs. 44.77 (14.8), p = 0.000]. Only 11(0.6 %) patients had a malignancy of the stomach., Conclusion: H pylori infection may be quite prevalent amongst Qatari nationals. Since prevalence of gastric premalignancies and incidence of gastric malignancy in patients with H pylori in Qatar may be low, generalized test and treat strategy is not economically and practically meaningful in Qatar. Symptomatic patients should be tested and treated, with endoscopy reserved for those with alarming symptoms, failure of proton pump inhibitors and older patients., Competing Interests: Declaration of competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The effect of 600 mg/kg given by oral route to rats of Ferula hermonis roots extracts (petroleum ether, ethyl acetate, methanol and water) was evaluated on sexual behaviour of male rats. Petroleum ether and ethyl acetate extracts produced a significant decrease in both the mount rate (MR) and the intromission rate (IR), significant prolongation of intromission latency (IL) was observed when these extracts were compared with both controls and sildenafil. Methanolic extract produced a significant increase in MR while no effect has been observed on IR or IL in comparison with control. The effect of water extract was not significantly different from controls for the MR and IR, but there was a significant prolongation in the IL.

In Jordan, pursuing legal procedures related to alcohol intake usually depends on the physicians' clinical judgment. A study was carried out on 825 medico-legal cases over a 2 year period to evaluate the extent of physicians' clinical decisions on patients suspected to be under the influence of alcohol. A significant number of cases (12.6%, n = 104) were found to be positive for alcohol. The study showed that the clinical examination failed to diagnose a large number of cases (78.9%, n = 82). Also, the majority of diagnosed cases (50%, n = 11) had a blood alcohol concentration (BAC) range of 50-100 mg/dl. 32% (n = 33) of the cases with positive BAC were admitted to hospital. A high admission rate was observed when BAC was <50 mg/dl and >150 mg/dl, which constituted 39.3% (n = 13) and 48.5% (n = 16) of the admitted cases respectively. A large number of the admitted cases had either simple or no trauma (48.4%, n = 16) as compared with the control group of cases (21.8%, n = 10). The admission rate of positive BAC cases in traffic accidents was double that of control group. These findings may reflect the unreliability of the clinical decision in positive BAC. Implementing a certain BAC level locally for both clinical and a jurisdiction purposes is strongly recommended.