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Key Clinical Message The significance of taking femoral neck stress fractures into account as a possible consequence in sickle cell anemia patients is underscored by this case report. In this high‐risk group, early identification, timely diagnosis, and suitable care are crucial for averting major problems and improving results. When sickle cell anemia patients complain with hip or groin discomfort, healthcare practitioners should keep a high index of suspicion for femoral neck stress fractures to assure prompt management and prevent long‐term impairment. Abstract Sickle cell disease (SCD) is a prevalent genetic hemoglobinopathy with significant global implications, affecting a substantial portion of the population. Avascular necrosis of the femoral head is a common complication in SCD, leading to severe joint damage and immobility. This case report is of a 20‐year‐old male who presented with severe hip pain due to a femoral neck stress fracture, which progressed to a complete fracture. This patient had a past medical history of sickle cell anemia and a malunited subtrochanteric fracture that resulted in shortening, external rotation, and a limping gait. Surgical treatment via subtrochanteric osteotomy with fixation using a dynamic hip screw with or without iliac crest bone graft was planned, with a satisfactory reduction and closure of the fracture gap, postoperatively. In cases of sickle cell anemia patients, bone complications such as both osteonecrosis and stress fractures are common. As a healthcare provider, it is important to manage and address these not only through medical interventions, but also through counseling and patient education. Patients must be reminded about the importance of compliance with medical advice to avoid progression or recurrence of complications.

Background We recently demonstrated that acute administration of ibrutinib, a Bruton's tyrosine kinase inhibitor used in chemotherapy for blood malignancies, increases ventricular arrhythmia (VA) vulnerability. A pathway of ibrutinib‐induced vulnerability to VA that can be modulated for cardioprotection remains unclear. Methods and Results The effects of ibrutinib on cardiac electrical activity and Ca2+ dynamics were investigated in Langendorff‐perfused hearts using optical mapping. We also conducted Western blotting analysis to evaluate the impact of ibrutinib on various regulatory and Ca2+‐handling proteins in rat cardiac tissues. Treatment with ibrutinib (10 mg/kg per day) for 4 weeks was associated with an increased VA inducibility (72.2%±6.3% versus 38.9±7.0% in controls, P

Key Clinical Message In managing a child with a solitary osteochondroma, the most advisable course of action involves vigilant observation and regular follow‐up, given the potential for spontaneous resolution. Abstract The most frequent benign cartilage tumors in children are osteochondromas, which develop when the growth plate herniates during bone development. Treatment depends on the symptoms, with asymptomatic cases requiring monitoring and symptomatic patients requiring surgical intervention. Rarely, an asymptomatic osteochondroma may spontaneously disappear. We report the case of a 3‐year‐old male who presented with left arm swelling and pain due to trauma while playing football. X‐rays revealed a proximal humerus posterolateral sessile osteochondroma. After 6 months of observation, the boy tolerated activity and had no pain. Five years later, the osteochondroma was resolved spontaneously both clinically and radiologically. Our study suggests that annual observation of child patients with osteochondroma is more effective than surgical intervention due to the possibility of spontaneous resolution.

Abstract Background Coronavirus disease 19 (COVID‐19) is life‐threatening infectious disease caused by SARS‐CoV‐2 virus that caused a global pandemic. SARS‐CoV‐2 has been widely transmitted throughout Ethiopia, with over 501,060 cases confirmed and 7574 deaths until November 2023. This study assessed for the first time the seroprevalence SARS‐CoV‐2 in the general population of the Somali Region during the COVID‐19 pandemic. Methods A cross‐sectional study design was conducted from May to June 2021 in 14 districts of Somali Region. Blood samples were collected in 820 participants in addition to administering a questionnaire that included sociodemographic characteristics and history of clinical symptoms of COVID‐19. Blood samples were tested for the presence or absence of anti‐SARS‐CoV‐2 using a commercial Enzyme‐Linked Immunosorbent Assay (ELISA) kit (Euroimmun). Results Overall, 477 (58.2%) were male and 343 (41.8%) were female. The majority of the participants (N = 581; 70.9%) were between 18 and 34 years old and not vaccinated against COVID‐19 (N = 793; 96.7%). The overall seroprevalence of SARS‐CoV‐2 antibodies was 41.7% (95% CI: 33.3%–47.6%). The highest prevalence was found in Goljano district (70%) and the lowest in Gunagado district (22.5%). Only age was found to be associated with COVID‐19 seropositivity. Conclusion Prevalence of SARS‐CoV‐2 antibodies was the highest ever reported in Ethiopia, indicating that a large proportion of the population had been infected 14 months after the start of the outbreak in the country. Such studies are important to swiftly reassess and improve specific COVID‐19 preventive and control measures to reduce transmissions within the community in a given setting.

Abstract Background Postcardiac surgery, numerous factors have been shown to predict postoperative harm of QoL, such as age, female sex, history of hypertension, chronic obstructive pulmonary disease, education level, marital status, and also psychological factors such as the presence of mood disorders. So, the essential key to self‐management is behavioural change, which is necessary to improve the quality of life of patients and Health outcomes. Aim The aim of this study is to evaluate the impact of the education programme on patients' health outcomes following open heart surgeries. Patients and Methods Quasi‐experimental research design carried out in intensive care for open heart surgery in Suez Canal university hospitals at Ismailia Governate on all available both sex patients performing open heart surgery for 6‐month period (60) using the following four tools: the first tool for patient's risk stratification model Euro Scale sheet; the second tool New York Heart Association scale for assessing functional abilities; the third tool for health outcomes sheet for assessing patient's quality of life and health status; and the fourth tool for assessing Hospital Anxiety and Depression Scale. Results There was no significant difference found in the patient's vital signs before and after the educational programme. On the other hand, there was no statistically significant difference between overall quality of life and socio‐demographic characteristics before and after the educational programme. Conclusion This study concluded that the educational programme has a positive effect on patients' quality of life in patients' educational programme; improve patient's health status as indicated by improved patient outcomes. Relevance to Clinical Practice The most important finding was the value of the educational training programme to address the needs of open heart surgery patients, indicating that after heart surgery, patient education by training can be helpful in self‐care, and nurses can use a programme containing preparatory information to enhance results, alleviate patients problems, and improve the quality of life in patients with CABG.

Abstract Molecular epidemiology studies are essential to refine our understanding of migrations of phytopathogenic bacteria, the major determining factor in their emergence, and to understand the factors that shape their population structure. Microsatellite and minisatellite typing are useful techniques for deciphering the population structure of Xanthomonas citri pv. citri, the causal agent of Asiatic citrus canker. This paper presents a molecular epidemiology study, which has improved our understanding of the history of the pathogen's introductions into the Arabian Peninsula, since it was first reported in the 1980s. An unexpectedly high genetic diversity of the pathogen was revealed. The four distinct genetic lineages within X. citri pv. citri, which have been reported throughout the world, were identified in the Arabian Peninsula, most likely as the result of multiple introductions. No copper‐resistant X. citri pv. citri strains were identified. The pathogen's population structure on Mexican lime (their shared host species) was closely examined in two countries, Saudi Arabia and Yemen. We highlighted the marked prevalence of specialist pathotype A* strains in both countries, which suggests that specialist strains of X. citri pv. citri may perform better than generalist strains when they occur concomitantly in this environment. Subclade 4.2 was the prevailing lineage identified. Several analyses (genetic structure deciphered by discriminant analysis of principal components, RST‐based genetic differentiation, geographic structure) congruently suggested the role of human activities in the pathogen's spread. We discuss the implications of these results on the management of Asiatic citrus canker in the region.

Key Clinical Message Giant‐cell tumors of the tendon sheath (GCT‐TS) are relatively common benign tumors that arise in close proximity to joints and tendons. Malignant GCT‐TS are extremely rare. Surgery with wide resection remains the cornerstone for treating malignant giant‐cell tumors of the tendon sheath especially in large tumor cases.

Key clinical message It is important to consider foot and ankle tuberculosis (TB) as a potential cause of cystic lesion around the ankle, especially in patients with a history of TB. Early diagnosis and treatment with a rifampin‐based regimen for a duration of 12 months can lead to good functional and clinical outcomes. Abstract Skeletal TB is an uncommon accounting for 10% of extra‐pulmonary TB may present slowly over an extended period of time, making a diagnosis difficult and time‐consuming (Microbiology Spectr. 2017;5:5). For the best possible outcome and to reduce the risk of deformity diagnosis must be early (Foot (Edinb). 2018;37:105). For the treatment of drug‐susceptible musculoskeletal illness, a rifampin‐based regimen lasting 12 months is advised (Clin Infect Dis. 2016;63:e147; J Bone Joint Surg Br. 1993;75:240; Tubercle. 1986;67:243). A 33‐year‐old female who are working as nurse with diffuse, persistent and low in intensity ankle pain not aggravated relieved by analgesia and swelling over a period of 2 months, static not related to activity. With past medical history of partially treated pulmonary TB 1 year ago. She reported night sweats and low‐grade fever during this period, and she denied any history of trauma. The right ankle was globally swollen and tender anteriorly and on the lateral malleolus. The skin over the ankle showed dark discoloration with cautery marks with no discharging sinuses. The range of motion of the right ankle was decreased. The plain x‐ray of the right ankle showed three cystic lesion at the distal tibia, one cyst at the lateral malleolus and another one at the calcaneum. Surgical biopsy and expert gene test confirmed the diagnosis of tuberculous osteomyelitis. The patient was planned for surgical curettage of the lesion. After the confirmation of the diagnosis of TB with the biopsy and gene expert test, with consultation of senior chest physician the patient fitted to anti‐tuberculous regimen. The patient had good functional and clinical outcome. This case report highlights the importance of considering skeletal TB as a potential cause of musculoskeletal symptoms, especially in patients with a history of TB. Early diagnosis and treatment with a rifampin‐based regimen for a duration of 12 months can lead to good functional and clinical outcomes. Further research on the management and prevention of musculoskeletal TB is warranted to improve patient outcomes. The lesson behind this case is that the diagnosis TB osteomyelitis should be on the top of differential diagnosis of multiple cystic lesions around the foot and ankle especially in area where TB is endemic. Early diagnosis and early start of anti‐tuberculous therapy can lead to full cure of the patient and in bad situation can minimize the complications.

Abstract A 17‐year‐old male was ejected from the motorcycle and brought to the Emergency Department with bilateral hip dislocation and absence of pelvic or femur fractures or sciatic nerve injury. Closed reduction and postreduction examination were performed with a bilateral stable full range of motion in all directions.

Abstract Objective This study aimed to assess the mortality and the influence of age, Abbreviated Mental Test (AMT) scores, and American Society of Anesthesiologists (ASA) grades on patients with dementia and femoral neck fracture (FNF) at 30 days, 4 months, 1 year, and 2 years after undergoing surgery. Methods Of 1296 patients admitted with FNF, 180 had had prefracture dementia. A retrospective study of these 180 patients was carried out. The patient demographics, including age, sex, presence of diabetes mellitus (DM), lipid profile, AMT score, preoperative comorbidities, ASA grade, and incidence of postoperative delirium, were documented. Results A total of 113 patients (62.8%) died postoperatively. The mortality rate was 17.7% (20 patients) at 30 days, 54.9% (62 patients) at 4 months, 77.9% (88 patients) at 1 year, and 87.6% (99 patients) at 2 years. The mortally rate in dementia with FNF was three times higher than that in FNF without dementia and was independent of age, ASA grades, DM, lipid profile, AMT scores, and development of postoperative delirium. Conclusions Dementia should be a principal predictive factor in mortality of FNF and should be a key determinant in all frailty scores.

Abstract Background Research from Western populations describes abdominal obesity as a low‐grade inflammatory disease; less is known from tropical areas with high pathogen burden. Objectives This cross‐sectional study investigated whether obesity contributes to low‐grade inflammation in 587 individuals from randomly selected households in Zanzibar. Materials and Methods The Association between obesity indices (body mass index [BMI], waist circumference [WC], and percentage body fat [%BF]), leptin, and inflammatory markers (C‐reactive protein [CRP], interleukin‐6 [IL‐6] and tumor‐necrosis factor‐α [TNF‐α]) was investigated using multinomial logistic regression analysis, accounting for ordinal outcome variables with four categories; 1st–4th quartile. Results Study participants were between 5 and 95 years; 49.6% were male. Mean serum levels were; leptin: 4.3 ± 5.2 ng/ml, CRP: 0.19 ± 0.42 µg/ml, IL‐6: 2.8 ± 5 pg/ml, and TNF‐α: 5.3 ± 5.2 pg/ml. Obesity indices were associated with leptin and CRP in the third and fourth quartiles in single models. In combined models, associations were observed between BMI (OR = 6.36 [95% CI, 1.09; 34.12]); WC (OR = 4.87 [95% CI, 1.59; 14.94]); and %BF (OR = 19.23 [95% CI, 4.70; 78.66]) and leptin in the fourth quartile; also between %BF and CRP in the third quartile (OR = 3.49 [95% CI 1.31; 9.31]). Conclusion Total body fat was associated with low‐grade inflammation in this tropical population rather than body fat distribution such as abdominal obesity. This may increase the risk of insulin resistance and other obesity‐related metabolic and cardiovascular health endpoints.

Abstract Background Pollen is a major cause of allergic respiratory diseases. In Qatar, data on the presence and prevalence of allergenic airborne types of pollen is quite limited. Methods The study aimed to determine and correlate the most frequently implicated airborne pollen detected by aerobiological monitoring samplers in respiratory allergy symptoms. An aerobiological survey was started on May 8, 2017. Airborne pollen was collected using two Hirst type seven-day recorder volumetric traps. Skin prick test in patients attending allergy clinics in Doha using commercial extracts was conducted. Results Twenty-five pollen types representing the native, as well as the introduced plants, with a relatively low daily mean concentration were observed from May 2017 to May 2019. The highest pollen concentrations were reached by Amaranthaceae (58.9%), followed by Poaceae (21.7%). SPT revealed a comparatively higher degree of sensitization to pollen. Among 940 patients, 204 were sensitized to pollen (54% female) with 135 (66.2%) and 114 (55.8%) to Amaranthaceae and Poaceae, respectively. Some patients had polysensitization. There was a statistically significant association between Amaranthaceae, and asthma (r = 0.169, P = 0.016) and allergic rhinitis (r = 0.177, P = 0.012). Conclusions This is the first study to monitor airborne pollen in the state of Qatar. The main pollen detected were Amaranthaceae and Poaceae. Pollen may represent a possible exacerbating factor in adult patients with allergic diseases such as asthma and allergic rhinitis.

Abstract Purpose The purpose of the study is to compare the effects of total cold‐water immersion to ice massage on muscle damage, performance, and delayed onset of muscle soreness. Methods Sixty participants were randomized into two groups where they completed a muscle damage protocol. Afterward, muscle damage, muscle performance, and delayed onset muscle soreness were respectively measured by serum Creatine Kinase (CK) test, one‐repetition maximum (1‐RM) test, countermovement jump (CMJ) test, and visual analog scale (VAS). The measurements were taken at five different timelines (Baseline, 2 H, 24 H, 48 H, and 72 H). Results Data showed that values of all within‐group measures of the dependent variables had extremely significant statistical differences (p

Abstract Plant biophysical and biochemical properties play important roles to explore the resistance sources against thrips. In this study, we investigated the effect of trichomes and biochemical contents of 11 mung bean (Vigna radiata L.) varieties to search for the most resistant varieties against the incidence and damage of two thrips species, Megalurothrips usitatus and Thrips palmi. Resistance was quantified by examining the incidence of the thrips on different plant parts regarding the trichomes and biochemical content of the varieties. Further, the extent of damage by the thrips species and the effects on yield of the selected varieties were examined. All the 11 mung bean varieties were attacked by both the thrips during vegetative and flowering stage, however, lowest incidence occurred in BARI Mung‐7 followed by BARI Mung‐8 and BU Mug 2. The lower incidence was associated with higher trichomes and biochemicals content of the same varieties, as thrips population showed significant negative relationships with trichome density, moisture, chlorophyll(a+b), potassium, and phenol content. Although several biochemicals had negative effects, the increasing total soluble sugar content in leaves increased the incidence of both M. usitatus and T. palmi. There was no variation in phosphorous content in the leaves of the 11 varieties. Significant variations were detected in damaging the flower bud, flower infestation, and shedding by thrips which affected the yield of mung bean. Negative responses of thrips to the increasing trichomes, moisture, chlorophyll, phenol, and potassium in mung bean suggest the significance of these properties to develop resistant varieties against thrips.

Abstract Further studies are needed on this unique population to better manage them and increase their chances of normal pregnancy and fewer complications and more favorable outcomes.

Abstract Aim Bee honey is widely used as a bioactive food to improve general health and produce therapeutic benefits in various physical disorders. It also improves cognitive and mood‐related behaviors and symptoms in mice and humans. Still, its direct effect on brain cells is unclear. Here, we examined the effect of whole honey on the survival of astrocytes exposed to oxidative stress. Methods Cultured cortical astrocytes were treated with honey (0.1%, 0.3%, 0.5%, 0.6%, 0.7%, 0.8%, 0.9%, 1%, 3%, and 5% [v/v]) for 24 hours followed by H2O2 (100 μmol/L) for 3 hours. Cellular viability was assessed with MTT assay. Results Honey prevented cellular death in a dose‐dependent manner compared with H2O2‐treated cells. Honey at 1% concentration had the most significant effect (P = .015). Conclusion Bee honey exerts a neuroprotective effect through its antioxidant activity.

Abstract Fault diagnosis and condition monitoring are important to increase the efficiency and reliability of photovoltaic modules. This paper reviews the challenges and limitations associated with fault diagnosis of solar modules. A thorough analysis of various faults responsible for failure of solar modules has been discussed. After reviewing relevant work, a monitoring tool is designed using thermography and artificial intelligent systems that allows the detection of various types of faults in PV modules and at the same time the designed tool aims to filter the nonsignificant anomalies. A neural network (NN) classifier is applied to the transfer characteristics (I‐V data) of the faulty PV module for the diagnosis which adapts multilayer perceptron (MLP) networks to identify the type and location of occurring faults. The Discrete wavelet transform (DWT) based signal processing technique is utilized in the feature extraction process to reduce the NN input size. The developed detection algorithm is adapted for 24/7 automated surveillance. For a given fault condition, the average fault detection time is observed to be

Aspergillosis is a wide spectrum of the disease process that is caused by the fungus Aspergillus. Endobronchial aspergilloma is a very rare type of aspergillosis which is not yet included in the classification of aspergillosis. Due to its rare nature and a limited number of cases, there are no current treatment guidelines. Here we present the case of a 57-year-old female with an endobronchial aspergilloma. The patient was started on intravenous voriconazole and subsequently discharged on oral voriconazole.

Abstract Primary enteroliths as a result of pelvic radiotherapy are a rare cause of intestinal obstruction.

This study presents a combination of the robust passivity-based controller (RPBC) and an extended state observer (ESO) for the tracking control of a three degree-of-freedom PUMA 500 robot manipulator under parameter variations and external disturbances. The dynamic model of the PUMA robot and its structural properties are analysed. The extra state in the ESO estimates the parameter variations and external disturbances in the control system. Then the RPBC cancels them in the control law. The stability of the proposed control system and the convergence of the observation errors are analysed. Simulations prove that the proposed controller is robust and tracks well under parameter variations, and external disturbances, validating the proposed control scheme.

Objectives. The present study aims to reveal the systemic effects of submucosal injection of plasma-rich platelets (PRP) on blood inflammatory markers which was used in an attempt to reduce the retraction time of the upper canine following extraction of upper maxillary premolars for patients with bimaxillary protrusion. Hypothesis. No change on comparing the values of blood inflammatory markers before and after submucosal injection of PRP. Methods. Eighteen female patients with bimaxillary protusion were selected from patients seeking orthodontic treatment from the College of Dentistry/University of Sulaimai, whose maxillary and mandibular first premolars were decided to be extracted after proper diagnosis. Thirty-three blood markers (twenty hematological and thirteen biochemical markers) were estimated before orthodontic bracketing, 24 hours and 7 days following submucosal injection of PRP (5 cc) to reveal the systematic effect of PRP on blood inflammatory markers that were used in an attempt to reduce the retraction time of the upper canine following extraction of upper maxillary premolars for patients with bimaxillary protrusion. Results. The results indicate nonsignificant differences in the values of all blood markers except for gamma GT (GGT), PDWa, serum albumin, serum total protein, and total calcium. Gamma level significantly increased for both test intervals. On the other hand, there was a significant drop in the value of PDWa while for alkaline phosphatase, there was a drop within the first 24 hr of PRP injection while after 7 days the value was significantly increased. On the other hand, there was a drop in the level of serum albumin, while there was an increase in the serum total protein and total calcium. Conclusion. Submucosal injection of PRP could lead to systematic alteration of blood parameters including ALK phosphatase, gamma GT, serum albumin, and serum total protein, which may be related to liver function in addition to increase in the level of PDWa and serum calcium. We present evidence that PRP contains and may trigger systemic effect. Thus, further investigation is recommended to follow up the patient for a longer period of time and on a larger sample. This trial is registered with U1111-1221-8829 by Sri Lanka Clinical Trial Registry, SLCTR/2018/040, and No. 64 on 6th August 2018 at the local clinical studies database, College of Dentistry.

BackgroundCharacterization of myocardial health by bipolar electrograms are critical for ventricular tachycardia therapy. Dependence of bipolar electrograms on electrode orientation may reduce reliability of voltage assessment along the plane of arrhythmic myocardial substrate. Hence, we sought to evaluate voltage assessment from orientation‐independent omnipolar electrograms. Methods and ResultsWe mapped the ventricular epicardium of 5 isolated hearts from each species—healthy rabbits, healthy pigs, and diseased humans—under paced conditions. We derived bipolar electrograms and voltage peak‐to‐peak (Vpps) along 2 bipolar electrode orientations (horizontal and vertical). We derived omnipolar electrograms and Vpps using omnipolar electrogram methodology. Voltage maps were created for both bipoles and omnipole. Electrode orientation affects the bipolar voltage map with an average absolute difference between horizontal and vertical of 0.25±0.18 mV in humans. Vpps provide larger absolute values than horizontal and vertical bipolar Vpps by 1.6 and 1.4 mV, respectively, in humans. Bipolar electrograms with the largest Vpps from either along horizontal or vertical orientation are highly correlated with omnipolar electrograms and with Vpps values (0.97±0.08 and 0.94±0.08, respectively). Vpps values are more consistent than bipoles, in both beat‐by‐beat (CoV, 0.28±0.19 versus 0.08±0.13 in human hearts) and rhythm changes (0.55±0.21 versus 0.40±0.20 in porcine hearts). ConclusionsOmnipoles provide physiologically relevant and consistent voltages that are along the maximal bipolar direction on the plane of the myocardium.