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Key Clinical Message: Neuroendocrine tumors of the bladder are rare, accounting for less than 1% of all bladder tumors. Among these, large cell neuroendocrine carcinoma is an extremely uncommon subtype. We report on a histologically confirmed case of mixed both large and small cells neuroendocrine tumor of the bladder in a 64‐year‐old male with a history of bilharzial cystitis. The diagnosis was made after radical cystectomy with Immunohistochemical staining revealing positivity for synaptophysin, CD56, and AE1/3. While bilharzia is commonly linked to squamous cell carcinoma in the bladder, the potential relationship with neuroendocrine tumors is still relatively unexplored in this context. This case marks the first reported instance of the atypical coexistence of bilharzial cystitis and mixed large and small cell neuroendocrine carcinoma of the bladder. This unique case of coexisting highlights a rare phenomenon warranting further study. Similar associations have been documented in other organs, emphasizing the importance of exploring underlying mechanisms and clinical implications for improved patient care and outcomes. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Penile self‐mutilation may result from a suicidal attempt during a major depression crisis. The management of this urological emergency should be multidisciplinary. A macroscopic penile reimplantation performed meticulously by a urological surgeon may yield an excellent cosmetic and functional outcome. Penile self‐mutilation is an infrequent form of self‐harming behavior seen primarily in patients with schizophrenia spectrum disorders and rarely reported in those with major depressive disorders. We herewith present a major depression related case of penile self‐mutilation successfully managed by macroscopic penile reimplantation performed 8 h after the incident. [ABSTRACT FROM AUTHOR]

The Lebanese scrap metal industry – one of the country's largest exports – relies heavily upon marginalized young boys displaced from their homes in Syria. These underage waste pickers are not supposed to be working, and yet work is the only legitimate reason for their presence in Lebanon. Workers engage in different types of trip as they journey across Beirut, discreetly rummaging through rubbish. These trips allow them to cover up play under the guise of work while fostering a community of complicity that functions according to age hierarchies, rites of passage and codes of conduct. [ABSTRACT FROM AUTHOR]

This study was conducted to investigate the effects of including potato peels ( PP) and sugar beet pulp (SBP), as unconventional feeds, with and without enzyme in broiler diets from 1 to 42 days of age by observing the growth performance, blood parameters and carcass characteristics. A total of 150, 1-day old, chicks were randomly assigned into five groups, each with 30 chicks. Birds in group 1 were fed on the control diet. Chicks in groups 2 and 3 were offered diets containing PP and SBP at the rate of 15% and 7.5%, respectively, while those in groups 4 and 5 were fed the same diets but with adding an enzyme mixture. Using the unconventional feeds in the diets was found to decrease the body weight (BW). However, the feed intake, weight gain and feed conversion did not differ from the control in PP at the grower period, but decreased in SBP throughout the experiment. Addition of enzyme greatly improved the BW in PP and SBP to a degree that it surpasses the control and also increased the feed intake and conversion. The total cholesterol and low-density lipoprotein cholesterol serum levels were decreased in all tested groups. Carcass yield was not affected by treatments, but the carcass fat content was reduced using the unconventional feeds with or without enzyme. In conclusion, PP can be used at a rate of 15% in the grower diets of broilers. Furthermore, 15% PP or 7.5% SBP can be included in starter and grower diets, but with the addition of enzymes. This can help in solving the problem of current shortage and rising costs of conventional feeds. [ABSTRACT FROM AUTHOR]

Projective synchronization and generalized projective synchronization have recently been observed in the coupled hyperchaotic systems. In this paper a generalized projective synchronization technique is applied in the hyperchaotic Lorenz system and the hyperchaotic Lü. The sufficient conditions for achieving projective synchronization of two different hyperchaotic systems are derived. Numerical simulations are used to verify the effectiveness of the proposed synchronization techniques. [ABSTRACT FROM AUTHOR]

Preterm birth remains one of the serious problems in perinatal medicine and is associated with an increased risk of neonatal complications and long-term morbidity. Although each day that delivery is delayed between 22 and 28 weeks of gestation increases survival by 3%, since most spontaneous preterm labour occurs between 28 and 34 weeks of gestation, this is of secondary concern; the primary goal of delay is to improve the function of certain systems in the fetus and to balance the risks of a hostile intrauterine environment with the complications of extrauterine preterm life. Although there is a lack of definitive evidence that tocolytic drugs improve outcome following spontaneous preterm labour and preterm birth, there is ample evidence that tocolysis delays delivery for long enough to permit administration of a complete course of antepartum glucocorticoids and to facilitate in utero transfer to a tertiary care unit where neonatal care will be optimal. Both these measures have been associated with improved outcomes; antepartum glucocorticoids reduce the incidence of respiratory distress syndrome, intraventricular haemorrhage, periventricular leucomalacia and necrotising enterocolitis, and in utero transfer is associated with decreased morbidity and mortality and less hospital-based intervention compared with postnatal transportation. Consequently, women who are more likely to benefit from tocolysis are those at early gestational ages, those needing transfer to a hospital that can provide neonatal intensive care and those who have not yet received a full course of antepartum glucocorticosteroids. In these cases, delaying labour for at least 48 hours with drugs such as atosiban should be considered, since it offers clear advantages for the fetus. [ABSTRACT FROM AUTHOR]

Background: The neural cell adhesion molecule (N-CAM) has been implicated in the behaviour of the adenoid cystic carcinoma. In vitro, it was demonstrated that N-CAM inhibits cell invasion. The aim of this study was to search for N-CAM in the most common salivary gland tumour that has a malignant counterpart.Methods: We investigated the presence of N-CAM in pleomorphic adenoma and its malignant counterpart, the carcinoma ex-pleomorphic adenoma, using the immunohistochemistry technique.Results: Neural cell adhesion molecule was expressed in all cases of pleomorphic adenoma, strongly labelling the luminal cells of the double-layered ductform structures. This expression was weaker in neoplastic myoepithelial cells and progressively diminished at a distance from the luminal cells. In carcinoma, ex-pleomorphic adenoma N-CAM was either totally absent or faintly present at the apical pole of the few luminal cells.Conclusions: As a result of the peculiar distribution of N-CAM in pleomorphic adenoma, we speculated that N-CAM behaves as a tumour-suppressor molecule, which is expressed in the benign neoplasm and which is down-regulated after malignancy, when the tumour assumes an invasive behaviour. [ABSTRACT FROM AUTHOR]

The objectives of this retrospective study were to assess the effect of ethnicity on birthweight percentiles and to compare ethnic-specific percentiles with other references. Analysis was made of 35 768 singleton live births from 22 to 44 completed weeks of gestation at two major obstetric hospitals in Kuwait, after exclusion of data with inaccurate gestational age, major congenital abnormalities, stillbirths, and outlying birthweights. The population included four major ethnic groups: Gulf Arabs, Mediterranean Arabs, Egyptians, and a group combining Indians and Southeast Asians. Total population and ethnic-specific smoothed birthweight percentiles according to gestational age were developed. Indians-Asians had the smallest birthweights, the highest prevalence of small-for-gestational-age (SGA) birthweights and the lowest prevalence of large-for-gestational-age (LGA) birthweights. On the contrary, Egyptians had the largest birthweights, the lowest prevalence of SGA birthweights and the highest prevalence of LGA birthweights. Plotting our birthweights on a reference from Canada resulted in a low prediction rate for SGA and a low sensitivity in identifying LGA of all ethnic groups. We conclude that interpretation of fetal growth and birthweight should involve locally derived and ethnically specific percentiles based on accurately calculated gestational age. [ABSTRACT FROM AUTHOR]

Clinical and epidemiological data were collected from 187 clinically diagnosed measles patients in Haj Yousif area, suburban Khartoum. Laboratory tests confirmed the diagnosis in 141 (75%) of the cases, but demonstrated that in 46 (25%) patients the clinical symptoms were not caused by an acute measles virus (MV) infection. According to their vaccination card, 59% of the laboratory-confirmed measles cases had been vaccinated for measles. Compared with non-measles rash disease cases, confirmed measles cases more often had severe illness (P < 0.0001), were dehydrated (P=0.01) at presentation and less likely to recover without complications [OR 0.19 (95% CI 0.09, 0.39)]. There was no difference in death rate (P=0.20). Underweight [weight-for-age Z score (WAZ)

The present research has been performed on black pepper of two cultivars to evaluate their nutritional quality and safety issue on the basis of proximate, chemical and pharmacological properties. The proximate results were compiled with the standard USDA limits. K, Ca, Mg, Na, Fe, Al and Se were detected as major elements, whereas the toxic elements were found within the recommended limit. The GC‐MS analysis of the essential oils showed the presence of δ‐3‐carene (32.61%) as the major component in Kerala cultivar whereas β‐caryophyllene (18.39%) was the major components in Indigenous cultivar. The IC50 values of DPPH antioxidant activity of the essential oils were found to be 44.16 and 22.88 mg/mL in Indigenous and Kerala cultivars, respectively. The antimicrobial activity of the essential oils showed good activity in both cultivars. The LC50 values of the brine shrimp cytotoxic activity were 1.03 and 1.21 μg/mL in Indigenous and Kerala cultivars, respectively. Practical applications: Spice quality is an important issue in the food industries as well as export markets. Due to the toxicological effect of imported spices, much attention has been paid to the safety issue especially on cytotoxicity and toxic metal contaminations. The present study reveals that both cultivars possess rich amount of nutritional components, essential minerals, phyto and flavouring components in their essential oils and recommended level of toxic elements as well as decent antioxidant and antimicrobial properties. This study promises to scaffold a new window for exportation of quality spice and confer potential for use in food, nutraceutical and pharmaceutical industries. [ABSTRACT FROM AUTHOR]

Maple syrup urine disease (MSUD) is a rare autosomal recessive inherited disorder due to defects in the branched-chain α-ketoacid dehydrogenase complex (BCKDC). MSUD varies in severity and its clinical spectrum is quite broad, ranging from mild to severe phenotypes. Thirty-three MSUD patients were recruited into this study for molecular genetic variant profiling and genotype-phenotype correlation. Except for one patient, all other patients presented with the classic neonatal form of the disease. Seventeen different variants were detected where nine were novel. The detected variants spanned across the entire BCKDHA, BCKDHB and DBT genes. All variants were in homozygous forms. The commonest alterations were nonsense and frameshift variants, followed by missense variants. For the prediction of variant's pathogenicity, we used molecular modeling and several in silico tools including SIFT, Polyphen2, Condel, and Provean. In addition, six other tools were used for the prediction of the conservation of the variants' sites including Eigen-PC, GERP++, SiPhy, PhastCons vertebrates and primates, and PhyloP100 rank scores. Herein, we presented a comprehensive characterization of a large cohort of patients with MSUD. The clinical severity of the variants' phenotypes was well correlated with the genotypes. The study underscores the importance of the use of in silico analysis of MSUD genotypes for the prediction of the clinical outcomes in patients with MSUD., (© 2020 Wiley Periodicals LLC.)

Meningoencephalic herniation into the middle ear is a rare and potentially life-threatening condition that may require prompt surgical intervention. Preoperative diagnosis is based on a high index of suspicion. Sometimes, however, meningoencephalic herniation is discovered during surgery. High-resolution computed tomography and magnetic resonance imaging should be performed to confirm the diagnosis and to evaluate the extension of the herniated tissue. This article discusses the diagnostic approach, management strategy, and surgical technique used in 27 patients with meningoencephalic herniation. In an attempt to avoid infective complications, the authors used the middle cranial approach in patients with large herniations.