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Intussusception, defined as the telescoping of one segment of the gastrointestinal tract into an adjacent one, is a rare cause of abdominal pain in the adult population due to underlying benign or malignant pathology. With the liberal use of CT in the evaluation of patients with abdominal pain, the diagnosis became more reliable. Resection of the bowel segment is the recommended treatment in most cases. We are presenting the case of a 76-year-old male patient who presented with a three-week history of abdominal pain and diarrhea. The evaluation was consistent with ileocolic intussusception. Robotic resection of the right colon was performed. Pathology revealed poorly differentiated adenocarcinoma of the cecum as the underlying pathology.

Abstract Magnesium oxide nanoparticles (MgO NPs) represent an interesting inorganic material widely utilized across various fields including sensing, antimicrobial applications, optical coatings, water purification, fuel additives, absorbents, and catalysis, owing to their exceptional broad energy band gap, surface affinity, and strong chemical and thermal durability. In this investigation, MgO NPs were successfully synthesized through a green approach employing fruit extract from the gingerbread tree (Hyphaene thebaica). Analysis via scanning electron microscopy (SEM) and transmission electron microscopy (TEM) confirmed their agglomerated quasi-spherical shape with a size range of 20–60 nm. The X-ray diffraction (XRD) pattern exhibited prominent peaks at planes (200) and (220), indicating the high crystallinity of MgO NPs with a crystallite size of 32.6 ± 5 nm while Energy-dispersive X-ray spectroscopy (EDS) analysis highlighted the composition comprises 40.47% Magnesium and 48.64% Oxygen by weight. Fourier transform infrared spectroscopy (FT-IR) revealed characteristic Mg-O bonds through peaks at 560 cm−1 and 866 cm−1, while Raman spectroscopy affirmed the cubic structure of MgO. Subsequently, the photocatalytic performance of MgO NPs under visible light irradiation was evaluated. Remarkably, the addition of 1 g/L of MgO nano-catalyst resulted in a degradation efficiency of 98% after 110 min on methylene blue dye, showcasing the high catalytic activity of MgO NPs. This remarkable photocatalytic efficiency emphasizes the potential of MgO NPs in environmental remediation.

Abstract Waste oyster shells (WOS) have the potential to serve as a construction material, offering a sustainable alternative to traditional fine aggregates in the production of WOS concrete. This can play a critical role in reducing environmental issues resulting from the overexploitation of river sand and the haphazard disposal of WOS. Although existing research has predominantly focused on understanding the static mechanical characteristics of concrete when WOS is employed, the dynamic mechanical properties have still received less attention. To understand the impact of WOS as a substitute for fine aggregates on the dynamic mechanical properties of concrete, a series of tests employing Split Hopkinson Pressure Bar (SHPB) were carried out. The findings demonstrate that the peak stress and elastic modulus increase as the WOS substitution ratio (S r ) increases from 0 to 20% but exhibit an exponential decline as S r increases from 20 to 100%. This response can be explained by the joint effects of the pore-filling effect caused by WOS sand and the increasing air content caused by WOS sand. As S r increases from 0 to 20%, the pore-filling mechanism becomes predominant as the water absorption rate decreases slightly from 4.31 to 3.83%. However, for S r increasing from 20 to 100%, the negative influence of the air content becomes the primary contributing factor, where the water absorption rate increases from 3.83 to 14.68%. Furthermore, under the same impact pressure, the concrete with S r = 20% absorbed the most energy, providing the best dynamic mechanical performance. These findings highlight the potential use of WOS in concrete for improving its dynamic characteristics, promoting both sustainable construction and enhancing the material properties in impact-resistant structures.

Background and Study Aim. Chronic mechanical neck pain significantly impacts the quality of life and functional capacity of individuals, often necessitating long-term management strategies. Traditional stretching exercises are commonly prescribed, but their effectiveness compared to other interventions remains underexplored. The objective of this study was to compare the effectiveness of traditional stretching exercise regimens against thoracic spine and rib mobilization in patients with chronic mechanical neck pain. Material and Methods. This randomized controlled trial included 30 patients aged between thirty and fifty years, all suffering from mechanical neck pain. Patients were randomly assigned to one of two groups, with 15 in each group (Group A: n=15; Group B: n=15). Group A received thoracic spine mobilization coupled with standard passive stretching exercises, whereas Group B underwent a traditional stretching exercise regimen. Both groups were evaluated using the visual analogy scale for pain, active cervical range of motion (ROM), and chest expansion, both before and after a two-week therapy course. Results. Findings from this study were analyzed using a two-way mixed-model multivariate analysis of variance (MANOVA). The results showed no significant differences between Group A (thoracic spine mobilization and standard passive stretching) and Group B (traditional stretching regimen) regarding pain intensity, active cervical range of motion, and chest expansion after the two-week intervention period (p > 0.05). However, significant improvements were observed within each group across all measured outcomes, including reductions in pain intensity and increases in cervical range of motion and chest expansion (p < 0.001). Conclusions. The study confirms that both passive stretching exercises and thoracic spine mobilization are beneficial interventions for enhancing physical outcomes in patients with mechanical nonspecific neck pain. These approaches are equally effective in improving overall physical functionality, underscoring their value in therapeutic settings for neck pain management.

Abstract Introduction Lipodystrophy can cause poor glycemic control in addition to cosmetic problems in children and adolescents with type 1 diabetes mellitus. However, data on its prevalence and associated factors is scarce among children and adolescents who live in developing countries like Ethiopia. Objective To determine the prevalence and identify associated factors of lipodystrophy in children and adolescents with type 1 diabetes mellitus who visited the endocrinology clinic of Ayder Comprehensive Specialized Hospital between May 1 and July 31, 2020. Method This was an institution-based cross-sectional study conducted on 57 children and 65 adolescents with type 1 diabetes mellitus who had been taking insulin injections for a year or more. The dependent variable was lipodystrophy. A pretested, structured questionnaire was used to collect data related to lipodystrophy and other characteristics. The principal investigator oversaw the data collection, which was done by pediatric and child health specialty residents with training. Data was subjected to descriptive statistics, and predictors of lipodystrophy were identified by fitting a multivariable logistic regression model. Statistical significance was declared at p

Nowadays, there is an increasing demand for buildings that offer ideal ventilation and thermal conditions, particularly in hot-arid regions. Courtyards emerge as pivotal elements facilitating enhanced airflow and utilizing natural energy, resulting in reducing energy consumption in addition to controlling the pressure created by the wind. In response to the motivation of optimizing building performance in the face of harsh environmental challenges, our study aims to investigate how different courtyard orientations affect airflow patterns and ventilation performance in an educational building model located in Cairo and Delta region. The building, designed for the Pre-university education phase by the General Authority for Educational Buildings (GAEB), as a free-running building. Using a Computational Fluid Dynamics (CFD) simulations through ANSYS-Fluent software, we performed a parametric analysis testing four different orientations (0°, 15°, 30°, and 45°) in the northwest direction to identify the optimal orientation for enhancing ventilation performance. The results consistently indicated that the 0° scenario yielded the best results, followed notably by the 15° scenario which outperformed others by demonstrating superior airflow patterns and pressure differences conducive to enhanced ventilation rates. The 45° scenario was identified as the least favorable result among the four scenarios. These findings provide valuable methodological insights for architects and policymakers seeking to optimize natural ventilation strategies within Egypt's climates.

Abstract Background Chronic cough in children is a challenging symptom for clinicians. So, we aimed in this study to evaluate the diagnostic role of flexible bronchoscope in differentiating between the underlying causes of chronic wet cough and chronic cough associated with wheeze. Methods This was a prospective cross-sectional study conducted on children referred to Tanta University Hospitals and Ain-Shams University Hospitals between January 2021 and January 2023, presenting with a primary complaint of chronic cough lasting more than 4 weeks. The children were further classified into two groups: the first group included children with chronic wet cough not associated with wheezing (Cohort A) and the second group included children with chronic cough associated with wheezing (Cohort B). Results The study enrolled 64 children. During clinical evaluation, 25 (39.1%) children had a chronic cough without wheezing and 39 (60.9%) had a chronic wheezy cough. Bronchoscopic examination findings indicated a notable disparity between the two groups of patients with chronic cough (p=0.006). Among Cohort A patients, the most prevalent bronchoscopic observation was purulent inflammatory secretions in 16 cases (64.0%), followed by congenital airway anomalies in 3 cases (12.0%). Conversely, Cohort B patients exhibited congenital airway anomalies as the primary finding in 14 cases (35.9%), followed by purulent secretions in 7 cases (17.9%). Conclusion Flexible bronchoscopy is a valuable and safe tool for diagnosing chronic cough in children. It helped differentiate between the underlying causes of chronic cough in children with and without wheezing.

Abstract Large language models (LLMs) like ChatGPT have potential applications in medical education such as helping students study for their licensing exams by discussing unclear questions with them. However, they require evaluation on these complex tasks. The purpose of this study was to evaluate how well publicly accessible LLMs performed on simulated UK medical board exam questions. 423 board-style questions from 9 UK exams (MRCS, MRCP, etc.) were answered by seven LLMs (ChatGPT-3.5, ChatGPT-4, Bard, Perplexity, Claude, Bing, Claude Instant). There were 406 multiple-choice, 13 true/false, and 4 "choose N" questions covering topics in surgery, pediatrics, and other disciplines. The accuracy of the output was graded. Statistics were used to analyze differences among LLMs. Leaked questions were excluded from the primary analysis. ChatGPT 4.0 scored (78.2%), Bing (67.2%), Claude (64.4%), and Claude Instant (62.9%). Perplexity scored the lowest (56.1%). Scores differed significantly between LLMs overall (p