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We report the case of a 56-year-old male with pancreatic cancer and 25 liver metastases. The patient underwent a distal pancreatectomy with 11 metastasectomies in the left liver lobe. Histological examination demonstrated a moderately differentiated ductal adenocarcinoma with pT3N0M1, Stage IVb. Three weeks later, we performed transarterial chemoembolization for the right lobe of the liver, and after 6 weeks we started systemic chemotherapy with FOLFIRINOX. After 31 months, computer tomography examination showed increases in size of the remaining lesions at segment VII/VIII of the right lobe. All liver metastases were surgically removed and a new chemotherapy was initiated. Nevertheless, after 40 months the patient developed two brain metastases. One was surgically resected and the smaller lesion was treated by gamma knife. Unfortunately, the patient died 42 months after the first presentation. Conclusively, in very selected patients with synchronic liver metastasis, multimodal treatment including repeated surgery, TACE and chemotherapy may prolong survival.

In our study prevalence of coronavirus Disease 2019 (COVID-19) among Children age groups, by diagnosis, symptoms, and treatment of COVID-19 in children. The incidence of COVID-19 among children under 18 years was 1.8 % based on the reported studies, where the mortality rate in the same age group was 0.3 %. No death has been reported in children under 10-years old. It has also been reported that the case fatality rates for the age groups of 0-9 years and 10-19 years are zero and 0.2%, respectively. Cai, et al. [1] There are some studies that report children with COVID-19 having rashes, symptoms and signs similar to Kawasaki’s disease. Heart complications were observed in these cases of Kawasaki’s disease. the levels of bilirubin and hepatic enzymes are the best markers for diagnosing the severity of the disease in the affected children. Large number of angiotensin converting enzyme 2 (ACE2) receptors on cell surfaces, effective innate immune system, and high level of blood lymphocyte have been reported to be the potent reasons for lower incidence of severe symptoms of COVID-19 among children. Children with severe COVID-19 clinical symptoms, especially those suffering from upper respiratory tract symptoms and signs and pneumonia, also children with gastrointestinal tract symptoms and signs as vomiting and diarrhea must be hospitalized similar to adults, while quarantine and home isolations are required for those having mild symptoms. Antiviral medication (Remdesivir, darunavir, ribavirin, oseltamivir, tocilizumab, umifenovir and favipiravir,) ACE inhibitors, interferon-α 2b, co-therapy with azithromycin, inhaling iNO, inhaled bronchodilators and oxygen therapy can be used for treatment. The best treatment for affected children without any clinical and infection symptoms, home isolation protocol has been recommended.

The mammalian lacrimal gland secretes an aqueous solution in which different chemical substances are present, including proteins and carbohydrates. The histochemical investigations on characterization of camel lacrimal secretion are limited. This study aimed to determine the histochemical properties of the dromedary camel lacrimal gland. Glandular samples of twenty healthy adult camels of both sexes were collected at Omdurman slaughterhouse, Sudan. The camel lacrimal gland was compound with tubulo-acinar mixed secretory units, having serous and mucous cells. Best’s carmine reactionwas negative, whereas a strong positive reaction to periodic acid-Schiff's (PAS) diastase resistant was observed in most of the secretory units; the reactions to alcian blue (AB pH 2.5) and aldehyde fuchsin (AF) were strong in the glandular tubules and weak or negative in the acini. Goblet cells in the epithelium of the interlobular ducts were strongly PAS, AB pH2.5 and AF positive.Both acini and tubules showed positive reactions to acid and alkaline phosphatases especially in their apical parts. These results suggest that the predominant acini secretion was serous which contained mainly neutral mucopolysaccharides, whereas the tubules secretion was mucous thatcontained sulfated and carboxylated acid mucopolysaccharides. Moreover, the different staining properties of the camel lacrimal secretion reflect various physiological functions.

Unlike other domestic animals the dromedary camel (Camelusdromedarius) lacks the lacrimal puncta, and hence, the lacrimal secretion function seems to be confined to the washing and moistening of the anterior surface of the eyeball. This study was conducted with the aim of studying the histological structure of the lacrimal gland of the dromedary camel. The study was performed on lacrimalglandsoffifteen animals obtained from Omdurman slaughter house, Khartoum, Sudan. The results revealed that the lacrimal gland was lobulated compound tubuloacinar with clusters of serous secretory end-pieces which were lined by a simple cuboidal epithelium of pyramidal cells. The dense connective tissue capsule sent connective tissue septa which divided the gland into lobes and lobules. The intralobular ducts were lined by simple columnar epithelium, whereas the interlobular and excretory ducts were lined by stratified columnar or pseudo-stratified columnar epithelium rich in goblet cells, melanin granules and lymphatic infiltration. The lymphocytes were replaced by a well-defined ring of lymphatic nodules around the conjunctival end of the excretory duct. The watery lacrimal secretion is suggested to be helpful in washing and moistening activitiesof the anterior part of the eyeball which is important in the camel dry, hot and dusty environment. Moreover, the increased diffuse and nodular lymphaticsin the excretory ducts might be due toincreased immune response along the draining duct. Keywords: Lacrimal gland,Dromedary Camel, Histology.