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Giant adrenal myelolipoma (AML) may cause severe symptoms. In contrast to the previous reports, laparoscopy may play a pivotal role in the management of giant AML. This report aims to discuss a case of giant AML managed successfully by laparoscopy. A 63-year-old male was found to have a giant (12 × 10 × 8 cm) left AML during a workup for left lower chest pain on imaging. laparoscopic excision of a left adrenal gland with the lesion was performed under general anesthesia. The patient was discharged from the hospital after 3 days uneventfully. AML is a benign tumor that is characterized by the presence of adipose tissue and hematopoietic elements. Myelolipomas are typically asymptomatic. AML diagnosis is based on imaging and blood workup. Small asymptomatic AML is usually managed conservatively, while symptomatic AML is managed with surgery. Even though an open approach is the standard option, laparoscopy, as a minimally invasive technique, in some centers may replace laparotomy. Laparoscopy can be a successful method for managing AML, even when they are large in size.

Abstract Background The emergence of the COVID-19 pandemic in 2019 imposed significant shifts in global health, particularly in understanding and addressing anxiety disorders precipitated by pandemic-related stressors. The current study aimed to adapt and validate the COVID-19 Anxiety Questionnaire (C-19 A) for Arabic-speaking populations (C-19 A-A), assessing its structural integrity, concurrent validity, factorial validity, and reliability. Methods The data of 571 individuals, including age range, educational history, gender, and marital status, were collected through online platforms. The translation process of C-19 A-A underwent rigorous verification by linguistic and subject matter experts. Several advanced statistical procedures were used to examine the C-19 A-A’s reliability, validity, and measurement invariances across demographic subsets. Results The results indicated robust internal consistency, with a Cronbach’s alpha coefficient of 0.889, confirming the questionnaire’s reliability. Concurrent validity showed significant and positive correlations between C-19-A and FCV-19S (r = 0.77, p

Mediastinal parathyroid cysts (MPCs) are extremely rare, benign lesions arising from the parathyroid glands and residing within the thoracic cavity. This study aims to advance understanding of MPC, emphasizing accurate diagnosis and management approaches for this rare condition. A 46-year-old woman presented with dysphagia for one week. Blood tests revealed elevated parathyroid hormone (PTH) (112.8 pg/mL) and normal serum calcium (9.54 mg/dL). Ultrasonography identified a large, well-defined cystic nodule measuring 46 × 30 × 25 mm, extending retro-sternally in the right upper third of the chest. A subsequent high-resolution computed tomography scan of the chest revealed a large space-occupying lesion (47 × 43 × 31 mm) in the superior mediastinum, near the esophagus, suggesting an esophageal duplication cyst or, less likely, a bronchogenic cyst. Video-assisted thoracoscopic surgery (VATS) was performed, and the entire cyst was excised, confirmed histologically as a mediastinal parathyroid cyst. Mediastinal involvement of PCs poses diagnostic challenges due to their rarity and diverse clinical presentations. Surgical excision is necessary for symptomatic cases, with VATS emerging as a favorable approach.

Prolonged air leak (PAL) represents the most commonly encountered complication following pulmonary resection. This review aims to show the role of autologous blood pleurodesis (ABPP) in the management of PAL. A search was conducted on the Web of Science, PubMed, MEDLINE, and Google Scholar for English-language articles until September 15, 2023, with titles containing the related phrase “autologous blood patch pleurodesis (ABPP), and prolonged air leaks.” Included studies comprised four randomised controlled trials, ten cohort studies, a case series, and nine case reports from various countries. Patients undergoing ABPP had a mean age of 52.7 years. Autologous blood volumes for pleurodesis varied (50 mL to 250 mL). Approximately 73.8% of cases responded to ABPP in 1 to 30 days (mean 3.75 days), and in-hospital complications were infrequent (3.9%). Follow-up durations post pleurodesis were up to 20 months. The evidence presented in this systematic review supports the role of ABPP as an effective and safe intervention for managing PAL, particularly after pulmonary resection.

Introduction Sarcoidosis involving the thyroid gland is an exceedingly rare condition characterized by non-necrotizing and non-caseating granuloma. This study represents a case of thyroid sarcoidosis in an elderly female.Case report A 62-year-old female presented with anterior neck swelling associated with difficulties in breathing and swallowing for six months. Physical examination revealed an enlarged, firm, and non-tender thyroid gland. Thyroid function tests were normal, with a high level of angiotensin-converting enzyme. A neck ultrasound revealed nodules in both thyroid lobes and bilateral cervical lymphadenopathies. The patient underwent a total thyroidectomy and lymph node excision. Histopathological examination of the specimen showed features suggestive of thyroid sarcoidosis.Conclusion Sarcoidosis involving the thyroid gland is a rare finding, and its diagnosis necessitates the exclusion of other potential explanations for similar symptoms. Surgery becomes necessary when there are compression symptoms or a risk of malignancy.

Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a rare benign lesion characterized by the presence of spindle and epithelioid cells and features resembling thymic tissue. A 35-year-old asymptomatic female with a history of two cesarean sections and a positive family history of breast cancer underwent a thyroid checkup. Clinical examination revealed a normal thyroid gland, while diagnostic tests indicated a solid hypoechoic nodule in the right lower parathyroid gland, which was confirmed as SETTLE after surgical resection was performed, leading to an uneventful postoperative period. The patient, discharged on the first postoperative day, underwent comprehensive follow-up and oncology referral for risk stratification. In the literature review of nine cases of SETTLE (seven male, two female), age (8–70 years), past medical and surgical history of the majority is not available, most of them presented with painless and slowly enlarging mass in the neck, on laboratory examination most of the cases had test results within the normal range, ultrasound (U/S) and computed tomography (CT) Scan are preferred imaging modality, most of the patient had undergone surgical resection, histopathological examination showed SETTLE after management more than half were disease free. SETTLE is a rare tumor with ∼50 reported cases worldwide and a single case report that involves parathyroid glands. It can be asymptomatic or present as a mass. Besides the necessity of surgical resection, long-term follow-up is mandatory.

Introduction Hemangiomas are benign vascular lesions. The complicated hemangiomas that are causing significant functional or cosmetic problems need surgical excision. This paper presents a novel technique of reconstruction using surgical mesh after removal of a facial hemangioma.Case report A 50-year-old male patient presented with right cheek swelling for more than 40 years causing disproportion of the face. A flap was raised by a nasolabial linear incision, then a 4*2 cm surgical mesh was put in, and the wound closed cosmetically. The excised tissue was sent for histopathological examinations and the results confirmed hemangioma. After more than two years follow up, the patient’s face was symmetrical with normal facial contour.Conclusion The application of surgical mesh for patients who seek functional and cosmetic improvements after hemangioma removal is a constructive method that gives the desired outcome for the patient.

Introduction: While the efficacy of flexible ureterorenoscopy (URS) in managing solitary kidney stones (KSs) is widely acknowledged, its effectiveness in treating multiple stones has scarcely been investigated. This study aims to assess the effectiveness and safety of retrograde intrarenal surgery (RIRS) utilizing flexible URS and laser lithotripsy in the management of multiple KSs. Methods: This study was a single-group cohort study conducted on patients with multiple KSs who underwent treatment with RIRS using flexible URS and laser lithotripsy. Stone-free status was considered as the lack of residual stone fragments or any residual stone of any size. The first follow-up appointment was arranged 3-4 weeks following the procedure. If significant residual stones were present, patients underwent reintervention within 2-4 weeks. Results: A total of 110 patients with multiple KSs were included. The mean stone burden was 27.5 ± 7.9 mm, and the mean duration of the operation was 54.9 ± 19.7 minutes. Seven cases (6.3%) experienced intraoperative complications, while postoperative complications were found in eight cases (7.3%). After four weeks, a stone-free rate (SFR) was documented in 80.9% of the cases, and this rate increased to 93.6% after three months. The SFR after three months was significant with Guy’s stone score (p < 0.001); however, it did not reach a significant level with any other parameters. Conclusions: The RIRS with flexible URS may be an effective and potentially safe procedure for treating multiple KSs. It may yield a favorable SFR with an acceptable complication rate.

Introduction: The third most prevalent malignant neoplasm involving the urinary tract is renal cell carcinoma (RCC), encompassing nearly 3.5% of the entire cancers afflicting the body. The aim of this research was to explore how the R.E.N.A.L. nephrometry score relates to the decisions made regarding surgery in individuals with localized RCC. Methods: This prospective study, assessed patients with localized parenchymal renal masses (stages I and II) tentatively diagnosed as RCC. Utilizing preoperative multiphasic renal CT scans and MRI, the R.E.N.A.L. score categorized masses for nephrometry values. Inclusion criteria involved collecting patient data, and data collection utilizing a structured format focusing on the nephrometry grading system. Results: The study included 64 patients aged (mean ± SD) 49.78 ± 12.35 yrs. Undergoing renal mass surgery, there were 17 (26.5%) low, 28 (43.8%) moderate and 19 (29.7%) high-complexity lesions. All patients with a low Nephrometry score (n = 17) underwent partial nephrectomy, and all cases with a high score (n = 19) underwent radical nephrectomy. For those with a moderate Nephrometry score (n = 28), 13 (46.4%) underwent partial nephrectomy, while the remaining 15 (53.6%) cases underwent radical nephrectomy. Morbidity was low, and no mortality occurred at 180 days. Patients who had lesions fully above or below polar lines were less likely to need blood transfusions. A trend towards higher Fuhrman grades in patients receiving transfusions suggests a potential link between tumor aggressiveness and bleeding risk. Conclusions: Our findings provide insight on the utilization of the R.E.N.A.L. nephrometry score in forecasting perioperative, post-surgical, and oncological results. Such data might help optimize surgical methods and pre-operative patient counseling.

Key Clinical Message Contraceptive implant migration is a rare complication associated with contraceptive implants: migration to the ulnar nerve, emphasizing the importance of accurate diagnosis, imaging, and a multidisciplinary approach to mitigate neurovascular risks during insertion and removal procedures. The case report demonstrates the necessity for careful removal techniques and thorough patient follow‐up to ensure positive outcomes and prevent long‐term nerve damage. There are some potential risks and complications associated with contraceptive implants, including neurovascular injury. The aim of this case report is to report a rare complication associated with contraceptive implants. A 32‐year‐old female, right‐hand dominant, presented to the orthopedic clinic for the extraction of a contraceptive implant (Implanon) from her left arm. She reported intermittent numbness in the ring and little fingers. Upon examination, the Implanon was not palpable. Both Phalen's test and Tinel signs were negative. An x‐ray of the arm revealed the implant's position. Under local anesthesia through a longitudinal incision, the Implanon was found within the perineurium of the ulnar nerve. Two weeks after the operation, the patient returned to the clinic. Upon examination, there were no indications of ulnar nerve neuropathy. If a patient undergoes subdermal implant‐associated pain or is at risk of neurovascular damage during removal, it is advisable to refer the patient to a family planning specialist experienced in handling challenging implant removals, and subsequently to a peripheral nerve surgeon, to optimize outcomes. The migration of a contraceptive implant to the ulnar nerve is an exceedingly rare but possible complication.

Although predatory publishers are increasingly recognized, universally accepted criteria for defining predatory journals are lacking. These journals challenge the scholarly community by blurring the line between legitimate and questionable publishing practices. Several lists and reports of predatory journals have been published, which offer valuable insights; however, they are not devoid of criticism. Beall’s list, although criticized for its inclusion criteria, is currently managed anony-mously and updated infrequently. Cabells’ list uses an extensive array of inclusion criteria, some of which are similar to those used in Beall’s list. Several of these cri-teria are redundant and fail to detect predatory practices, and using all of them in evaluating a journal is seldom practicable. Kscien’s list has emerged as a promising alternative for identifying predatory publishers or journals. However, it requires refinement, potentially through creating a distinct list supported by unequivocal evidence, such as accepting a fake manuscript (ascertained through a sting opera-tion). The present review seeks to catalyze research on identifying predatory jour-nals and publishers by comparing existing lists and suggesting new techniques for detecting predatory practices.

IntroductionA Urethral diverticulum can be defined as sac-like dilation lined with epithelial tissue, which may be congenital or acquired. It usually develops in the penoscrotal angle region but can also be observed in the penile urethra. It usually occurs in female teenagers. This report aims to discuss a male infant with a large urethral diverticulum.Case presentationA 5-month-old male presented to the urological department at Sulaimani Teaching Hospital with a penile swelling that had been noticeable since birth. Clinical examination revealed a ventral cystic penile shaft swelling, which would fill with fluid during urination. A urethrocystoscopy was performed and showed a wide cystic ventral diverticulum. Diverticulectomy was performed as a surgical approach to remove the diverticulum.DiscussionCongenital anterior urethral diverticulum is an uncommon condition that typically begins in early life. It can manifest with various symptoms, like recurrent infections of the urinary tract, painful urination, and post-void urine dribbling. Diagnosis involves imaging, with urethrocystoscopy, to rule out other potential diagnoses. Different surgical techniques exist that show promising results in preventing recurrence. The current case involved diverticulectomy and multi-layered wound closure with a dartos flap.ConclusionLarge anterior diverticulum in early infancy is rare but possible; operation is the preferred intervention method.

Abstract Background and Aims Behçet's disease is a chronic, multisystemic, and relapsing inflammatory disorder. It lacks a permanent cure, the focus of treatment is on mitigating symptoms, decreasing the frequency and severity of relapses, and preventing life‐threatening complications. This study aims to report the experience of a single center in managing patients with Behçet's disease and discuss the treatment outcomes. Methods This study was a retrospective case series conducted over 2 years. All cases were clinically diagnosed according to the International Criteria for Behçet's Disease. The extracted data were demographics, family history, clinical findings, criteria scores, treatment, and outcomes. Results A total of 31 patients were included, consisting of 13 males (42%) and 18 females (58%). Most cases were over the age of 30, and both genders were nearly equally distributed among age groups. The most commonly affected site was the oral cavity, observed in 96.77% of cases. Genital, cutaneous, and vascular involvements were more common in males, while females were more likely to have oral, ocular, and musculoskeletal involvements. For various treatment regimens, oral, cutaneous, vascular, and musculoskeletal involvements showed complete response in all cases. Among cases with genital involvement, complete response was achieved in seven cases (41.2%), while four cases (23.5%) showed only partial response, and six cases (35.3%) experienced recurrence. In cases with ocular involvement, only partial responses were observed. Conclusion Oral, cutaneous, vascular, and musculoskeletal involvements may have a higher likelihood of a complete response to treatment regimens. However, genital involvement may be the most recurrent manifestation, followed by ocular involvement.

IntroductionWhile different methods are employed for fixing narrowed nasal valves and preventing the notching of soft triangles, this study aims to demonstrate the effectiveness of a new technique called Süreyya-Dani Technique.MethodsThis prospective study composed 100 patients who underwent rhinoplasty using the Süreyya-Dani technique. All patients presented with either notching of the soft triangle and/or external nasal valve dysfunction. Patients with the absence of soft triangle notching and external nasal valve dysfunction were excluded from this study. Facial analysis was conducted for all patients to identify any asymmetry in the face, and all nasal defects were identified. Descriptive statistics were calculated for different variables. Analytical statistics, namely Chi-Square test, was conducted with a significance level set at P

Lingual osteoma, a rare, benign bone tumor that primarily affects the posterior tongue, can be difficult to diagnose. This study aims to report a case of osteoma affecting the tongue in a 17-year-old female. The patient had a foreign body sensation and a progressively growing lesion for 3 years and underwent clinical examination and diagnostic procedures. A well-defined, smooth-surfaced, white mass was discovered in the posterior third of the tongue. The 1.5 × 1 × 0.4 cm mass was completely excised under local anesthesia and histopathologically confirmed as a benign lingual osteoma. The 2-month post-operative outcome was uneventful. The rarity of lingual osteoma, as well as the fact that it is often asymptomatic, makes diagnosis difficult. The diagnosis entails a proper clinical examination, imaging studies, and histopathological analysis. Surgical intervention, primarily aimed at complete excision while preserving tongue function, remains the primary treatment option. Successful excision entails educating healthcare professionals about this rare benign bony tumor to ensure the best possible patient outcomes.

Pacemaker and implantable cardioverter defibrillator migration to the breast are an extremely rare complication. The rarity of this phenomenon and its potential to mimic breast cancer emphasize the importance of reporting such cases. This study presents a rare migration of the device to the breast tissue that clinically mimicked breast cancer. This case underscores the need for comprehensive diagnostic approaches and individualized management strategies when faced with such clinical challenges. A 59-year-old female patient complained bilateral breast masses for a 3-month duration. She is a known case of diabetes mellitus and hypertension. In 2015, she underwent Implantable cardioverter defibrillator implantation for dilated cardiomyopathy and left ventricular failure. On examination, there was a skin dimpling in the left upper quadrant of her breast. The skin dimpling was clinically suspected to be breast cancer. Mammography showed an implantable cardiac device in the upper central part extending into the glandular parenchyma. A consultation with a cardiologist confirmed that the ICD was functioning properly, and as a result, no medical interventions were deemed required. Implantable cardioverter defibrillator migration to the breast is an extremely rare phenomenon and represent a complex clinical challenge that require a comprehensive diagnostic approach and individualized management strategies.

Introduction: The rising prevalence of global end-stage renal disease (ESRD) is a significant health concern, especially among children. Although renal replacement therapy is available, children with ESRD are at an increased risk of mortality. Kidney transplantation is the preferred modality of treatment and surpasses renal replacement therapy in terms of survival. However, pediatric renal transplantation could prove difficult due to factors like smaller recipients and donor-recipient mismatches leading to higher complications. Materials and methods: A retrospective single-group case series study was conducted on children with ESRD who were planned to undergo kidney transplantation from living donors between 2015 and 2021. The data was collected from two centers in the city of Sulaymaniyah. Results: The study comprised a predominantly male patient population, with a total of 39 individuals (n = 39) and 13 female patients. The donors were mostly males between 25-40 years old. The majority of participants were 15-18 years old. In majority of the patients Thymoglobulin was the immunosuppressive agent used in induction. The most common etiology for renal failure was reflux nephropathy and artery anastomosis was performed to the external iliac artery in the majority of patients. Only 9 patients had complications following the transplantation and 3 patients had an episode of acute rejection. Conclusions: Renal transplantation is the preferred treatment of renal failure in pediatric patients in the city of Sulaymaniyah. The most common etiology for pediatric renal failure was reflux nephropathy which was different from the findings of North American Pediatric Renal Trials and Collaborative Studies.

BackgroundVaccine hesitancy is a significant global problem resulting from the interaction of multiple factors, including mental health factors. However, the association of COVID-19 vaccine hesitancy with mental health has not been well-examined, especially in Arab culture. This study aims to identify the correlation between anxiety/fear of COVID-19 and vaccine hesitancy among Saudi adults.MethodsAn online-based survey was administered to 558 participants from all regions of Saudi Arabia using the snowball technique. However, this sample may not be representative of the Saudi adult population. Participants responded to the Questionnaire of Vaccine Hesitancy, the COVID-19-Anxiety Questionnaire (C-19-A), and the Fear of COVID-19 Scale (FCV-19S). Data were analyzed on vaccine uptake, vaccine hesitancy, coronavirus infection, and demographic variables. The predictive factors of vaccine hesitancy were examined in one model using multiple regression analysis by the Enter method (P= 0.05).ResultsCOVID-19 anxiety and fear have significant correlations with vaccine hesitancy (Phi=0.33, P=0.017; Phi=0.29, P=0.013, respectively). Anxiety and fear were higher among unhesitating participants (t =2.469, P=0.014; t=2.025, P=0.043, respectively). Participants who had previously been infected with coronavirus were more likely to be hesitant (X2 = 23.126, P=0.000). Participants who scored high in anxiety were more likely to be vaccinated (F=3.979, P=0.019) and have a secondary school or college education (F=4.903 P=0.002). COVID-19 anxiety, gender, and coronavirus infection significantly predicted vaccine hesitancy.ConclusionAnxiety and fear of COVID-19 are among the most important factors correlated with vaccine hesitancy; unhesitant people are more likely to have anxiety and fear. COVID-19 anxiety significantly predicted vaccine hesitancy. We recommend integrating psychological care into vaccination plans to help increase the uptake rate during potential subsequent pandemics. Relevant intervention programs can be designed to help increase vaccine acceptance, deal with vaccine hesitancy, and relieve psychological symptoms during major pandemics. Psychologists can provide awareness messages, counselling seminars, online mentoring, or telemental health outreach.

Background: Urolithiasis is one of the most prevalent urological diseases and is associated with a substantial economic burden. Its prevalence varies according to geographical location. Qatar is a Middle Eastern country located in the Afro-Asian Stone Belt. It has a dry and hot climate, which may predispose individuals working in these environments to form kidney stones (KSs). Methods: A population sample of 4204 patients was categorized into five occupational classes. The frequencies and correlations of these occupations with KS formation were calculated. Results: Among the total cases, 2000 presented with KSs, with the majority being of Asian descent (49%), followed by individuals of Middle Eastern descent (35.1%). Technicians accounted for 35.15% of KS cases followed by clerks (29.2%) and executives (14.6%). Among KS cases, 44% had a single stone, 30% had multiple stones, and 26% had two stones. In comparing both KS and non-KS groups, age, gender, occupation, and race were significantly associated with KS formation (p-value < 0.05), while BMI did not show any significant correlation (p-value > 0.05). Asian males aged 31-40, working as technicians, were significantly more prone to urolithiasis. In comparing age, BMI, and gender with stone characteristics, only age was found significantly associated with stone size (p-value < 0.05). Occupation showed an impact on all studied stone characteristics. Clerks and technicians presented more frequently with stones within the 11-15 mm range, while executives more frequently presented with smaller stones (p-value < 0.001). Stone density was more frequently < 500 HU in workers, technicians and housewives and > 500 HU in executives and clerks (p-value < 0.001). Conclusions: Our findings revealed an elevated risk of urolithiasis among certain occupational groups, particularly technicians, who frequently work outdoors in high-temperature environments. Alternatively, the sedentary nature of clerical and executive positions can also contribute to the risk of urolithiasis.

IntroductionThe prevalence and risk factors of stunting in various geographical regions have been well investigated. However, not enough data exists regarding the communities in Iraq. This study investigated the prevalence and risk factors of stunting in preschool children in Halabja governorate.MethodsThe required data for the study was collected through a structured questionnaire form from the children’s parents. Then, the height and weight of the children were measured. According to the World Health Organization Child Growth Standards and using the WHO Anthro Survey Analyser software, children were classified as “stunted” when their height-for-age z-score was below two standard deviations.ResultsA total of 646 children were included, of which 310 (48%) were male and 336 (52%) were female. The gestational age of 556 (86%) children was 9 months, while 84 (13%) were born between 7–9 months, and 6 (1%) were born in 7 months. Regarding feeding during the first 2 years of life, 229 children (35.4%) were exclusively breastfed, 93 (14.4%) were bottle-fed, and 324 (50.2%) had mixed feeding. The prevalence of stunting was 7.9% in the sample pool, with 4.6% of females and 3.3% of males. Among stunted children, 6.35% were term babies, and 1.55% were preterm babies. None of the studied factors had a significant association with stunting.ConclusionThe prevalence of stunting in the studied population was 7.9%. However, we could not find any significant association between the studied factors and stunting. Thus, the factors that may significantly affect stunting in our area of study, especially the historical chemical warfare side effects, need to be more extensively investigated in future studies.

BackgroundSocial intelligence (SI) is of great importance in the success of the counseling and psychotherapy, whether for the psychologist or for the artificial intelligence systems that help the psychologist, as it is the ability to understand the feelings, emotions, and needs of people during the counseling process. Therefore, this study aims to identify the Social Intelligence (SI) of artificial intelligence represented by its large linguistic models, “ChatGPT; Google Bard; and Bing” compared to psychologists.MethodsA stratified random manner sample of 180 students of counseling psychology from the bachelor’s and doctoral stages at King Khalid University was selected, while the large linguistic models included ChatGPT-4, Google Bard, and Bing. They (the psychologists and the AI models) responded to the social intelligence scale.ResultsThere were significant differences in SI between psychologists and AI’s ChatGPT-4 and Bing. ChatGPT-4 exceeded 100% of all the psychologists, and Bing outperformed 50% of PhD holders and 90% of bachelor’s holders. The differences in SI between Google Bard and bachelor students were not significant, whereas the differences with PhDs were significant; Where 90% of PhD holders excel on Google Bird.ConclusionWe explored the possibility of using human measures on AI entities, especially language models, and the results indicate that the development of AI in understanding emotions and social behavior related to social intelligence is very rapid. AI will help the psychotherapist a great deal in new ways. The psychotherapist needs to be aware of possible areas of further development of AI given their benefits in counseling and psychotherapy. Studies using humanistic and non-humanistic criteria with large linguistic models are needed.

Code clones, referring to code fragments that are either similar or identical and are copied and pasted within software systems, have negative effects on both software quality and maintenance. The objective of this work is to systematically review and analyze recurrent neural network techniques used to detect code clones to shed light on the current techniques and offer valuable knowledge to the research community. Upon applying the review protocol, we have successfully identified 20 primary studies within this field from a total of 2099 studies. A deep investigation of these studies reveals that nine recurrent neural network techniques have been utilized for code clone detection, with a notable preference for LSTM techniques. These techniques have demonstrated their efficacy in detecting both syntactic and semantic clones, often utilizing abstract syntax trees for source code representation. Moreover, we observed that most studies applied evaluation metrics like F-score, precision, and recall. Additionally, these studies frequently utilized datasets extracted from open-source systems coded in Java and C programming languages. Notably, the Graph-LSTM technique exhibited superior performance. PyTorch and TensorFlow emerged as popular tools for implementing RNN models. To advance code clone detection research, further exploration of techniques like parallel LSTM, sentence-level LSTM, and Tree-Structured GRU is imperative. In addition, more research is needed to investigate the capabilities of the recurrent neural network techniques for identifying semantic clones across different programming languages and binary codes. The development of standardized benchmarks for languages like Python, Scratch, and C#, along with cross-language comparisons, is essential. Therefore, the utilization of recurrent neural network techniques for clone identification is a promising area that demands further research.

Abstract Backgrounds Although calcifications have been observed in various renal masses, osseous metaplasia has very rarely been reported. Here, we present a case of concomitant clear cell renal cell carcinoma with osseous metaplasia and papillary thyroid microcarcinoma. Case presentation A 52-year-old male was being investigated for having post-prandial gaseous abdominal distention. Computed tomography of the abdomen showed a heterogeneous mass lesion measuring 27 × 24 mm at the upper/mid pole of the right kidney. It also revealed two small (10 and 11 mm) benign bone islands in the body of the D4 and L4 vertebrae. The patient underwent a metastatic workup by computed tomography, which revealed a 93 × 35 mm mass in the left thyroid lobe with coarse calcification. A partial nephrectomy was planned for the renal mass, but the site of the mass deemed this impossible. Six months after the operation, the patient underwent total thyroidectomy. Histopathology of both tissue samples revealed concomitant clear cell renal cell carcinoma with heterotopic bone formation and papillary thyroid microcarcinoma. Conclusion Although rare, osseous metaplasia in renal cell carcinoma can occur and may indicate an early-stage carcinoma with a favorable prognosis.

Penile calciphylaxis, also known as calcific uremic arteriolopathy is an uncommon condition of the penile vessels due to its extensive vascular network. The aim of this report is to report a very rare case of penile calciphylaxis with penoscrotal necrosis. A 54-year-old male patient presented with progressive penoscrotal necrosis within a duration of one month. He had a history of diabetes mellitus and stage 5 chronic kidney disease. Under spinal anesthesia, partial penectomy and excision of the necrotic scrotum were performed. Histopathological examination was consistent with calciphylaxis. Despite it is a rare occurrence, penile calciphylaxis should be included in the different diagnosis of any diabetic and end stage kidney disease patients who presented with penile pain.

Abstract Introduction Brucella epididymo-orchitis is a complication that occurs in 5.7% of patients with brucellosis and can rarely mimic a testicular tumor. We here report a case of a 25-year-old man with a testicular brucellosis that presented as a testicular mass that responded to conservative treatment using antibiotic therapy. Case report A 25-year-old patient presented with left testicular pain, abdominal pain, easy fatiguability, and feeling unwell. Physical examinations were normal. A testicular tumor was suggested by a scrotal color Doppler US scan and testicular MRI. However, tumor markers were all within the normal range. A serum Brucella agglutination test (Rose Bengal test) was done, and it was positive. The patient received anti-brucella antibiotics. An ultrasound scan 3 months later revealed complete recovery after completing antibiotic treatments. Discussion Brucella orchitis can be determined based on the triad of serology, ultrasonography, and the presence of the common symptoms like fever, testicular pain, redness, and enlargement. The early diagnosis of this phenomenon is crucial due to the morbidity and complications that may be encountered. Moreover, it has several differential diagnoses, such as testicular tumor, epididymitis, trauma, torsion of the testis, and hematocele. Failure to obtain an adequate diagnosis, particularly if a testicular tumor is suspected, may result in unnecessary intervention like orchiectomy. Conclusion Brucella orchitis is a complication of brucella infection that may mimic a testicular tumor. Several techniques of diagnosis are required for an accurate assessment.

Testicular cancers comprise 1–1.5% of entire cancers in men, and sex cord-stromal tumors include 5% of testicular cancers. This study aims to report a simultaneous Sertoli cell-only syndrome and Leydig cell tumor in the same patient. A 32-year-old man presented with a history of primary infertility for 3 years. Physical examination revealed normal secondary sexual characteristics. Two successive seminal fluid analyses revealed azoospermia. A scrotal ultrasound scan showed a 28 × 27 mm hypoechoic and hypervascular right testicular mass. Right radical orchiectomy and simultaneous left testicular biopsy were conducted. The histopathological examination revealed Sertoli cell-only syndrome and Leydig cell tumor with focal Leydig cell hyperplasia. Reversing fertility following the management of Leydig cell tumor is rarely mentioned in the literature. A study revealed that fertility recovered following 4 months of management in a primary infertile male. However, infertile men with nonobstructive azoospermia due to SCOS can only have a child by testicular sperm extraction technique. Despite the rare occurrence of Leydig cell tumor, it could be seen in association with Sertoli cell-only syndrome in infertile men with azoospermia. Clinical examination and imaging studies are important in these patients as the possibility of having a testicular mass is high among them.

BackgroundCardiac myxoma is a rare cardiac tumor that may be asymptomatic or can cause embolization or intracardiac obstruction, leading to heart failure, sudden cardiac death, and arrhythmia. This study aims to report an 11-year experience of a single center in the management of cardiac myxoma.MethodThis study is a single-center retrospective case series. Eighty cases of cardiac myxoma were collected in Ibn Albitar's specialized center for cardiac surgery. Transthoracic echocardiography was used to make the preoperative diagnosis in all patients. The surgeries were undertaken through the standard approach of a median sternotomy. All four cardiac chambers were thoroughly explored for additional myxomas. The major objective of the operations was complete tumor resection.ResultThe mean age of the patients was 46.3 years. Females (67.5%) were predominant over males (32.5%). Shortness of breath was the most common symptom (86.25%). The left atrium was the most affected site (83.75%), followed by the right atrium (13.75%). Coronary artery bypass grafting was required as the secondary or associated intervention in 19 (23.75%) cases. The recurrence rate was 11.25%, with a mortality rate of 3.75%.ConclusionRecurrence and tumor embolism are risks of surgical intervention for myxoma. Good preparation using transthoracic echocardiography as a diagnostic tool and standard median sternotomy to complete resection of the tumors can decrease the rate of recurrence, embolism, and even mortality.

Vaginal foreign bodies are infrequent events; their occurrence due to an alkaline battery is far rarer. This report is about a vaginal discharge in a 2-year-old child due to inserting an alkaline battery into her vagina. A 2-year-old child presented with lower abdominal pain, vaginal pain, and brownish-black vaginal discharge for a duration of 7 hours. A physical examination revealed a soft abdomen, while she had a swollen and erythematous vulva. A pelvic X-ray showed a radiopaque shadow of an alkaline battery in the pelvic region. Vaginoscopy was done under general anesthesia using a 9.5 Fr semi-rigid ureteroscope. The battery was grasped and extracted from the vagina using stone grasping forceps. She was discharged on oral and topical antibiotics. Vaginal FBs are a rare phenomenon, especially in children under three years of age. It is essential to recognize that the differential diagnosis of vaginal discharge in young children can be a vaginal FB.

Abstract Background Aerococcus species are Gram-positive cocci, with negative catalase and oxidase activities and growth characteristics similar to viridans streptococci. They rarely cause infection in humans. However, there are reports of bacteremia, meningitis, septic arthritis, and endocarditis due to this pathogen in the literature. Herein we report a rare case of pyelonephritis due to A. viridans. Case presentation A 31-year-old-female patient with type 1 diabetes mellitus was presented with left loin pain, fever, nausea, and anorexia for 3 days. She had a history of obstructive nephropathy due to sloughed necrotic papillae 3 months earlier, mandating bilateral JJ stent insertion. She was treated with a 2 weeks course of doxycycline (100 mg, twice daily) based on the antibiotic susceptibility profile of her urine culture and responded well. Conclusion This case highlights the possibility of complicated urinary tracts infection due to a rare human pathogen.

Objective The incidence of thyroglossal duct diseases in the general population is about 7%. We aimed to demonstrate the clinical presentations and management of thyroglossal duct diseases. Methods We conducted a retrospective review of all patients who underwent surgery for histopathologically confirmed thyroglossal duct cyst, sinus, or fistula at a single center. Results A total of 151 cases were included in this study. There were more female patients (87, 58%) than male patients (64, 42%). The patients’ ages ranged from 1 to 63 years old. The most prevalent complaint was painless upper midline neck swelling (93.3%). Most cases were diagnosed as thyroglossal duct cysts (137, 90.7%). Six cases (4%) were associated with carcinoma. All the cases were managed using the modified Sistrunk procedure. There were no procedure-related complications, and five cases of recurrence. Conclusions Although thyroglossal duct cyst is the most common neck anomaly in children, it may also present with various characteristics later in life. This condition can be managed successfully without complications and with a low recurrence rate.

Acinar cell carcinoma (ACC) of the pancreas is a rare neoplasm which is mostly diagnosed in late adulthood. This study aims to report an incidental finding of ACC in a child who was treated successfully with operation. A 9-year-old male presented with signs of delayed growth. Physical examination revealed a swelling in the left upper abdomen, which was shown to be a pancreatic tumor on a CT scan. Total surgical excision of the neoplasm was performed and the histopathology report confirmed the diagnosis of ACC. Pancreatic ACC is very rarely reported in children and its signs and symptoms are non-specific. Its diagnosis needs a high index of suspicion and CT scan is a good imaging modality for detection. Resectable tumors are best managed with complete removal of the cancer, while unresectable neoplasms can be treated with chemotherapy. However, treatment guidelines and prognosis of pancreatic ACC are not clear in pediatric age groups due to scarcity of reports. Accidental finding of ACC involving the body and tail of the pancreas is extremely rare in children. Early detection and proper management provide an excellent outcome.

Introduction: Covid-19 vaccines have been assessed in randomized trials, which are designed to establish efficacy and safety, but are insufficient in power to detect rare adverse outcomes. Among the adverse cardiac events associated with mRNA COVID-19 vaccines are inflammations (e.g., pericarditis or myocarditis), thrombosis, and ischemia. Objective: This systematic review aims to evaluate the reported cases of myocardial infarction (MI) after COVID-19 vaccinations. Method: Web of Science, MEDLINE on OVID, PubMed, and Google Scholar were searched for English-language papers published until March 25, 2022. Results: This study included 15 papers (10 case reports and 5 case series). In total, 20 individuals were included who had received COVID-19 vaccines and experienced MI. Males (55%) reported more adverse occurrences than females (45%) across the majority of event categories. The mean time from the administration of the vaccine to the onset of symptoms was 2 days (0–10 days). The AstraZeneca vaccine was responsible for more than half of the reported events. In the majority of cases, the event developed after receiving the first dose of vaccination. Conclusion: MI related to COVID19 vaccination is a rare, but serious and life-threatening condition. Chest discomfort should be regarded as a warning sign, particularly in people who have been administered a dose of the vaccine within the previous two days.

Hydatid cyst is a zoonotic disease commonly caused by the larval stage of Echinococcus granulosus. The involvement of the head and neck regions is an exceedingly rare phenomenon even in endemic geographical areas. The present study aims to report an incidental finding of a hydatid cyst in the left anterior triangle of the neck. A 24-year-old male presented with a swelling on the left side of the neck. It started to increase gradually over the last year. It was firm and immobile. There were neither overlying skin changes nor associated palpable lymph nodes. Imaging modalities - ultrasound and CT scan - showed a cystic lesion in the neck. Cystotomy and pericystectomy were performed, and the hydatid cyst was removed. Histopathological examination identified the specimen as a hydatid cyst. Hydatid cyst of the neck is a tremendously rare entity that comprises about 0.75% of all cases of hydatid cysts. All age groups are susceptible to this disease, though it is more common in younger individuals. The involvement of the neck is thought to be caused by the systemic circulation of the Echinococcus embryos in the lymphatic system. A hydatid cyst of the neck is a very rare entity. It can be easily misdiagnosed. The the diagnosis should be suspected in cases with cyst-like lesions on imaging modalities to anticipate the proper management and prevent unnecessary complications.

Objective This study was performed to report and analyze the prevalence of permanent facial nerve paralysis following parotidectomy for various benign and malignant lesions in a single center. Methods This single-center retrospective study included all patients who underwent parotidectomy (total and superficial) for benign and malignant tumors and chronic inflammatory diseases during a 6-year period. Patients who had previously undergone an operation of the parotid gland and those with preoperative facial weakness were excluded. Results The study included 127 patients ranging in age from 14 to 83 years (median, 45.89 years). Most patients were female (n = 83, 65.4%). The most prevalent procedure was superficial parotidectomy (n = 117, 92.1%), followed by total parotidectomy (n = 6, 4.7%). The average operative duration was 138 minutes (range, 80–400 minutes). Histopathology revealed that 109 (85.8%) patients had benign tumors, 14 (11.0%) had malignant tumors, and 4 (3.1%) had chronic sialadenitis. Only two patients sustained an injury to the cervical branch of the facial nerve. Conclusion In this single-center experience of parotid surgery, the rates of transient and permanent facial paralysis were acceptably low at 9.0% and 1.6%, respectively, for all pathologies.

Pattern mining is an unsupervised data mining approach aims to find interesting patterns that can be used to support decision-making. High Utility Pattern Mining (HUPM) aims to extract patterns having high utility or importance which has broad applications in domains such as market basket analysis, product recommendation, bioinformatics, e-learning, text mining, and web click stream analysis. However, it has several limitations on real life scenarios; as a consequence, many extensions of HUPM appeared in the literature such as Correlated High Pattern Mining, Incremental Utility Mining, On-Shelf High Utility Pattern Mining, and Concise Representations of High Utility Patterns. The Correlated High Utility Pattern Mining aims to extract interesting high utility patterns by utilizing both Utility and Correlation measures. Several algorithms have been proposed to mine the correlated high utility patterns. These algorithms differ in the measures used to evaluate the interestingness of the patterns, data structures and pruning properties which they use to improve the mining performance. This paper presents a detailed survey on correlated high utility pattern mining, their methods, measures, data structures and pruning properties.

High Utility Itemset Mining (HUIM) is one of the most investigated tasks of data mining. It has broad applications in domains such as product recommendation, market basket analysis, e-learning, text mining, bioinformatics, and web click stream analysis. Insights from such pattern analysis provide numerous benefits, including cost cutting, improved competitive advantage, and increased revenue. However, HUIM methods may discover misleading patterns as they do not evaluate the correlation of extracted patterns. As a consequence, a number of algorithms have been proposed to mine correlated HUIs. These algorithms still suffer from the issue of the computational cost in terms of both time and memory consumption. This paper presents an algorithm, named Efficient Correlated High Utility Pattern Mining (ECoHUPM), to efficiently mine the high utility patterns having strong correlation items. A new data structure based on utility tree (UTtree) named CoUTlist is proposed to store sufficient information for mining the desired patterns. Three pruning properties are introduced to reduce the search space and improve the mining performance. Experiments on sparse, very sparse, dense, and very dense datasets indicate that the proposed ECoHUPM algorithm is efficient as compared to the state-of-the-art CoHUIM and CoHUI-Miner algorithms in terms of both time and memory consumption.

Areca catechu shell (ACS) was utilised as adsorbent for removal of Cu(II) from aqueous solution. FTIR and SEM analysis were conducted to characterise the surface morphology of chemical activated ACS adsorbent. The ACS adsorbent has been investigated in terms of contact time and Cu(II) initial concentration. As a result, the efficiency of Cu(II) removal in solution exponentially increased with contact time reaching equilibrium at 9.6 ks. Cu (II) adsorption capacity increased over the increasing Cu(II) initial concentration in solution from 0 to 14 mg/L, and it decreased for the decreasing Cu(II) initial concentration in solution from 14 to 25 mg/L. The highest Cu(II) adsorption capacity for the Cu(II) initial concentration being in the range of 1-25 mg/L was 1.33 mg/g at 14 mg/L Cu(II) initial concentration. The kinetics study showed the Cu(II) adsorption kinetics followed the pseudo-second-order kinetics with the correlation coefficients (R2) being 0.999 and the rate constant, kH being 0.18 g/mg.ks. Meanwhile, the pseudo-first-order rate constant, kL being 0.52 /ks with the R2 being 0.807. Moreover, the Cu(II) adsorption isotherm followed the Langmuir model with the R2 being 0.98, and the mono-layer adsorption capacity being approximately 0.964 mg/g. The Langmuir over-all adsorption capacity is approximately 2.788 L/mg.

Foreign body aspiration (FBA) is a common and lethal accident in the pediatric age group. It requires early recognition and treatment by rigid bronchoscopy to avoid fatal outcomes. Objective. The aim of this study was to study the pattern of FBA in the tracheobronchial tree as well as the success rate of rigid bronchoscopy in children admitted to a single center and to analyze the relationship of the type of foreign body (FB) with patients’ age, presentation, and complications. Methods. A retrospective cross-sectional study of FBA was conducted in children in the Sulaimani/Kurdistan region, Iraq, admitted to the emergency teaching hospital of the University of Sulaimani from January 2014 to March 2016. Result. Data of 83 patients between 6 months and 15 years old were studied. The most affected was the 1- to 5-year-old group. There was a slight female predominance (male to female ratio 0.93:1). The most common FB was sunflower seed (49.4%). History of choking was present in 92.8% of patients; 55.4% had normal air entry, and 37.3% had no added sound on chest auscultation. Normal chest X-ray (CXR) was found in 40% of patients. The most common site was the right bronchial tree (39.8%). Two patients needed mechanical ventilation; both of them died. There was a significant relationship between the type of FB ( P = .013, .000, respectively). Conclusion. Medical history is the most important factor for reaching the diagnosis; bronchoscopy is mandatory if choking was witnessed, even if examination and CXR are normal. Organic material causes more local reaction than nonorganic material.