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The focus of this article is to spotlight the ritual frame of the canonical Friday prayer that is organized weekly around midday in places of Islamic worship in Italy. I verify how the Muslim communities in Italy, as a “cognitive minority”, use different strategies related to the performance of the Friday prayer ritual, and I analyze its continuous reframing. During the preliminary investigation I selected seventeen places of worship located in major cities and provincial towns located in the North, Central and South of Italy including Sicily. I have only considered spaces run by Sunni Arabs because they are the majority of Muslims in Italy. In these places I performed the participant observation from October 2016 to July 2017 collecting empirical data and more than a hundred sermons that I analyzed later. I also relied on interviews with preachers and people in charge of these places.

The simultaneous occurrence of Wilms tumor (WT) and multicystic kidney disease (MCKD) is extremely uncommon. Diagnosing WT in pediatric patients with multicystic dysplastic kidney (MCDK) substantially impacts management strategies, especially in surgical interventions and long-term outcomes. In summary, while the exact prevalence of WT in children with MCKD is not well-defined, children with MCDK are followed up throughout childhood by ultrasound because of the perceived risk of developing WT, although this risk is poorly defined and somewhat controversial. Herein, we present the case of an 8-year-old child diagnosed with WT arising in a clearly defined MCDK, discovered incidentally through histological analysis. This case contributes to the ongoing discussion by adding to the existing reports in the literature., Competing Interests: The authors have no conflicts of interest to declare., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2025.)

Purpose: The concept of interposing double dorsal preputial flaps to cover the urethroplasty was introduced in 2005 to reduce the risk of urethrocutaneous fistula (UCF). Our study aims to compare the postoperative outcomes of urethroplasty for distal hypospadias between two groups: one receiving single preputial flap coverage and another receiving double flap coverage., Materials and Methods: We conducted a retrospective analysis study of boys with primary distal hypospadias who underwent surgery by the same experienced surgeon, at our department between 2010 and 2021. The study population was divided into two groups: Group A, which underwent urethroplasty coverage with single dorsal preputial flap, and Group B, which underwent coverage with double flap. Postoperative complications were compared between the two groups., Results: We collected 105 cases, comprising 51 in Group A and 54 cases in Group B. The mean age at surgery was 29 months in Group A and 24 months in Group B. Post-operative follow-up period ranged from 6 months to 8 years. Functional and cosmetic outcomes were judged excellent in 88.7%. Only 10 boys experienced complications requiring reoperation. UCF occurred in 5 patients from Group A, while no cases were reported in Group B (p = 0.024). Meatal stenosis was identified in three patients in Group A and in two patients in Group B (p = 1). No other complications, such as glans dehiscence or penile torsion, were noted., Conclusion: Double dorsal dartos flap is an effective method for covering the new urethra and can be recommended in the treatment of patients with virgin distal hypospadias., (© 2024 The Author(s). International Journal of Urology published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Urological Association.)

OEIS complex is a rare congenital malformation characterized by the presence of omphalocele, bladder exstrophy, anal imperforation, and spina bifida, with an unclear etiology thought to be multifactorial and heterogeneous. We report a case of OEIS complex in a spontaneous dizygotic twin pregnancy involving a 29-year-old gravida 2, para 1 woman. The condition was first suspected at 22 weeks of gestation during a detailed ultrasound, which revealed characteristic abnormalities, and was later confirmed by magnetic resonance imaging (MRI) showing omphalocele, bladder exstrophy, and spinal malformations. This case emphasizes the importance of prenatal imaging, particularly ultrasound and MRI, in the early detection of OEIS complex, as accurate prenatal diagnosis is crucial for effective counseling, optimizing perinatal management, and planning for postnatal reconstructive surgery., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Purpose: Orotracheal intubation is one of the most frequently used techniques in emergency procedures and especially in anesthesia and resuscitation. Teeth may be "victims" of the orotracheal intubation. Several factors may predispose to these accidents. The aim of this study is to determine the incidence of oral trauma that occurs during scheduled and urgent oral tracheal intubation, and identify the risk factors, the types and locations of these dental injuries., Methods: It is a cross-sectional study that lasted 6 months from June to November 2022. This study was carried out in several departments. An examination of the dental and periodontal status of patients who will undergo surgery under general anesthesia was performed before the operation according to the surgical program. Yet, in emergency settings, this examination was not possible. Patients with anterior edentation and patients refusing participation in the study were excluded. After the surgery, included patients were examined to detect eventual dental trauma such as fracture, luxation, and contusion. Collected data were entered and analyzed using SPSS version 18 software. The Wilcoxon Mann-Whitney U test was used to compare quantitative variables. The Chi-square test was used to compare qualitative variables with a statistical significance level of 5% (p < 0.05)., Results: There were 43 patients included in the study, and dental trauma was noted in 11 patients (25.6%). Their mean age was (59.8 ± 15.4) years. The statistical analysis shows that there is a significant relationship between age (over 40 years old) and trauma (p = 0.004). Among the traumatized group, orotracheal intubation was undergone for 8 cases according to the surgical program whereas it was performed, for 3 cases, in emergency settings. The difference between the 2 types of intervention is statistically significant (p = 0.045). The odds ratio was 0.086 (95% CI: 0.008 - 0.942). A Mallampati score of 1 was rated for 6 injured (54.5%). The difference between the difficulty of the intubation evaluated by the Mallampati score and the occurrence of trauma was statistically insignificant (p = 0.278). The dental partial dislocation was the most frequent trauma (6 cases, 54.5%). The maxillary teeth were the most affected (n = 13, 72.2%)., Conclusion: According to the present study, the incidence of orotracheal intubation dental traumas is relatively high. The age of the patient is one of the factors predisposing to these traumas. In scheduled surgery, orotracheal intubation is quietly performed during general anesthesia, and the risk of incidence of dental trauma is reduced than in emergency settings., Competing Interests: Declaration of competing interest Authors declare no conflict of interests., (Copyright © 2024 Chinese Medical Association. Published by Elsevier B.V. All rights reserved.)

Isolated primary diaphragmatic hydatid disease (HD) occurs in approximately 1% of adult cases. However, this unique presentation of a pediatric diaphragmatic cystic mass has not been previously described in the literature. This study reports a rare case of a 12-year-old girl who was diagnosed with a diaphragmatic hydatid cyst. Surgical exploration via subcostal incision revealed an isolated cyst, free from the thoracic and abdominal viscera. Cystotomy, removal of daughter cysts, and excision of the pericyst cavity were performed, followed by diaphragmatic repair. Histopathological examination confirmed the diagnosis. The postoperative course was uneventful, and the patient completed an 8-week mebendazole regimen with no recurrence at 3 months' follow-up. This paper recommends including HD in the differential diagnosis for pediatric patients presenting with diaphragmatic lesions, particularly in regions endemic for echinococcosis., Competing Interests: The authors of this manuscript have no conflicts of interest to declare. All co-authors have seen and agree with the manuscript’s contents and there is no financial interest to report., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2024.)

Background: we aim to discuss the origin and the differences of the phenotypic features and the management care of rare form of disorder of sex development due to Mosaic monosomy X and Y chromosome materiel., Methods: We report our experience with patients harboring mosaic monosomy X and Y chromosome material diagnosed by blood cells karyotypes and cared for in our department from 2005 to 2022., Results: We have included five infants in our study. The current average age was 8 years. In four cases, the diagnosis was still after born and it was at the age of 15 years in one case. Physical examination revealed a variable degree of virilization, ranging from a normal male phallus with unilateral ectopic gonad to ambiguous with a genital tubercle and bilateral not palpable gonads in four cases and normal female external genitalia in patient 5. Karyotype found 45, X/46, XY mosaicism in patient 1 and 2 and 45, X/46, X, der (Y) mosaicism in patient 3, 4 and 5. Three cases were assigned to male gender and two cases were assigned to female. After radiologic and histologic exploration, four patients had been explored by laparoscopy to perform gonadectomy in two cases and Mullerian derivative resection in the other. Urethroplasty was done in two cases of posterior hypospadias. Gender identity was concordant with the sex of assignment at birth in only 3 cases., Conclusion: Because of the phenotypic heterogeneity of this sexual disorders and the variability of its management care, then the decision should rely on a multidisciplinary team approach., (© 2024. The Author(s).)

Competing Interests: The authors have disclosed no conflicts of interest.

Background: Trichobezoar is an uncommon clinical entity in which ingested hair mass accumulates within the digestive tract. It is generally observed in children and young females with psychological disorders. It can either be found as an isolated mass in the stomach or may extend into the intestine. Untreated cases may lead to grave complications., Material and Methods: We retrospectively analyzed the clinical data of six patients treated for trichobezoar in Monastir pediatric surgery department during 16-year-period between 2004 and 2019. Imaging (abdominal computed tomography and upper gastroduodenal opacification) and gastroduodenal endoscopy were tools of diagnosis., Results: Our study involved 6 girls aged 4 to 12. Symptoms were epigastric pain associated with vomiting of recently ingested food in 3 cases and weight loss in one case. Physical examination found a hard epigastric mass in all cases. The trichobezoar was confined to the stomach in 4 cases. An extension into the jejunum was observed in 2 cases. Surgery was indicated in all patients. In two cases, the attempt of endoscopic extraction failed and patients were then operated on. All patients had gastrotomy to extract the whole bezoar even those with jejunal extension. Psychiatric follow-up was indicated in all cases. The six girls have evolved well and did not present any recurrence., Conclusion: open surgery still plays a crucial role in Trichobezoard management . After successful treatment, psychiatric consultation is imperative to prevent reccurrence and improve long term prognosis., Competing Interests: None

This study is focused on analyzing the linkage between carbon dioxide (CO 2 ) emissions, renewable energy consumption (RE), foreign direct investment (FDI), national patents (NP), exports (X), imports (M), and gross domestic product (GDP) in Tunisia by using the time series data from 1980 to 2017. A unit root test and an autoregressive distributed lag (ARDL) model were applied to avoid bias caused by data mismatch and autocorrelation of time series data. Elasticity long-run test shows that renewable energy consumption, exports, and gross domestic product have a positive impact on CO 2 emissions, while foreign direct investment acts negatively on CO 2 emissions. Depending on the error correction term test, there is a long-run causality: from CO 2 emissions, renewable energy, foreign direct investment, exports, and gross domestic product to home patent. Findings of the short-run causality show that there is a unidirectional causality running from exports to CO 2 emissions and from exports to gross domestic product. Our results also show that Tunisia should encourage foreign direct investment because it seems to be an important factor in the mitigation of CO 2 emissions., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: Several clinical obstructive sleep apnea syndrome (OSAS) phenotypes associated with heterogeneous cardiovascular risk profiles have been recently identified. The purpose of this study was to identify clusters amongst these profiles that allow for the differentiation of patients., Methods: This retrospective study included all moderate-to-severe OSAS patients referred to the sleep unit over a 5-year period. Demographic, symptom, comorbidity, polysomnographic, and continuous positive airway pressure (CPAP) adherence data were collected. Statistical analyses were performed to identify clusters of patients., Results: A total of 567 patients were included (67% men, 54±13 years, body mass index: 32±7 kg/m 2 , 65% Caucasian, 32% European African). Five clusters were identified: less severe OSAS (n=172); healthier severe OSAS (n=160); poorly sleeping OSAS patients with cardiometabolic comorbidities (n=87); younger obese men with sleepiness at the wheel (n=94); sleepy obese men with very severe desaturating OSAS and cardiometabolic comorbidities (n=54). Patients in clusters 3 and 5 were older than those in clusters 2 and 4 (P=0.034). Patients in clusters 4 and 5 were significantly more obese than those in the other clusters (P=0.04). No significant differences were detected in terms of symptoms and comorbidities. Polysomnographic profiles were very discriminating between clusters. CPAP adherence was similar in all clusters but, among adherent patients, daily usage was more important in cluster 1 (less severe patients) than in cluster 5., Conclusion: This study highlights that the typical sleepy obese middle-aged men with desaturating events represent only a minority of patients in our multi-ethnic moderate-to-severe OSAS cohort of 33% females., (© 2021. Huazhong University of Science and Technology.)

Erythema multiforme is an acute mucocutaneous hypersensitivity reaction with various etiological factors, including herpes simplex virus, medications, autoimmune diseases, and malignancies, but the most common cause is infection by herpes simplex virus. The most characteristic feature is the presence of "target lesions." There are no specific diagnostic tests for EM, and the diagnosis is based on clinical signs and symptoms and biopsy if required. We report a case of recurrent herpes-associated erythema multiforme managed with prophylactic acyclovir for 6 months: a 17-year-old boy had recurrent cutaneous lesions as well as lesions in the oral cavity and lips. Positive serology for herpes simplex virus and histopathological examination confirmed the diagnosis., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Aya Mtiri et al.)

Objectives: The purpose of this study was to document clinical features of inguinal hernia (IH) in the pediatric population. It provides data to evaluate associated risk factors of incarcerated hernia, its recurrence as well as the occurrence of contralateral metachronous hernia., Materials and Methods: We report a retrospective analytic study including 922 children presenting with IH and operated from 2010 to 2013 in our pediatric surgery department., Results: We managed 143 girls (16%) and 779 boys (84%). The mean age was 2 years; the right side was predominantly affected (66.8%, n = 616). Incarcerated hernia was documented in 16% of cases with an incidence of 33% in neonates. The incarceration occurrence was 15.5% in males versus 2.09% in females. The surgical repair was done according to Forgue technique. Postoperatively, four cases of hernia recurrence were documented, and contralateral metachronous hernia was reported in 33 children with 7.7% females versus 2.8% males. Forty-five percent of them were infants. The mean follow-up period was 4 years. We think that incarceration can be related to several risk factors such as feminine gender, prematurity, and the initial left side surgical repair of the hernia., Conclusion: IH occurs mainly in male infants. Prematurity and male gender were identified as risk factors of incarceration. Contralateral metachronous hernia was reported, especially in female infants and after a left side surgical repair of the hernia., Competing Interests: There are no conflicts of interest.

Background: Recurrent intussusceptions in child and infants are problematic and there are controversies about its management. The aim of this study is to determine the details of the clinical diagnosis of recurrent intussusception and to determine the aetiology of recurrent intussusceptions., Patients and Methods: It's a retrospective study of 28 cases of recurrent intussusception treated in the paediatric surgery department of Monastir (Tunisia) between January 1998 and December 2011., Results: During the study period, 505 patients were treated for 544 episodes of intussusception; there were 39 episodes of recurrent intussusceptions in 28 patients; the rate of patients with recurrence was 5.5%. With comparison to the initial episode, clinical features were similar to the recurrent episode, except bloody stool that was absent in the recurrent group (P = 0,016). Only one patient had a pathologic local point., Conclusion: In recurrent intussusception, patients are less symptomatic and consult quickly. Systematic surgical exploration is not needed as recurrent intussusceptions are easily reduced by air or hydrostatic enema and are not associated with a high rate of pathologic leading points.

The authors report two cases of coronary-right ventricular fistulas diagnosed in a 7-month-old infant and a 9-year-old girl. The discovery of the heart disease was incidental in both cases, following detection of a low continuous murmur. Doppler ultrasonography established the diagnosis, which was confirmed by haemodynamic studies and coronary angiography. The left anterior descending artery was involved in both cases and the recipient cavity was the right ventricle. The first patient was cured by early operation with distal ligation of the artery. In the second patient, the natural course was complicated by aneurysmal dilatation of the coronary artery. The authors recall the value of colour Doppler ultrasound in the noninvasive diagnosis, especially of the recipient cavity by colour Doppler and the need to rapidly treat coronary fistulas to prevent the development of complications reported after an average age of 20 years.