Incidental Discovery of Asymptomatic Stage IV Hiatal Hernia With Complete Gastric Thoracic Herniation: A Case Report.

Hiatal hernia is a gastrointestinal disorder characterized by abnormal displacement of a portion of the stomach into the thoracic cavity. It has multiple stages ranging from type I-IV according to severity. The more severe the hernia, the more likely it will produce symptoms, and it would be unlikely for it to be asymptomatic. In this case report, we describe a rare situation in which a 79-year-old woman's type IV hiatal hernia was incidentally found after she suffered a mechanical fall.

A Rare Case of a Neuroendocrine Tumor at the Duodenum.

Neuroendocrine tumors (NETs) are slow-growing cancers derived from neuroendocrine cells that typically affect the pancreas, lungs, and gastrointestinal tract. A rare form can develop in the duodenum and can be difficult to diagnose and treat. The case below describes a rare incidence of a well-differentiated duodenal bulb NET in a 77-year-old man who had early satiety and persistent dyspepsia. Endoscopy, biopsies, and immunohistochemistry staining were used to confirm the diagnosis. According to the features of the tumor, management techniques, including endoscopic, surgical, and medicinal procedures, are being implemented.

A Complex Presentation of Esophageal Pseudodiverticulosis With Candida Albicans Esophagitis in a 68-Year-Old Female.

Esophageal pseudodiverticulosis, a rare condition, involves small sac-like structures in the esophageal wall, stemming from dilated excretory ducts of submucosal glands. While uncommon, it can complicate Candida albicans esophagitis, a yeast infection linked to various clinical issues, including pseudodiverticula formation. This unique association underscores the importance of understanding its clinical implications and optimal management. In this case, a 68-year-old female sought medical attention for dysphagia and recurrent food impaction. The diagnostic journey revealed esophageal pseudodiverticulosis and Candida albicans esophagitis, emphasizing the complexity of esophageal disorders.

Submucosal Lipoma in the Rectum Found Incidentally During Colonoscopy Screening: A Case Report.

Gastrointestinal (GI) tract lipomas are a benign entity of GI tumors. In this case report, we present a 53-year-old patient who was found to have a rectal lipoma incidentally in an asymptomatic middle-aged female during a routine colonoscopy screening. The tumor was excised during colonoscopy and sent for histopathology, which confirmed the diagnosis. We also provide a literature review of GI lipomas, focusing on their occurrence in the rectum.

Ischaemic Gastropathy: An Under-Recognised cause of Abdominal Pain.

Ischaemic gastropathy is an under-recognised phenomenon with a particularly poor prognosis, where early diagnosis is crucial for successful medical intervention and the prevention of life-threatening complications. We present a case involving a 42-year-old female with no history of vascular insufficiency who developed ischaemic gastropathy following a prolonged stay in the intensive care unit, from septic shock secondary to Escherichia coli bacteraemia due to complicated acute appendicitis. This case underscores the importance of the physician's awareness regarding this rare entity and the necessity to consider it in the differential diagnosis of abdominal pain and haematemesis. Prompt diagnosis and treatment may significantly improve survival outcomes in this less-documented pathology, especially in the younger adult population. LEARNING POINTS: Awareness needs to be increased regarding the consideration of ischaemic gastropathy as a differential diagnosis.A patient without a history of vascular compromise could have a diagnosis of ischaemic gastropathy.This is possibly the first noted case of ischaemic gastropathy occurring after an appendectomy, which is complicated by gram-negative bacteraemia and haemodynamic instability.

Salmonella Group B Ileitis Mimicking Crohn's Disease: A Case Report.

Salmonellae, considered among the enteric-fever-causing pathogens, is associated with a range of human infections, including gastroenteritis, bacteremia, and osteomyelitis. Salmonella-induced mesenteric adenitis and terminal ileitis resembling acute appendicitis have been reported in the literature. Here, we present a rare case of a patient presenting with severe acute active ileitis and colitis mimicking Crohn's disease with no prior history of inflammatory bowel disease and found to have Salmonella group B bacteremia.

Symptomatic Gastric Diverticulum in the Antrum: A Case Report.

Gastric diverticulum is an out-pouching that occurs in the gastric wall and, often, when found, is incidental and asymptomatic. While they do not occur commonly, gastric diverticula are located most commonly in the posterior wall of the fundus of the stomach, and their presence in the antrum, as appreciated in the case described below, is quite rare. We present a 65-year-old female who was found to have an antral gastric diverticulum on esophagogastroduodenoscopy (EGD). There have been a few reported cases in the literature of gastric diverticulum that occurred in the antrum. This case report will shed light on this rare pathology, focusing on the occurrence in the antrum.

Obstructive Jaundice Secondary to Hepatic Hilar Tuberculosis Without Pulmonary Involvement.

Tuberculosis (TB) is primarily a respiratory infection with huge mortality and morbidity worldwide. Extrapulmonary TB infection is common, affecting lymph nodes, pleura, and abdomen, but the prima-ry biliary presentation without lung involvement is exceedingly rare. We report on a 38-year-old male patient presented with isolated obstructive jaundice secondary to TB infection. This case highlights the importance of considering TB infection in the differential diagnosis of obstructive jaundice, especially in the endemic area. We also provide a literature review on TB infection, mainly in the biliary tract. LEARNING POINTS: Tuberculosis (TB) can affect the biliary system, mimicking cholangiocarcinoma without pulmonary involvement.Early recognition of biliary TB and treatment can prevent permanent complications and invasive intervention requirements.Using standard anti-tuberculous medications has shown high efficiency in treating and eradicating mycobacterial infection in such locations.

Application of multivariate discriminant analysis for differentiation between Saudi sheep (Ovis aries) breeds based on physical and histochemical meat characteristics.

Background and Aim: The multivariate discriminant (MVD) analysis was a successful statistical tool with a discriminatory capacity for tracing sheep breeds based on meat characteristics. Thus, this study aimed to identify three Saudi sheep breeds based on the physical and histochemical aspects of meat using MVD analysis. Materials and Methods: Eight male lambs from each breed, Najdi, Neami, and Harri, were selected randomly at 90 days of age and allocated into three groups for breeding in a completely randomized design. The feeding and rearing management were similar for an experimental period of 90 days. The experimental diet consisted of a concentrated mixture with identical amounts of calories and nitrogen. Fifty-one meat characteristics were measured in the preliminary MVD, representing hot and cold carcass weight, meat cuts and quality measures, body component weights, fat deposit weights, and histochemical characteristics. Results: Out of the total meat characteristics measured, only 19 characteristics had significant discriminant power. The most powerful characteristics were temperature, empty intestinal weight, pH24, external carcass length, heart weight, and L1, based on partial R-square and Wilks' lambda values. The phenotypic associations between the characteristics had strong associations. The obtained principal components efficiently classified the eight individuals of each breed into distinct groups using robust discriminant characteristics. Conclusion: This method allowed us to determine the breed of sheep carcasses and cuts by considering the physical characteristics of the meat. Therefore, butchers and consumers should use scientific techniques for assigning carcasses and meat to their sheep breed after slaughtering.

A Rare Case Report of Persistent Hiccups as an Atypical Presentation of COVID-19.

Sudden, involuntary spasm of the diaphragm associated with closure of the glottis will lead to a hiccup sound. Brief episodes of hiccups are often self-limiting and may be physiologically encountered in everyday life. However, prolonged attacks of hiccups are associated with significant morbidity. Herein, we present a rare and interesting case of coronavirus disease 2019 (COVID-19) induced persistent hiccups in a 61-year-old gentleman with no signs or symptoms of gastric pathology. As the patient required less oxygen supplementation, with inflammatory markers down-trending, his hiccups improved. The timeline of the symptom presentation and his response to treatment highly suggested that his hiccups were associated with COVID-19 infection. To the best of our knowledge, there are only two cases of persistent hiccups secondary to COVID-19 that have been reported thus far. Our case will add to the existing literature and highlight the potential association of COVID-19 with hiccups.

Power of phenotypes in discriminating Awassi sheep to pure strains and from other breeds.

The phenotypic description is the oldest method for animal taxonomic studies. In this study, we report phenotypic traits of discriminant power to assign sheep individuals into Awassi breed or other exotic breeds found in Jordan. Twenty-two and 19 phenotype traits for ewes and rams, respectively, were utilized using multivariate and discriminant analyses. Seven traits, out of them, for ewes and five for rams were qualitative traits: body color, nose shape, horn presence, ear shape, wattles presence, udder shape, and teat placement. The other 15 traits were quantitative traits: body weight, head width, head length, chest depth, chest girth, shoulder width, withers height, foreleg height, shin circumference, body length, rump width, rump length, rump height, rear leg height, and udder height. The traits were taken on 1697 and 652 adult ewes and rams of different breeds, respectively. The breeds were predefined as Awassi and three exotic breeds: Chios, Assaf, and improved Awassi sheep. The results indicated a significant relationship of the 21 and 16 studied traits in assigning and discriminating individual's sheep into their correct breed. The analysis revealed the clustering of the three strains of Awassi sheep in Jordan as the Baladi, the Naemi, and the Saqri. The genetic distances have also confirmed the findings. However, the potential of gene flow between Awassi strains and the exotic breed was reported. The phenotypic traits with discriminant power would be utilized in a guideline for sheep taxonomy in general and for Awassi sheep in particular.

Varicella-Zoster Virus Reactivation in AIDS Patient After Pfizer-BioNTech COVID-19 Vaccine.

Since early 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected millions of individuals and changed the face of medicine. As the fight against COVID continues, there is still unclear long term effects; although as time passes, more and more is being updated, in regards to the risks of exposure, length of recovery, outcomes of those infected, effectiveness of vaccines, and both expected and unique side effects of both the virus and vaccines, all in an array of individuals. This paper will review a unique topic of the SARS-CoV-2 virus and the abnormal immune response in a young patient. This case is unique due to the fact that there have been an abundance of side effects reported that are associated with the virus that affects every organ system, yet very few have affected the neurological and integumentary (skin) system. This case emphasizes the reactivation of a Herpes/Varicella-Zoster virus (VZV) in a young male shortly after he received the Pfizer-BioNTech COVID-19 vaccine. The other interesting aspect about this case is the patient's immunocompromised state, as he was diagnosed with HIV several years before this viral reactivation occurred. The interesting aspect about this was trying to understand whether the VZV was truly reactivated because of an overly stressful immune reaction in response to the Pfizer-BioNTech COVID-19 vaccine or was it mainly due to the patient's already weak immune system, or even a combination of both? The in-depth review will evaluate whether there should be more done in regards to bringing more awareness about potential side effects and preparing for a VZV reactivation and/or other dermatological complications after being vaccinated. This presentation could also simply be a very unique, isolated case, and that each individual should have no hesitations regarding the Pfizer-BioNTech COVID-19 vaccine.

Hemophagocytic Lymphohistiocytosis Secondary to Disseminated Histoplasmosis in AIDS Patient.

Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening syndrome that is often underdiagnosed. There are limited treatments and clinical outcomes documented in adults, more so in the immunocompromised population. Here, we described the clinical features, diagnosis, treatment, and clinical outcome of an HLH secondary to histoplasmosis in an AIDS patient.

The wild species genome ancestry of domestic chickens.

BACKGROUND: Hybridisation and introgression play key roles in the evolutionary history of animal species. They are commonly observed within several orders in wild birds. The domestic chicken Gallus gallus domesticus is the most common livestock species. More than 65 billion chickens are raised annually to produce meat and 80 million metric tons of egg for global human consumption by the commercial sector. Unravelling the origin of its genetic diversity has major application for sustainable breeding improvement programmes. RESULTS: In this study, we report genome-wide analyses for signatures of introgression between indigenous domestic village chicken and the four wild Gallus species. We first assess the genome-wide phylogeny and divergence time across the genus Gallus. Genome-wide sequence divergence analysis supports a sister relationship between the Grey junglefowl G. sonneratii and Ceylon junglefowl G. lafayettii. Both species form a clade that is sister to the Red junglefowl G. gallus, with the Green junglefowl G. varius the most ancient lineage within the genus. We reveal extensive bidirectional introgression between the Grey junglefowl and the domestic chicken and to a much lesser extent with the Ceylon junglefowl. We identify a single case of Green junglefowl introgression. These introgressed regions include genes with biological functions related to development and immune system. CONCLUSIONS: Our study shows that while the Red junglefowl is the main ancestral species, introgressive hybridisation episodes have impacted the genome and contributed to the diversity of the domestic chicken, although likely at different levels across its geographic range.

Renal efficiency underlies adaptive heterothermy of heat-stressed hypohydrated goats.

We investigated the thermotolerance of the F1 progeny (Black Bedouin × Damascus crossbreed) to summer conditions alongside that of two pure breeds. Male goats (n = 7 per breed) were used to conduct a summertime 28-day trial along with hypohydration. The animals were fitted with miniscule thermologgers, intraperitoneally and subcutaneously, to measure core (Tc) and peripheral (Tp) body temperatures (BT), respectively. All goats were kept under shaded housing for a 7-day basal period before being switched to unshaded pens for the next 21 days. During the first 14 days, animals had free access to water. However, during the third 7-day period, access to water was time-restricted (4 h/day). Finally, it was restricted to 40% of the third week's average daily intake over the last 7 days. Exposure to the unshaded conditions resulted in pronounced heat stress in all animals, as reflected by 0.42 and 1.44 °C rises for Tc and Tp, respectively. The F1 goats displayed a clear heterothermic adaptive response, especially after the water restriction bouts' initiation. Interestingly, the F1 goats displayed higher ratios of renal relative medullary thickness (77.7, 73.3, and 72.6 ± 1.1%) along with higher circulating concentrations of antidiuretic hormone (44.6, 31.6, and 11.6 ± 3.7 ng/mL), respectively, which suggested an improved water metabolism.

Microsatellite-Based Genetic Structure and Diversity of Local Arabian Sheep Breeds.

The genetic diversity of the sheep breeds in the Arab countries might be considered to be a mirror of the ecology of the region. In this study, the genetic structure and diversity of sheep breeds from Saudi Arabia (Harri, Najdi, Naemi, Arb, and Rufidi) and Awassi sheep from Jordan as an out-group were investigated using 19 microsatellites. All the breeds had high intra-population genetic diversity expressed as allelic number (7.33) and richness (2.9) and, expected heterozygosity (0.77). Structure analysis revealed three main gene pools underlying the ancestral genetic diversity of the study populations. The first pool had Harri, Najdi, and Rufidi breeds; the second had Naemi and Awassi breeds, and the third had the Arb breed which was significantly differentiated from the other breeds. Factorial correspondence analysis lent further support to the presence of the three gene pools. Although the outgroup Awassi sheep was more clearly differentiated, it still genetically close to Naemi sheep. The differentiation of the Arb breed could have been resulted from geographic and reproductive isolation. On the other hand, the genetic structure of the other two gene pools could be the result of the past and recent gene flow between individuals reared in the region known to be the center for animal husbandry and trading until the current time.

Whole-Genome Resequencing of Red Junglefowl and Indigenous Village Chicken Reveal New Insights on the Genome Dynamics of the Species.

The red junglefowl Gallus gallus is the main progenitor of domestic chicken, the commonest livestock species, outnumbering humans by an approximate ratio of six to one. The genetic control for production traits have been well studied in commercial chicken, but the selection pressures underlying unique adaptation and production to local environments remain largely unknown in indigenous village chicken. Likewise, the genome regions under positive selection in the wild red junglefowl remain untapped. Here, using the pool heterozygosity approach, we analyzed indigenous village chicken populations from Ethiopia, Saudi Arabia, and Sri Lanka, alongside six red junglefowl, for signatures of positive selection across the autosomes. Two red junglefowl candidate selected regions were shared with all domestic chicken populations. Four candidates sweep regions, unique to and shared among all indigenous domestic chicken, were detected. Only one region includes annotated genes (TSHR and GTF2A1). Candidate regions that were unique to each domestic chicken population with functions relating to adaptation to temperature gradient, production, reproduction and immunity were identified. Our results provide new insights on the consequence of the selection pressures that followed domestication on the genome landscape of the domestic village chicken.

Genetic origin of goat populations in Oman revealed by mitochondrial DNA analysis.

The Sultanate of Oman has a complex mosaic of livestock species and production systems, but the genetic diversity, demographic history or origins of these Omani animals has not been expensively studied. Goats might constitute one of the most abundant and important domestic livestock species since the Neolithic transition. Here, we examined the genetic diversity, origin, population structure and demographic history of Omani goats. Specifically, we analyzed a 525-bp fragment of the first hypervariable region of the mitochondrial DNA (mtDNA) control region from 69 Omani individuals and compared this fragment with 17 mtDNA sequences from Somalia and Yemen as well as 18 wild goat species and 1,198 previously published goat sequences from neighboring countries. The studied goat breeds show substantial diversity. The haplotype and nucleotide diversities of Omani goats were found equal to 0.983 ± 0.006 and 0.0284 ± 0.014, respectively. The phylogenetic analyses allowed us to classify Omani goats into three mtDNA haplogroups (A, B and G): haplogroup A was found to be predominant and widely distributed and accounted for 80% of all samples, and haplogroups B and G exhibited low frequencies. Phylogenetic comparisons with wild goats revealed that five of the native Omani goat populations originate from Capra aegagrus. Furthermore, most comparisons of pairwise population FST values within and between these five Omani goat breeds as well as between Omani goats and nine populations from nearby countries were not significant. These results suggest strong gene flow among goat populations caused by the extensive transport of goats and the frequent movements of human populations in ancient Arabia. The findings improve our understanding of the migration routes of modern goats from their region of domestication into southeastern Arabia and thereby shed light on human migratory and commercial networks during historical times.

Dynamic of Bacterial Diversity in Ileum Digesta Under Water Supplements of Antibiotics and Probiotics.

BACKGROUND AND OBJECTIVE: Intestinal bacteria plays an important role in the physiological and immunological status of birds. The present study investigated the diversity of intestinal bacterial of broilers that were fed corn-soy diet and supplements of antibiotics and probiotics. MATERIALS AND METHODS: The supplemented treatments were water, water with antibiotics, water with probiotic and water with antibiotics and probiotic. Eight randomly sampled broilers were slaughtered and their ileum digesta taken. The total of 32 samples was then subjected for DNA extraction. Subsequently, bacterial tag-encoded 16 FLX ampliconpyro sequencing (bTEFAP) procedures were performed. RESULTS: Nearly all treatments samples contained Lactobacillus, with the majority related to water with probiotic treatment. In contrast, different pathogenic bacteria along with Lactobacillus observed for other three treatments. CONCLUSION: The probiotics supplements made a shift towards useful bacterial species; Lactobacillus salivarius and Lactobacillus aviarius. This study promoted for replacing the probiotics as a prophylaxis in gastrointestinal infection and diseases instead of antibiotics.

Effects of concentration of corn distillers dried grains with solubles and enzyme supplementation on cecal microbiota and performance in broiler chickens.

With the increasing production of ethanol for biofuels, a by-product of corn-based ethanol fermentation, dried distillers grains with solubles (DDGS) is finding its way into the feed of agricultural animals including cattle, pigs, poultry, sheep, goats, aquaculture species and horses. Corn DDGS contains very high levels of non-starch polysaccharides and could be considered a good source of fibre. Despite knowledge of the role of the fibre in modulating intestinal microbiota and consequently influencing health, there is currently little information on the interactions between DDGS and intestinal microbiota. We assessed the changes in the cecal microbiota of broilers feed rations supplemented with DDGS (five concentrations: 0, 6, 12, 18 and 24% w/w) with and without presence of digestive enzymes. DDGS concentration was strongly positively correlated (P = 3.7e-17, r = 0.74) with feed conversion efficiency (FCR), diminishing broiler performance with higher concentrations. Additionally, DDGS concentrations positively correlated with Richness index (P = 1.5e-3, r = 0.5), increasing the number of detectable species in the cecum. Among the most affected genera, Faecalibacterium (P = 0.032, r = -0.34) and Streptococcus (P = 7.9e-3, r = -0.39) were negatively correlated with DDGS, while Turicibacter (P = 2.8e-4, r = 0.52) was positively correlated with the DDGS concentration. Enzymes showed minimal effect on cecal microbiota.