Native and non-native freshwater bivalves in the bioremediation of bacterial pollution caused by the disposal of sewage.

Treated sewage contains a large diversity of pathogens that can be transmitted to the environment and, directly or indirectly, infect humans through water use (i.e., consumption, bathing, or irrigation). In urban environments, wastewater normally flows into wastewater treatment plants (WWTPs), where it is subjected to different processes in order to eliminate the greatest amount of waste. However, there are inequalities among European countries concerning wastewater management. In this context, we evaluate the potential of freshwater mussels to improve water quality (i.e., reduce bacterial abundance) in rivers receiving primary, secondary, or tertiary sewage-treated effluents. Additionally, because freshwater mussels are declining at a global scale and empty niches are progressively occupied by non-native counterparts, we evaluate if depauperate communities and the Asian clams, Corbicula genus, can provide equivalent ecosystem services (i.e., water quality improvement by biofiltration) formerly provided by diverse native communities. For this, an analysis of the bacterial biodiversity of the samples filtered by the different bivalve communities was carried out. The experimental approach was performed by metabarcoding the 16S rRNA gene using Illumina technologies. According to the results obtained, secondary treatment processes were effective in reducing the bacterial diversity. Furthermore, the waters filtered by the bivalves presented a lower bacterial abundance for certain genera. Biofiltration differs, however, among species, with Corbicula reducing a large number of taxa much more efficiently than native freshwater mussels in both diverse and depauperated communities. These results are likely related to Corbicula being a generalist species in front of native mussels, which may be more selective. Considering it is not possible to eradicate Corbicula from European rivers, its filtering capacity should be considered when managing freshwater ecosystems.

A Systematic Review of Genetics- and Molecular-Pathway-Based Machine Learning Models for Neurological Disorder Diagnosis.

The process of identification and management of neurological disorder conditions faces challenges, prompting the investigation of novel methods in order to improve diagnostic accuracy. In this study, we conducted a systematic literature review to identify the significance of genetics- and molecular-pathway-based machine learning (ML) models in treating neurological disorder conditions. According to the study's objectives, search strategies were developed to extract the research studies using digital libraries. We followed rigorous study selection criteria. A total of 24 studies met the inclusion criteria and were included in the review. We classified the studies based on neurological disorders. The included studies highlighted multiple methodologies and exceptional results in treating neurological disorders. The study findings underscore the potential of the existing models, presenting personalized interventions based on the individual's conditions. The findings offer better-performing approaches that handle genetics and molecular data to generate effective outcomes. Moreover, we discuss the future research directions and challenges, emphasizing the demand for generalizing existing models in real-world clinical settings. This study contributes to advancing knowledge in the field of diagnosis and management of neurological disorders.

CDKN2A/B Homozygous Deletion Sensitizes IDH-Mutant Glioma to CDK4/6 Inhibition.

PURPOSE: Treatment paradigms for isocitrate dehydrogenase (IDH)-mutant gliomas are rapidly evolving. Although typically indolent and responsive to initial treatment, these tumors invariably recur at a higher grade and require salvage treatment. Homozygous deletion of the tumor suppressor gene CDKN2A/B frequently emerges at recurrence in these tumors, driving poor patient outcomes. We investigated the effect of CDK-Rb pathway blockade on IDH-mutant glioma growth in vitro and in vivo using CDK4/6 inhibitors (CDKi). EXPERIMENTAL DESIGN: Cell viability, proliferation assays, and flow cytometry were used to examine the pharmacologic effect of two distinct CDKi, palbociclib and abemaciclib, in multiple patient-derived IDH-mutant glioma lines. Isogenic models were used to directly investigate the influence of CDKN2A/B status on CDKi sensitivity. Orthotopic xenograft tumor models were used to examine the efficacy and tolerability of CDKi in vivo. RESULTS: CDKi treatment leads to decreased cell viability and proliferative capacity in patient-derived IDH-mutant glioma lines, coupled with enrichment of cells in the G1 phase. CDKN2A inactivation sensitizes IDH-mutant glioma to CDKi in both endogenous and isogenic models with engineered CDKN2A deletion. CDK4/6 inhibitor administration improves survival in orthotopically implanted IDH-mutant glioma models. CONCLUSIONS: IDH-mutant gliomas with deletion of CDKN2A/B are sensitized to CDK4/6 inhibitors. These results support the investigation of the use of these agents in a clinical setting.

Attitudes, Beliefs, and Behaviors of Topical Antibiotic Prescribing among Primary Care Providers in Saudi Arabia: A Cross-Sectional Study.

BACKGROUND: The World Health Organization (WHO) estimates that 20-50% of antibiotics are misused in society. In addition to the development of antimicrobial resistance, topical antibiotics have been associated with adverse effects such as allergic contact dermatitis (ACD) and inadequate wound healing. This study investigated the appropriateness of topical antibiotic prescriptions among primary care providers in Saudi Arabia. METHODS: A cross-sectional survey was conducted among Saudi Arabian primary care providers (physicians (general, family, and internal medicine)) employed in governmental and non-governmental healthcare facilities (primary care centers and outpatient clinics). RESULTS: In total, 222 participants were included in the analysis. A total of 73% agreed that inappropriate topical antibiotic use puts patients at risk, and 43% reported antibiotic resistance in daily practice. Many respondents lacked knowledge of the proper indications for topical antibiotics, and 66.2% attributed this to a lack of updated knowledge, while 45% blamed inadequate supervision. CONCLUSION: Antibiotic prescription patterns deviated from the standards recommended by WHO. This calls for continuous review at all levels of healthcare, providing more physician education and ensuring that antibiotic therapy guidelines are easily accessible and effectively used to avoid the negative consequences of inappropriate antibiotic prescription.

Emerging Roles and Mechanisms of RNA Modifications in Neurodegenerative Diseases and Glioma.

Despite a long history of research, neurodegenerative diseases and malignant brain tumor gliomas are both considered incurable, facing challenges in the development of treatments. Recent evidence suggests that RNA modifications, previously considered as static components of intracellular RNAs, are in fact dynamically regulated across various RNA species in cells and play a critical role in major biological processes in the nervous system. Innovations in next-generation sequencing have enabled the accurate detection of modifications on bases and sugars within various RNA molecules. These RNA modifications influence the stability and transportation of RNA, and crucially affect its translation. This review delves into existing knowledge on RNA modifications to offer a comprehensive inventory of these modifications across different RNA species. The detailed regulatory functions and roles of RNA modifications within the nervous system are discussed with a focus on neurodegenerative diseases and gliomas. This article presents a comprehensive overview of the fundamental mechanisms and emerging roles of RNA modifications in these diseases, which can facilitate the creation of innovative diagnostics and therapeutics for these conditions.

The Prevalence and Associated Factors of Occupational Stress in Healthcare Providers in Saudi Arabia.

Background: Occupational stress is a negative physical and emotional response to job requirements, which might be caused by various factors that can harm the emotional and physical well-being of the employee. We aimed to investigate the factors and conditions associated with occupational stress. Study Design: The study was cross-sectional, conducted with the Perceived Stress Scale ten item version. Results: The majority of the participants reported moderate stress 223 (71%) and a small proportion (n=38, 12.2%) a high stress level. Several factors associated with higher risk of stress level for example being single were associated with higher risk of stress level in 135 (74.6%), moderate and high stress level was also reported in the group without enough income, 96 (75%) and 20 (15.6%), respectively. Conclusion: A group of sociodemographic factors were consistently associated with occupational stress, including gender, income, comorbidity and marital status. However, some factors remained complex and multifaceted. Recommendation: It is important to focus on reducing stress levels for all employees, regardless of their work experience or income. To prevent losing control of the healthcare worker's stress and to prevent an escalation to anxiety or depression, stress-management programs are necessary, specifically for those who are experiencing high stress levels.

Emergence of Carbapenemase Genes in Gram-Negative Bacteria Isolated from the Wastewater Treatment Plant in A Coruña, Spain.

Wastewater treatment plants (WWTPs) are recognized as important niches of antibiotic-resistant bacteria that can be easily spread to the environment. In this study, we collected wastewater samples from the WWTP of A Coruña (NW Spain) from April 2020 to February 2022 to evaluate the presence of Gram-negative bacteria harboring carbapenemase genes. Bacteria isolated from wastewater were classified and their antimicrobial profiles were determined. In total, 252 Gram-negative bacteria carrying various carbapenemase genes were described. Whole-genome sequencing was conducted on 55 selected carbapenemase producing isolates using Oxford Nanopore technology. This study revealed the presence of a significant population of bacteria carrying carbapenemase genes in WWTP, which constitutes a public health problem due to their risk of dissemination to the environment. This emphasizes the usefulness of WWTP monitoring for combating antibiotic resistance. Data revealed the presence of different types of sequences harboring carbapenemase genes, such as blaKPC-2, blaGES-5, blaGES-6, blaIMP-11, blaIMP-28, blaOXA-24, blaOXA-48, blaOXA-58, blaOXA-217, and blaVIM-2. Importantly, the presence of the blaKPC-2 gene in wastewater, several months before any clinical case was detected in University Hospital of A Coruña, suggests that wastewater-based epidemiology can be used as an early warning system for the surveillance of antibiotic-resistant bacteria.

The multispecies microbial cluster of Fusobacterium, Parvimonas, Bacteroides and Faecalibacterium as a precision biomarker for colorectal cancer diagnosis.

The incidence of colorectal cancer (CRC) has increased worldwide, and early diagnosis is crucial to reduce mortality rates. Therefore, new noninvasive biomarkers for CRC are required. Recent studies have revealed an imbalance in the oral and gut microbiomes of patients with CRC, as well as impaired gut vascular barrier function. In the present study, the microbiomes of saliva, crevicular fluid, feces, and non-neoplastic and tumor intestinal tissue samples of 93 CRC patients and 30 healthy individuals without digestive disorders (non-CRC) were analyzed by 16S rRNA metabarcoding procedures. The data revealed that Parvimonas, Fusobacterium, and Bacteroides fragilis were significantly over-represented in stool samples of CRC patients, whereas Faecalibacterium and Blautia were significantly over-abundant in the non-CRC group. Moreover, the tumor samples were enriched in well-known periodontal anaerobes, including Fusobacterium, Parvimonas, Peptostreptococcus, Porphyromonas, and Prevotella. Co-occurrence patterns of these oral microorganisms were observed in the subgingival pocket and in the tumor tissues of CRC patients, where they also correlated with other gut microbes, such as Hungatella. This study provides new evidence that oral pathobionts, normally located in subgingival pockets, can migrate to the colon and probably aggregate with aerobic bacteria, forming synergistic consortia. Furthermore, we suggest that the group composed of Fusobacterium, Parvimonas, Bacteroides, and Faecalibacterium could be used to design an excellent noninvasive fecal test for the early diagnosis of CRC. The combination of these four genera would significantly improve the reliability of a discriminatory test with respect to others that use a single species as a unique CRC biomarker.

Retraction: Giant Traumatic Diaphragmatic Hernia: A Report of Delayed Presentation.

[This retracts the article DOI: 10.7759/cureus.20315.].

A multiband SSr diode RF rectifier with an improved frequency ratio for biomedical wireless applications.

This paper described a four-band implantable RF rectifier with simplified circuit complexity. Each RF-rectifier cell is sequentially matched to the four operational frequencies to accomplish the proposed design. The proposed RF rectifier can harvest RF signals at 1.830, 2.100, and white space Wi-Fi bands between 2.38 to 2.68 GHz, respectively. At 2.100 GHz, the proposed RF harvester achieved a maximum (radio frequency direct current) RF-to-DC power conversion efficiency (PCE) of 73.00% and an output DC voltage [Formula: see text] of 1.61 V for an RF power of 2 dBm. The outdoor performance of the rectenna shows a [Formula: see text] of 0.440 V and drives a low-power bq25504-674 evaluation module (EVM) at 1.362 V. The dimension of the RF-rectifier on the FR-4 PCB board is 0.27[Formula: see text] [Formula: see text] 0.29[Formula: see text]. The RF-rectifier demonstrates the capacity to effectively utilize the frequency domain by employing multi-band operation and exhibiting a good impedance bandwidth through a sequential matching technique. Thus, by effectively controlling the rectenna's ambient performance, the proposed design holds the potential for powering a range of low-power biomedical implantable devices. (BIDs).

Parvimonas micra can translocate from the subgingival sulcus of the human oral cavity to colorectal adenocarcinoma.

Oral and intestinal samples from a cohort of 93 colorectal cancer (CRC) patients and 30 healthy controls (non-CRC) were collected for microbiome analysis. Saliva (28 non-CRC and 94 CRC), feces (30 non-CRC and 97 CRC), subgingival fluid (20 CRC), and tumor tissue samples (20 CRC) were used for 16S metabarcoding and/or RNA sequencing (RNAseq) approaches. A differential analysis of the abundance, performed with the ANCOM-BC package, adjusting the P-values by the Holm-Bonferroni method, revealed that Parvimonas was significantly over-represented in feces from CRC patients (P-value < 0.001) compared to healthy controls. A total of 11 Parvimonas micra isolates were obtained from the oral cavity and adenocarcinoma of CRC patients. Genome analysis identified a pair of isolates from the same patient that shared 99.2% identity, demonstrating that P. micra can translocate from the subgingival cavity to the gut. The data suggest that P. micra could migrate in a synergistic consortium with other periodontal bacteria. Metatranscriptomics confirmed that oral bacteria were more active in tumor than in non-neoplastic tissues. We suggest that P. micra could be considered as a CRC biomarker detected in non-invasive samples such as feces.

Wastewater early warning system for SARS-CoV-2 outbreaks and variants in a Coruña, Spain.

Wastewater-based epidemiology has been widely used as a cost-effective method for tracking the COVID-19 pandemic at the community level. Here we describe COVIDBENS, a wastewater surveillance program running from June 2020 to March 2022 in the wastewater treatment plant of Bens in A Coruña (Spain). The main goal of this work was to provide an effective early warning tool based in wastewater epidemiology to help in decision-making at both the social and public health levels. RT-qPCR procedures and Illumina sequencing were used to weekly monitor the viral load and to detect SARS-CoV-2 mutations in wastewater, respectively. In addition, own statistical models were applied to estimate the real number of infected people and the frequency of each emerging variant circulating in the community, which considerable improved the surveillance strategy. Our analysis detected 6 viral load waves in A Coruña with concentrations between 103 and 106 SARS-CoV-2 RNA copies/L. Our system was able to anticipate community outbreaks during the pandemic with 8-36 days in advance with respect to clinical reports and, to detect the emergence of new SARS-CoV-2 variants in A Coruña such as Alpha (B.1.1.7), Delta (B.1.617.2), and Omicron (B.1.1.529 and BA.2) in wastewater with 42, 30, and 27 days, respectively, before the health system did. Data generated here helped local authorities and health managers to give a faster and more efficient response to the pandemic situation, and also allowed important industrial companies to adapt their production to each situation. The wastewater-based epidemiology program developed in our metropolitan area of A Coruña (Spain) during the SARS-CoV-2 pandemic served as a powerful early warning system combining statistical models with mutations and viral load monitoring in wastewater over time.

A Cross-Sectional Study on the Prevalence of Self-Prescribed Aspirin Use for Prevention of Adverse Ischemic Vascular Events Among Moderate-Risk Individuals: A Single Center Study.

Introduction Despite the overwhelming amount of evidence against the use of aspirin for primary prophylaxis of cardiovascular disease (CVD), the arguably unwarranted use of aspirin has increased over the years, which may or may not be based on any specific medical advice, and merely self-prescribed. Aim This study aimed to determine the prevalence of unwarranted aspirin use among moderate-risk individuals for the primary prevention of adverse vascular events in Saudi Arabia. Patient and method A cross-sectional study was conducted among 100 patients who presented to the emergency room (ER) due to suspected cardiac diseases. The data were collected from the patients who visited ER in King Fahad Hospital, Al-Hofuf, Saudi Arabia. Participants were asked about their socio-demographic characteristics, aspirin use habits, and their comorbidities. Results Of the 100 patients, 35% were aged more than 60 years old. The overall use of aspirin was 78%. The prevalence of aspirin use was significantly more common among the older age group (53.8%), those with associated chronic diseases, such as diabetes (59%) and hypertension (75.6%) and those with a previous history of hospitalization due to stroke or a cardiac event (66.7%). Conclusion The use of aspirin among patients who are at moderate risk of cardiovascular events was widely prevalent, but their unwarranted use was low. Older patients with chronic diseases who believed in its great benefit and tended to ignore its complications are the most common users of aspirin. More research is recommended to determine the prevalence and the factors associated with unwarranted use of aspirin in patients with CVD in our region.

Cherubism in Saudi population: a rare case report / Querubismo na população Saudi: relato de um caso raro

Cherubism is a rare hereditary benign fibro-osseous disorder characterised by bilateral swelling of the mandible and/or maxilla with varying severity of involvement. It occurs because of dominant mutations in SH3BP2 gene on the chromosome 4p16.3. On radiography cherubic lesions appear as multilocular cystic radiolucencies in the jaw bones giving a soap bubble appearance. These lesions usually heal by themselves by the time the patient attains puberty. Treatment is necessary only in aggressive cases where there is severe facial deformity or vital functions are hampered. Surgical corrections are preferred when the lesion is in its dormant phase. The aim of the present case report is to illustrate a case of cherubism in a 9-year-old Saudi boy which is a very rare occurrence as only 1 case of cherubism has been reported so far in the Saudi Arabian population (AU)

Querubismo é uma desordem fibro-óssea hereditária rara caracterizada por aumento de volume bilateral da mandíbula e/ou maxila com graus variáveis de severidade. Ocorre devido a mutação dominante no gene SH3BP2 no cromossomo 4p16.3. Radiograficamente as lesões de querubismo aparecem como radiolucência multilocular semelhantes a bolhas de sabão nos ossos maxilares. Geralmente as lesões involuem espontaneamente quando o paciente atinge a puberdade. O tratamento se faz necessário apenas nos casos mais agressivos que demonstram deformidade facial severa ou comprometimento de funções vitais. Correções cirúrgicas são preferíveis quando a lesão está na fase dormente. O objetivo do presente relato é ilustrar um caso de querubismo em um paciente de 9 anos da Arábia Saudita, sendo este um evento raríssimo com apenas um outro caso relatado na população da Arábia Saudita (AU)

Optimal Deep-Learning-Enabled Intelligent Decision Support System for SARS-CoV-2 Classification.

Intelligent decision support systems (IDSS) for complex healthcare applications aim to examine a large quantity of complex healthcare data to assist doctors, researchers, pathologists, and other healthcare professionals. A decision support system (DSS) is an intelligent system that provides improved assistance in various stages of health-related disease diagnosis. At the same time, the SARS-CoV-2 infection that causes COVID-19 disease has spread globally from the beginning of 2020. Several research works reported that the imaging pattern based on computed tomography (CT) can be utilized to detect SARS-CoV-2. Earlier identification and detection of the diseases is essential to offer adequate treatment and avoid the severity of the disease. With this motivation, this study develops an efficient deep-learning-based fusion model with swarm intelligence (EDLFM-SI) for SARS-CoV-2 identification. The proposed EDLFM-SI technique aims to detect and classify the SARS-CoV-2 infection or not. Also, the EDLFM-SI technique comprises various processes, namely, data augmentation, preprocessing, feature extraction, and classification. Moreover, a fusion of capsule network (CapsNet) and MobileNet based feature extractors are employed. Besides, a water strider algorithm (WSA) is applied to fine-tune the hyperparameters involved in the DL models. Finally, a cascaded neural network (CNN) classifier is applied for detecting the existence of SARS-CoV-2. In order to showcase the improved performance of the EDLFM-SI technique, a wide range of simulations take place on the COVID-19 CT data set and the SARS-CoV-2 CT scan data set. The simulation outcomes highlighted the supremacy of the EDLFM-SI technique over the recent approaches.

Satisfaction of patients with health care services in tertiary care facilities of Riyadh, Saudi Arabia: A cross-sectional approach.

As part of Saudi Vision 2030, the country's healthcare system is undergoing a significant makeover, with accessibility and effectiveness serving as the benchmarks for measuring patient care quality. This study's goal was to ascertain the degree of patient satisfaction with the medical care and services received in Riyadh's tertiary care facilities. The PSQ-18 (Patient Satisfaction Questionnaire-18), a standardized validated questionnaire including areas of "overall satisfaction," "technical quality," "interpersonal aspect," "communication," "financial aspect," "time spent with the doctor," and "accessibility and convenience," was used in this cross-sectional study on 384 patients of two tertiary care facilities in Riyadh, Saudi Arabia, over a 6-month period. The degree to which sociodemographic characteristics and components of patient satisfaction are correlated was assessed using binary and multiple regression analysis. When the P-value was < 0.05, the results were considered significant and were presented as adjusted odds ratios (AOR). To ascertain how each PSQ-18 subscale affected other subscales, a Pearson Correlation analysis was conducted. The overall degree of satisfaction with all 18 items was 73.77%. The financial component received a rating of 81% compared to 77% for general satisfaction. Technical quality (75%) was followed by accessibility and convenience (73.5%), communication (73%), and interpersonal elements (72%). At 68%, the time spent in the doctor's domain received the lowest rating. The odds of satisfaction were increased by 3.87 times, 3.45 times, and 3.36 times among those who are employed, qualified by university education, and married compared to unemployed (P-value = 0.018), less qualified (P-value = 0.015) and singles (P-value = 0.026), respectively. The younger age group also made 1.78 times more of a difference in higher satisfaction ratings. The general satisfaction domain showed a positive association with other areas. Participants who were satisfied with the communication and accessibility and convenience domains of healthcare providers were the only ones who were typically satisfied with the domain of doctor time spent. The study's findings could act as a benchmark for Saudi Arabia's healthcare services as well as a starting point for quality assurance procedures.

Modeling the number of people infected with SARS-COV-2 from wastewater viral load in Northwest Spain.

The quantification of the SARS-CoV-2 RNA load in wastewater has emerged as a useful tool to monitor COVID-19 outbreaks in the community. This approach was implemented in the metropolitan area of A Coruña (NW Spain), where wastewater from a treatment plant was analyzed to track the epidemic dynamics in a population of 369,098 inhabitants. Viral load detected in the wastewater and the epidemiological data from A Coruña health system served as main sources for statistical models developing. Regression models described here allowed us to estimate the number of infected people (R2 = 0.9), including symptomatic and asymptomatic individuals. These models have helped to understand the real magnitude of the epidemic in a population at any given time and have been used as an effective early warning tool for predicting outbreaks in A Coruña municipality. The methodology of the present work could be used to develop a similar wastewater-based epidemiological model to track the evolution of the COVID-19 epidemic anywhere in the world where centralized water-based sanitation systems exist.

Herd Immunity against Severe Acute Respiratory Syndrome Coronavirus 2 Infection in 10 Communities, Qatar.

We investigated what proportion of the population acquired severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and whether the herd immunity threshold has been reached in 10 communities in Qatar. The study included 4,970 participants during June 21-September 9, 2020. Antibodies against SARS-CoV-2 were detected by using an electrochemiluminescence immunoassay. Seropositivity ranged from 54.9% (95% CI 50.2%-59.4%) to 83.8% (95% CI 79.1%-87.7%) across communities and showed a pooled mean of 66.1% (95% CI 61.5%-70.6%). A range of other epidemiologic measures indicated that active infection is rare, with limited if any sustainable infection transmission for clusters to occur. Only 5 infections were ever severe and 1 was critical in these young communities; infection severity rate of 0.2% (95% CI 0.1%-0.4%). Specific communities in Qatar have or nearly reached herd immunity for SARS-CoV-2 infection: 65%-70% of the population has been infected.

Giant Traumatic Diaphragmatic Hernia: A Report of Delayed Presentation.

Diaphragmatic rupture is an uncommon injury after blunt abdominal trauma. The diaphragmatic defect may not be obvious in imaging studies immediately after the initial injury. Patients may have delayed presentation when the diaphragmatic defect enlarges and allows abdominal content to herniate into the thoracic cavity. Here, we present the case of a 30-year-old man who presented with the emergency department complaining of shortness of breath at rest for two days duration. He reported having shortness of breath for the last five years, but he attributed it to his smoking. The shortness of breath was associated with cough productive and vague abdominal pain. The patient had an unremarkable relevant medical history. He reported having a motor vehicle accident five years ago that was severe but he did not sustain any significant injuries or fractures. Upon examination, the patient appeared in respiratory distress. Respiratory examination revealed diminished air entry on the left hemithorax and the abdominal examination revealed increased generalized tenderness with increased bowel sounds. The patient underwent a thoracic computed tomography scan, which unexpectedly demonstrated a huge left-sided diaphragmatic defect with bowel loops observed to occupy the left hemithorax completely. The patient was stabilized and shifted to emergency laparotomy during which the hernia content was reduced and the defect was closed with a mesh. The patient reported the resolution of his symptoms after the surgery. Intensive chest physiotherapy exercises were performed. After six months of follow-up, the patient remained asymptomatic with no active complaints. The diaphragmatic hernia may have delayed presentations after several years of blunt abdominal trauma. The case highlighted the importance of initial imaging studies after blunt trauma may not identify the diaphragmatic defect.