Young-Onset Colon Cancer: A Case Report.

Colorectal cancer (CRC) which is diagnosed in patients under the age of 50 years is defined as young-onset CRC. There has been a substantial increase in the incidence and mortality of young-onset CRC in the past four decades and the patients have delayed diagnoses leading to the advanced stages of CRC at the time of diagnosis. Here we present a case of a 34-year-old male patient with colon cancer and a literature review on young-onset colon cancer to highlight the age-related disparities in CRC incidence and try to explore the possible causative factors for the rise in incidence and mortality in young patients due to CRC.

Effects of foliar application of selenium and potassium-humate on oat growth in Baloza, North Sinai, Egypt.

In this study, the effects of foliar application of selenium (Se) at different concentrations were examined based on changes in several parameters such as nitrogen, phosphorous, and potassium (NPK) concentration in soil and oat plant, oat yield, organic matter in the soil (OMS), non-enzymatic antioxidants, and total phenol content. Chromium (Cr), iron (Fe), manganese (Mn), zinc (Zn), and copper (Cu) concentrations were also assessed in oat straw and seeds. The study complies with local and national guideline. Simultaneous application of potassium humate (K-humate) with Se was also investigated in this study. Se application increased the bioavailability of N and P in soil and their total concentration in the straw and seeds of each plant. Se concentrations were proportional to the amount of phosphorous found in soil (P-soil) but not with K concentrations in seed (K-plant). Application of K-humate with Se increased the bioavailable fraction of K-soil; however, it did not increase the bioavailable fraction of K-straw or K-seed. Although the application of Se alone substantially enhanced yield, the simultaneous application of K-humate showed no additional effect. Moreover, responses of seed yield and plant length were not significant after the application of Se with or without K-humate. OMS and total phenol content were proportional to the application rate of Se with and without K-humate. Non-enzymatic antioxidant content was also proportional to Se concentrations but not proportional to K-humate. The total Se concentrations in the soil, plant straw, and seeds increased with the addition of K-humate. Furthermore, the total Cr concentrations were reduced after the application of Se and K-humate. Fe concentration in the straw and seeds varied from one treatment to another, and Mn concentration was reduced in response to the foliar application of Se and K-humate. Zn concentrations in the straw and seeds of plants were reduced with the application of varying concentrations of Se. Increasing the application rate of Se induced a reduction in the Cu concentration in seeds. In contrast, the simultaneous application of Se and K-humate increased the Cu concentration in seeds.

A Case of Megaesophagus Secondary to a Massive Phytobezoar in a Patient With Achalasia.

Bezoar is a rare entity that is composed of indigested foreign material and is most commonly seen in the stomach. Phytobezoars are the most common type of bezoars and are composed of indigestible cellulose and lignin from fruits and vegetables. We present a unique case of esophageal phytobezoar, which was seen in a patient with long-standing achalasia. The patient presented to the gastroenterology clinic complaining of decreased appetite as she had worsening dysphagia, weight loss, vomiting on eating food. An endoscopy revealed a large phytobezoar that was extending along the whole length of the esophagus. There was stenosis at the gastroesophageal (GE) junction. The phytobezoar was dissolved with carbonated soda lavage and the remainder of the phytobezoar was fragmented with water irrigation and rescue net via the endoscope and fragments were retrieved. Botulinum was injected at the GE junction in all four quadrants which resulted in a relaxation of the stenosis. Untreated long-standing esophageal phytobezoars can lead to life-threatening complications like perforation. Endoscopic modalities with carbonated soda lavage is an efficacious mode of treatment. Surgical interventions are recommended in case of endoscopic modality failure.

Green synthesis of ZnO, MgO and SiO2 nanoparticles and its effect on irrigation water, soil properties, and Origanum majorana productivity.

The synthesis of different metal oxide nanoparticles (NPs) (e.g., ZnO, MgO and SiO2) using green methods is a promising alternative to traditional chemical methods. In this work, ZnO, MgO, and SiO2 NPs were prepared using lemon peel extract. The synthesized NPs were characterized using Fourier transform infrared spectroscopy, UV-Visible spectroscopy, X-ray diffraction, and transmission electron microscopy. Also, the effects of the green synthesis of different NPs on the irrigation water quality, the availability of some heavy metals in soil and plants, and the productivity of Origanum majorana (marjoram) were studied in detail. The obtained results showed that the addition of the NPs resulted in noticeable variations in the removal percentages of Cu2+ and Fe3+ from aqueous solutions. The maximum values obtained for the adsorption of Cu(II) on ZnO, MgO, and SiO2 NPs within the pH values of 3-5 were 89.9%, 83.3%, and 68.36%, respectively. Meanwhile, the maximum adsorption values of Fe(III) at pH 3.3 were 82%, 80%, and 65% for ZnO, MgO, and SiO2 NPs, respectively. Clearly, the application of the NPs effectively reduced the available Cu2+ in the studied soil samples in the following order: Zn2 > Zn1 > Mg2 > Si2 > Mg1 > Si1 > C (control). The highest values of available Cu2+ were observed in the control treatment, whereas the lowest values were obtained when Zn2 was added. The same tendencies were observed with substantial concentrations of Fe. The addition of NPs to the soil samples positively affected the plants' Cu2+ uptake. The effects of NPs and the additions of Cu2+ and Fe3+ on the availability of nitrogen, phosphorus, and potassium (NPK) in the soil system were very completed and osculated from one treatment to another. The same tendencies were observed with the total concentration of NPK in plants.

A Rare Cause of Recurrent Lower Gastrointestinal Bleed: Colonic Dieulafoy's Lesion.

Dieulafoy's lesion accounts for 1%-2% of acute gastrointestinal (GI) bleeding cases, and approximately 2% of Dieulafoy's lesions are present in the colon. We report the case of an 83-year-old female who presented with recurrent gastrointestinal bleeding from colonic Dieulafoy's lesion located at the hepatic flexure. She initially presented four weeks prior with melena in the setting of Eliquis use for venous thrombosis, coronary artery disease, and end-stage renal disease. Upper endoscopy revealed esophagitis, gastritis, and duodenitis. Diagnostic colonoscopy and video capsule endoscopy both revealed blood in the colon without an identifiable source. During the second admission for recurrent melena with hemoglobin of 3.9 g/dL, Eliquis was discontinued, and the patient was resuscitated with three units of packed red blood cell transfusions. Repeat colonoscopy revealed a pulsating vessel with active oozing located at the hepatic flexure, consistent with a Dieulafoy's lesion. Hemostatic endoclips and bipolar electrocautery were applied to achieve complete hemostasis. Colonic Dieulafoy's lesions, albeit rare, should be considered in patients presenting with an acute obscure lower GI bleed. Primary hemostasis can be achieved with several endoscopic modalities including epinephrine, hemoclipping, thermocoagulation, or sclerotherapy.

Characterization of Patients with COVID-19 Admitted to a Community Hospital of East Harlem in New York City.

Background New York City was the epicenter for the coronavirus disease 2019 (COVID-19) in the United States. Accordingly, the aim of this study was to characterize the population of patients admitted with this condition to a community hospital in East Harlem located in the northeast part of the city. Methods A retrospective review of medical records of patients at least 18 years of age, admitted to the hospital with COVID-19 disease from March 14 to April 30 of 2020. Results Three hundred and seventy-one patients were identified. The majority was comprised of men. Obesity, hypertension, and hyperlipidemia were the most prevalent comorbidities. Most patients were treated with a combination of hydroxychloroquine, azithromycin, zinc, and vitamin C. Twenty-three percent of the patients died from the disease during the study period. Conclusion Morbidity and mortality were substantial in patients with COVID-19 admitted to a community hospital in East Harlem.

Endoscopic band ligation versus endoscopic hemoclip placement for Dieulafoy's lesion: a meta-analysis.

Dieulafoy lesions (DL) are abnormally large arterial lesions that fail to decrease in size as they emerge from the submucosa to the mucosal surface. Endoscopic treatment has become the mainstay of therapy for actively bleeding DL lesions. In this meta-analysis, we aim to assess the efficacy of both techniques in achieving primary hemostasis of actively bleeding DL lesions and their rates of rebleeding. Our search included the Pubmed, Scopus and CINAHL electronic databases. The initial search yielded 440 articles and after appropriate review by 2 individual reviewers, 5 studies met inclusion criteria. Review manager version 5.3 was used for statistical analysis. There were 75 patients treated with EBL and 87 patients treated with EHC. The success rate of primary hemostasis of EBL for bleeding DL lesions was 0.96 [95% confidence interval (CI): 0.88-0.99]. The success rate of primary hemostasis of EHC for bleeding DL lesions was 0.91 (95% CI: 0.83-0.96). The recurrence of bleeding for patients treated with EBL was 0.06 (95% CI: 0.02-0.15). The recurrence of bleeding for patients treated with EHC was 0.17 (95% CI: 0.10-0.28). There was no statistical significance in primary hemostasis or rebleeding in patients treated with EBL or EHC. There was no significant heterogeneity between studies included in the analysis. Endoscopic band ligation and endoscopic hemoclip placement are efficacious procedures for the treatment of NVUGIB secondary to DL with similar rates of primary hemostasis and rebleeding.

Thrombotic thrombocytopenic purpura possibly triggered by Graves' disease.

Thrombotic thrombocytopenic purpura (TTP) is a part of a spectrum of thrombotic microangiopathy syndromes which are mainly characterized by platelet aggregation causing microangiopathic hemolytic anemia, thrombocytopenia and microvascular occlusion. In literature, very few cases expressing a direct association between pre-existing Grave's disease and TTP have been described. A 37-year-old African-American woman with past medical history of Grave's disease and polysubstance abuse who presented with complaints of dyspnoea at rest and chest pain was diagnosed to have TTP on further evaluation. Patient also showed severely elevated thyroid hormones and suppressed thyroid stimulating hormone levels indicating severe thyrotoxicosis. Initiation of prompt management of TTP and thyrotoxicosis led to a favorable patient outcome. In conclusion, patients presenting with thyrotoxicosis, thrombocytopenia and microangioapthic hemolytic anemia without an alternative cause should be treated and screened for TTP due to the high fatality associated with untreated or untimely detection of this disease.

Blastocystis sp. Infection Mimicking Clostridium Difficile Colitis.

We report an unusual case of severe diarrhea related to Blastocystis sp. infection in a patient with end stage renal disease on hemodialysis. The patient was admitted due to profuse diarrhea associated with fever and leukocytosis. Pertinent stool work-up such as leukocytes in stool, stool culture, clostridium difficile toxin B PCR, and serology for hepatitis A, hepatitis B, and hepatitis C and cytomegalovirus screening were all negative. Ova and parasite stool examination revealed Blastocystis sp. The patient was given intravenous metronidazole with clinical improvement by day three and total resolution of symptoms by day ten.

Structural features, kinetics and SAR study of radical scavenging and antioxidant activities of phenolic and anilinic compounds.

BACKGROUND: Phenolic compounds are widely distributed in plant kingdom and constitute one of the most important classes of natural and synthetic antioxidants. In the present study fifty one natural and synthetic structurally variant phenolic, enolic and anilinic compounds were examined as antioxidants and radical scavengers against DPPH, hydroxyl and peroxyl radicals. The structural diversity of the used phenolic compounds includes monophenols with substituents frequently present in natural phenols e.g. alkyl, alkoxy, ester and carboxyl groups, besides many other electron donating and withdrawing groups, in addition to polyphenols with 1-3 hydroxyl groups and aminophenols. Some common groups e.g. alkyl, carboxyl, amino and second OH groups were incorporated in ortho, meta and para positions. RESULTS: SAR study indicates that the most important structural feature of phenolic compounds required to possess good antiradical and antioxidant activities is the presence of a second hydroxyl or an amino group in o- or p-position because of their strong electron donating effect in these positions and the formation of a stable quinone-like products upon two hydrogen-atom transfer process; otherwise, the presence of a number of alkoxy (in o or p-position) and /or alkyl groups (in o, m or p-position) should be present to stabilize the resulted phenoxyl radical and reach good activity. Anilines showed also similar structural feature requirements as phenols to achieve good activities, except o-diamines which gave low activity because of the high energy of the resulted 1,2-dimine product upon the 2H-transfer process. Enols with ene-1,2-diol structure undergo the same process and give good activity. Good correlations were obtained between DPPH inhibition and inhibition of both OH and peroxyl radicals. In addition, good correlations were obtained between DPPH inhibition and antioxidant activities in sunflower oil and liver homogenate systems. CONCLUSIONS: In conclusion, the structures of good anti radical and antioxidant phenols and anilines are defined. The obtained good correlations imply that measuring anti DPPH activity can be used as a simple predictive test for the anti hydroxyl and peroxyl radical, and antioxidant activities. Kinetic measurements showed that strong antioxidants with high activity have also high reaction rates indicating that factors stabilizing the phenoxyl radicals lower also the activation energy of the hydrogen transfer process.