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Recently, phishing attacks have become one of the most prominent social engineering attacks faced by public internet users, governments, and businesses. In response to this threat, this paper proposes to give a complete vision to what Machine learning is, what phishers are using to trick gullible users with different types of phishing attacks techniques and based on our survey that phishing emails is the most effective on the targeted sectors and users which we are going to compare as well. Therefore, more effective phishing detection technology is needed to curb the threat of phishing emails that are growing at an alarming rate in recent years, thus will discuss the techniques of mitigation of phishing by Machine learning algorithms and technical solutions that have been proposed to mitigate the problem of phishing and valuable awareness knowledge users should be aware to detect and prevent from being duped by phishing scams. In this work, we proposed a detection model using machine learning techniques by splitting the dataset to train the detection model and validating the results using the test data , to capture inherent characteristics of the email text, and other features to be classified as phishing or non-phishing using three different data sets, After making a comparison between them, we obtained that the most number of features used the most accurate and efficient results achieved. the best ML algorithm accuracy were 0.88, 1.00, and 0.97 consecutively for boosted decision tree on the applied data sets.
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AIMS: (1) To explore correlations between medical students' participation in undergraduate research (UR) activities and their characteristics, and (2) to explore students' perceived influential factors toward participation in UR activities at Alfaisal University-College of Medicine, Saudi Arabia. METHODS: An online, anonymous, cross-sectional, self-rating survey was administered. Chi-square test was used to correlate between participation in UR activities and students' characteristics (age, academic year and grade point average [GPA]). Two-tailed Mann-Whitney U-test was used to compare the mean 5-point Likert scale responses between students with and without previous UR activities. RESULTS: About 218 students participated in the survey (n = 218/350; response rate: 62.3%). The top three influential factors to undertake UR activities were "facilitate entry into competitive residency programs," (88.1%) "improve curriculum vitae" (81.2%) and "publish in peer-reviewed journals" (79.8%). Percentage of participation in previous UR activities significantly differed by gender (p < 0.03825), academic year (p < 0.000003) and GPA (p < 0.02627). Students who had previous UR activities were more positively influenced to participate in future UR activities than those who did not (p < 0.0488). CONCLUSION: Students demonstrated positive attitudes toward UR activities. The relationships between participation in UR activities and male gender, increased number of years spent at medical college and higher GPA were directly proportional.
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Investigación Biomédica , Educación de Pregrado en Medicina , Estudiantes de Medicina/psicología , Estudios Transversales , Femenino , Historia del Siglo XVI , Humanos , Masculino , Percepción , Arabia Saudita , Factores SexualesRESUMEN
CONTEXT: Pancreatic arteriovenous malformations (AVMs) are uncommon in the gastrointestinal tract. Less than 100 cases have been identified in the medical literature. Approximately 10% of all pancreatic AVMs are sporadic. CASE REPORT: Herein, we report the first documented case of sporadic concurrent pancreatic head and tail AVMs in a 40-year-old gentleman who presented with a 10-day history of epigastric pain and one episode of hematemesis. Patient denied any history of traumatic incidents, cigarette smoking, alcohol abuse, chronic gastric/duodenal ulcer, chronic pancreatitis, chronic hepatic disease, difficulty swallowing, respiratory compromise, or weight loss. Physical examination and laboratory results were unremarkable. Contrast-enhanced computed tomography scan showed two hypervascular masses involving the pancreatic head and tail. The celiac trunk angiogram showed proliferating vascular networks involving the pancreatic head and tail. The superior mesenteric angiogram demonstrated significant vascular contribution to the pancreatic head arteriovenous malformation only. Due to the extreme locations of pancreatic AVMs in the head and tail, surgical resection of both lesions (leaving behind the normal pancreatic body) was not possible. Instead, patient underwent intraoperative irradiation therapy (IORT). During the procedure, patient was surgically operated to retract healthy organs/tissues, and then a single concentrated dose of radiation therapy was precisely applied to both pancreatic head and tail AVM lesions. Patient had an uneventful postoperative recovery and was discharged home on the second postoperative day in stable condition. The patient is to be seen in clinic in a 4-month-period during which patient will be completing a 12-month period of postoperative IORT. CONCLUSION: This is the first documented case of sporadic concurrent pancreatic head and tail AVMs. Angiography is the gold standard diagnostic modality.
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Malformaciones Arteriovenosas/diagnóstico por imagen , Arteria Celíaca/anomalías , Arterias Mesentéricas/anomalías , Páncreas/irrigación sanguínea , Tomografía Computarizada por Rayos X , Adulto , Angiografía , Malformaciones Arteriovenosas/radioterapia , Arteria Celíaca/diagnóstico por imagen , Humanos , Masculino , Arterias Mesentéricas/diagnóstico por imagenRESUMEN
BACKGROUND: Pleomorphic leiomyosarcomas make up around 8.6% of all leiomyosarcomas. They behave aggressively and often have poor prognoses. They can affect the gastrointestinal tract and retroperitoneum. To date, pleomorphic leiomyosarcoma involving the mesocolon have been reported in nine patients. CASE SUMMARY: The patient was a 44-year-old man with a history of pleomorphic leiomyosarcoma of the left maxilla with metastasis to the lung and liver. His most recent positron emission tomography-computed tomography (PET-CT) scan showed uptake in the ascending and transverse colons. A colonoscopy revealed a 5.0 cm × 3.5 cm × 3.0 cm pedunculated polyp in the ascending colon. The polyp was removed using hot snare polypectomy technique and retrieved with Rothnet. Histopathologic examination of the polyp showed a metastatic pleomorphic leiomyosarcoma. CONCLUSION: Uptake(s) on PET-CT in a patient with pleomorphic leiomyosarcoma should raise suspicion for metastasis.
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Background: Food poisoning caused by bacterial agents is a worldwide problem, usually accompanied by unpleasant symptoms and may be severe leading to death. Natural compounds from marine algae namely flavonoids may play a role in the remedy of this condition. Aim: This research aims to assess the potency of flavonoids extracted from Enteromorpha intestinalis and Caulerpa prolifera as antibacterial agents. Methods: Enteromorpha intestinalis was collected from Western Libyan Coast and C. prolifera was collected from Farwa Island. The antimicrobial activity and determination of minimum inhibitory concentration of algal flavonoid-containing extracts was performed in vitro against some positive and negative Gram bacteria. Results: Crude extract containing flavonoids from E. intestinalis was more effective than C. prolifera extract against Staphylococcus aureus with antimicrobial essay (25-28 + 1 and 14.5-37.5 + 0.5-1.5), MIC (50 and 50-250 µg/ml), MBC (75 and 75-250 µg/ml). In Bacillus cereus, the antimicrobial assay (19-24.5 + 0.5-1.5: 24 + 1), MIC (50-250 + 100 µg/ml), and MBC (250 and 125 µg/ml). On the other hand, flavonoids containing extract from C. prolifera were more effective than E. intestinalis against Enterohemorrhagic Escherichia coli O157 EHEC O157 (25-28 + 1: 14-18.5 + 0.5-1.5), MIC (100-250:100-500 µg/ml), and MBC (150-250 and 250-500 µg/ml). Salmonella enterica qualitatively combat by flavonoid from E. intestinalis (13.5-14 + 0.5-1: 10.5-13.5 + 0.5-1.5), MIC (100-250: 250 µg/ml), and MBC (100-250: 250 µg/ml). Flavonoids from C. prolifera (4 strains: 2 strains) were effective against S. enterica. Crude flavonoids from both algae were not effective against Bacillus pumilus. Conclusion: Data from this study could conclude that flavonoid extracts from E. intestinalis and C. prolifera could be used against foodborne bacterial agents.
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Antibacterianos , Caulerpa , Farmacorresistencia Bacteriana Múltiple , Flavonoides , Pruebas de Sensibilidad Microbiana , Flavonoides/farmacología , Flavonoides/química , Antibacterianos/farmacología , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Caulerpa/química , Ulva/química , Extractos Vegetales/farmacología , Extractos Vegetales/química , Enfermedades Transmitidas por los Alimentos/microbiología , Enfermedades Transmitidas por los Alimentos/prevención & control , Enfermedades Transmitidas por los Alimentos/veterinaria , AnimalesRESUMEN
Celiac disease epilepsy and occipital calcification (CEC) syndrome is a rare, emerging disease first described in 1992. To date, fewer than 200 cases have been reported worldwide. CEC syndrome is generally thought to be a genetic, noninherited, and ethnically and geographically restricted disease in Mediterranean countries. However, we report the first ever case of probable CEC in a Saudi patient. Furthermore, the patient manifested a magnitude of brain magnetic resonance imaging (MRI) signal abnormalities during the periictal period which, to the best of our knowledge, has never been described in CEC. The brain MRI revealed diffusion-weighted imaging (DWI) restriction with a concordant area of apparent diffusion coefficient (ADC) hypointensity around bilateral occipital area of calcification. An imbalance between the heightened energy demand during ictal phase of the seizure and unadjusted blood supply may have caused an electric pump failure and cytotoxic edema, which then led to DWI/ADC signal alteration.
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Primary mediastinal synovial sarcomas are exceedingly uncommon tumors. Herein, we present the case of primary mediastinal synovial sarcoma (monophasic spindle cell-shaped variant) fully occupying the right hemithorax in a 37-year-old woman who presented to clinic with a 2-month history of right-sided chest pain and shortness of breath. Although extremely rare, however, synovial sarcoma should be considered in the differential diagnosis of all monophasic and biphasic spindle cell neoplasms of the mediastinum. Despite molecular testing for (t[x; 18] [p11.2; q11.2]) is characteristically positive in 90% of synovial sarcoma cases, it is not routinely done. Histopathological and immunohistochemical analyses can greatly confirm the diagnosis. Optimal surgical resection is the standard of care. Adjuvant therapy (radiotherapy and/or chemotherapy) is indicated in inoperable advanced disease or unachieved surgical tumor-free surgical margins. Prognosis is poor with a 5-year overall survival (OS) rate of 35.7%. Early diagnosis and prompt appropriate management yield better disease-free and OS rates.
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Neoplasias Pulmonares/patología , Neoplasias del Mediastino/patología , Sarcoma Sinovial/patología , Tórax/patología , Adulto , Femenino , Humanos , Neoplasias Pulmonares/cirugía , Neoplasias del Mediastino/cirugía , Pronóstico , Sarcoma Sinovial/cirugíaRESUMEN
HEHE is a rare neoplasm of vascular origin that occurs in the liver; UNOS reported a favorable outcome after liver transplantation in 110 patients with 1-year and 5-year survival of 80% and 64%. Case Report. A 40-year-old lady presented with a three-month history of right upper abdominal pain with nausea, vomiting, and significant loss of weight associated with scleral icterus and progressive abdominal distension. Examination revealed jaundice, hepatomegaly, and ascites. Serum bilirubin was 26.5 mg/dL and ALP was 552 CT. Abdomen and pelvis showed diffuse infiltrative neoplastic process of the liver with a mass effect and stretching of the hepatic and portal veins, in addition to bile duct dilatation. Viral hepatitis markers were negative and serum alpha fetoprotein was within reference range. Liver biopsy was consistent with HEHE, with positive endothelial markers (CD31, CD34, and factor VIII-related antigen). She underwent living related liver transplantation on June 2013 and was discharged after 20 days with normal liver enzymes. Four months later, she presented with diffuse disease recurrence. Liver biopsy confirmed disease recurrence; she received supportive treatment and unfortunately she died 2 weeks later. Conclusion. HEHE can have rapid and aggressive recurrence after liver transplantation.
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Hemangioendotelioma Epitelioide/cirugía , Neoplasias Hepáticas/cirugía , Trasplante de Hígado/métodos , Recurrencia Local de Neoplasia , Adulto , Resultado Fatal , Femenino , Hemangioendotelioma Epitelioide/patología , Humanos , Neoplasias Hepáticas/patología , Recurrencia Local de Neoplasia/patologíaRESUMEN
There are limited numbers of studies which comprehensively explored the research publications authored by medical students. To descriptively analyze the student-authored research publications originating from Alfaisal University-College of Medicine (Riyadh, Saudi Arabia) over a 6-year period. All student-authored research publications were retrieved from PubMed(®) and the College's publication database. Study inclusion criteria included: (1) at least one medical student author, (2) published and/or accepted in-press PubMed-indexed article from 10 September 2008 to 31 December 2014. Data was transferred to Microsoft Excel Software for descriptive statistical analysis of variable parameters. Seventy-three (n = 73) articles met the study inclusion criteria. They were published by 170 students; the majority were males (79.4 %) and clerkship students (65.9 %). There was a markedly steady increase in number of yearly publications from 1 publication in 2009 to 35 publications by the end of 2014. Fifty (68.5 %), twenty-nine (39.7 %) and thirty-seven (50.7 %) students were first, second and corresponding authors, respectively. The most frequent research areas were clinical science (43.8 %), basic science (23.3 %) and medical education (21.9 %). The most frequent research types were case reports (41.1 %), research articles (32.9 %) and correspondence letters (15.1 %). Fifty-seven (78.1 %) and sixteen (21.9 %) publications took place in local and abroad institutes, respectively. Most publications (71.2 %) had impact factors below 2. The mean ± SD of articles' impact factors and citations were 3.9 ± 9.9 and 1.9 ± 4.1, respectively. Students demonstrated positive attitudes towards publishing and significantly contributed to the institution's pool of research publications.
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INTRODUCTION: Meningoencephalitis is the most common clinical manifestation of cryptococcal infection, as the organism has a propensity to invade the CNS. Patients often present with elevated intracranial pressure, focal motor deficits, altered mentation and internal hydrocephalus. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) has been reported as a notable cause of euvolemic hyponatremia in immunocompromised patients. CASE PRESENTATION: A 67-year-old male with liver transplantation due to hepatitis C (HCV) related liver cirrhosis developed severe hyponatremia four months after liver transplantation, which was discovered during routine clinic visit. Patient was referred to the emergency department, treated and discharged with normal serum sodium level. Few days later, he presented with dizziness, confusion, ataxia, abnormal muscle movements and leg pain. Laboratory investigations were consistent with SIADH and revealed a sodium level of 115 mmol/L. Brain MRI showed a leptomeningeal enhancement in the superior cerebellar sulci suspicious for infection. Lumbar puncture was performed and consistent with Cryptococcus neoformans infection; therefore, cryptococcal meningitis was diagnosed. Amphotericin B was started for the patient for six weeks followed by fluconazole for one year. His level of consciousness improved significantly, and his serum sodium level slowly returned to its normal baseline over three weeks after starting amphotericin B. CONCLUSIONS: Symptomatic hyponatremia secondary to SIADH remains a rare complication of cryptococcal meningitis.
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There is a rapidly increasing movement towards integrating scientific research training into undergraduate medical education. The aim of this study was to explore the perceived attitudes of female second-year undergraduate medical students towards research at the College of Medicine, Alfaisal University, Saudi Arabia, as well as to explore if any differences exist between students with and without previous research experiences. An online, anonymous, cross-sectional, self-rating survey was administered. A two-tailed Mann-Whitney U test was used to compare the mean 5-point Likert scale responses between students with and without previous research experiences. Sixty-one students (61/81) participated in the survey with a 75.3 % response rate. Nineteen participants (31.1 %) had previous research experiences. Overall, all students demonstrated positive attitudes towards undergraduate research. There were significant statistical differences in the means of attitudes towards undergraduate research between students with versus without previous research experiences in regards to the following statements: 'my adequate possession of research knowledge and skills promotes participation in future research activities' (3.4 vs. 2.9; p < 0.02), 'I will participate in scientific research activities throughout my undergraduate medical education' (3.7 vs. 3.1; p < 0.00), and 'I have no interest at all in scientific research' (1.6 vs. 2.4; p < 0.01). Previous exposure to scientific research experiences promotes more positive attitudes towards scientific research.
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Desmoplastic small round cell tumor (DSRCT) is an extremely uncommon, highly aggressive, and malignant mesenchymal neoplasm of undetermined histogenesis. Less than 200 case reports have been documented in literature so far. Herein, we report a 26-year-old otherwise healthy female patient who presented with a 1-month history of epigastric pain. On physical examination, a palpable, slightly mobile, and tender epigastric mass was detected. All laboratory tests were normal. A chest, abdominal, and pelvic contrast-enhanced computed tomography (CT) scans showed a 3.8 × 7.2 × 8.7 cm ill-defined mass, involving gastric fundus and extending into gastric cardia and lower gastroesophageal junction. It was associated with multiple enlarged gastrohepatic lymph nodes; the largest measured 1.2 cm. There was no evidence of ascites or retroperitoneal or mesenteric lymphatic metastases. Patient underwent total gastrectomy with D2 lymphadenectomy, splenectomy, and antecolic Roux-en-Y esophagojejunal anastomosis. Histopathological examination revealed coexpression of mesenchymal, epithelial, and neural markers. The characteristic chromosomal translocation (t(11; 22)(p13; q12)) was demonstrated on fluorescence in situ hybridization (FISH) technique. Diagnosis of DSRCT of stomach was confirmed. Patient received no postoperative radiotherapy or chemotherapy. A postoperative 3-month followup failed to show any recurrence. In addition, a literature review on DSRCT is included.