[Extra-nodal NK/T-cell lymphoma, nasal-type, revealed by cutaneous and ocular involvement]. / Atteintes cutanée et oculaire révélatrices d'un lymphome T/NK extra-nodal de type nasal.

BACKGROUND: Extra-nodal NK/T-cell lymphoma (ENKTL) is a form of highly malignant non-Hodgkin's lymphoma. There are two types: nasal forms primarily affecting the oropharyngeal sphere and so-called nasal-type extra-nasal forms in which primary skin involvement is the most common feature enabling diagnosis. Herein, we report a case of systemic nasal-type ENKTL (ENKTL-NT) that was diagnosed based on skin involvement associated with ocular involvement. PATIENTS AND METHODS: A 67-year-old female patient, without immunodepression, was admitted to the dermatology department for a worsening inflammatory scaly patch of skin on her right calf. Secondarily, further lesions appeared on her body as well as a generalized macropapular rash and sores. These were associated with fever spikes, as well as ophthalmoplegia and edema, preventing her from opening her right eyelid. Tests for infectious, autoimmune and inflammatory disorders were negative. A cerebro-orbital scan revealed infiltration and contrast enhancement of the right periocular fat without any mass effect or cerebral extension. A positron emission tomography (PET) scan revealed multiple hypermetabolic skin lesions. Histological analyses indicated dermal-hypodermal lymphomatous tumor proliferation, and immunohistochemical analyses revealed lymphocytes expressing NK-cell markers (strong CD56+ expression), cytotoxic markers (granzyme B and TIA-1), and the presence of Epstein Barr virus (EBV) in the tumor cells. The patient was diagnosed with systemic ENKTL-NT. Her condition deteriorated rapidly, with the onset of refractory macrophage activation syndrome leading to death due to multiple organ failure. DISCUSSION: Skin involvement in ENKTL is non-specific and uncommon, which can delay diagnosis. Treatment is based on polychemotherapy comprising L-asparaginase and possibly consolidation therapy with autologous or allogeneic hematopoietic stem cell transplantation. The prognosis of ENKTL-NT is poor due the more aggressive nature of the disease compared with the nasal forms, with frequent visceral involvement and macrophage activation syndrome. Skin involvement seems to be a poor prognostic factor. Although ocular involvement is documented, its association with skin involvement is rare and mainly secondary to nasal forms of ENKTL. This case of an extra-nasal form of ENKTL-NT with systemic involvement illustrates the difficulty of diagnosis and the poor prognosis of this type of lymphoma.

[Rare presentations of infantile hemangiomas: 4 cases]. / Présentations rares d'hémangiomes infantiles : 4 cas.

BACKGROUND: Infantile hemangioma (IH) is a common benign vascular tumor in children. In most cases, diagnosis is based entirely on clinical examination. When the diagnosis is uncertain, the first-line complementary examination is Doppler ultrasound. We report 4 cases of atypical infantile hemangiomas with delayed diagnosis and non-contributory imaging. PATIENTS AND METHODS: One child had congenital purple papules and nodules on the back of the foot, the second had inaugural ulceration of the buttocks, and the last two presented telangiectasia, either isolated or on an erythematous macula. In two cases, ultrasound showed no vascular lesions, and in the other two cases, the absence of hyperemia did not allow a diagnosis of IH to be made. For one patient, diagnosis was made on the basis of cutaneous biopsy, and for the other three, on the basis of clinical course. DISCUSSION: We report 4 rare forms of infantile hemangioma resulting in initial diagnostic error. The atypical nature of some IHs may direct the clinician and the radiologist toward other diagnoses that in some cases have no vascular contingent. It is important for the dermatologist to be aware of these rare forms of IH in order to reduce the time to diagnosis and allow early initiation of appropriate management.

[Annular leukocytoclastic vasculitis: A particular form of small vessel vasculitis?]. / Vasculite leucocytoclasique annulaire : une forme particulière de vasculite des petits vaisseaux ?

BACKGROUND: Leukocytoclastic vasculitis is characterized by necrotizing inflammation around small blood vessels, composed mainly of neutrophils. Skin lesions in leukocytoclastic vasculitis are polymorphous, but a rare annular variant exists of which dermatologists must be aware. Herein we present a new case of this entity. PATIENTS AND METHODS: We report the case of a 74-year-old man who developed annular purpuric infiltrated lesions mainly on the lower limbs, with leukocytoclastic vasculitis being confirmed by histology. This annular leukocytoclastic vasculitis regressed spontaneously with no recurrence after 6 months. The aetiology was not established. DISCUSSION: Annular leukocytoclastic vasculitis is rare, and the mechanisms underlying annularity and peripheral spread as well as the aetiology remain unexplained. This form of vasculitis with unusual clinical features may constitute a new entity in the subclass of immune complex small vessel vasculitis within the Chapel Hill classification. While the aetiology and physiopathology of this vasculitis are unknown, despite the possibility of recurrence, skin involvement appears isolated and the condition carries a good prognosis.

Numerical treatment and global error estimation for thermal electro-osmosis effect on non-Newtonian nanofluid flow with time periodic variations.

The essential purpose of this study is to discuss the impact of time-periodic variations on mixed convection heat transfer for MHD Eyring-Powell nanofluid. The fluid flows through a non-Darcy porous medium over an infinite vertical plate. The effects of viscous dissipation, Ohmic dissipation, electro-osmosis force, heat source, thermal radiation, Dufour feature, and chemical reaction are presumed. The system of partial differential equations which governs the problem is transformed into a system of non-linear algebraic equations and then an explicit finite difference approach is espoused to solve these nonlinear algebraic equations. The numerical results for the velocity, temperature, and nanoparticles concentration distributions are computed and displayed through a set of graphs. Also, the skin friction coefficient, reduced Nusselt number, and Sherwood number are computed numerically for various values of the physical parameters. It is found that the velocity becomes greater with an elevation in the value of the Helmholtz-Smoluchowski velocity. Meanwhile, it enlarges with rising in the value of the electro-osmotic parameter. The rise in the value of the thermal radiation parameter causes a dwindling influence on both temperature and nanoparticles concentration. Investigations of these effects together are very useful due to their important vital applications in various scientific fields, especially in medicine and medical industries, such as endoscopes, respirators, and diverse medical implementations, as nanoparticles can be utilized in the remedy of cancer tumors. Additionally, electroosmotic flow is important due to its ability to control fluid movement and enhance mass transport, making it valuable in various application such as sample separation, drug delivery, and DNA analysis, offering enhanced efficiency and sensitivity.

Ten-year incidence (1981-90) of insulin-dependent diabetes in the 0-29-year-old age group in Benghazi, Libya.

The incidence of Type 1 diabetes in Benghazi, Libya in the < 30-years age group was prospectively studied during the period 1981-1990. A total of 161 male and 150 female new cases were diagnosed during the study period. Case ascertainment was estimated to be 100%. The overall incidence rate (per 100,000) was 8.8 (95% C.I., 7.8-9.9). Rates were 8.9 (95% C.I., 7.6-10.4 among males and 8.6 (95% C.I., 7.3-10.1) among females). A female predominance in the 0-14-years age range and a male predominance in the 15-29-years age range were observed (P > 0.05). The age-specific incidence rate increased steadily from 2.2 (95% C.I., 1.4-3.4) in the 0-4-years age group to 16.9 (95% C.I., 13.6-21.0) in the 15-19-years age group and declined afterwards. Age adjusted incidence rates in the 0-14- and 15-29-years age ranges were 7.0 (95% C.I., 6.0-8.2) and 11.9 (95% C.I., 10.0-14.0), respectively. Yearly variation and seasonality of onset were not significant. The study revealed a relatively high incidence rate of Type 1 diabetes among Libyan Arabs aged less than 30 years.

Biological effects of some natural and chemical compounds on the potato tuber moth, Phthorimaea operculella Zell. (Lepidoptera:Gelechiidae).

The olfactory reaction of larvae and moths was investigated towards 18 oils (6 natural oils and 12 commercial chemical oils). Some of these oils such as peppermint and camphor (natural oils) and eugenol and camphene (commercial oils) were repellent to both larvae and moths. Other oils such as strawberry and d-limonene were attractive to both larvae and moths. Some of the repellent oils were, therefore, tested for their effect on certain biological aspects of the insects. Eugenol and peppermint oils, each at the 0.01% conc., caused a significant depression in the fecundity of moth and decreased the percentage of egg hatchability. Eugenol oil was much more effective than peppermint oil at 1%. Dried (leaves, fruits or seeds) powder of 14 different plants species were tested in different concentrations with talcum powder (carrier material) against egg deposition. The results indicated that dried powders of Allium cepa, Curcuma longa, Colocasia antiqurum, Ocimum basilicum. Dodonaea viscose and Thuja orientalis played a highly significant role in reducing egg deposition. The most impressive effect was displayed by powders of D. viscose and A. cepa, which caused the highest depression in egg deposition as well as in the emerging offsprings. Ethanolic extracts of 11 plants indicated that extracts of Pithuranthos tortosus and Iphiona scabra caused the maximum inhibition of egg hatchability, followed by C. longa, Citrullus colocynthia and T. orientalis. Ethanolic extracts of Schinus terebenthiflius (leaves) and I. scabra caused the highest depression in the deposited eggs, as they played a remarkable role as ovipositor deterrents. The majority of the plant extracts at 1% conc. could protect potato tubers at different intervals according to the calculated tuber damage index as follows: Iphiopna > Pithuranthos > Curcuma > Schinus (fruits) Thuja > Schinus (leaves) > Dodonaea > Citrullus.

Incidence and prevalence of type 1 diabetes in children and adolescents in Benghazi, Libya.

The mean annual incidence rates of Type 1 diabetes mellitus in Arab children and adolescents in Benghazi, Libya were assessed as based on prospective registration of patients during the period 1981-1990. Results showed an annual incidence (per 100,000) of 7.0 (6.0-8.2) (males 6.3(5.0-7.9) females 7.8(6.3-9.7)) in 0-14 year olds and 8.8(7.8-10.0) (males 8.3(6.9-10.0), females 9.2(7.7-11.0)) in 0-19 year olds. There were no significant differences between males and females or between season of onset. The commonest age of onset was 15-19 years. Annual variations were significant in the 0-14 years age group (p < 0.001) and non-significant in the 0-19 years age group. In 1981 the age adjusted prevalence rates of Type 1 patients (per 100,000) were 23.5 (17.1-31.5) (males 21.2(13.1-32.3), females 25.9(16.8-38.3)) in 0-14 year olds and 36.2(29.1-45.1) (males 31.4(22.2-43.2), females 41.0(30.2-54.5)) in 0-19 year olds. In 1990 the prevalence rates had increased to 37.3(30.5-45.5) (males 40.7(30.8-53.3), females 33.8 (24.6-45.3)) in 0-14 year olds and 59.5(51.6-58.5) (males 60.3(49.3-73.6), females 58.6 (47.7-72.1)) in 0-19 year olds. Increase in prevalence rates was significant in both sexes and in both age groups (p < 0.001). Increase in prevalence rates in girls in 1981 and in boys in 1990 were not significant. It is concluded that Type 1 diabetes is a common chronic disease of children and adolescents in Benghazi, Libya.

The use of nurse practitioners for the provision of family planning services in Egypt.

PIP: This study was done to assess the performance of specially prepared professional nurses in the provision of family planning services at Shatby Maternity Hospital in Egypt. A special family planning record was designed for their use and implemented for 6 months. The data accumulated were then analyzed. The results of the study were encouraging. During the 6 months, these nurses provided services for 425 clients, 86.4% of whom received some kind of contraceptive on their 1st visit. The nurses inserted IUDs for 60.9% of clients, prescribed oral contraceptives for 11.3%, fitted diaphragms for 8%, and dispensed spermicidals and condoms for 4.5%. Also 7 clients were referred for tubal ligation. Papanicolaou smears for 357 women and wet smears for 309 women were analyzed. Nurses also contributed to decreasing the workload on doctors because they were able to care for 69.7% of the clients with no need for medical consultation. The study also showed that nurses were successful in motivating women to use contraceptives, to shift some to a more suitable method, and to make follow-up visits. When different contraceptives were prescribed by nurses, the incidence of complications or complaints was found to be within reasonable limits for all.^ieng