Papillary thyroid carcinoma associated with non­functioning parathyroid carcinoma with Warthin's tumor of the parotid gland: A case report and brief literature review.

Multiple neck pathologies occurring simultaneously are a rare condition. The present study describes an extremely rare case of papillary thyroid carcinoma, non-functioning parathyroid carcinoma (PC) and Warthin's tumor of the parotid gland. A 59-year-old male presented with a 3-month history of anterior neck swelling. The neck ultrasound revealed a left-sided thyroid nodule associated with pathological lymph nodes. There was a parotid gland mass. A fine-needle aspiration of the left parotid mass was not diagnostic, although the left thyroid nodule revealed a malignancy with metastasis to the left cervical group lymph nodes. The patient underwent total thyroidectomy, left central and left lateral cervical lymph node dissection. A superficial parotidectomy was also performed. A histopathological examination revealed three different pathologies: Papillary thyroid microcarcinoma, PC and Warthin's tumor. The simultaneous occurrence of a Warthin's tumor, papillary thyroid microcarcinoma and PC is an unusual condition. The concurrent findings of these three pathologies have not yet been reported in the literature, at least to the best of our knowledge. The synchronous findings of PTC, non-functioning PC and Warthin's tumor are extremely rare, yet possible. Surgical intervention remains the most appropriate treatment strategy.

Recycling of sugar crop disposal to boost the adaptation of canola (Brassica napus L.) to abiotic stress through different climate zones.

We need to produce higher foods even under declining natural resources to feed the projected population of 9 billion by 2050 and to sustain food security and nutrition. Abiotic stress has adversely affected canola crop and oil quality especially in sandy soils. To combat this stress, adaptation at the farm level using new and cost-effective amendments are required. Field trials were conducted in two different climatic zones to determine the efficacy of cane molasses, bagasse ash, sugar beet factory lime, and their compost mixtures to improve soil quality and heat stress-adapting canola. The results showed a significant improvement in bulk density, hydraulic conductivity, organic matter content, and available macronutrients of sandy soil and subsequent canola growth, yield, quality and water productivity due to the application of the tested soil amendments, particularly those mixed with compost. Despite the estimated reduction of yield by 18.5% due to heat stress, application of sugar beet lime and compost mixture not only compensated for this reduction but also increased the seed yield by 27.0%. These findings highlight the value of recycling compost-based sugar crop disposal as a cost-effective technology to boost crop tolerance to abiotic stress, ensuring sustainable agriculture and food security in arid environments.

A vermicompost and deep tillage system to improve saline-sodic soil quality and wheat productivity.

Land degradation due to soil salinity and sodicity is a serious concern in arid ecosystems. Despite the importance of conservation tillage in carbon sequestration and improving soil properties, its effect on saline-sodic soils under amendment application remains unknown. Therefore, the present study aimed to explore the combined effects of inorganic (sulfuric acid and gypsum) and organic (vermicompost) soil amendments and tillage systems (zero, reduced and deep tillage) on saline-sodic soil properties and wheat productivity. Deep tillage with vermicompost application significantly improved soil physical and chemical properties compared with control. Interestingly, integration between deep tillage and vermicompost decreased soil salinity and sodicity by 37% and 34%, respectively, compared with zero tillage and unamended soils. The application of vermicompost surpassed chemical amendments in the improvement of saline-sodic soils and consequently increased the growth and yield of wheat, provided that deep tillage was used as a suitable tillage system. Although deep tillage reduced soil organic carbon, application of vermicompost not only compensated this reduction, but also significantly increased soil organic carbon. This confirms the potential of combined deep tillage and vermicompost as a method for environmentally reclaiming saline-sodic soils.

Considerations for service delivery for emergency care in low resource settings.

In a shift from the more traditional disease focused model of global health interventions, increasing attention is now being placed on the importance of strengthening healthcare systems as a key component for achieving improved health outcomes. As emergency care systems continue to develop and strengthen around the world, the concept of service delivery provides one way to assess how well these systems are functioning. By focusing on service delivery, a system can be evaluated based on its ability to provide patients with access to the high-quality emergency care that they deserve. While the concept of service delivery is commonly used to evaluate the effectiveness of care in high-resource settings, its use in low resource settings has previously been limited due to challenges in operationalizing the concept in a context appropriate way. This article will begin by discussing the concept of service delivery as it specifically applies to emergency care systems and then discuss some of the challenges in defining and assessing this concept in low resource settings. The article will then discuss several new tools that have been developed to specifically address ways to evaluate emergency care service delivery in low-resource settings that can be used to inform future systems strengthening activities.

The integrated effect of salinity, organic amendments, phosphorus fertilizers, and deficit irrigation on soil properties, phosphorus fractionation and wheat productivity.

Soil degradation due to global warming, water scarcity and diminishing natural resources negatively impacts food security. Soil fertility deterioration, particularly phosphorus (P) deficiency, remains a challenge in the arid and semi-arid regions. In this study, field experiments were conducted in different geographical locations to investigate the effects of organic amendments coupled with P fertilization and irrigation on soil physical-chemical properties, and the growth, yield and quality of wheat. Application of P fertilizers combined with organic amendments mitigated soil salinity, increased organic matter content, available water, hydraulic conductivity and available macronutrients, but decreased soil bulk density. Application of organic amendments slightly increased total Cd, Ni and Pb in soil, but Cd and Ni concentration was below allowable limits whilst Pb reached a hazardous level. Soil P fractions were significantly increased with the combined application of mineral P and organic amendments irrespective of salinity and irrigation. Crop growth yield and quality of wheat improved significantly in response to the integrated application of mineral P and organic amendments. In conclusion, the combination of mineral P sources with organic amendments could be successfully used as a cost-effective management practice to enhance soil fertility and crop production in the arid and semi-arid regions stressed with water scarcity and natural resource constraints.

An outbreak of locally acquired Plasmodium vivax malaria among migrant workers in Oman.

Plasmodium vivax is the most widely distributed human malaria parasite. Outside sub-Saharan Africa, the proportion of P. vivax malaria is rising. A major cause for concern is the re-emergence of Plasmodium vivax in malaria-free areas. Oman, situated in the south-eastern corner of the Arabian Peninsula, has long been an area of vivax malaria transmission but no locally acquired cases were reported in 2004. However, local transmission has been registered in small outbreaks since 2007. In this study, a local outbreak of 54 cases over 50 days in 2014 was analyzed retrospectively and stained blood slides have been obtained for parasite identification and genotyping. The aim of this study was to identify the geographical origin of these cases, in an attempt to differentiate between imported cases and local transmission. Using circumsporozoite protein (csp), merozoite surface protein 1 (msp1), and merozoite surface protein 3 (msp3) markers for genotyping of parasite DNA obtained by scrapping off the surface of smears, genetic diversity and phylogenetic analysis were performed. The study found that the samples had very low genetic diversity, a temperate genotype, and a high genetic distance, with most of the reference strains coming from endemic countries. We conclude that a small outbreak of imported malaria is not associated with re-emergence of malaria transmission in Oman, as no new cases have been seen since the outbreak ended.

Genetic diversity of Plasmodium vivax metacaspase 1 and Plasmodium vivax multi-drug resistance 1 genes of field isolates from Mauritania, Sudan and Oman.

BACKGROUND: Plasmodium vivax is the second most important human malaria parasite, widely spread across the world. This parasite is associated with important issues in the process toward malaria elimination, including potential for relapse and increased resistance to chloroquine. Plasmodium vivax multi-drug resistant (pvmdr1) is suspected to be a marker of resistance although definitive evidence is lacking. Progress has been made in knowledge of biological factors affecting parasite growth, including mechanisms of regulated cell death and the suspected role of metacaspase. Plasmodium vivax metacaspase1 (PvMCA1-cd) has been described with a catalytic domain composed of histidine (H372) and cysteine (C428) residues. The aim of this study was to test for a link between the conserved histidine and cysteine residues in PvMCA1-cd, and the polymorphism of the P. vivax multi-drug resistant gene (pvmdr1). RESULTS: Thirty P. vivax isolates were collected from Mauritania, Sudan, and Oman. Among the 28 P. vivax isolates successfully sequenced, only 4 samples showed the conserved His (372)-Cys (428) residues in PvMCA1-cd. Single nucleotide polymorphisms observed were H372T (46.4%), H372D (39.3%), and C428R (85.7%). A new polymorphic catalytic domain was observed at His (282)-Cys (305) residues. Sequences alignment analysis of pvmdr1 showed SNP in the three codons 958, 976 and 1076. A single SNP was identified at the codon M958Y (60%), 2 SNPs were found at the position 976: Y976F (13%) and Y976V (57%), and 3 SNPs were identified at the position 1076: F1076L (40%), F1076T (53%) and F1076I (3%). Only one isolate was wildtype in all three codons (MYF), 27% were single MYL mutants, and 10% were double MFL mutants. Three new haplotypes were also identified: the triple mutant YVT was most prevalent (53.3%) distributed in the three countries, while triple YFL and YVI mutants (3%), were only found in samples from Sudan and Mauritania. CONCLUSIONS: Triple or quadruple mutants for metacaspase genes and double or triple mutants for Pvmdr1 were observed in 24/28 and 19/28 samples. There was no difference in the frequency of mutations between PvMCA1-cd and Pvmdr1 (P > 0.2). Histidine and cysteine residues in PvMCA1-cd are highly polymorphic and linkage disequilibrium with SNPs of Pvmdr1 gene may be expected from these three areas with different patterns of P. vivax transmission.