Bilateral Renal Lymphangiomatosis: A Case Report and Literature Review.

Renal lymphangiomatosis is a rare congenital condition characterized by the abnormal development of lymphatic channels in the kidney, resulting in cystic dilatations. While more commonly observed in children, it can occur in adults but is extremely rare. Clinical manifestations range from asymptomatic cases to symptoms such as abdominal pain, hypertension, and renal dysfunction. In this case report, we present a rare case of bilateral renal lymphangiomatosis in an eight-year-old male with high blood pressure. Renal ultrasound revealed bilateral kidney enlargement and perinephric hypoechoic collections with septations consistent with lymphangiomatosis. The diagnosis was confirmed through CT imaging which shows bilateral non-enhancing perinephric collections. As a part of the patient's management plan, bilateral perinephric cystic lesions were successfully aspirated without complications. In conclusion, accurate diagnosis is crucial for appropriate management decisions, and treatment primarily focuses on conservative measures to manage associated hypertension, reduce lymphatic fluid accumulation, and alleviate pain, reserving invasive interventions for severe cases or complications.

Hydrothermal synthesis of Mg/Al-layered double hydroxide modified water hyacinth hydrochar for remediation of wastewater containing mordant brown dye.

A high-performance dye adsorbent of Mg/Al-layered double hydroxide modified water hyacinth hydrochar (MgAl@WH) was synthesized by a simple hydrothermal method. The surface functional groups, elemental composition, crystalline structure, and surface morphology of the prepared (MgAl@WH) were determined using different analytical techniques. The characterization results revealed that the (MgAl@WH) hydrochar surface offered more active adsorption sites, facilitating the mordant brown (anionic dye) adsorption, leading to its superior performance with much higher uptake capability (311.0 mg g-1 at 298 K) than Mg/Al double hydroxide nanosheets (MgAl DLHs, 80.2 mg g-1 at 298 K) and dried water hyacinth (WH, 10.0 mg g-1 at 298 K). The adsorption behavior of MgAL@WH follows the pseudo second order kinetic model (R2 = 0.999) and Langmuir isotherm model (R2 = 0.999). Moreover, MgAl@WH bonded efficiently with mordant brown dye via hydrogen bonding and interlayer anion exchange with monolayer formation. Additionally, the recycling tests revealed that the MgAl@WH can be reused over 10 cycles without significant change in the removal efficiency. Based on the obtained findings, Mg/Al-layered double hydroxide modified water hyacinth hydrochar (MgAl@WH), for its economic and environmental benefits, has recently been used as an efficient adsorbent to remediate industrial wastewater containing anionic dyes.

Knowledge, attitudes, and practices related to the prevention of adverse pregnancy outcomes among samples of females in Al-Suwaira city, Wasit Governorate, Iraq.

Introduction: Adverse pregnancy outcomes pose serious health risks to both periconceptional women and newborns. This study aimed to investigate the levels of knowledge, attitudes, and practice (KAP) toward adverse pregnancy outcomes among women of reproductive age in Al-Suwaira, Wasit governorate, Iraq. Methods: During November 2021 to February 2022, cross-sectional research of randomly selected women was performed. The KAP was evaluated with a standard, self-administered questionnaire. The outcomes were described using a descriptive analysis. Results: The questionnaire was completed by 118 women. Participants had good knowledge and positive attitudes and practices toward adverse pregnancy outcomes. The findings revealed that the majority of participants were between the ages of 20 and 25 (n = 57, 48.3%) and had a Bachelor's degree (n = 106, 89.8%).Knowledge gaps were discovered in the areas of the danger of pregnancy at a young age of less than 17 years (30.5%), the link between lack of maternal education and poor births (24.6%), and the influence of drug misuse on the fetus (17.8%). The participants learn more around pregnancy-related risk factors via internet (n = 38, 32.2%) and university (n = 34, 28.8%). Conclusions: The participants in this study had good knowledge, positive attitude, and positive practice regarding adverse pregnancy outcomes. However, there were some knowledge gaps. Therefore, to raise awareness among local women, it seems advisable to strengthen and strictly apply awareness-raising plans.

Differences in Depression, Anxiety, and Stress in Relation to Changes in Living Conditions, Work Conditions, and Daily Life During the COVID-19 Pandemic in Jordan.

Introduction: The COVID-19 pandemic was associated with numerous changes in daily life conditions that could affect the psychological response of individuals worldwide. Objective: The study aimed to describe and examine differences in depression, anxiety, and stress in relation to living conditions during the COVID-19 pandemic. Methods: A cross-sectional design was used. Purposive snowball sampling was employed to include 642 participants. Arabic versions of the Depression, Anxiety, and Stress Scales were used to collect data. Descriptive statistics, t-test, ANOVA, and Pearson's correlation were used to analyze the data. Results: The total mean scores of depression, anxiety, and stress were 12.26 (SD = 10.53), 9.04 (SD = 9.34), and 13.49 (SD = 10.72), respectively. Of the study sample, 122 (19.5%), 139 (22.2%), and 99 (15.9%) had severe to extremely severe levels of depression, anxiety, and stress, respectively. Significant differences were found in depression, anxiety, and stress in relation to age, chronic diseases, and house size. Conclusion: The findings showed an increased prevalence of depression and anxiety during the COVID-19 pandemic. Mental health practitioners need to recognize the impact of pandemics on youth, females, low-income populations, and individuals with chronic diseases. Preventive mental health services among these populations, such as screening and counseling, would help reduce the health risks.

Modified Release 3D-Printed Capsules Containing a Ketoprofen Self-Nanoemulsifying System for Personalized Medical Application.

This study explores the realm of personalized medicine by investigating the utilization of 3D-printed dosage forms, specifically focusing on patient-specific enteric capsules designed for the modified release of ketoprofen, serving as a model drug. The research investigates two distinct scenarios: the modification of drug release from 3D-printed capsules crafted from hydroxypropyl methylcellulose phthalate:polyethylene glycol (HPMCP:PEG) and poly(vinyl alcohol) (PVA), tailored for pH sensitivity and delayed release modes, respectively. Additionally, a novel ketoprofen-loaded self-nanoemulsifying drug delivery system (SNEDDS) based on pomegranate seed oil (PSO) was developed, characterized, and employed as a fill material for the capsules. Through the preparation and characterization of the HPMCP:PEG based filament via the hot-melt extrusion method, the study thoroughly investigated its thermal and mechanical properties. Notably, the in vitro drug release analysis unveiled the intricate interplay between ketoprofen release, polymer type, and capsule thickness. Furthermore, the incorporation of ketoprofen into the SNEDDS exhibited an enhancement in its in vitro cylooxygenase-2 (COX-2) inhibitory activity. These findings collectively underscore the potential of 3D printing in shaping tailored drug delivery systems, thereby contributing significantly to the advancement of personalized medicine.

Pediatric and Adolescent Traumatic Macular Hole: A Systematic Review.

PURPOSE: The optimal management of pediatric traumatic macular holes (TMH) is unclear from lack of prospective randomized trials. The literature is divided into early (≤1month post-trauma), delayed (>1month) pars plana vitrectomy (PPV), and observation. Our aim is to find which group can achieve superior spectacle corrected visual acuity (VA), visual gain, and time for hole closure. DESIGN: Systematic Review. METHODS: This systematic review was registered with PROSPERO (ID:CRD42022383134). The databases searched from inception until July 31, 2023, were MEDLINE OVID, Scopus, Web of Science, and Embase and Google Scholar. The articles were screened for title and abstract then for full text. Risk of bias was also assessed. Three outcome measures were analyzed: final VA, visual gain, and time to closure of MH. MH size was divided into small (≤250 µm), medium (>250-500 µm), and large (>500 µm). RESULTS: Ninety eight (98) studies with 234 patients in the PPV group and 87 patients in the observation group were included in the review. Final VA (logMAR) and visual gain were respectively in PPV vs. observation groups: 1) small MH 0.37 ± 0.52 vs. 0.42 ± 0.56 (p=0.484) and -0.96 ± 0.83 vs. -0.49 ± 0.40 (p=0.005); (2) medium MH 0.58 ± 0.39 vs. 0.34 ± 0.34 (p=0.06) and -0.36 ± 0.42 vs. -0.74 ± 0.44 (p<0.001); (3) large MH 0.62 ± 0.42 vs. 0.59 ± 0.35 (p=0.337) and -0.31 ± 0.48 vs. -0.62 ± 0.37 (p=0.11). Small TMH had comparable closure time: 3.21 ± 2.52 months vs. 3.49 ± 4.43 (p=0.954) in the PPV and observation groups. Early and late PPV yielded comparable final VA 0.67 ± 0.66 vs. 0.54 ± 0.35 (p=0.576) and visual gain -0.58 ± 0.69 vs. -0.49 ± 0.48 (p=0.242) in the PPV and observation groups. CONCLUSIONS: PPV was very effective in closing TMH and VA gain in children throughout a wide range of hole size. Early and delayed PPV yielded similar anatomic and visual results. Observation and PPV yielded comparable final VA and closure time. Clinicians can choose either early PPV or delayed PPV when healing biomarkers are absent on periodic OCT.

Cost-effectiveness of l-glutamine versus crizanlizumab for adults with sickle cell disease: model focused on reducing pain episode costs from Qatar's healthcare perspective.

Objectives: Treatment options for preventing vaso-occlusive crises among sickle cell disease patients are on the rise, especially if hydroxyurea treatment has failed. This economic analysis is conducted to assess the comparative clinical effectiveness, safety, and acquisition cost of l-glutamine and crizanlizumab for older adolescents and adults (⩾16 years old) with sickle cell disease in Qatar, with an emphasis on treatment costs and acute pain crises. Methods: We conduct a decision-tree model, where we compare the clinical and economic outcomes of two novel Food and drug administration (FDA)-approved medications which are available in Qatar; l-glutamine and crizanlizumab over a time horizon of 1 year in a hypothetical cohort of adult sickle cell disease patients from a Qatar healthcare perspective. The main outcome is incremental cost per sickle cell disease-related acute pain crises averted. Model clinical parameters were derived from individual drug randomized trials, published literature, whereas cost parameters from Qatar healthcare payer system (2020-2021). A sensitivity analysis was carried out, and the study results were robust around model inputs. Costs were converted to 2020 US dollars. Results: Study results showed that both treatment modalities' costs were the main driver of this analysis, with an average annual cost of the treatments per patient being $189,014 for crizanlizumab (5 mg/kg), $143,798 for crizanlizumab (2.5 mg/kg), and $74,323 for l-glutamine. The probability of no first-time sickle cell disease-related vaso-occlusive crises averted was 0.001/year for glutamine, 0.26/year for crizanlizumab (5 mg/kg), and 0.34/year for crizanlizumab (2.5 mg/kg). Lower dose crizanlizumab (2.5 mg/kg) dominated the higher one (5 mg/kg). The incremental cost-effectiveness ratio of crizanlizumab (2.5 mg/kg), when compared to l-glutamine was $81,265 per sickle cell disease-related vaso-occlusive crises averted. When comparing crizanlizumab (5 mg/kg) and l-glutamine, crizanlizumab (5 mg/kg) showed higher efficacy, yet the crizanlizumab incremental cost-effectiveness ratio was at $459,620 than l-glutamine. Conclusions: Crizanlizumab (2.5 mg/kg) may be a cost-effective intervention, yet it is not the approved dose for preventing vaso-occlusive crises in adolescents and adults with sickle cell disease. Crizanlizumab (5 mg/kg) was more cost-effective than the approved l-glutamine per sickle cell disease vaso-occlusive crisis prevented. Of note, we primarily focused on modeling acute vaso-occlusive pain, which limited our ability to consider other key outcomes in sickle cell disease.

Hindering the biofilm of microbial pathogens and cancer cell lines development using silver nanoparticles synthesized by epidermal mucus proteins from Clarias gariepinus.

Scientists know very little about the mechanisms underlying fish skin mucus, despite the fact that it is a component of the immune system. Fish skin mucus is an important component of defence against invasive infections. Recently, Fish skin and its mucus are gaining interest among immunologists. Characterization was done on the obtained silver nanoparticles Ag combined with Clarias gariepinus catfish epidermal mucus proteins (EMP-Ag-NPs) through UV-vis, FTIR, XRD, TEM, and SEM. Ag-NPs ranged in size from 4 to 20 nm, spherical in form and the angles were 38.10°, 44.20°, 64.40°, and 77.20°, Where wavelength change after formation of EMP-Ag-NPs as indicate of dark brown, the broad band recorded at wavelength at 391 nm. Additionally, the antimicrobial, antibiofilm and anticancer activities of EMP-Ag-NPs was assessed. The present results demonstrate high activity against unicellular fungi C. albicans, followed by E. faecalis. Antibiofilm results showed strong activity against both S. aureus and P. aeruginosa pathogens in a dose-dependent manner, without affecting planktonic cell growth. Also, cytotoxicity effect was investigated against normal cells (Vero), breast cancer cells (Mcf7) and hepatic carcinoma (HepG2) cell lines at concentrations (200-6.25 µg/mL) and current results showed highly anticancer effect of Ag-NPs at concentrations 100, 5 and 25 µg/mL exhibited rounding, shrinkage, deformation and granulation of Mcf7 and HepG2 with IC50 19.34 and 31.16 µg/mL respectively while Vero cells appeared rounded at concentration 50 µg/mL and normal shape at concentration 25, 12.5 and 6.25 µg/ml with IC50 35.85 µg/mL. This study evidence the potential efficacy of biologically generated Ag-NPs as a substitute medicinal agent against harmful microorganisms. Furthermore, it highlights their inhibitory effect on cancer cell lines.

Antioxidant and Hypoglycemic Potential of Phytogenic Selenium Nanoparticle- and Light Regime-Mediated In Vitro Caralluma tuberculata Callus Culture Extract.

In vitro plant cultures have emerged as a viable source, holding auspicious reservoirs for medicinal applications. This study aims to delineate the antioxidant and hypoglycemic potential of phytosynthesized selenium nanoparticle (SeNP)- and light stress-mediated in vitro callus cultures of Caralluma tuberculata extract. The morphophysicochemical characteristics of biogenic SeNPs were assessed through a combination of analytical techniques, including UV-visible spectrophotometry, scanning electron microscopy, energy-dispersive X-rays, Fourier transform infrared spectrometry, and zeta potential spectroscopy. The antioxidative potential of the callus extract 200 and 800 µg/mL concentrations was assessed through various tests and exhibited pronounced scavenging potential in reducing power (26.29%), ABTS + scavenging (42.51%), hydrogen peroxide inhibition (37.26%), hydroxyl radical scavenging (40.23%), and phosphomolybdate (71.66%), respectively. To inspect the hypoglycemic capacity of the callus extract, various assays consistently demonstrated a dosage-dependent relationship, with higher concentrations of the callus extract exerting a potent inhibitory impact on the catalytic sites of the alpha-amylase (78.24%), alpha-glucosidase (71.55%), antisucrase (59.24%), and antilipase (74.26%) enzyme activities, glucose uptake by yeast cells at 5, 10, and 25 mmol/L glucose solution (72.18, 60.58 and 69.33%), and glucose adsorption capacity at 5, 10, and 25 mmol/L glucose solution (74.37, 83.55, and 86.49%), respectively. The findings of this study propose selenium NPs and light-stress-mediated in vitro callus cultures of C. tuberculata potentially operating as competitive inhibitors. The outcomes of the study were exceptional and hold promising implications for future medicinal applications.

Fluoride Removal Using Nanofiltration-Ranged Polyamide Thin-Film Nanocomposite Membrane Incorporated Titanium Oxide Nanosheets.

Drinking water defluoridation has attracted significant attention in the scientific community, from which membrane technology, by exploring thin film nanocomposite (TFN) membranes, has demonstrated a great potential for treating fluoride-contaminated water. This study investigates the development of a TFN membrane by integrating titanium oxide nanosheets (TiO2 NSs) into the polyamide (PA) layer using interfacial polymerization. The characterization results suggest that successfully incorporating TiO2 NSs into the PA layer of the TFN membrane led to a surface with a high negative charge, hydrophilic properties, and a smooth surface at the nanoscale. The TFN membrane, containing 80 ppm of TiO2 NSs, demonstrated a notably high fluoride rejection rate of 98%. The Donnan-steric-pore-model-dielectric-exclusion model was employed to analyze the effect of embedding TiO2 NSs into the PA layer of TFN on membrane properties, including charge density (Xd), the pore radius (rp), and pore dielectric constant (εp). The results indicated that embedding TiO2 NSs increased Xd and decreased the εp by less than the TFC membrane without significantly affecting the rp. The resulting TFN membrane demonstrates promising potential for application in water treatment systems, providing an effective and sustainable solution for fluoride remediation in drinking water.

Angioembolization for splenic injuries: does it help? Retrospective evaluation of grade III-V splenic injuries at two level I trauma centers.

Background: Splenic angioembolization (SAE) has increased in utilization for blunt splenic injuries. We hypothesized lower SAE usage would not correlate with higher rates of additional intervention or mortality when choosing initial non-operative management (NOM) or surgery. Study design: Trauma registries from two level I trauma centers from 2010 to 2020 were used to identify patients aged >18 years with grade III-V blunt splenic injuries. Results were compared with the National Trauma Data Bank (NTDB) for 2018 for level I and II centers. Additional intervention or failure was defined as any subsequent SAE or surgery. Mortality was defined as death during admission. Results: There were 266 vs 5943 patients who met inclusion/exclusion criteria at Stanford/Santa Clara Valley Medical Center (SCVMC) versus the NTDB. Initial intervention differed significantly between cohorts with the use of SAE (6% vs 17%, p=0.000). Failure differed significantly between cohorts (1.5% vs 6.5%, p=0.005). On multivariate analysis, failure in NOM was significantly associated with NTDB cohort status, age 65+ years, more than one comorbidity, mechanism of injury, grade V spleen injury, and Injury Severity Score (ISS) 25+. On multivariate analysis, failure in SAE was significantly associated with Shock Index >0.9 and 10+ units blood in 24 hours. On multivariate analysis, a higher risk of mortality was significantly associated with NTDB cohort status, age 65+ years, no private insurance, more than one comorbidity, mechanism of injury, ISS 25+, 10+ units blood in 24 hours, NOM, more than one hospital complications, anticoagulant use, other Abbreviated Injury Scale ≥3 abdominal injuries. Conclusions: Compared with national data, our cohort had less SAE, lower rates of additional intervention, and had lower risk-adjusted mortality. Shock Index >0.9, grade V splenic injuries, and increased transfusion requirements in the first 24 hours may signal a need for surgical intervention rather than SAE or NOM and may reduce mortality in appropriately selected patients. Level of evidence: Level II/III.

A cross-sectional study of resilience and well-being among nursing students in Saudi Arabia.

Objectives: Promoting resilience and embracing healthy coping strategies can effectively assist nursing students in managing stress and enhancing their welfare. Nonetheless, a comprehensive understanding of the factors influencing their well-being and resilience, pivotal for both academic accomplishments and future career longevity, remains incomplete. Methods: A cross-sectional descriptive correlational design was adopted for this study. Participants comprised students enrolled in pre-registration nursing programs at both undergraduate and graduate levels. The World Health Organization-5 Well-Being Index and the 10-item Connor-Davidson Resilience Scale were utilized to assess psychological well-being and resilience, respectively. Results: The study involved 175 university nursing students selected through convenience sampling. On the 10-item Connor-Davidson Resilience Scale, the average score was 25.5, with undergraduate and graduate students scoring an average of 25.4 and 26.3, respectively. Nevertheless, the two groups had no statistically significant difference (p = 0.526). Regarding perceived well-being, the average World Health Organization-5 score was 16.1, with no noticeable distinction between undergraduates and postgraduates (p = 0.858). Notably, bivariate analysis revealed a moderate positive correlation between self-reported resilience and perceived well-being (rp = 0.281, p = 0.001). Moreover, senior students exhibited significantly higher scores on the perceived well-being scale than junior students (17.0 vs 15.1, p = 0.010). Multivariable regression analysis also identified that self-reported resilience represents a consistent means of predicting perceived well-being (regression coefficient B = 0.22, p < 0.001). Conclusions: The outcomes indicate that university-based nursing students who exhibit higher levels of resilience have more positive perceptions of their well-being. Moreover, postgraduate students exhibit more significant resilience levels than undergraduate students.

Medical photography and the reconstructive urologist: A 6-month prospective study.

Medical photography has multiple, important roles. The education of medical practitioners, documentation of disease, response to treatment, research, publication, intraoperative recording and trauma documentation all rely on medical photography. Additionally, there are important medicolegal implications pertaining to medical photography across many medical disciplines. Other than specific image use to document cases, there remains a paucity of urological literature regarding the use of medical photography in Urology. The aims of this 6-month study were to document the use of medical photography by a Reconstructive Urological Service in a tertiary referral centre and to assess the range of urological conditions photographed. A secondary aim was to specifically document intraoperative use of the medical photography.

Exposure of Caralluma tuberculata to biogenic selenium nanoparticles as in vitro rooting agent: Stimulates morpho-physiological and antioxidant defense system.

The commercial-scale production of Caralluma tuberculata faces significant challenges due to lower seed viability and sluggish rate of root growth in natural conditions. To overcome these obstacles, using phyto-mediated selenium nanomaterials as an in vitro rooting agent in plant in vitro cultures is a promising approach to facilitate rapid propagation and enhance the production of valuable therapeutic compounds. This study aimed to investigate the impact of phytosynthesized selenium nanoparticles (SeNPs) on the morphological growth attributes, physiological status, and secondary metabolite fabrication in in vitro propagated Caralluma tuberculata. The results demonstrated that a lower dose of SeNPs (100 µg/L) along with plant growth regulators (IBA 1 mg/L) had an affirmative effect on growth parameters and promoted earliest root initiation (4.6±0.98 days), highest rooting frequency (68.21±5.12%), number of roots (6.3±1.8), maximum fresh weight (710±6.01 mg) and dry weight (549.89±6.77 mg). However, higher levels of SeNPs (200 and 400 µg/L) in the growth media proved detrimental to growth and development. Further, stress caused by SeNPs at 100 µg/L along with PGRs (IBA 1 mg/L) produced a higher level of total chlorophyll contents (32.66± 4.36 µg/ml), while cultures exposed to 200 µg/L SeNPs alone exhibited the maximum amount of proline contents (10.5± 1.32 µg/ml). Interestingly, exposure to 400 µg/L SeNPs induced a stress response in the cultures, leading to increased levels of total phenolic content (3.4 ± 0.052), total flavonoid content (1.8 ± 0.034), and antioxidant activity 82 ± 4.8%). Furthermore, the combination of 100 µg/L SeNPs and plant growth regulators (1 mg/L IBA) led to accelerated enzymatic antioxidant activities, including superoxide dismutase (SOD = 4.4 ± 0.067 U/mg), peroxidase dismutase (POD = 3.3 ± 0.043 U/mg), catalase (CAT = 2.8 ± 0.048 U/mg), and ascorbate peroxidase (APx = 1.6 ± 0.082 U/mg). This is the first report that highlights the efficacy of SeNPs in culture media and presents a promising approach for the commercial propagation of C. tuberculata with a strong antioxidant defense system in vitro.

Early Outcomes of Minimally Invasive Right Anterior Thoracotomy vs. Median Full Sternotomy in Isolated Aortic Valve Replacement: A Propensity Score Analysis.

INTRODUCTION: This study aimed to compare the early postoperative outcomes of right anterior thoracotomy minimally invasive aortic valve replacement (RAT-MIAVR) surgery with those of median full sternotomy aortic valve replacement (MFS-AVR) approach with the goal of identifying potential benefits or drawbacks of each technique. METHODS: This retrospective, observational, cohort study included 476 patients who underwent RAT-MIAVR or MFS-AVR in our hospital from January 2015 to January 2023. Of these, 107 patients (22.5%) underwent RAT-MIAVR, and 369 patients (77.5%) underwent MFS-AVR. Propensity score matching was used to minimize selection bias, resulting in 95 patients per group for analysis. RESULTS: After propensity matching, two groups were comparable in preoperative characteristics. RAT-MIAVR group showed longer cardiopulmonary bypass time (130.24 ± 31.15 vs. 117.75 ± 36.29 minutes, P=0.012), aortic cross-clamping time (76.44 ± 18.00 vs. 68.49 ± 19.64 minutes, P=0.004), and longer operative time than MFS-AVR group (358.47 ± 67.11 minutes vs. 322.42 ± 63.84 minutes, P=0.000). RAT-MIAVR was associated with decreased hospitalization time after surgery, lower postoperative blood loss and drainage fluid, a reduced incidence of mediastinitis, increased left ventricular ejection fraction, and lower pacemaker use compared to MFS-AVR. However, there was no significant difference in the incidence of major complications and in-hospital mortality between the two groups. CONCLUSION: RAT-MIAVR is a feasible and safe alternative procedure to MFS-AVR, with comparable in-hospital mortality and early follow-up. This minimally invasive approach may be a suitable option for patients requiring isolated aortic valve replacement.

Recurrent fibroepithelial vaginal polyp in a 2-year-old girl: a case report and review of the literature.

Introduction and importance: Fibroepithelial vaginal polyps (FEPV) are rare mucosal polypoid lesions primarily found in adult women. However, FEPV in paediatric patients, especially beyond the neonatal period, is exceedingly uncommon. Documenting cases improves diagnosis and management. FEPV can mimic malignancy, posing challenges for interpretation. Early detection, treatment, and follow-up are crucial for optimal outcomes. Case presentation: The authors present the case of a 2-year-old girl with a recurrent FEPV. The patient had a painless, reddish, smooth, soft, rubbery polypoid vaginal mass measuring 2.3 × 1.5 cm. Physical examination revealed no concurrent systemic issues. Surgical excision of the polyps confirmed them as fibroepithelial polyps. Despite previous excisions, the polyps recurred within a month. The patient's postoperative recovery was uneventful, and subsequent follow-up showed no recurrence. Clinical discussion: FEPV presents as mucosal polypoid lesions with a connective tissue core covered by benign squamous epithelium. It is rare before menarche and after menopause. Although the pathophysiology remains unclear, hormonal factors and local injuries may contribute. FEPV is usually asymptomatic but may cause pressure, obstruction, bleeding, or discharge. Differential diagnosis includes vaginal connective tissue malignancies. The diagnosis was confirmed by surgical excision and histopathology. Complete excision is crucial for preventing recurrence. Conclusion: This case report highlights recurrent FEPV in a 2-year-old girl. Despite previous excisions, polyps recurred, emphasizing the need for complete excision. Documenting cases will enhance our understanding. Further research is needed to elucidate the pathogenesis of paediatric FEPV. Early detection, treatment, and follow-up are essential for optimal management.

Sclerectomy Reverses Nanophthalmic Optic Neuropathy.

Introduction: Nanophthalmos is characterized by a short axial length, a thick choroid, and a thick sclera. Unilateral symptomatic disc swelling in nanophthalmos presents both a diagnostic and a therapeutic challenge. Case Presentation: A healthy 59-year-old man reported a two-week-long abrupt vision reduction in his right eye. 20/100 best spectacle (+17.25 diopter) corrected visual acuity, unilateral widespread disc enlargement, central scotoma, and a slight color vision disruption without an afferent pupillary defect were among the positive findings in the right eye. Workup for neuro-ophthalmology was negative. Numerous consultations did not suggest any form of treatment for the patient. Review of the optical coherence tomography (OCT) indicated a small, crowded optic nerve head and substantial diffuse choroidal thickening with dome-shaped temporal peripapillary area with choroidal expansion. In addition to circumferential anterior four-quadrant 95%-deep sclerectomy from recti insertion to the vortices, radial nasal posterior sclerotomy reaching the optic nerve sheath was performed on the patient. After the procedure, 2 weeks later, the patient's vision returned, and it persisted until the 6-month follow-up. By OCT, the two eyes were comparable as far as disc contour and nerve fiber layer thickness. Conclusion: This form of sclerectomy, which aims at decompressing the oncotic choroidal pressure, is an effective treatment for compressive optic neuropathy in the context of nanophthalmos. Could sclerectomy assist in treating other optic neuropathies associated with peripapillary pachychoroid?

GWAS in a Collection of Bulgarian Old and Modern Bread Wheat Accessions Uncovers Novel Genomic Loci for Grain Protein Content and Thousand Kernel Weight.

Genetic enhancement of grain production and quality is a priority in wheat breeding projects. In this study, we assessed two key agronomic traits-grain protein content (GPC) and thousand kernel weight (TKW)-across 179 Bulgarian contemporary and historic varieties and landraces across three growing seasons. Significant phenotypic variation existed for both traits among genotypes and seasons, and no discernible difference was evident between the old and modern accessions. To understand the genetic basis of the traits, we conducted a genome-wide association study with MLM using phenotypic data from the crop seasons, best linear unbiased estimators, and genotypic data from the 25K Infinium iSelect array. As a result, we detected 16 quantitative trait nucleotides (QTNs) associated with GPC and 15 associated with TKW, all of which passed the false discovery rate threshold. Seven loci favorably influenced GPC, resulting in an increase of 1.4% to 8.1%, while four loci had a positive impact on TKW with increases ranging from 1.9% to 8.4%. While some loci confirmed previously published associations, four QTNs linked to GPC on chromosomes 2A, 7A, and 7B, as well as two QTNs related to TKW on chromosomes 1B and 6A, may represent novel associations. Annotations for proteins involved in the senescence-associated nutrient remobilization and in the following buildup of resources required for seed germination have been found for selected putative candidate genes. These include genes coding for storage proteins, cysteine proteases, cellulose-synthase, alpha-amylase, transcriptional regulators, and F-box and RWP-RK family proteins. Our findings highlight promising genomic regions for targeted breeding programs aimed at improving grain yield and protein content.

Physio-biochemical responses and crop performance analysis in chickpea upon botanical priming.

Chickpea is a highly nutritious protein-rich source and one of the major crops to alleviate global malnutrition, but poor seed quality affects its productivity. Seed quality is essential for better crop establishment and higher yields, particularly in the uncertain climate change. The present study investigated the impact of botanical priming versus hydropriming and bavistin seed treatment on chickpea seeds. A detailed physiological (germination percentage, root and shoot length, vigour index) and biochemical (amylase, protease, dehydrogenase, phytase, and lipid peroxidation) analysis was carried out in order to assess the effect of priming treatments. Turmeric-primed seeds showed better germination rate (94.5%), seedling length, enzyme activity, and lower malondialdehyde (MDA) content. Sodium dodecyl-sulfate polyacrylamide gel electrophoresis (SDS-PAGE) analysis revealed the expression of minor polypeptides of albumin and globulin in the primed seeds. Moreover, field experiments indicated increased crop growth, vigour, days to 50% flowering, yield and its attributing traits in turmeric-primed seeds. Botanical priming can increase chickpea yield by up to 16% over the control group. This low-cost and eco-friendly technique enhances seed and crop performance, making it a powerful tool for augmenting chickpea growth. Therefore, chickpea growers must adopt botanical priming techniques to enhance the quality of seed and crop performance. Moreover, this approach is environmentally sustainable and can help conserve natural resources in the long term. Therefore, this new approach must be widely adopted across the agricultural industry to ensure sustainable and profitable farming practices.

Characterization of vitamin D3 biotransformation by the cell lysate of Actinomyces hyovaginalis CCASU-A11-2.

A former work conducted in our Lab, lead to in a effective scale up of vitamin D3 bioconversion into calcitriol by Actinomyces (A.) hyovaginalis isolate CCASU-A11-2 in Lab fermenter (14 L) resulting in 32.8 µg/100 mL of calcitriol. However, the time needed for such a bioconversion process was up to 5 days. Therefore, the objective of this study was to shorten the bioconversion time by using cell-free lysate and studying different factors influencing bioconversion. The crude cell lysate was prepared, freeze-dried, and primarily fractionated into nine fractions, of which, only three fractions, 50, 100, and 150 mM NaCl elution buffers showed 22, 12, and 2 µg/10 mL, calcitriol production, respectively. Ammonium sulfate was used for protein precipitation, and it did not affect the bioconversion process except at a concentration of 10%w/v. Secondary fractionation was carried out using 80 mL of the 50 mM NaCl elution buffer and the results showed the 80 mL eluent volume was enough for the complete elution of the active protein. The pH 7.8, temperature 28 °C, and 6 h reaction time were optimum for maximum calcitriol production (31 µg/10 mL). In conclusion, the transformation of vitamin D3 into calcitriol was successfully carried out within 6 h and at pH 7.8 and 28 °C using fractionated cell lysate. This process resulted in a 10-fold increase in calcitriol as compared to that produced in our previous study using a 14 L fermenter (32.8 µg/100 mL). Therefore, cell-free lysate should be considered for industrial and scaling up vitamin D3 bioconversion into calcitriol.