Infant Salmonella enterica Meningitis: A Rare Case Report and Review of Literature.

Meningitis caused by Salmonella enterica can be a fatal condition that is more common in low- and middle-income countries and uncommon in infants. This case of a 2-month-old male infant reported Salmonella meningitis symptoms, such as fever, irritability, altered sensorium, and diarrhoea. Clinical examination revealed bulging anterior fontanelles, dehydration, and sunken eyes. Screening for normal hearing, cranial ultrasound, and magnetic resonance imaging (MRI) revealed no brain abnormalities. A cerebrospinal fluid (CSF) culture revealed gram-negative Salmonella enterica bacilli. Treatment with meropenem and ampicillin was initiated after antibiotic susceptibility testing showed sensitivity. The patient's cerebrospinal fluid parameters and bacterial growth improved after antibiotic therapy. Two weeks later, the baby was neurologically healthy and discharged. Paediatricians should be aware that Salmonella enterica can cause meningitis in children with non-specific symptoms.

A large cheek lipoma misdiagnosed as a dental infection: a rare case report.

The most frequent benign tumor is lipoma. About 1-4% of people have intraoral lipomas. This uncommon case report shows a large cheek lipoma misinterpreted as dental infection. A 14-year-old girl with a right cheek tumor was diagnosed and treated for a dental infection. Multiple imaging examinations complete the diagnosis. A benign lipoma, common in subcutaneous tissues but unusual in the mouth, created the lesion. A histological investigation confirmed lipoma after extraoral excision under general anesthesia utilizing an external flap. The edema did not return after surgery, which restored face symmetry. This case study shows that diagnosing and treating oral and maxillofacial edema requires extensive clinical and radiographic testing. Lipomas should be evaluated in the differential diagnosis of mouth swelling even without usual risk markers to prevent excessive treatments and delays. Surgery is recommended for lipomas since it has a low recurrence and fewer risks.

A Huge Abdominal Wall Inflammatory Myofibroblastic Tumor: A Report of a Rare Case and Literature Review.

An inflammatory myofibroblastic tumor (IMT), frequently misdiagnosed as a malignant neoplasm, is a rare tumor characterized by the presence of myofibroblastic spindle cells and infiltration of inflammatory cells. In the current study, a 49-year-old female patient with a huge abdominal mass in the left abdominal wall was examined. Diagnostic procedures included blood tests, as well as ultrasound, Doppler, and computed tomography (CT) scans, which revealed the presence of a huge complex multiloculated cystic lesion measuring 30 x 37 x 20 cm. The patient underwent complete excision of the mass. Histopathological examination confirmed the benign nature of the tumor and revealed no evidence of malignancy. A comprehensive review of the available literature shows that the current case is one of the few documented cases. The report concluded by emphasizing the importance of surgical intervention as the primary therapeutic strategy and the crucial role of histopathology in the diagnostic process.

Perceptions of Obstetrics/Gynecology Surgeons on Non-medically Indicated Cesarean Sections: A Cross-Sectional Study.

BACKGROUND: Numerous factors can influence decisions regarding the type of delivery of human babies. There is an increasing demand for non-medically indicated cesarean sections (CS) (non-miCS) or CS on request (CSor). Therefore, this survey study aimed to identify the factors that may foster the decision of CS among obstetricians. METHODS: After the sample size calculation returned with 132 needed participants, confidence surveys were sent electronically or disseminated in paper form to nearly all obstetricians (around 200) in the province between mid-August 2021 and mid-February 2022. After signing the consent form, obstetricians were able to provide responses to the four sections of the questionnaire. Data from the copies of the paper were entered into Excel by a local data collector. The data analysis was done using Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Armonk, NY) and followed the following sequence: summary statistics were done first; then the groups (for and against non-miCS) were compared using analysis of variance (ANOVA); and, finally, regression models were conducted to determine the factors that may affect the favorability of doing non-miCS. RESULTS: A total of 104 obstetricians responded to the survey. Approximately 62.5% of them performed CSor for women who requested it. In addition, more than half (57.7%) agreed that all women had the right and autonomy to choose their mode of delivery. Most providers (65.4) agreed that fear of vaginal delivery (VD) and a bad experience with it are rational reasons for performing a CSor. Unfortunately, some obstetricians (18.3%) faced lawsuits when they refused to perform CSor. As for the factors that may influence the acceptance of obstetricians to non-miCS, it was found that obstetricians who are unsure or refuse to answer (OR=4.30, 95%-CI 1.25-16.29, p=0.025), along with people who do not always perform CSor (OR=4.33, 95%-CI 1.59-12.50, p=0.005) or even refuse it (3.54, 95%-CI 1.05-12.96, p=0.046), are more likely to agree that women have the right to request CSor. CONCLUSION: The surge in CSor rates was mostly correlated with an attempt to escape the fear of VD. However, given the wide discrepancies in obstetricians' opinions in this survey, we cannot draw firm conclusions about the reasons behind this phenomenon. It is also important to explore possible ways to address the problem, such as through litigation with providers who refuse to perform a CSor and through economic reform to protect women from money-grubbing obstetricians.

Bilateral Endometriotic Cystic Ovaries and Huge Splenic Epithelial Cyst With Elevated CA-125, CA19-9: A Report of a Rare Case.

Histologically benign splenic cysts (SCs) resemble splenic sacs. SCs are rare. Here, we present and discuss a new case of bilateral endometriotic cystic ovaries with massive SCs. A 26-year-old single female visited the hospital with left lower quadrant discomfort and suprapubic pain for three months, accompanied by anorexia, weight loss for these three months, and persistent dysmenorrhea for two years. Splenic examination revealed a soft abdomen with left hypochondria, suprapubic tenderness, and a lump in the upper left quadrant. All laboratory results were normal, except for two cancer antigens (CA-125 and CA 19-9). Therefore, magnetic resonance imaging was used to make the definitive diagnosis, which revealed bilateral ovarian endometrioma with a left upper abdominal cystic mass of splenic origin. When CA-125 and CA-19-9 readings are high, physicians should investigate endometriotic and SCs. Imaging aids diagnosis. Histopathological results are essential. Tools and follow-up should rule out malignancy, and surgery is the best treatment option.

Estimation of Serum Calcium on the Severity and Mortality in COVID-19 Infections in Sulaymaniyah City, Kurdistan Region of Iraq: A Cross-Sectional Study.

BACKGROUND: Coronaviruses (COV) are a large family of viruses that cause infections ranging from the common cold to more serious diseases. Mild to severe respiratory illnesses have been linked to coronavirus disease 2019 (COVID-19), which has been classified as a pandemic disease by the World Health Organization. It has been demonstrated that the severity of COVID-19 is highly positively linked with hypocalcemia. Furthermore, calcium imbalances among other electrolytes are linked to the prognosis of COVID-19. OBJECTIVES: This study demonstrates a connection between serum calcium levels and COVID-19 as biomedical indicators of COVID-19 infections in Sulaymaniyah city, Iraq. METHODS: A cross-sectional study was conducted at Baxshin Hospital for about two months from February 2022 to April 2022. The work was conducted with a total of 40 patients including 22 males and 18 females. The patients' ages ranged from 22 to 80 years old. By analyzing a sample from a nasopharyngeal swab and performing real-time reverse transcription-polymerase chain reaction (RT-PCR), all of the patients tested positive as having COVID-19 infection. Serum calcium was determined from the blood samples of the patients in order to evaluate their serum calcium levels. The statistical package for social science (SPSS) was utilized to examine the obtained data. RESULTS: The study revealed a level of calcium between 6.10 and 9.86 mg/dL in male and female patients. The majority of the female patients (61%) displayed low levels of serum calcium, and 33% of the males had a low level of calcium. It can be seen that the highest rate of male patients (66.6%) exhibited a normal level of serum calcium, while 33.3% showed decreased serum calcium. Based on gender and age groups, a statistically significant difference in calcium levels was observed. CONCLUSIONS: This study discovered that infection with COVID-19 has some significant laboratory abnormalities, including hypocalcemia, showing that serum calcium might be employed as a prognostic marker in the clinic.

Burden and mortality of sepsis and septic shock at a high-volume, single-center in Vietnam: a retrospective study.

BACKGROUND: Sepsis and septic shock have high mortality rates and often require a prolonged hospital stay. Patient outcomes may vary according to multiple factors. We aim to determine the prevalence of antimicrobial resistance and factors associated with mortality and hospital stay. METHODS: Clinical and microbiological data of patients with sepsis or septic shock were retrospectively collected for 15 months. Patients with negative blood cultures and patients that did not meet the SEPSIS 3 criteria were excluded. RESULTS: We included 48 septic shock and 28 septic patients (mean APACHE II 20.32 ± 5.61 and mean SOFA 9.41 ± 3.17), with a mean age of 60.5 ± 16.8 years and 56.6% males. WBCs, neutrophils, INR, and fibrinogen levels were significantly associated with mortality. 59.5% of the cultured bacteria were gram-negative (most common E. coli) and 27.8% were gram-positive (most common S. aureus), while 7.6% were other types of bacteria and 5.1% were fungi. Resistance patterns to gram-negative were varying, and resistance to piperacillin/tazobactam, carbapenems, and aminoglycosides were from 60% to 100% (A. baumanii), while they were highly sensitive to Colistin. E. coli was also resistant to ceftriaxone (77.8%) and sulbactam/cefoperazone (44.4%). Resistance rates for Gram-positives were high, from 86% to 100% for oxacillin, while for vancomycin, teicoplanin, and linezolid, they were often low but arrived up to 42.8%. According to our logistic regression analysis, patients over 65 year-old and those who received corticosteroids had a significantly increased risk of in-hospital mortality (OR: 4.0; OR: 4.8). CONCLUSION: Sepsis still poses a significant threat to patients' health, even when positive blood culture results allow the administration of specific antibiotic treatment.

Facial deformity correction and genioplasty; a case report and literature review.

Introduction: dentofacial deformities are mainly congenital problems that distort the face structure. However, they have many adverse effects on adolescents' quality of life and self-esteem. Case presentation: We report a case of an 18-year-old female with no family history or previous surgical method. She presented to our hospital with a facial deformity, including a midline shift of 1.5 teeth to the left side and a malalignment of dentation. Orthopantomography (OPG) X-ray and cephalometric X-ray assessed the deformity extent and determined the appropriate surgical procedure. As a result, the patient underwent genioplasty and bimaxillary (BiMax) surgery to correct the problem. Discussion: Facial deformities occur during the normal embryonic phase and develop clearly when the patient reaches puberty due to a growth spurt. Some researchers encourage early correction, while others recommend the surgery only after completing the growth. However, the perfect age for this surgery is 19 years old for boys and 17 for girls after the cessation of facial growth. Therefore, our patient underwent surgery at 18 years old, which is the desirable age. Conclusion: Genioplasty and BiMax are reasonable procedures to treat facial deformities and correct malalignment of dentation in an 18-year-old patient without major complications.

A rare case of benign vulvovaginal leiomyoma: Case report and literature review.

Introduction: Smooth muscle tumors of the vulva are more difficult to diagnose and are frequently mistaken as Bartholin cysts prior to surgery. Case presentation: A 41-year-old female presented with a left vulvar mass that increased in size compared to the previous year. The patient had normal urination and a regular menstrual cycle. The presentation was not associated with dyspareunia, abnormal bleeding, and signs of infection (e.g., fever, vaginal discharge). The history of any sexually transmitted disease was inconclusive. There was also no family history of malignancy. Physical examination showed a solitary swelling mass, measuring 5 × 2 cm in the left labia majora at the site of the Bartholin gland. The mass was firm in consistency, partially movable, and non-tender with no inguinal lymphadenopathy. Histopathology after surgical removal revealed a benign vulvar leiomyoma. Discussion: Labia majora leiomyoma at the site of the Bartholin gland is rather uncommon. Some cases can develop into atypical leiomyoma or even leiomyosarcoma with local tissue infiltration. Conclusion: If the clinical picture is unusual, it is better to send the patient for ultrasound and MRI to exclude other causes followed by performing wide local surgical excision of the mass to allow proper histopathological and/or immunohistochemistry examination to differentiate between benign and malignant tumors.

Large trichobezoar associated with misdiagnosis, a rare case report with a brief literature review.

INTRODUCTION: Trichobezoar is a rare disorder that almost exclusively affects young females. Up to 90% between 13 and 20 years of age. The current study aims to report and discuss a rare case of Misdiagnosis of Trichobezoar. CASE PRESENTATION: A 18-year-old girl student patient admitted to the Baxshin hospital, with a large trichobezoar filling the entire stomach with a long tail of hair extending within the pylorus into the proximal jejunum at a length of 70 cm; associated with abdominal pain, constipation, and vomiting. Laboratory data showed mild iron deficiency anemia, with a normal liver, and renal function test, patients' electrolytes showed a normal profile. Confirmation of the presence of the mass was done through abdominal Computed Tomography (CT) with contrast. The physician initially diagnosed as alopecia and suspected the abdominal pain was related to the postprandial emesis because the patient didn't provide a history of trichotillomania and used treatment for alopecia for a long time. DISCUSSION: The presence of a mass in the abdomen of a child is considered one of the most severe findings. Physical examination of the patient plus a full history taken, and the age of the patients provide a clear clue to the origin of the mass. Further investigation, including laboratory data and imaging findings, provides better understanding and a firm diagnosis. Trichobezoar should be considered by the physicians in this case. CONCLUSION: In the early diagnosis of the trichobezoar, the physicians should investigate for any medical history of clinical trichophagia, trichotillomania, or a psychological problem.

Structural Characterization, Antimicrobial Activity, and In Vitro Cytotoxicity Effect of Black Seed Oil.

This study was aimed to investigate the structure of bioactive components of black seed oil (BSO) and their antimicrobial and cytotoxic effects. Initially, the structural examination was conducted using various spectroscopic techniques, such as FTIR, TLC, and UV-visible spectroscopy, which are important in determining substituents, functional groups, and the presence of conjugated double bonds in BSO. From the FTIR spectra, a variety of sharp, strong, and weak peaks were specified relating to the main components of thymoquinone (TQ), dithymoquinone, thymohydroquinone, and thymol in BSO. The results of UV-visible spectroscopy confirmed the presence of thymoquinone as a major compound, and conjugated double bonds were also found. In addition, qualitative TLC analysis was used to identify thymoquinone from the methanol-extracted layer in BSO, by calculating the retention factor (R f) value. Furthermore, antimicrobial activity of BSO was studied against various types of bacteria. Strong bacterial inhibitory effects were observed, especially against Bacillus subtilis, with an average inhibition zone of 15.74 mm. Moreover, through the use of the MTT assay in vitro, it was shown that BSO does not exhibit any cytotoxicity towards human peripheral blood mononuclear cells (PBMCs). It was also found from the structural characterization of BSO that the existence of TQ is responsible for potential antibacterial activity without any cytotoxic effects. The main observation of this work is that BSO has antimicrobial activity even against methicillin-resistant Staphylococcus aureus (MRSA).