Cooperation transitions in social games induced by aspiration-driven players.

Cooperation and defection are social traits whose evolutionary origin is still unresolved. Recent behavioral experiments with humans suggested that strategy changes are driven mainly by the individuals' expectations and not by imitation. This work theoretically analyzes and numerically explores an aspiration-driven strategy updating in a well-mixed population playing games. The payoffs of the game matrix and the aspiration are condensed into just two parameters that allow a comprehensive description of the dynamics. We find continuous and abrupt transitions in the cooperation density with excellent agreement between theory and the Gillespie simulations. Under strong selection, the system can display several levels of steady cooperation or get trapped into absorbing states. These states are still relevant for experiments even when irrational choices are made due to their prolonged relaxation times. Finally, we show that for the particular case of the prisoner dilemma, where defection is the dominant strategy under imitation mechanisms, the self-evaluation update instead favors cooperation nonlinearly with the level of aspiration. Thus, our work provides insights into the distinct role between imitation and self-evaluation with no learning dynamics.

Spondylodiscitis following perforated acute appendicitis in a 14-year-old female: A case report.

INTRODUCTION AND IMPORTANCE: Acute appendicitis is a common surgical emergency, often resulting in perforation and increased morbidity. Up to 55 % of children with complicated appendicitis may experience a complication such as infection, bowel obstruction, or unplanned hospital re-admission (Blakely et al., 2011 [23]). However, the development of infectious spondylodiscitis following appendectomy is an extremely rare complication, particularly in pediatric patients. We present the first reported case of lumbar spondylodiscitis occurring post-perforated appendicitis in a 14-year-old female, highlighting the importance of recognizing and managing uncommon complications. CASE PRESENTATION: A previously healthy 14-year-old female underwent urgent appendectomy for perforated appendicitis. Postoperatively, she developed severe back pain and immobility. Imaging revealed early lumbar discitis, and Pseudomonas aeruginosa was isolated from the surgical site. The patient received multiple antibiotic regimens, including vancomycin, ceftazidime, and meropenem, resulting in clinical improvement. CLINICAL DISCUSSION: Infectious spondylodiscitis is typically hematogenously spread or due to direct inoculation. In this case, the spread from a contiguous focus of infection without vascular insufficiency is suspected. The coexistence of appendicitis and spondylodiscitis poses diagnostic challenges, requiring a multidisciplinary approach for accurate diagnosis and appropriate treatment. CONCLUSION: This unique case highlights the need for vigilance in recognizing rare complications of appendicitis, such as infectious spondylodiscitis. Early diagnosis and tailored antibiotic therapy are crucial for optimal outcomes. Further research is needed to explore the underlying mechanisms and risk factors associated with this rare complication.

Evaluation of ionic liquids based imidazolium salts as an environmentally friendly corrosion inhibitors for carbon steel in HCl solutions.

The features of this work on corrosion inhibition have been investigated based on the ecological awareness and according to the strict environmental legislations. This was done by studying how different imidazolium derivatives ionic liquids containing different alkyl chains R8, R10 and R12 affected the corrosion reaction of carbon steel specimen immersed in 1 M hydrochloric acid at various temperatures. Weight loss, potentiodynamic polarization and electrochemical impedance spectroscopy were utilized to examine the corrosion inhibition behavior on carbon steel. In addition, FT-IR spectroscopy was used to analyze the coated film that has been formed on the metal surface. The prepared ionic liquids showed effective inhibition efficiency, where the corrosion rate after the using of 100 ppm of R8-IL, R10-IL and R12-IL was decreased from 5.95 (µg cm-2 min-1) to 0.66, 0.56, and 0.44 (µg cm-2 min-1), respectively at 20 °C. In the polarization curves, the corrosion current, Icorr, decreases by ILs addition and suggest that ILs act as mixed type inhibitors. From EIS findings, the increase in Rct and decrease in Cdl values proves the adherence of inhibitor molecules on carbon steel surface. The temperature effect was also studied on the film formed, where increasing the temperature from 20 to 50 °C, the corrosion rate increased and the inhibitors efficacy decreased. The increasing in the length of the attached alkyl chain, the efficacies of the prepared inhibitors increases. Various thermodynamic parameters such as the reaction activation free energy (ΔG*), the entropy of activation (ΔS*), and the enthalpy of activation (ΔH*), as well as the adsorption isotherm were investigated in order to interpret the mechanism and obtain the most accurate perception.

Auranofin attenuates Schistosoma mansoni egg-induced liver granuloma and fibrosis in mice.

Schistosomiasis is a serious tropical disease. Despite extensive research into the etiology of liver fibrosis, effective therapeutic options remain limited. This study aims to assess the effectiveness of auranofin in treating hepatic granuloma and fibrogenesis produced by Schistosoma (S.) mansoni eggs. Auranofin is a gold complex that contains thioglucose tetraacetate and triethylphosphine. Eighty BALB/c male mice were divided into four groups (n=20/group): negative control (GI), positive control (GII), and early (GIII) and late (GIV) treatment groups with oral auranofin according to beginning of treatment 4th week and 6th week post-infection. Mice were infected subcutaneously in a dose of 60±10 cercariae/mouse. Worm counts, egg loads, and oogram patterns were determined. Biochemical, histological, and immunostaining of interleukin-1ß (IL-1ß), Sirtuin 3 (SIRT3), and smooth muscle actin (SMA) were assessed. GIII showed a significant decrease in the total S. mansoni worm burden and ova/gram in liver tissue (with reduction percent of 63.07% and 78.26%, respectively). Schistosomal oogram patterns, immature and mature ova, also showed a significant decrease. The reduction in granuloma number and size was 40.63% and 48.66%, respectively, in GIII, whereas in GIV, the reduction percent was 76.63% and 67.08%. In addition, the degree of fibrosis was significantly diminished in both treated groups. GIV showed significant reduction in IL-1ß and SMA expression and increase in SIRT3 expression. These findings reveal how auranofin suppresses the development of liver fibrosis. Therefore, it is crucial to take another look at auranofin as a prospective medication for the treatment of S. mansoni egg-induced hepatic granuloma and consequent fibrosis.

Imidazolium-based ionic liquids as dispersants to improve the stability of asphaltene in Egyptian heavy crude oil.

Deposition of asphaltene aggregates can easily depress the oil production, because it may clog the wellbores, annulus, pipelines, and surface facilities. Moreover, asphaltene molecules have a negative effect on the catalytic reactions in the refinery process. Therefore, in this work, three different ionic liquids (IL-H, IL-CH3, and IL-NO2) were synthesized, and characterized using FT-IR and NMR spectroscopy to evaluate their efficiency as asphaltene dispersants. The thermal gravimetric analysis of the prepared ILs showed that IL-H, IL-NO2, and IL-CH3 were thermally stable up to 280 °C. The ILs showed good dispersion activity of the petroleum asphaltenes, where the asphaltene onset precipitation (AOP) was changed from 7.5 to 10.5, 11, and 13.5 ml added n-heptane after the use of IL-H, IL-NO2, and IL-CH3, respectively. Moreover, the colloidal instability index of crude oil was changed from 0.92 (unstable asphaltene) to 0.69 (stable asphaltene). It is noted during the experiments that the presence of an alkyl chain attached to the ionic liquid moiety increases the efficiency of the dispersant. This may be owing to the formation of π-π* with asphaltene molecules due to the presence of electron donating group. Quantum chemical parameters were calculated for the prepared ILs, and the theoretical data confirmed the experimental results.

CP110 and CEP135 localize near the proximal and distal centrioles of cattle and human spermatozoa.

Centrosomes play an important role in the microtubule organization of a cell. The sperm's specialized centrosome consists of the canonical barrel-shaped proximal centriole, the funnel-shaped distal centriole, and the pericentriolar material known as striated columns (or segmented columns). Here, we examined the localization of the centriole proteins CEP135 and CP110 in cattle and human spermatozoa. In canonical centrioles, CP110 is a centriole tip protein that controls cilia formation, while CEP135 is a structural protein essential for constructing the centriole. In contrast, we found antibodies recognizing CEP135 and CP110 label near the proximal and distal centrioles at the expected location of the striated columns and capitulum in cattle and humans in an antibody and species-specific way. These findings provide a pathway to understanding the unique functions of spermatozoan centrosome.

Live IBD vaccine exacerbates disease and pathological effects of Asian lineage H9N2 LPAIV in chickens.

Avian influenza H9N2 is one of the most commonly circulating viruses in numerous Egyptian poultry farms. The Asian lineage H9N2 exhibits an immunosuppressive effect, and its pathogenicity is amplified when it co-infects with other pathogens, especially with the immunosuppressive infectious bursal disease virus (IBDV), resulting in increased mortality rates. Both vaccines and field infection can exacerbate the pathogenicity of H9N2, particularly in the bursa of Fabricius, causing more significant lymphoid depletion. To comprehend the impact of the IBD vaccine on the viral and pathogenic effect of H9N2 infection in specific pathogen-free chicks (SPF), the experiment was designed as four groups; group 1 served as the negative control, group 2 received (228E) IBD vaccine, group 3 was challenged with H9N2, and group-4 was vaccinated by the IBD vaccine then challenged with H9N2. The clinical signs, relative immune organs weights and histopathological lesion scores were recorded. The tracheal and cloacal H9N2 viral shedding were also measured. Group 4 exhibited a significant decrease (P ≤ 0.05) in the relative bursal weight and an increase in the bursal lesion score when compared with groups 1 and 3 at 4 and 8 days post-challenge (dpc). The tracheal lesion score of group-4 recorded a significant increase when compared with groups 1 and 3. The renal lesion score of group 4 achieved a significant increase when compared with 1 and 3 at 8 dpc. Also, group 4 recorded a significant increase in H9N2 shedding in comparison with groups 1 and 3. Consequently, our study concluded that routine vaccination with the IBD intermediate plus vaccine exacerbates the silent infection of H9N2 resulting in outbreaks.

Tracking of thermal microbial shock proteins and genomic variation of Bacillus cereus due to some abiotic stresses.

Bacillus cereus is considered the most potent bacterial strain in terms of the increment in induced proteins during thermal treatment at 52 °C for 90 min. Protein production in food-born microorganism (Bacillus cereus) recovered from contaminated food was investigated in response to heat shock treatment. Bacterial tolerance towards pH, salinity, and temperature at various levels was also investigated. Heat-shock proteins (HSPs) produced when exposed to 52 °C for up to 60 minutes led to significant differences (30%) above the untreated control (37 °C), and the maximum difference was recorded at 52°C at 90 minutes. ISSR detected a higher number of bands/primer than RAPD (13.7 vs. 12.7, respectively), and more polymorphic bands (10.7 vs. 8.4 bands/primer, respectively). The untreated bacterial strain did not grow at pH levels lower than 3, whereas the thermally treated strain grew significantly at pH two. A consistent increase in HSPs was observed, with a gradual increase in salinity of less than 16%. Surprisingly, the gradual increase in temperature did not induce tolerance against higher temperatures. However, a significant growth rate was noticed in response to heat-shocked treatments. The untreated Bacillus cereus demonstrated antibiotic resistance to gentamycin and clindamycin (1.54 and 1.65 cm, respectively), much lower than the corresponding inhibition areas with preheat-treated test pathogen which were recorded (2.37 and 2.49 cm, respectively).

Somato-somatic theory of referred pain elucidates observations of referred sensations during micropigmentation of nipple-areolar complex in a cohort study on patients undergoing pedicled latissimus dorsi flap breast reconstruction.

AIM: Micropigmentation of the nipple-areolar complex is the final aesthetic step in autologous breast reconstruction. The mechanism of referred pain observed in patients during micropigmentation after a non-neurotonized pedicled latissimus dorsi flap breast reconstruction is poorly understood. METHODS: Patients undergoing micropigmentation for nipple-areolar restoration at our breast unit were included in this study. Baseline sensitivity of both breasts was recorded using a questionnaire and non-invasive Semmes-Weinstein monofilament testing. Patients experiencing local and regional referred symptoms, while undergoing micropigmentation, were identified and their clinical data were collected and analysed. Three months postoperatively, the patients completed a questionnaire pertaining to their satisfaction and future analgesic preference. RESULTS: Thirty (17.8%) patients experienced referred sensations during micropigmentation. Their symptoms ranged from "ache" (6.7%), "discomfort" (13.3%) to "deep pain" (13.3%) and were either local and/or referred to ipsilateral axilla, upper limb and back. The majority were pleased with postoperative outcomes [shape (30, 100%), size (28, 93.3%), colour match (22, 73.3%)] and a small number were not satisfied with the shape (2, 6.7%,) position (1, 3.3%) and appearance of the tattoo (1, 3.3%). CONCLUSION: Micropigmentation is a safe procedure with good patient satisfaction and low rates of complications; however, patients may experience significant local or referred symptoms. This observation can be explained by the proposed "somato-somatic" theory of referred pain and ascertains the need for use of oral and/or local anaesthetic as well as improved counselling in these patients.

Response of Moringa oleifera Seeds and Fixed Oil Production to Vermicompost and NPK Fertilizers under Calcareous Soil Conditions.

A shortages of soil nutrients resources and a lack of accessibility to them especially in calcareous soil are considered some of the main factors that limit plant production. In particular, the cultivation of the Moringa oleifera trees in this type of soil is of special interest given the increasing demand for every part of this tree. Several studies have focused on the production of its leaves as an herbaceous plant and not as a tree, but there has not been extensive research on its pods, seeds, and fixed oil production. In this sense, in this study, we provide an assessment of the use of fertilizers, vermicompost and NPK (as traditional minerals and as nanoparticles), in order to improve pods, seeds, and fixed oil contents, as indicators of the quality of the production of the Moringa oleifera trees in calcareous soil conditions. In this experiment, it was observed that all parameters and the yield of pods, seeds, and fixed oil of the Moringa oleifera tree were significantly improved by increasing the level of vermicompost and using NPK fertilization and combination treatments in both seasons of the study. The combination treatments of 10 and 20 ton ha-1 vermicompost plus NPK control produced the highest percentage of oleic acid with insignificant differences between them.

Focal therapy for prostate cancer: Making the punishment fit the crime.

BACKGROUND: Focal therapy is recently gaining popularity as an intermediate option between active surveillance and whole-gland treatment for localized prostate cancer. OBJECTIVE: This comprehensive review aims to present the different focal therapy technologies available to date while tackling the rationale for focal treatment, its indications, principles and outcomes of each technique. EVIDENCE ACQUISITION: A comprehensive review of the PubMed, Embase, and Web of Science was done. Keywords used for research were: "prostate cancer"; "focal therapy"; "focal treatment"; "High-Intensity Focal Ultrasound"; "cryotherapy"; "photodynamic therapy"; "focal laser ablation"; "irreversible electroporation"; "focal brachytherapy" and "gold nanoparticle directed therapy". Accepted languages were English and French. EVIDENCE SYNTHESIS: Choosing the best candidate for focal therapy is crucial (localized small to medium sized Gleason≤7 lesions). Focal high-intensity focal ultrasound has shown excellent survival rates at 5 years, while maintaining good functional outcomes (urinary continence and erectile function). Focal cryotherapy, one of the oldest focal treatments for prostate cancer, has shown good oncologic outcomes, with good continence rates and fair erectile function rates. Focal laser ablation seems a safe and feasible technique, with promising results. Irreversible electroporation has demonstrated good survival outcomes with no biochemical recurrence or disease relapse in the preliminary studies. Focal brachytherapy has a good toxicity profile, a good biochemical outcome, and gives a sustained quality of life. Finally, gold nanoparticle directed therapy is safe and is being studied in current trials. CONCLUSION: While proven to be safe in terms of continence and sexual aspects, the challenge remains to better assess oncological outcomes of these techniques in randomized longer follow-up studies.

Modeling the survival times of the COVID-19 patients with a new statistical model: A case study from China.

Over the past few months, the spread of the current COVID-19 epidemic has caused tremendous damage worldwide, and unstable many countries economically. Detailed scientific analysis of this event is currently underway to come. However, it is very important to have the right facts and figures to take all possible actions that are needed to avoid COVID-19. In the practice and application of big data sciences, it is always of interest to provide the best description of the data under consideration. The recent studies have shown the potential of statistical distributions in modeling data in applied sciences, especially in medical science. In this article, we continue to carry this area of research, and introduce a new statistical model called the arcsine modified Weibull distribution. The proposed model is introduced using the modified Weibull distribution with the arcsine-X approach which is based on the trigonometric strategy. The maximum likelihood estimators of the parameters of the new model are obtained and the performance these estimators are assessed by conducting a Monte Carlo simulation study. Finally, the effectiveness and utility of the arcsine modified Weibull distribution are demonstrated by modeling COVID-19 patients data. The data set represents the survival times of fifty-three patients taken from a hospital in China. The practical application shows that the proposed model out-classed the competitive models and can be chosen as a good candidate distribution for modeling COVID-19, and other related data sets.

Bioengineering of the digestive tract: approaching the clinic.

The field of regenerative medicine is developing technologies that, in the near future, will offer alternative approaches to either cure diseases affecting the gastrointestinal tract or slow their progression by leveraging the intrinsic ability of our tissues and organs to repair after damage. This article will succinctly illustrate the three technologies that are closer to clinical translation-namely, human intestinal organoids, sphincter bioengineering and decellularization, whereby the cellular compartment of a given segment of the digestive tract is removed to obtain a scaffold consisting of the extracellular matrix. The latter will be used as a template for the regeneration of a functional organ, whereby the newly generated cellular compartment will be obtained from the patient's own cells. Although clinical application of this technology is approaching, product development challenges are being tackled to warrant safety and efficacy.

SAVR contemporary outcomes in TAVI era: Still a valid option for the future.

The advent of transcatheter aortic valve implantation (TAVI) has changed the way aortic stenosis (AS) is treated. In the last decade, the improvement of techniques and the development of more performing devices helped in granting TAVI approval for its use in high- and intermediate-risk patients and more recently in low-risk patients. With the majority of surgical aortic valve replacement (SAVR) procedures being done on low-risk patients, recent results from the PARTNER 3 and Evolut Low Risk trials have ignited the question of TAVI use in patient category as well as an alternative to SAVR. The paper by a group from the Royal Papworth Hospital from the University of Cambridge, UK, published in the Journal of Cardiac Surgery, should serve as concrete proof that SAVR remains an excellent option with favorable outcomes in the treatment of AS. It is a wake-up call to the entire surgical community to push forward to ameliorate outcomes and reduce complications through innovation and experience, newer surgical techniques, better equipment, and improved valves to adapt to the changing world of heart valve diseases.

Hydroxyapatite-decorated ZrO2 for α-amylase immobilization: Toward the enhancement of enzyme stability and reusability.

Herein, the immobilization of α-amylase onto hydroxyapatite (HA) and hydroxyapatite-decorated ZrO2 (10%wt) (HA-ZrO2) nanocomposite were investigated. The immobilization yield was 69.7% and 84% respectively. The structural differences were characterized using X-Ray diffraction, attenuated total reflectance-Fourier transform infrared spectra, Raman, and scanning electron microscope. After 10 repeated cycles, the residual activity of immobilized α-amylase onto HA and HA-ZrO2 nanocomposite was 46% and 70%, respectively. The storage stability was recorded to be 27%, 50% and 69% from its initial activity in the case of free and immobilized enzyme onto HA and HA-ZrO2 nanocomposite, respectively after 8 weeks. The pH-activity profile and temperature revealed pH 6.0 and temperature 50 °C as the optimal values of free α-amylase, while the optimum values for α-amylase on HA and HA-ZrO2 was shifted to pH 6.5 and 60 °C after immobilization. The immobilized α-amylase onto HA-ZrO2 showed comparatively higher catalytic activity than the free α-amylase. The Km value after the immobilization process onto HA was 2.1 folds highly than that of the free enzyme. In conclusion, it can be inferred that HA-ZrO2 is more sustainable and beneficial support for enzyme immobilization and it represents promising supports for different uses of α-amylase in the biomedical applications.

Changes in outcomes over time in intermediate-risk patients treated for severe aortic stenosis.

BACKGROUND: The advent of transcatheter aortic valve replacement (TAVR) has changed the practice of treating patients with severe aortic stenosis (AS). Heart-Teams have improved their decision-making process to refer patients to the best and safest treatment. The evidence allowed centers to increase funding and TAVR volume and extend indications to different risk categories of patients. This study evaluates the outcomes of intermediate-risk patients treated for severe AS in an academic center. METHODS: Between 2012 and 2019, 812 patients with AS underwent TAVR or surgical aortic valve replacement (SAVR). A propensity score-matching analytic strategy was used to balance groups and adjust for time periods. Outcomes were recorded according to the Society of Thoracic Surgeons Guidelines; the primary outcome being 30-day mortality and the secondary outcomes being perioperative course and complications. RESULTS: No difference in mortality was seen but complications differed: more postoperative transient ischemic attacks, permanent pacemaker implantations, and perivalvular leaks in the transcatheter group, while more acute kidney injuries, atrial fibrillation, delirium, postoperative infections and bleeding, tamponade and need for reoperation in the surgical group as well as a longer hospital length-of-stay. However, over the years, morbidities/mortality decreased for all patients treated for AS. CONCLUSIONS: Data showed an improvement in morbidities/mortality for intermediate-risk patients treated with SAVR or TAVR. Increased funding allowed for a higher TAVR volume by increasing access to this technology. Also, the difference in complications could impact healthcare costs. By incorporating important metrics such as length-of-stay, readmission rates, and complications into decision-making, the Heart-Team can improve clinical outcomes, healthcare economics, and resource utilization.

Functional restoration of ex vivo model of pylorus: Co-injection of neural progenitor cells and interstitial cells of Cajal.

Transplantation of neural stem cells is a promising approach in treatment of intestinal dysfunctionality. The interstitial cells of Cajal (ICCs) are also critical in conditions such as pyloric dysfunctionality and gastroparesis. The objective of this study was to replenish neurons and ICCs in a dysfunctional pylorus as cell-based therapy to restore functionality. ICCs and enteric neural progenitor cells (NPCs) were isolated from rat duodenum and transduced with fluorescent proteins. Rat pylorus was harvested, and an ex-vivo neuromuscular dysfunctional model was developed by selective ablation of neurons and ICCs via chemical treatments. Cellular repopulation and restoration of motility were assessed by immunohistochemistry, qPCR, and functional analysis after delivery of fluorescently tagged cells. Chemical treatment of pylorus resulted in significant depletion of ICCs (67%, P = .0024; n = 3) and neural cells (83%, P = .0012; n = 3). Delivered ICCs and NPCs survived and integrated with host muscle layers. Co-injection of ICCs with NPCs exhibited 34.4% (P = .0004; n = 3) and 61.0% (P = .0003; n = 3) upregulation of ANO1 and ßIII tubulin, respectively. This regeneration resulted in the restoration of agonist-induced excitatory contraction (82%) and neuron evoked relaxation (83%). The functional studies with specific neuronal nitric oxide (NO) synthase blocker confirmed that restoration of relaxation was NO mediated and neuronally derived. The simultaneous delivery of ICCs observed 35.7% higher neuronal differentiation and functional restoration compared with injection of NPCs alone. Injected NPCs and ICCs integrated into the dysfunctional ex vivo pylorus tissues and restored neuromuscular functionality. The co-transplantation of NPCs and ICCs can be used to treat neurodegenerative disorders of the pylorus.

Imaging Properties of Additive Manufactured (3D Printed) Materials for Potential Use for Phantom Models.

Over the last few decades, there has been growing interest in the application of additive manufacturing (AM) or 3D printing for medical research and clinical application. Imaging phantoms offer clear benefits in the way of training, planning, and quality assurance, but the model's availability per catalog tend to be suited for general testing purposes only. AM, on the contrary, offers flexibility to clinicians by enabling custom-built phantoms based on specific interests or even individual patient needs. This study aims to quantify the radiographic properties (ultrasound, magnetic resonance imaging, and computed tomography) of common additive manufacturing technologies and to discuss potential opportunities to fabricate imaging phantoms. Test phantoms were composed of samples from the three most common AM styles, namely PolyJet, fused deposition modeling (FDM), and stereolithography (SLA). Test imaging of the phantoms was performed on ultrasound, MRI, and CT and reviewed and evaluated with radiology software. The ultrasound images showed clearly defined upper and lower edges of the material but did not demonstrate distinct differences in internal echogenicity between materials. The MR scans revealed a distinct signal intensity difference between the model (17 grayscale value) and the printer support (778 grayscale value). Finally, the CT images showed a slight variation between the plastic (82 HU) and rubber (145 HU) materials. The radiographic properties of AM offer a clear opportunity to create basic two- or three-material phantoms. These would be high-accuracy and cost-effective models. Although the materials currently available are not suitable for complex multi-material applications as realistic as true human anatomy, one can easily foresee the development of new materials with broader density in the near future.

Post-era mass drug administration: an update on intestinal parasitic infections in urban poor communities in Peninsular Malaysia.

The health impact of a Malaysian national helminth control program which provided school-based anthelmintic chemotherapy from 1974 to 1983 was re-visited after three decades post MDA and associated risk factors amongst urban poor communities identified. Stool samples collected were screened using the formalin ethyl-acetate concentration technique recovered at least one species of helminth and/or protozoan. Despite a steady decline observed between 1974-1983 however, post MDA infections continue to persist in pockets of communities moderately (18.9%; n=39/206) with higher infection recorded amongst PPR flat residents (22.5%, n=16/71). Among risk factors identified, waste management method was the primary factor for Ascaris lumbricoides infections (n=33; 16.0%), whereas age, education, employment and source of drinking water were significant risk factors for cryptosporidiosis. Despite the government's efforts to improve health through the provision of basic amenities to the general public, higher prevalence values amongst PPR flat dwellers suggests the need to implement targeted chemotherapeutic treatment of, once a year deworming as recommended by World Health Organization when the baseline prevalence of soil-transmitted helminth infections in the community is over 20%, in addition to preventive measures though improvements in health awareness programs and improved waste management methods.

Appendicitis-Like Picture Induced by Foreign Body in a 2-Year-Old Boy.

Background and Aim. Appendicitis is unusual in toddlers and foreign body- (FB-) induced appendicitis is rare. We present a FB-induced appendicitis in a toddler with no suggestive history of FB ingestion. Case Presentation. A 2-year-old healthy boy presented to the emergency department with irritability for 3 days duration associated with fever of 39°C, nausea, anorexia, and vomiting. There was no history of foreign body ingestion. The abdomen was distended and diffusely tender. An abdominal ultrasound (US) was suggestive of perforated appendicitis with appendicular mass formation. An abdominal X-ray showed a pin-like foreign body in the abdomen. An emergent appendectomy was performed. Intraoperatively, a sealed small cecal perforation was noticed. A 5 cm pin-like metallic foreign body was found to obstruct the appendicular lumen. The appendix was grossly normal without inflammatory changes. Conclusion. FB-induced perforations or appendicitis albeit in patients with no history of FB ingestion or infants and toddlers need a high clinical suspicion to prevent the delay in diagnosis and the subsequent complications.