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Background: Laparoscopic cholecystectomy (LC), is one of the most commonly performed surgical procedures worldwide, it is accepted as the gold standard in the treatment of symptomatic gallstones for its minimal invasiveness, less pain and early recovery. Purpose: To predict the difficulty of laparoscopic cholecystectomy in patients according to the recently published scoring system and select the difficult cases to be done by a senior surgeon. Patients: This is a prospective cohort study. This study took place Oct 6th University Hospital and Kasr El Aini Hospital, Cairo university; the study involved 120 patients admitted with calcular cholecystitis, arranged for laparoscopic cholecystectomy. Methods: Laparoscopic cholecystectomy after applying the scoring system. Results: In our study we found that age, sex and ultrasonographic data were significant predictive factors for assessment preoperatively difficult cases that will be operated upon. We found 14 patients above 50 years who scored to be difficult and very difficult were at outcome difficult, only three patients converted to open surgery over fifty. Conclusion: We can report that obese patient who were over fifty with history of previous upper abdominal surgery and ultrasonographic picture showed thick walled GB and pericholecystic collection had high risk of conversion. At this study scoring system was used for prediction of difficult laparoscopic cholecystectomy sensitivity was 93.75% and specificity was 52.94% of the scoring system at score 5 for prediction of easy or difficult laparoscopic cholecystectomy.

Many reports are showing no differences in prognosis between patients with Heart Failure (HF) with preserved and reduced ejection fraction. All-in-one analysis with a multivariable model, including clinical characteristics, blood test, comorbidity, and echocardiographic indices, on clinical outcomes in patients with HF has not been performed rarely in previous studies. We have to accept the need to be more comprehensive in the outcome analysis of patients with HF and consider the intricate interplay of multiple variables in patient outcomes.

This review was conducted for the objective of assessing causes of COVID-19 pandemic impacts on life animals and dairy product processing industry of the world. Since its outbreak in Wuhan town of China, the newly emerged strains of corona virus COVID-19 causes incredible crisis both on life animal and its product especially dairy industry of the globe. During the outbreak of the virus, majority of the world people were stayed home to prevent the spread of the diseases. At that time, the wildlife found in the zoo were exposed to diseases and missed human attention, global wildlife trade was spotlighted and wildlife was running… wild. For the reason of COVID-19 pandemic, many schools and restaurants which received dairy product from dairy producers and cooperatives were shutdown. Due to schools and restaurant shutter, milk supply chain was disrupted. For this moment milk demand and supply was decreased, huge volume of milk was dumped, mode of milk trade was changed, market and farm prices was fluctuated, import- export route was interrupted and Farm workforce absenteeism were some of the challenges cases dairy industry crisis. Trade law modification, provision of financial assistance for dairy industry and farmers, and expansion of export route were the measures taken by concerned bodies to save dairy industry from corona virus crisis. Therefore, COVID-19 pandemic is the disaster diseases which causes social and economic crisis on dairy producers of the world. So, to save wildlife and dairy industry from corona virus crisis, global solidarity prevention is mandatory.

Primary adrenocortical insufficiency or Addison’s disease (AD) is a rare, life-threatening condition with different aetiologies, but the most common cause is autoimmune destruction of the adrenal cortex. Autoimmune Addison’s disease (AAD) can present as an isolated condition or associated with others, as part of an autoimmune polyglandular syndrome (APS). The aim of this work is to investigate and emphasise the roles of autoantibodies in adrenocortical insufficiency, through the description of three clinical cases.

Glomus tumors are rare, usually benign, lesions that arise most often in the extremities. They are derived from the glomus body and have a propensity to be found in the fingers and toes, and often in the subungual area [1]. They typically demonstrate pinprick sensitivity, cold hypersensitivity and paroxysmal pain [2]. Only two glomus tumors of the scrotum have been reported and we report a third case of this rare tumor.

In the current study, the blood flow through an inclined cylindrical tube subjected to an external magnetic field is evaluated. The blood flow has been considered under the consequence of a transverse magnetic field. Previously the mathematical model was solved by using Caputo-Fabrizio (CF) fractional order derivative with a non-singular kernel which has the limitations like it fails to satisfy the fundamental theorem of fractional calculus. Whereas, in the present study Adomian Decomposition Method (ADM) which is suitable for all types of linear and non-linear differential equations is used. The flow of magnetized blood in an inclined cylindrical tube has been studied by using the ADM. An external magnetic field and an oscillating pressure gradient drove the blood flow. ADM algorithm has been developed and used to find the Adomian solution. Computer software MATHEMATICA has been used to visualize the influence of various flow characteristics such as Hartmann number (Ha), different radial locations and angle of inclination on the Adomian velocity. Due to the Lorentz effect and central radial location, the results show that the magnetic field diminishes the velocities of blood. Meanwhile, progressive inclination angle enhanced the blood flow.

The Canadian healthcare system, grappling with issues like systemic and intelligently established structural anti-black racism, including indigenous nations; even within Pathology and Laboratory Medicine Communities: and deteriorating outcomes, sees potential in AI to address challenges, though concerns exist regarding exacerbating discriminatory practices. In clinical pathology, AI demonstrates superior diagnostic accuracy compared to pathologists in a study, emphasizing its potential to improve healthcare. However, AI governance is crucial to navigating ethical, legal, and societal concerns. The Royal College of Physicians of Canada acknowledges the transformative impact of AI in healthcare but stresses the need for responsible AI tools co-developed by diverse teams. Despite positive attitudes towards AI in healthcare, concerns about patient safety, privacy, and autonomy highlight the necessity for comprehensive education, engagement, and collaboration. Legal concerns, including liability and regulation, pose challenges, emphasizing the need for a robust regulatory framework. AI application in healthcare is categorized as high-risk, demanding stringent regulation to ensure safety, efficacy, and fairness. A parallel is drawn to drug regulation processes, suggesting a similar approach for AI. The lack of transparency in AI-based decision-making raises ethical questions, necessitating measures to address biases and ensure patient privacy. Social accountability is crucial to prevent AI from exacerbating health disparities and harming marginalized communities. In conclusion, while AI offers potential benefits in clinical pathology, a cautious approach with comprehensive governance measures is essential to mitigate risks and ensure ethical AI integration into healthcare.

The main purpose of this investigation is to inspect the innovative conception of the magneto hydrodynamic (MHD) nanoparticles of single wall carbon nanotubes base on the fluids (water, engine oil, and ethylene, glycol and kerosene oil) between two rotating parallel plates. Carbon nanotubes (CNTs) parade sole assets due to their rare structure. Such structure has significant optical and electronics features, wonderful strength and elasticity, and high thermal and chemical permanence. The heat exchange phenomena is deliberated subject to thermal radiation. Kerosene oil is taken as based nano fluids because of its unique attention due to their advanced thermal conductivities, exclusive features, and applications. The fluid flow is presumed in steady state. With the help of suitable resemblance variables, the fundamental leading equations have been converted to a set of differential equations. To obtain the solution of the modeled problem, the homotopic approach has been used. The influence of imbedded physical variables upon the velocities and temperature profiles are defined and deliberated through graphs. Moreover, for the several values of relevant variables, the skin fraction coefficient and local Nusselt number are tabulated. Plots have been presented in order to examine how the velocities and temperature profile get affected by various flow parameters.

Chronic foot and heel pain is a clinical dilemma that Pain Physicians often encounter in their daily practice. In the younger active patients, this is often attributed to plantar fasciitis but other rarer etiologies should also be considered. In patients who present with pain over the medial calcaneus, entrapment neuropathy of the inferior calcaneal nerve, the first branch of the lateral plantar nerve (FBLPN), also known as “Baxter’s nerve” must be considered [1,2]. Initially described in 1984 by Baxter and Thigpen, it is often overlooked as a cause of medial heel pain, particularly in athletes, where it may coexist with plantar fasciitis [3]. The nerve has a tortuous course in the foot and can be entrapped as it passes through the fascia of the abductor hallucis, travels in close proximity to a plantar spur or the medial calcaneal tuberosity, or gets enmeshed in scar tissue from prior surgery [1,3].

Anti-glomerular basement membrane (GBM) antibody glomerulonephritis is an extremely rare glomerular disease. Around 90% of the patients are positive for serum anti-GBM antibodies while up to 10% can be negative. In such patients, only a kidney biopsy can reveal the anti-GBM disease it is then labeled as an atypical anti-GBM disease. Though anti-GBM disease can be associated with Anti Neutrophil Cytoplasmic Antibodies (ANCA) positivity, it is extremely rare to find atypical anti-GBM with ANCA positivity so much so that till now there are very few such cases reported from across the world.The case presented here is one such case where the patient presented with adult-onset nephrotic syndrome features with active urinary sediments and mildly deranged renal function. Myeloperoxidase (MPO) ANCA was positive and it was considered ANCA-associated crescentic glomerulonephritis (GN) but after the renal biopsy the picture was of anti-GBM disease. She was treated with pulse methylprednisolone but her creatinine increased in the meantime and considering anti-GBM she was put on Plasma Exchange (PLEX). She received 5 sessions of PLEX after which her renal function improved. She was also planned for Rituximab which could not be given due to local infection. As there are no protocols for treating such cases because of the extremely rare nature of the presentation, this case will increase the understanding of such presentations for the clinicians. This will help to plan for building the approach for such cases.