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Cancer is a disease that implies several different genotypic and phenotypic traits in its whole process of development: tumorigenesis.

We present a 54-year-old male with abdominal pain, Vomiting and weight loss since 5 months. Perforation was noted at recto-sigmoid junction and underwent Hartman’s procedure with end colostomy. Histology of sigmoid colon confirmed a Stercoral perforation without any evidence of dysplasia or malignancy. Patient had chemotherapy for squamous cell carcinoma (SCC) of epiglottis a year ago and was on codeine phosphate and Oromorph as and when required since his treatment for SCC for pain. Patient also had been suffering from constipation since he finished chemotherapy. Stercoral perforation always need to kept in mind in patients who present with constipation and need to take all patients who present with chronic constipation and initiate measures we encounter commonly in everyday practice. We present a brief review about Stercoral perforation and its management.

Introduction: Busulfan (Bu)-based regimens are crucial for myeloablative conditioning in pediatric allogeneic stem cell transplantation. Despite its efficacy, Intravenous Bu has a narrow therapeutic index and variable pharmacodynamics especially in children, heightening the risk of adverse events. This study explores Bu dosing and related organ toxicities in pediatric patients at a tertiary center in Saudi Arabia.Methodology: This retrospective study at King Fahad Specialist Hospital in Dammam (KFSH-D), Saudi Arabia, included pediatric patients (≤16 years) treated with intravenous Bu before bone marrow transplantation from 2010 to 2022. Pharmacokinetic dose adjustments were based on AUC targets of 900-1350 µMol-min. Descriptive measures included mean, Standard Deviation (SD), median, minimum-maximum values, counts, and percentages. Statistical analyses used Kruskal-Wallis, Chi-square, and Fisher’s exact tests. Ethical approval was obtained from KFSH-D.Results: We identified 44 pediatric patients who underwent Bu prior to HSCT. Mean age was 4.95 ± 2.49 years, with a female majority (56.8%). Primary diseases included Beta Thalassemia (34.09%), Neuroblastoma (29.55%) among others. There was no significant difference in the cohort’s demographic and clinical features of the cohort. Nonetheless, higher infections were found in the Low-AUC group (66.7%) compared to the Target-AUC (40.0%) and Higher-AUC groups (0.0%) (p = 0.015).Conclusion: This study emphasizes the need for therapeutic drug monitoring and individualized Bu dosing in pediatric HSCT to minimize toxicity and improve outcomes. Larger multicenter studies are recommended to refine dosing strategies and enhance the safety and efficacy of Bu-based regimens.

Introduction: Few studies have explored the vulnerability of women with polycystic ovary syndrome (PCOS) to developing cervical cancer and its precursor lesions. Objective: To describe the clinical, metabolic, and endocrine characteristics of a series of women with cervical squamous intraepithelial lesions and polycystic ovary syndrome, aiming to generate hypotheses regarding the potential pathophysiological mechanisms linking both conditions.Methods: A descriptive and hypothesis-generating study was conducted. The series consisted of nine women with a cytological diagnosis of cervical squamous intraepithelial lesions (SIL) who also met the Rotterdam criteria for PCOS. Characterization included age, sexual behavior, toxic habits, history of hypertension and diabetes mellitus, body mass index (BMI) and waist-to-hip ratio (WHR), metabolic parameters (insulin resistance, dyslipidemia), serum hormone levels (testosterone, prolactin, estradiol), human papillomavirus (HPV) 16/18 infection, grade of the lesion, and PCOS phenotypes. Results: The mean age was 37,11 ± 12,8 years. Abdominal obesity was detected in 55,5% and insulin resistance in 44,4% of cases. Hyperprolactinemia was present in 33,3%. HPV 16/18 infection was identified in 77,7% of cases. Most patients presented high-grade squamous intraepithelial lesions (HSIL) and PCOS phenotype D. Conclusion: The presence of HSIL in more than a third of the women in this case series is compatible with the hypothesis that PCOS, particularly those with insulin resistance, abdominal obesity, or hyperprolactinemia, may act as a multifactorial risk factor for cervical lesions, either independently or synergistically through metabolic and hormonal pathways that interact with HPV. These findings should be interpreted as preliminary observations that warrant confirmation in larger, controlled studies.

Diarrheal diseases continue to be the major cause of morbidity and mortality among children under 5 years. This study aimed to isolate, identify and determining the prevalence, antimicrobial susceptibility profile of Shigella sp associated with acute diarrhea among children in Kano, Northern Nigeria. A cross sectional study was conducted among children less than 5 years diagnosed with acute diarrhea and admitted to paediatric ward of Murtala Muhammad Specialist Hospital Kano. Stool samples from a total of 37 (20 male and 17 female) subjects were used to isolate and identified the pathogen. Antimicrobial susceptibility test was conducted using disc diffusion method. The result showed 12 out of 37 samples were positive for Shigella sp which accounted for 32.4%. Higher incidence of Shigella sp was found among subjects of age between 2 – 3 years. The isolates were 100% resistant to Ampicillin. High resistance was also observed in Amoxicillin (83.33%), Chloramphenicol (58.33%) and Tetracycline (25%). The isolates are 100% sensitive to ciprofloxacin, 66.7% to Levofloxacin and Gentamicin each and 58.33% to Erythromycin. Three (3) isolates were resistance to Ampicillin and Amoxicillin, 5 isolates were resistance to Ampicillin, Chloramphenicol and Amoxicillin while 2 isolates were resistance to Ampicillin, Chloramphenicol, Tetracycline and Amoxicillin. It is concluded that Shigella sp is one of the etiological agent of diarrhea in children. Ciprofloxacin, levofloxacin and Gentamicin are drugs of choice for treating diarrhea caused by Shigella sp.

Background: Malaria and typhoid fever remain major public health problems and important causes of febrile illness in sub-Saharan Africa, particularly in urban settings characterized by poor sanitation, unsafe water supply, overcrowding, and persistent malaria transmission. The clinical manifestations of both diseases frequently overlap, making accurate diagnosis difficult and often leading to empirical treatment, inappropriate antimicrobial use, and delayed patient management. This study assessed the occurrence, associated risk factors, and clinical implications of malaria–typhoid co-infection among febrile patients attending the Camrail Medical Center in Douala, Cameroon. Methods: A hospital-based analytical cross-sectional study was conducted among 220 febrile patients recruited systematically at the outpatient department. Data were collected using structured questionnaires, clinical assessment forms, and laboratory investigations. Malaria infection was diagnosed using standard parasitological methods, while typhoid fever was assessed using routine laboratory procedures. Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression in SPSS version 25. Results: Malaria mono-infection accounted for 31.8% of cases, typhoid mono-infection for 10.9%, and malaria–typhoid co-infection for 15.5%, whereas 41.8% of participants had neither infection. Significant predictors of co-infection included unsafe water sources (AOR = 3.12; p = 0.001), poor food hygiene (AOR = 3.85; p < 0.001), non-use of bed nets (AOR = 2.21; p = 0.021), and exposure to stagnant water (AOR = 2.76; p = 0.004). Co-infected patients experienced significantly more severe clinical manifestations, including high fever, vomiting, diarrhea, abdominal pain, and headache. Age-stratified analysis showed a higher proportion of co-infection among participants aged ≤25 years (18.8%) compared with those aged ≥26 years (12.9%), although the difference was not statistically significant (p = 0.194). Gender-based analysis demonstrated no significant association between sex and infection category (p = 0.606).Conclusion and recommendations: Malaria–typhoid co-infection remains a significant public health concern in Douala. Integrated diagnostic approaches, improved environmental sanitation, safe water access, food hygiene promotion, and strengthened malaria prevention measures are essential to reducing the burden of co-infection and limiting inappropriate antimicrobial use.

Background: Sarcoidosis is a systemic granulomatous inflammatory disease that is associated with inflammatory eye manifestations such as uveitis, cystoid macular edema, and retinal vasculitis. Although Corticosteroids (CS) have traditionally been the mainstay of treatment, there is a clinical need and growing interest in exploring alternative therapeutic options for patients who are refractory to or intolerant of CS or require long-term steroid-sparing agents. Purpose: This case series aims to describe the effectiveness of adalimumab, an anti-tumor necrosis factor (TNF)-α monoclonal antibody, in the management of complex sarcoidosis-related inflammatory eye disease via reduction in CS dosage and ocular exam findings before and after initiation of adalimumab therapy.Method: A retrospective chart review of patients between 2010 and 2023 seen at our academic center’s rheumatology and eye clinics was conducted, with 5 patients meeting the inclusion criteria. Results: Most patients were able to lower, discontinue, or remain off oral CS, while all 5 patients demonstrated a reduction in uveitis activity, Cystoid Macular Edema (CME), and/or retinal vasculitis. Conclusion: These findings suggest a potential role for adalimumab as an effective and safe therapeutic option in the management of complex sarcoidosis-related inflammatory eye disease.

Venous Thromboembolism (VTE) is a major public health concern, affecting approximately 900,000 people annually in the United States. In rare cases, a Patent Foramen Ovale (PFO) may allow a venous thrombus to cross into the arterial circulation, causing a paradoxical embolism. This case report presents a 46-year-old male who developed left renal artery stenosis after a paradoxical embolism, likely triggered by a prolonged flight and binge alcohol consumption. The patient was found to have a moderate-sized PFO and renal infarction, confirmed by imaging studies. Despite initial anticoagulation therapy and a planned stenting procedure, intraoperative findings revealed only mild stenosis, leading to cancellation of the stent placement. The patient ultimately underwent PFO closure with an Amplatzer Talisman device. This case underscores the diagnostic challenges in managing paradoxical embolism and the need for individualized treatment, particularly concerning anticoagulation duration, the decision for PFO closure, and post-procedural antithrombotic therapy. Further research is required to establish optimal management strategies for cryptogenic embolic events.

The global obesity epidemic that was previously reported [1,2] is now to worsen with obesity to double in 73 countries around the world [3,4]. Improving the health of obese individuals by dietary restriction, anti-obese foods and increased physical activity [1] has not reduced the global obesity epidemic. Obesity is linked to nonalcoholic fatty liver disease (NAFLD) [5,6] with complications relevant to the metabolic syndrome and cardiovascular disease [7]. Appetite control has become critical to endocrinology and metabolism with the apelinergic pathway and nuclear receptor Sirtuin 1 (Sirt 1) now connected to the endocrine system [8] and critical to metabolism. The apelin-Sirt 1 interaction involves nitric oxide (NO) [9] that is now considered as the defect [10] in the interaction between the peptide apelin and calorie sensitive gene Sirt 1 involved in NO imbalances in the adipose tissue, liver and the brain.

Objective: To study the therapeutic effect of B-ultrasound-guided intrahepatic infusion of autologous bone marrow nucleated cells on decompensated cirrhosis. Methods: To observe the clinical treatment of 75 cases of decompensated cirrhosis. Among them, 30 cases received routine liver protection and diuretic treatment. 45 cases were treated by percutaneous transhepatic infusion of autologous bone marrow nucleated cells under the guidance of B ultrasound. There were no significant differences in liver function and blood routine indexes between the two groups before treatment (p > 0.05). Results: The indexes of liver function and blood routine at different time periods of 1 month, 3 months, 6 months, and 12 months in the conventional treatment group did not change significantly. 6 cases died of liver failure within 1 year, the fatality rate was 20%. The indexes of liver function and blood routine of percutaneous liver transhepatic infusion of autologous bone marrow nucleated cells at 1 month, 3 months, 6 months, and 12 months under the guidance of B-ultrasound were significantly better than those of the conventional treatment group (p < 0.05). One case died of gastrointestinal bleeding in the group of percutaneous transhepatic infusion of autologous bone marrow nucleated cells guided by B ultrasound, with a fatality rate of 2.5%. Compared with the conventional treatment group, there were significant differences (p < 0.05). Conclusion: Conventional drug therapy has no obvious effect on decompensated cirrhosis. Intrahepatic infusion of bone marrow nucleated cells can significantly promote liver function reconstruction in decompensated cirrhosis.