Basidiobolomycosis of the Colon Masquerading as Stenotic Colon Cancer

Basidiobolus ranarum is a widespread saprophyte fungus with pathogenic potential. It affects mainly the subcutaneous tissues of the trunk and limbs. Relatively recently, occasional reports of gastrointestinal basidiobolomycosis appeared in the literature. Due to the rarity of the condition and the nonspecific presenting features, the correct diagnosis is usually hard to reach. In this paper, we describe the clinical course of an otherwise healthy female, who presented with a colonic mass. She received subtotal colectomy followed by oral itraconazole, with successful outcome

Histopathologic profile of esophageal atresia and tracheoesophageal fistula

Purpose Few reports are available in the literature on the histology of the congenital atretic esophagus in humans. Histologic abnormalities  including congenital esophageal stenosis (CES) may contribute toward the abnormal esophageal motility after successful repair of esophageal atresia (EA) and tracheoesophageal fistula (TEF). The main aim of this study is to document the histopathologic profile in cases of EA.Methods One hundred and nineteen surgical specimens were collected from 69 consecutive EA patients who underwent surgical repair at the Aseer Central Hospital, Abha, and Armed Forces Hospital Southern Region, Saudi Arabia, from May 1999 through May 2009. This included 62 cases with EA and distal TEF, five cases of pure EA, and two cases of N-type TEF. Samples from tips of the upper pouch (UP), lower pouch (LP), and mid portion of the TEF were preserved in 10% formalin, sectioned, and stained with hematoxylin and eosin.Results The combined three elements of tracheobronchial tissue were observed in only three LP specimens. Gastrictype mucosa was seen in one UP and one LP specimen. Except for one N-type fistula, all sections showed fullthickness muscle coats. Distortion of muscles by fibrosis was most commonly seen in the UP. The muscle layer in the LP was more commonly distorted by glands with or without cartilage. Fourteen samples (10.8%) showed a histological picture consistent with CES.Conclusion Glands in the submucosa may be abnormal innumber and type, and may extend to different esophageal  coats. Muscle distortion by fibrosis, glands, or cartilage and associated CES may contribute toward esophageal dysmotility and stricture after surgery. Cutting the TEF B3–5mm distal to its origin from the trachea is adequate histologically for primary anastomosis of the atretic esophagus. The histological changes associated with the TEF need to be revised.Keywords: congenital esophageal stenosis, esophageal atresia,  esophageal dysmotility, histopatholog

New derivatives of sulfonylhydrazone as potential antitumor agents: Design, synthesis and cheminformatics evaluation

Phosphoinositide 3-kinase α (PI3Kα) is a propitious target for designing anticancer drugs. A series of new N\u27-(diphenylmethylene)benzenesulfonohydrazide was synthesized and characterized using FT-IR, NMR (1H and 13C), HRMS, and elemental analysis. Target compounds exhibited an antiproliferative effect against the human colon carcinoma (HCT-116) cell line. Our cheminformatics analysis indicated that the para-tailored derivatives [p-NO2 (3) and p-CF3 (7)] have better ionization potentials based on calculated Moran autocorrelations and ionization potentials. Subsequent in vitro cell proliferation assays validated our cheminformatics results by providing experimental evidence that both derivatives 3 and 7 exhibited improved antiproliferative activities against HCT-116. Hence, our results emphasized the importance of electron-withdrawing groups and hydrogen bond-acceptors in the rational design of small-molecule chemical ligands targeting PI3Kα. These results agreed with the induced-fit docking against PI3Kα, highlighting the role of p-substituted aromatic rings in guiding the ligand-PI3Kα complex formation, by targeting a hydrophobic pocket in the ligand-binding site and forming π-stacking interactions with a nearby tryptophan residue

New tetradentate Schiff base Cu(II) complexes: synthesis, physicochemical, chromotropism, fluorescence, thermal, and selective catalytic oxidation

Three neutral Cu(II)/ƞ4-NNNO Schiff base complexes (1-3) were prepared from the (E)-4-nitro-2-(((2-(piperazin-1-yl)ethyl)imino)methyl)phenol, tetradentate Schiff base (SB) ligand, and the corresponding copper(II) salts. The new SB and its complexes were fully characterized by CHN-EA, standard spectroscopic, thermal, and fluorescence analyses. The formation of the complexes was monitored by EDX, FT-IR, and UV-Vis. The chromotropism studies of the complexes reflected remarkable findings, in which bathochromic solvato- and thermochromism shifts were detected. The turn-off-on halochromism phenomena were observed in the acidic and basic medium. On the other hand, the fluorescence of the free SB ligand was turned off via complexation to the Cu(II) center. In the presence of H2O2 as green oxidant and under mild oxidation catalytic condition, the three complexes successfully catalyzed the formation benzaldehyde from benzyl alcohol

Angiomatoid giant cellular blue nevus of vaginal wall associated with pregnancy

<p>Abstract</p> <p>Background</p> <p>Blue nevi that arise from the Müllerian tract are rare melanocytic lesions. Several histopathologic variants of cellular blue nevi have been described. The angiomatoid variant is characterized by a vascular component, and is considered to be a rare variant. Few studies have explored the influence of pregnancy on melanocytic lesions.</p> <p>Case</p> <p>A 29-year-old woman was presented with a pigmented vaginal lesion that increased gradually during pregnancy. A full term gynecologic examination showed a tumor mass protruding into the vaginal canal. The mass was resected during cesarean-section under the clinical impression of vaginal hemangioma.</p> <p>Result</p> <p>Gross examination revealed a cystic mass measuring 6.0 × 4.3 × 3.5 cm, which was filled with dark friable material. Histologically, the mass showed a subepithelial cellular proliferation of heavily pigmented dendritic melanocytes with prominent vascular stroma. Cytologic pleomorphism, junctional activity, atypical mitosis, and necrosis were not found. The proliferation was immunoreactive for HMB-45, S-100 and melan-A, and non-immunoreactive for CD34, smooth muscle actin, and AE1/AE3. The MIB-1 proliferative index was less than 1%. The patient had a postoperative course without complication.</p> <p>Conclusions</p> <p>Angiomatoid giant cellular blue nevus arising from the vagina during pregnancy is extremely rare. The low proliferative index and absence of cytologic pleomorphism, or necrosis, supports a benign biological behavior. Clinical follow-up showed no evidence of recurrence at one year after the resection of the mass.</p

The lived experiences of frontline nurses during the coronavirus disease 2019 (COVID-19) pandemic in Qatar: A qualitative study

This study aims to explore the lived experiences of frontline nurses providing nursing care for COVID-19 patients in Qatar. Qualitative, Phenomenological. Nurses were recruited from a designated COVID-19 facility using purposive and snowball sampling. The participants were interviewed face-to-face using semi-structured interview questions from 6 September-10 October 2020. The interviews were transcribed and analyzed using Colaizzi's phenomenological method. A total of 30 nurses were interviewed; (76.7%) were deployed for >6 months. Three major themes were drawn from the analysis: (a) Challenges of working in a COVID-19 facility (subthemes: working in a new context and new working environment, worn out by the workload, the struggle of wearing protective gear, fear of COVID-19, witnessing suffering); (b) Surviving COVID-19 (subthemes: keeping it safe with extra measures, change in eating habits, teamwork and camaraderie, social support); and (c) Resilience of Nurses (subthemes: a true calling, a sense of purpose).This study was funded by the Medical Research Center at Hamad Medical Corporation (MRC-01-20-423

Quality of life, sleep quality, depression, anxiety, stress, eating habits, and social bounds in nurses during the coronavirus disease 2019 pandemic in qatar (The PROTECTOR study): A cross-sectional, comparative study

There have been numerous concerns regarding the physical and mental health of nurses during the COVID-19 pandemic. Stress, sleep deprivation, anxiety, and depression potentiated nurses’ vulnerability to poor eating habits. Aims and Objectives: The purpose of this study was to explore the differences between nurses’ characteristics with COVID-19 facility designation, and sleep quality, depression, anxiety, stress, eating habits, social bonds, and quality of life. Design: A cross-sectional, comparative study. Methods: An online survey was sent using the corporation’s email to nurses working in three hospitals in Qatar from September to December 2020. One of them is a designated COVID-19 facility. The sleep quality, depression, eating habits, social bonds, and quality of life were measured using The Insomnia Severity Index (ISI), Depression Anxiety and Stress Scale 21 (DASS-21), Emotional Eater Questionnaire (EEQ), Oslo Social Support Scale (OSSS-3), and the World Health Organization Quality of Life (WHOQOL-BREF), respectively. Results: A total of 200 nurses participated in the study (RR: 13.3%). No statistically significant association was found between designated facility (COVID-19 vs. not COVID-19) or nurses’ characteristics and ISI categories (OR 1.15; 95% CI 0.54, 2.44). Nurses working in COVID-19 facilities had increased odds of having higher EEQ categories by 2.62 times (95% CI 1.18, 5.83). Similarly, no statistically significant associations were found between any of the nurses’ characteristics and OSSS-3 categories. On the other hand, no statistically significant associations were found between any of the nurses’ characteristics and QOL domains except for the gender and social relationships’ domain. Conclusion: Overall, the quality of life of nurses in Qatar is on a positive level whether they are assigned to a COVID-19 facility or not. Although no significant difference was found with regard to the sleep quality, stress, anxiety, depression, and eating habits between nurses in a COVID-19 facility and in a non-COVID-19 facility, special interventions to diminish stressors need to be implemented and maintained.This study was funded by the Medical Research Center at Hamad Medical Corporation (MRC-01-20-392)

A Case of Corticotroph Carcinoma that Caused Multiple Cranial Nerve Palsies, Destructive Petrosal Bone Invasion, and Liver Metastasis

A 52-year-old woman experienced sudden onset of double vision due to a right abducens nerve palsy and was diagnosed as having a pituitary macroadenoma that invaded into the right cavernous sinus. Otherwise, she was asymptomatic despite marked elevation of ACTH (293 pg/ml) and cortisol (24.6 μg/dl) levels. The patient underwent transsphenoidal surgery followed by γ-knife radiosurgery (GKR), which healed the diplopia and ameliorated the hypercortisolemia. The excised tumor was diffusely stained for ACTH with a high (15%) Ki-67 labeling index. Early tumor recurrence occurred twice thereafter, producing right lower cranial nerve palsies with petrosal bone destruction at 8 months and an ipsilateral oculomotor nerve palsy at 12 months after GKR; all palsies resolved completely with the second and third GKRs. Hypercortisolemia worsened rapidly soon after the third GKR, and the patient developed marked weight gain, hypokalemia, and hypertension. Multiple liver lesions were incidentally detected with computer tomography and identified as metastatic pituitary tumor on immunohistochemistry. An ACTH-producing adenoma should be followed carefully for early recurrence and/or metastatic spread when the tumor is an invasive macroadenoma with a high proliferation marker level. The unique aggressive behavior and high potential for malignant transformation of this case are discussed

Delayed granulomatous reaction to hyaluronic acid gel injection

Injectable hyaluronic acid (HA) derivatives are the most used resorbable dermal fillers used for soft tissue augmentation. While their use is considered safe, there have been reports of cutaneous granulomatous reactions.We describe the clinical, radiological, and cytological findings in a patient who presented a full year after cosmetic treatment with HA injections and discuss the various treatment options. Level of Evidence: Level V, therapeutic study

Epstein-Barr virus: clinical and epidemiological revisits and genetic basis of oncogenesis

Epstein-Barr virus (EBV) is classified as a member in the order herpesvirales, family herpesviridae, subfamily gammaherpesvirinae and the genus lymphocytovirus. The virus is an exclusively human pathogen and thus also termed as human herpesvirus 4 (HHV4). It was the first oncogenic virus recognized and has been incriminated in the causation of tumors of both lymphatic and epithelial nature. It was reported in some previous studies that 95% of the population worldwide are serologically positive to the virus. Clinically, EBV primary infection is almost silent, persisting as a life-long asymptomatic latent infection in B cells although it may be responsible for a transient clinical syndrome called infectious mononucleosis. Following reactivation of the virus from latency due to immunocompromised status, EBV was found to be associated with several tumors. EBV linked to oncogenesis as detected in lymphoid tumors such as Burkitt's lymphoma (BL), Hodgkin's disease (HD), post-transplant lymphoproliferative disorders (PTLD) and T-cell lymphomas (e.g. Peripheral T-cell lymphomas; PTCL and Anaplastic large cell lymphomas; ALCL). It is also linked to epithelial tumors such as nasopharyngeal carcinoma (NPC), gastric carcinomas and oral hairy leukoplakia (OHL). In vitro, EBV many studies have demonstrated its ability to transform B cells into lymphoblastoid cell lines (LCLs). Despite these malignancies showing different clinical and epidemiological patterns when studied, genetic studies have suggested that these EBV- associated transformations were characterized generally by low level of virus gene expression with only the latent virus proteins (LVPs) upregulated in both tumors and LCLs. In this review, we summarize some clinical and epidemiological features of EBV- associated tumors. We also discuss how EBV latent genes may lead to oncogenesis in the different clinical malignancie