Polyorchidism: case report and literature review

Polyorchidism is a rare congenital anomaly frequently associated with maldescent testis, hernia, and torsion. Reports in the literature show an increased risk of testicular malignancy in the presence of polyorchidism. This entity has characteristic sonographic features and the diagnosis is often made on the basis of sonography. A conservative approach is the treatment of choice in uncomplicated cases. We report a male of 26-years old with 2 testicles in right side diagnosed by ultrasound. A brief history and review of the literature is also presente

Treatment of Bronchiolitis Using Nebulized Hypertonic Saline in Asthma-Prone and Non-Asthma-Prone Patients

Background: In bronchiolitis, children under the age of two experience cough, dyspnea and wheezing, following a viral upper respiratory infection. Frequently recurrent bronchiolitis in infants with atopic background is the best example of asthma-prone viral-induced wheeze. In bronchiolitis management, inhaled hypertonic saline is the subject of debate among pediatricians and researchers. Nebulized hypertonic saline acts by increasing fluidity of airway surface liquid. Bronchospasm is a theoretical risk for inhaled hypertonic saline when used without adjunctive bronchodilators. Objective: To compare the response to nebulized hypertonic saline plus B 2 agonists, with nebulized isotonic saline plus B 2 agonists, in asthma-prone and non-asthma-prone bronchiolitis patients. Patients and methods: This study was a randomized double blind controlled trial, which was carried out at Pulmonology Unit, Pediatric Department, Zagazig University Children Hospital. The study was conducted on 104 infants with acute viral bronchiolitis of mild to moderate severity. They were divided into two groups 52 in each group. Group 1: Asthma-prone patients and group 2, which included non-asthma-prone patients. Patients were randomly assigned to receive inhalation of 0.3 mg/kg salbutamol added to 5 ml of either normal saline 0.9% or hypertonic saline 3%. Within each group the number of patients receiving hypertonic or isotonic saline inhalation was equal to 26. Results: Nebulized hypertonic saline salbutamol mixture resulted in better improvement of the studied asthmaprone and non-asthma prone bronchiolitis patients. Hypertonic saline decreased case severity and days of hospital stay. Conclusion: Nebulized hypertonic saline shortened the days of hospital admission and improved the respiratory distress in mild to moderate bronchiolitis. Nebulized hypertonic saline is equally effective in asthmaprone and non-asthma-prone patients and its beneficial effect outweighs its theoretical broncho-constrictive effect

Consolidating Medical Education in Sudan During War

Background: Providing quality medical education in Sudan faces challenges due to armed conflicts. This short communication explores practical solutions for ensuring the continuity of medical education during the conflict in the Sudanese context. Methods: A comprehensive literature review covered relevant articles published from 1915 to 2023. Four major databases (PubMed, Scopus, Web of Science, and Google Scholar) were searched using keywords related to medical education, war, armed conflict, and affected countries. Data synthesis identified common themes, challenges, and trends and suggested solutions for medical education in conflict zones. Case studies from Ukraine, Liberia, and Iraq were included for a comprehensive understanding. Results: Collaborative alliances among medical schools facilitate resource sharing and support. Engaging the Sudanese diaspora through virtual collaborations, mentorship programs, and faculty exchanges enhance educational experiences. Stable regions as educational hubs ensure uninterrupted academic progress for students from conflict-affected areas. Online and remote education, including asynchronous learning and social media platforms, overcome access barriers and fosters knowledge sharing. Ambulatory teaching provides practical experience and adaptability. Prioritizing faculty well-being and professional development through training and support is crucial. Emphasizing resilience and adaptability in student education prepare them for healthcare delivery in resource-limited settings. Research and innovation contribute to evidence-based strategies. International collaboration and support offer opportunities for knowledge exchange and infrastructure improvement. Conclusion: Implementing collaborative strategies and innovative approaches helps Sudanese medical schools overcome challenges during armed conflicts and maintain quality medical education. These solutions empower students and faculty, enhance resilience, and contribute to improving healthcare systems in post-war Sudan

Inappropriate use of antibiotics in the treatment of pharyngo-tonsilitis in children in Khartoum, Sudan

Background: Pharyngo-tonsillitis represents a major public health problem all over the world. Recent studies in Sudan have revealed alarming results reporting antibiotics over prescription in the management of acute tonsillitis.Objectives: The aim of this study was to estimate the prevalence of Group A Beta hemolytic streptococci and document the appropriateness of using antibiotics in the treatment of acute tonsillo-pharyngitis in Jaafar Ibn Auf Pediatrics Hospital.Materials and Methods: A cross sectional hospital based study was conducted in the period January to August 2012 in Jaafar Ibn Auf Hospital, the largest tertiary pediatrics hospital in Sudan. The sample size was 100 including children aged 2-17 years and got antibiotics treatment for their current sore throat. A pharyngeal swab was collected at presentation from tonsils and posterior pharynx. Gram staining was done first, and then Group A Beta hemolytic streptococci were isolated and identified in the laboratory by their growth characteristics. All children included in the study were assessed clinically and subjected to a structural questionnaire. Data were analyzed by SPSS version 19.Results: The estimated prevalence of Group A Beta hemolytic streptococci tonsillitis and/or pharyngitis was 22%, nevertheless the proportion of antibiotic prescription was 100%.Conclusion: Most children were treated inappropriately regarding the need for using antibiotics, the type of antibiotics used and the duration of management. As many studies suggested that increased using of antibiotics may be due to uncertainty of diagnosis, requesting scoring system or rapid diagnostic test can contribute to the reduction of the rate of antibiotics prescription.Keyword: Pharyngo-tonsillitis, inappropriate, children, antibiotics, Suda

Mesalamine-Induced Myopericarditis: A Case Report and Literature Review

Inflammation of the myocardium (myocarditis) or pericardium (pericarditis) or both (myopericarditis) as side effects of mesalamine, a drug widely used in the treatment of inflammatory bowel disease, is a rare, but potentially lethal complication. We report a case of myopericarditis occurring in a young Caucasian woman 14 days following initiation of mesalamine therapy for treatment of a newly diagnosed ulcerative colitis (UC). She presented with pleuritic chest pain, elevated troponin levels and pre-syncope. The diagnosis of myopericarditis was made based on the clinical features, electrocardiogram (EKG) and cardiac magnetic resonance, which showed trace pericardial effusion. The patient's symptom and condition were dramatically improved upon discontinuing mesalamine, and a full recovery was achieved. Mesalamine-induced inflammation of the myocardium (myocarditis) or pericardium (pericarditis) or both (myopericarditis) is rare, but has fatal side effects. Early recognition of these side effects by clinicians and patients is important to prevent progression of the inflammation. Furthermore, patients should be educated to seek urgent medical attention if cardiac symptoms arise

Nodulation and nitrogen fixation of some wild legumes from differing habitats in Egypt

This study was devoted to exploring the natural nodulation and nitrogen fixation of wild legumes grown in different Egyptian habitats. These habitats are representative to four phytogeographical regions. Sites that inhabited by Melilotus indicus, Medicago polymorpha, Trifolium resupinatum, Trigonella hamosa and Vicia sativa in each region were selected for study. High nodulation, nitrogen fixation and plant biomass were recorded in plants grown at Nile region and Oases compared with those at Mediterranean region and Sinai. The inhibition in nodulation and potential of nitrogen fixation in legumes at MR and S were attributed to drought and low soil fertility. Differences in species, regions or their interaction have significant effect on nodulation, legheamoglobin, nitroginase activity and biomass of nodules, shoots and roots; the magnitude of effect due to different species was the greatest. Five rhizobial isolates (Sinorhizobium fredii, Rhizobium mesosinicum, Rhizobium daejeonense, Rhizobium huautlense, Rhizobium alamii) recovered from root nodules of the five species were identified by 16S rRNA gene sequence. The indigenous rhizobia of legumes grown at MR and S expected to be exhibit higher tolerance to the existing harsh environmental conditions. These rhizobia can be used as inoculants for crop legumes under unfavorable environmental conditions of agroecosystems or recently reclaimed desert. DOI: http://dx.doi.org/10.5281/zenodo.22401

FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) IN DIAGNOSIS OF TUMORAL CALCINOSIS, A REPORT OF THREE CASES

Introduction: Tumoral calcinosis (T.C.) is very rare and generally of unknown aetiology characterized by calcific deposits in the soft tissues. Commonly seen in the second decade of life (reported age range 15 months to 83 years). We are reporting 3 cases of T. C. who were initially diagnosed by FNAC. Two of the 3 cases were female siblings who were referred to us as possible cases of recurrent fibrosarcomas following surgical excision. Case reports:  (1) Two female siblings aged 17 and 14 years  complaining of large swelling in the upper   outer right thigh and the left outer upper thigh around the hip joints respectively. There was no limitation of movement. The masses recurred within a short period after total excision. Neither specimen was subjected to histopathology. Clinical examination showed two masses each approximately 30cm maximum diameter and 10 cm width. In addition the younger sister showed an additional mass 4.5 cm in the outer aspect of her right elbow. (2) 18 months old female child, unrelated to the above two cases, presented with an egg-sized mass in the mid-lateral aspect of her right thigh  cystic and mobile.There is a history of quinine injection in the same area. No positive family history of a similar condition. All three cases showed normocalcaemia and hyperphosphataemia with specks of calcification on x - ray and cysts in ultrasound. FNAC showed structureless gung , calcium granules and inflammatory cells including foreign body type multinucleated giant cells. Histopathology confirmed the diagnosis of T. C. Discussion: Described the three types of T. C. (familial, idiopathic, and that in patients of chronic renal failure on dialysis). The differential diagnoses were also discussed as well as lines of management such as Ca++ supplementation, phosphate restriction, acetazolamide, parathyroidectomy and the treatment of choice is total surgical excision. To our best knowledge this is the first time to report the use of fine needle aspiration cytology in the diagnosis of T. C. in Sudan.&nbsp

Pulsed Electric Field: Fundamentals and Effects on the Structural and Techno-Functional Properties of Dairy and Plant Proteins

Dairy and plant-based proteins are widely utilized in various food applications. Several techniques have been employed to improve the techno-functional properties of these proteins. Among them, pulsed electric field (PEF) technology has recently attracted considerable attention as a green technology to enhance the functional properties of food proteins. In this review, we briefly explain the fundamentals of PEF devices, their components, and pulse generation and discuss the impacts of PEF treatment on the structure of dairy and plant proteins. In addition, we cover the PEF-induced changes in the techno-functional properties of proteins (including solubility, gelling, emulsifying, and foaming properties). In this work, we also discuss the main challenges and the possible future trends of PEF applications in the food proteins industry. PEF treatments at high strengths could change the structure of proteins. The PEF treatment conditions markedly affect the treatment results with respect to proteins’ structure and techno-functional properties. Moreover, increasing the electric field strength could enhance the emulsifying properties of proteins and protein-polysaccharide complexes. However, more research and academia-industry collaboration are recommended to build highly effective PEF devices with controlled processing conditions. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.Institute of Solid State Physics, University of Latvia as the Center of Excellence acknowledges funding from the European Union’s Horizon 2020 Framework Programme H2020-WIDESPREAD-01-2016-2017-TeamingPhase2 under grant agreement No. 739508, project CAMART2

Modeling and Parametric Study of a Ceramic High Temperature Heat Exchanger and Chemical Decomposer”.

ABSTRACT It is proposed to use ceramic high temperature heat exchanger as a sulfuric acid decomposer for hydrogen production within the sulfur iodine thermo-chemical cycle. The decomposer is manufactured using fused ceramic layers that allow creation of channels with dimensions below one millimeter. A three-dimensional computational model is developed to investigate the fluid flow, heat transfer, stresses and chemical reactions in the decomposer. Fluid, thermal and chemical reaction analyses are performed using FLUENT software. Temperature distribution in the solid is imported to ANSYS software and used together with pressure as the load for stress analysis. Results of this research can be used as a basis for investigation optimal design of the decomposer that can provide maximum chemical decomposition performance while maintaining stresses within design limits

Snake Bite in Gezira Revision of 63 Envenomed Child

   Sixty three patients admitted to the Gezira National Center of Pediatric Surgery with snake bite were analyzed. All patients were envenomed and the snake was positively identified. In 39 patients (61.9%) the offending snake was (washash) (Echis carinatus) and in 24 patients (38.1%) (Abdafan) (atractaspis microlepidata) was identified. All patients were from rural Gezira where children are actively involved in agriculture and harvesting. The median age group was 9.3 years. Females were equally involved as males. The mean time elapsed since the bite was 56 hours. Quicker arrival at hospital was seen in severe envenomation. Fifty patients had already received native remedies which was observed to increase the local wound complications. Most bites (79%) occurred in the leg .The majority of the bites occurs in the early rainy summer months. All patients presented initially with progressive painful swelling. Local necrosis was observed in seventeen patients (26.9%).  Fourteen patients (22.2%) developed compartment syndrome and three patients (4.76%) developed fingertip gangrene. one patient (1.6%) developed extensive bilateral common iliac vein thrombosis. DIC developed in 21 patients (33.3%). Two patients (3.2%) of theses developed intracranial haemorrhage. Four patients (6.3%) with local necrosis presented few month later with extensive chronic osteomyelitis.Treatment options included cardiovascular support, local wound debridement, fasciotomy and minor amputation. Patients with DIC were managed with fresh frozen plasma, blood transfusion and heparin. Antivenin was not administered to our patients. All patients eventually recovered except one child (1.6%) who succumbed of massive intracerebral haemorrhage. ملخص:  تم تحليل البيانات لثلاث وستين طفلا تم تنويمهم بمركز الجزيرة القومي لجراحة الأطفال في الفترة من مارس 2001م الي ابريل2010م  بعد أن شخصت حالتهم بلدغة ثعبان سام. في كل المرضى تم التعرف على الثعبان, في 39 مريض كان الثعبان اللادغ من نوع و شاش(echis carinatus)  وفي 24 أبو دفان (atractaspis   (micolepidata كل المرضي كانوا أطفالا من أرياف الجزيرة وجميعهم يعمل في الزراعة والحصاد. بلغ متوسط العمر لديهم 9.3 سنة. كانت الإصابة متساوية لدي الذكور والإناث, متوسط الوقت المنصرم منذ اللدغة بالثعبان وحتى ألمجي للمستشفي  كانت 56 ساعة ,لوحظ إن ألمجي الباكر للمستشفي يكون في حالات التسمم الوخيم . المعالجة لهؤلاء المرضي تضمنت مساعدة الجهاز الدوري وانضار الجرح الموضعي و بضع اللفافة وإجراء البتر البسيط ,المرضي اللذين عانوا من التخثر المنتشر داخل الأوعية الدموية تمت معالجتهم بحقن المصورة المتجمدة الطازجة ونقل الدم الطازج واعطا الهبارين. لم يتم استخدام الترياق في أي من المرضي. كل المرضي تماثلوا للشفاء إلا مريضا واحدا توفي بسبب نزف جسيم داخل القحف.   &nbsp