Diagnostic challenge of intestinal obstruction secondary to Henoch–Schonlein purpura

Henoch–Schonlein purpura is the most common form of vasculitis in pediatric age group. Gastrointestinal manifestations have been long recognized as part of the disease, but usually preceded by other manifestations. We present a case of a boy whose initial manifestation of the disease was bowel obstruction and ischemia requiring surgical intervention twice with diagnostic dilemma prior to diagnosis of Henoch–Schonlein purpura. Although common surgical diseases prove to be the culprit in most cases, a surgeon should always keep an open mind for possibility beyond surgical diseases. Multidisciplinary approach to situations where ambiguities in diagnosis exist proves to be a valuable tool aiding surgical decision.Keywords: gastrointestinal, henochscholine, intestinal ischemia, intussusception, purpur

Diagnostic challenge of intestinal obstruction secondary to Henoch–Schonlein purpura

Henoch–Schonlein purpura is the most common form of vasculitis in pediatric age group. Gastrointestinal manifestations have been long recognized as part of the disease, but usually preceded by other manifestations. We present a case of a boy whose  initial manifestation of the disease was bowel obstruction and ischemia requiring surgical intervention twice with diagnostic  dilemma prior to diagnosis of Henoch–Schonlein purpura. Although common surgical diseases prove to be the culprit in most cases, a surgeon should always keep an open mind for possibility beyond surgical diseases. Multidisciplinary approach to  situations where ambiguities in diagnosis exist proves to be a valuable tool aiding surgical decision.Keywords: gastrointestinal, henochscholine, intestinal ischemia, intussusception, purpur

Effectiveness of interactive teaching intervention on medical students' knowledge and attitudes toward stem cells, their therapeutic uses, and potential research applications

Background: Stem cell science is rapidly developing with the potential to alleviate many non-treatable diseases. Medical students, as future physicians, should be equipped with the proper knowledge and attitude regarding this hopeful field. Interactive teaching, whereby the teachers actively involve the students in the learning process, is a promising approach to improve their interest, knowledge, and team spirit. This study aims to evaluate the effectiveness of an interactive teaching intervention on medical students' knowledge and attitudes about stem cell research and therapy. Methods: A pre-post test study design was employed. A six-session interactive teaching course was conducted for a duration of six weeks as an intervention. Pre- and post-intervention surveys were used. The differences in the mean scores of students' knowledge and attitudes were examined using paired t-test, while gender differences were examined using an independent t-test. Results: Out of 71 sixth-year medical students from different nationalities invited to participate in this study, the interactive teaching course was initiated by 58 students resulting in a participation rate of 81.7%. Out of 58 students, 48 (82.8%) completed the entire course. The mean age (standard deviation) of students was 24 (1.2) years, and 32 (66.7%) were males. The results showed poor knowledge about stem cells among the medical students in the pre-intervention phase. Total scores of stem cell-related knowledge and attitudes significantly improved post-intervention. Gender differences in knowledge and attitudes scores were not statistically significant post-intervention. Conclusions: Integrating stem cell science into medical curricula coupled with interactive learning approaches effectively increased students' knowledge about recent advances in stem cell research and therapy and improved attitudes toward stem cell research and applications. Keywords: Arab; Attitudes; Education; Interactive teaching; Jordan; Knowledge; Medical curriculum; Stem cells; Students

A valid treatment option for isolated congenital microgastria

Congenital microgastria (CM) is an extremely rare anomaly of the caudal part of the foregut. Treatment of CM has not yet been standardized. We present the case of a 34-monthold girl with an isolated CM complicated by nasogastric tube-related gastric perforation. During the definitive reconstructive surgery, a scarred structure (1.5 1.5 cm) was found to follow a dilated esophagus. The scarred microstomach was resected, and a Roux-en-Y esophagojejunostomy was performed. The patient has been followed for 6 months. She tolerates a regular oral diet and has reached acceptable growth parameters. We describe the first case of CM to be treated with resection of the microstomach and with a Roux-en-Y esophagojejunostomy.Keywords: congenital microgastria, gastrectomy, Roux-en-Y esophagojejunostom

Impact of Aspiration in the Assessing Process of Pediatric Lung Disease

This study aimed at analyzing the impact of Aspiration in the assessing process of pediatric lung disease, as the affected children will frequently encounter a situation where swallowing is insecure and aspiration is likely. Besides analyzing the Aspiration of foreign matter into the airways and lungs that can cause a wide spectrum of pulmonary disorders with various presentations. And discussing the type of syndrome resulting from aspiration depends on the quantity and nature of the aspirated material, the chronicity, and the host responses. Considering that Aspiration is most likely to occur in subjects with a decreased level of consciousness, compromised airway defense mechanisms, dysphagia, gastroesophageal reflux, and recurrent vomiting

Pollen and seed morphology of Justicieae (Ruellioideae, Acanthaceae) of Yemen

Pollen and seeds of 12 genera and 28 species belonging to Justicieae namely, Anisotes, Angkalanthus, Asystasia, Ballochia, Dicliptera, Ecbolium, Hypoestes, Isoglossa, Justicia, Megalochlamys, Rhinacanthus and Trichocalyx were collected from different field localities in Yemen and were investigated using both light and scanning electron microscopes. Nine pollen types were observed whose shapes were prolate, subprolate and spheroidal while the apertures varied from dicolporate, tricolporate, porate to colpate. The exine ornamentation was reticulate in most of the species except Megalochlamyas, which showed perforate ornamentation, and Isoglossa, which showed reticulate to rugulate ornamentation. Scanning electron microscopy and morphological observations showed that mature dry seeds of the genera have various sizes and shapes, the surface ornamentations observed were reticulate, cristate, tuberculate and papillae. In addition, hairs were present in some Ballochia species. The variation in the seed structures between the genera and within the species was useful for their identification and classification; their high structural diversity is of important taxonomic value for species differentiation

Stem and leaf anatomical studies of selected species of barlerieae and ruellieae (acanthaceae) from Yemen

The anatomy of stems and leaves of selected species of tribes Barlerieae and Ruellieae (Acanthaceae) was studied to assess the taxonomic significance of anatomical characteristics in the two tribes. The anatomical characters such as the outline of stems, midribs, petioles, margins, shape of epidermal cells, vascular bundles, stomata, anticlinal cells, cystoliths, aerenchyma cells, layer of wax, layer of hypodermis were observed and analysed. Type of trichomes observed on the leaf surface using Scanning Electron Microscopy and light microscope provides information of taxonomic significance to both tribes and the taxa within them. The trichomes vary from non-glandular (unicellular, bicellular, multicellular, and multiradiate) to capitate glandular. Abundance of long-stalked trichomes was recorded only in Neuracanthus aculeatus. Cystoliths of different size and position are present in epidermis, parenchyma and collenchyma in addition to oil cells in some genera. The placement of Neuracanthus among the recognized tribes of Acanthaceae is assessed using anatomical characters

Melatonin ameliorates serobiochemical alterations and restores the cardio-nephro diabetic vascular and cellular alterations in streptozotocin-induced diabetic rats

Melatonin possesses a wide range of pharmacological activities, including antidiabetic properties. Diabetes mellitus (DM) induces several physiopathological changes in body organs, which could be observed lately after systemic failure. In the current study, we aimed to investigate the serobiochemical changes and the histopathological picture in the diabetic heart and the kidney early before chronic complications and highlight the association between hyperglycemia, glomerular alterations, and cardiovascular changes. In addition, the role of melatonin in the treatment of cardio-nephro diabetic vascular and cellular adverse changes in streptozotocin-induced diabetic rats was also studied. A total of 40 mature Wistar albino rats were distributed into five groups; (1) control untreated rats, (2) diabetic mellitus untreated (DM) rats, in which DM was induced by the injection of streptozotocin (STZ), (3) control melatonin-treated (MLT), (4) melatonin-treated diabetic (DM + MLT) rats, in which melatonin was injected (10 mg/kg/day, i.p.) for 4 weeks, and (5) insulin-treated diabetic (DM + INS) rats. The serum biochemical analysis of diabetic STZ rats showed a significant (P < 0.05) increase in the concentrations of blood glucose, total oxidative capacity (TOC), CK-MB, endothelin-1, myoglobin, H-FABP, ALT, AST, urea, and creatinine as compared to control rats. In contrast, there was a significant (P < 0.05) decrease in serum concentration of insulin, total antioxidative capacity (TAC), total nitric oxide (TNO), and total protein level in DM rats vs. the control rats. Significant improvement in the serobiochemical parameters was noticed in both (DM + MLT) and (DM + INS) groups as compared with (DM) rats. The histological examination of the DM group revealed a disorder of myofibers, cardiomyocyte nuclei, and an increase in connective tissue deposits in between cardiac tissues. Severe congestion and dilation of blood capillaries between cardiac muscle fibers were also observed. The nephropathic changes in DM rats revealed various deteriorations in glomeruli and renal tubular cells of the same group. In addition, vascular alterations in the arcuate artery at the corticomedullary junction and interstitial congestion take place. Melatonin administration repaired all these histopathological alterations to near-control levels. The study concluded that melatonin could be an effective therapeutic molecule for restoring serobiochemical and tissue histopathological alterations during diabetes mellitus

Sunitinib in relapsed or refractory diffuse large B-cell lymphoma: a clinical and pharmacodynamic phase II multicenter study of the NCIC Clinical Trials Group

There are limited effective therapies for most patients with relapsed diffuse large B-cell lymphoma (DLBCL). We conducted a phase II trial of the multi-targeted vascular endothelial growth factor receptor (VEGFR) kinase inhibitor, sunitinib, 37.5 mg given orally once daily in adult patients with relapsed or refractory DLBCL. Of 19 enrolled patients, 17 eligible patients were evaluable for toxicity and 15 for response. No objective responses were seen and nine patients achieved stable disease (median duration 3.4 months). As a result, the study was closed at the end of the first stage. Grades 3—4 neutropenia and thrombocytopenia were observed in 29% and 35%, respectively. There was no relationship between change in circulating endothelial cell numbers (CECs) and bidimensional tumor burden over time. Despite some activity in solid tumors, sunitinib showed no evidence of response in relapsed/refractory DLBCL and had greater than expected hematologic toxicity