Introduction: Road traffic incidents are the most common cause of multiple organ trauma in low- and middle-income countries. Multiple blunt intra-abdominal organs that rupture in conjunction with a ruptured aorta are terrible and rare.

Case presentation: A 65-year-old man sustained critical injuries during a traffic collision between a motorcycle and truck. The Injury Severity Score was 42 points,. After open abdominal exploration, we repaired the left diaphragmatic rupture with a 13-cm-long tear of IV grade (American Association for the Surgery of Trauma), resected partial small bowel, simple suture of the transverse colon, and Hartmann procedure in the descending colon. Thoracic endovascular aortic repair (TEVAR) was performed 22 h after laparotomy. Reconstruction of the head depicting a cheekbone fracture and inferior to the left orbital bone was performed on the 14th day. The patients survived and were discharged from the hospital, at 22 days without morbidity or mortality.

Discussion: Diaphragmatic rupture provides a signal to relate head, thoracic, and abdominal blunt trauma. If the patient sustains more serious life-threatening injuries that require emergency laparotomy or craniotomy, and aortic repair may be delayed. Laparotomy is the best initial surgical method in this case. TEVAR is a feasible and gold standard procedure for the treatment of patients with the necessary indications.

Conclusion: It is essential to evaluate the level of organ damage to properly coordinate the specialists. The timing of the operation and therapeutic alternatives should be decided for each patient.

Keywords: Case report; Diaphragmatic rupture; Intestinal trauma; Multiple organ trauma; Peritonitis; Traumatic aortic rupture.

Introduction: Orchiepididymitis is an inflammation of the testis and epididymis. Epididymitis, orchitis, and true orchiepididymitis are all examples of orchiepididymites. They are the most frequent cause of adult acute scrotal pain.

Objectives: to investigate the epidemiological, clinical, paraclinical, therapeutic, and evolutionary characteristics of acute orchiepididymitis in the urology department of University Hospital Center.

Materials and methods: This is a three-year retrospective, descriptive study of 152 patients who consulted the urology department at the university hospital center for treatment of orchiepididymitis (2017-2019).

Results: In our study, 152 patients were included. The average age was 49,5 years (17-82 years). The average of consultation delay was 7 days. Prostatic pathology was found to be the main medical antecedent in 18.5% of patients, and transurethral resection of the prostate was found to be the main surgical antecedent in 8.5% of cases. Clinical examination revealed that the predominant clinical symptom was painful inflammatory bursa in 94% of cases, followed by lower urinary tract disorders in 57.5% of cases, and fever in 10% of cases.A germ was isolated in 26 cases after a systematic cytobacteriological examination of the urine (CBEU) (17%). All patients received medical treatment, and 21% of them were received urgical treatment. In 84.5% of cases, the outcome was favorable.

Conclusion: Acute orchiépididymitis is a common cause for a consultation to the emergency room. Diagnosis is based on clinical examination and ultrasound. Because of the frequency of complications and sequelae that might influence fertility in the long term, it is a diagnostic and therapeutic emergence.

Keywords: AO, Acute Orchiepididymitis; ATCD, Antecedents; CBEU, Cytobacteriological examination of urine; Emergency; Epididymite; HIV, Human immunodeficiency virus; Management; Orchi-epididymite; Orchite; STD, Sexually Transmitted Disease; UGI, Urogenital Infections.

Background: Neuropathic pain is a major problem to date because of its high prevalence and lack of effective treatment. Neuropathic pain processes can be influenced by many factors and at various levels of the nervous system, including progesterone and the opioid system. The various mechanisms of the effect of progesterone on pain are still controversial, while the effect of progesterone on the activation of the opioid system also needs to be proven. This study aimed to determine the effect of progesterone on pain through the modulation mechanism of the opioid system.

Methods: This research is a completely randomized experimental study using male wistar rats aged around three months at the Experimental Animal Laboratory, Department of Medical Biochemistry, Faculty of Medicine, Airlangga University.

Results: The result was analyzed by using statistical analysis of two independent samples (t-test). The t value was obtained at 6.880, p = 0.000 (p < 0.05).

Conclusion: It was shown that there was a significant difference in the delta (δ) opioid receptor expression between the control group and the progesterone group, which indicated that progesterone causes an increase in the delta (δ) opioid receptor expression in the spinal cord.

Keywords: Delta (δ) opioid receptors; Pain; Peripheral nervous system; Progesterone.

Objectives: This study explored the HIV counselling and testing (HCT) experiences of women who were diagnosed positive in the current pregnancy in a district hospital within the Sekondi-Takoradi Metropolis in Ghana following the implementation of the 'opt out' testing policy.

Methods: Adopting a qualitative explorative descriptive design, 12 mothers were sampled purposively and in-depth interviews were conducted. Thematic analysis using Colaizzi's approach was applied to unearth the experiences of the participants.

Results: Three key themes emerged: The Pre-test Counselling Experience; The Test; and After Talk: Post-test Counselling. Provider-initiated testing was offered to all the participants at antenatal booking. Most counsellors were silent about the 'opt-out' option of testing while pretest counselling focused on preventing vertical transmission and not on the health of the woman. Attitudes towards pretest counselling was mainly indifference or anxiety which affected the women's initial acceptance of a positive result. All the women took a confirmatory test after the initial positive results which aided them in accepting their diagnosis. Of the women who tested, all received post-test counselling that focused on enrolling on antiretroviral therapy (ART).

Conclusion: Attitudes towards pretest counselling impacts the mothers' reaction to a positive test result. HIV counselling that does not solicit voluntary testing may be effective in increasing testing but may affect uptake of treatment. It is recommended that midwives providing HCT be trained periodically to enhance service delivery while focus on women-centred care and improving women's agency in the prevention of vertical transmission services should be the paramount.

Keywords: Ghana; HIV counselling and testing; experiences; prevention of vertical transmission.

Background: Leiomyosarcoma is a type of soft tissue sarcoma and one of the most common subtypes among all sarcomas. It is also the most common malignancy affecting the vascular system with an overall poor prognosis with 10-years survival rate of <60%. Leiomyosarcoma can occur with identifiable risk factors such as radiotherapy exposure or due to unidentifiable factors and genetic factors.

Case: We present a 49-year-old female patient with painful left inner thigh lump for six months which has been increasing in size. The swelling location was in the medial side of the left thigh, non-pulsatile and tender with no signs of hotness, discoloration or discharge. Ultrasound was performed and reported a subcutaneous hypoechoic well-defined lesion that is in close proximity to Great Saphenous Vein. The diagnosis was confirmed after surgical excision and was followed up by computed tomography for metastatic lesions.

Discussion: Cases of leiomyosarcoma is rare and usually present with painful swelling. However, non-painful and non-tender lesions can present, and clinicians should be wary of such swelling, especially when they are in close proximity to vascular area. Great saphenous vein leiomyosarcoma is difficult to diagnose solely by radiology, but ultrasound can help guide the course. Other associated factors such as deep venous thrombosis may arise.

Conclusion: In conclusion, a thorough radiological assessment is necessary in lesions close to vascular lesions to accurately diagnose it.

Keywords: Great saphenous vein; Leiomyosarcoma; Painful lump; Soft tissue sarcoma.

Obturator hernia is a pelvic floor type of hernia in which abdominal or pelvic contents protrude through the obturator foramen. It is considered rare in patients with signs and symptoms of intestinal obstruction causing a diagnostic challenge for clinicians. This case reports a 91-year-old multiparous female who presented with vague lower abdominal pain associated with obstipation and vomiting. We present a successful laparoscopic repair of obturator hernia in an elderly female.

The bronchial carcinoid (BC) tumor is a neuroendocrine lung tumor that accounts for 1-2% of all lung neoplasia occurrences. However, BC tumors remain rare in the literature. Nowadays, video-assisted thoracoscopic surgery VATS can be safely performed with an excellent clinical outcome. The typical procedure involves three incisions. We assume that performing the same procedures with a single utility incision is possible. This report describes our experience performing sleeve bilobectomy for a neglected carcinoid tumor using a uniportal VATS without spreading of ribs.

Keywords: BC, bronchial carcinoid; Carcinoid tumor; Minimally invasive surgery; Right main bronchus; Sleeve bilobectomy; TNM, tumor (T) nodes (N) and metastases (M); Uniportal VATS; VATS, Video-assisted thoracoscopic surgery.

The liver is the organ most commonly injured in blunt abdominal trauma. Significant changes in the management of liver trauma have occurred over the last four decades with non-operative management being the first-line of treatment. Although hepatic resection for trauma is an accepted and established option for definitive treatment, it is rarely performed because of the associated morbidity and mortality, at least historically. Herein we describe a case of a 24-year old male who had blunt abdominal injury for which a right hepatectomy was eventually performed after an initial attempt at damage control surgery. We would like to highlight that early decision by a dedicated team of surgeons coupled with the necessary support from ancillary services as well as coordination between trauma surgeons led to a successful outcome in this case. This case presents an opportunity to revisit the role of hepatic resection in the management of complex liver injuries.

Keywords: Blunt abdominal injury; Case report; Hepatectomy; Non-operative management.

Pseudomonas aeruginosa (PA) is an important pathogen that has been proven to colonize and cause infection in the respiratory tract of patients with structural lung diseases and to lead to bronchial fibrosis. The development of pulmonary fibrosis is a complication of PA colonization of the airway, resulting from repeated infection, damage and repair of the epithelium. Bronchial epithelial cell epithelial-mesenchymal transition (EMT) plays a vital role in bronchial fibrosis. To date, research on bronchial epithelial cell EMT caused by PA-secreted virulence factors has not been reported. Here, we found that PA3611 protein stimulation induced bronchial epithelial cell EMT with mesenchymal cell marker upregulation and epithelial cell marker downregulation. Moreover, integrin αvβ6 expression and TGF-β1 secretion were markedly increased, and p38 MAPK phosphorylation and NF-κB p65 subunit phosphorylation were markedly enhanced. Further research revealed that PA3611 promoted EMT via integrin αvβ6-mediated TGF-β1-induced p38/NF-κB pathway activation. The function of PA3611 was also verified in PA-infected rats, and the results showed that ΔPA3611 reduced lung inflammation and EMT. Overall, our results revealed that PA3611 promoted EMT via integrin αvβ6-mediated TGF-β1-induced p38/NF-κB pathway activation, suggesting that PA3611 acts as a crucial virulence factor in bronchial epithelial cell EMT and is a potential target for the clinical treatment of bronchial EMT and fibrosis caused by chronic PA infection.

Keywords: PA3611; Pseudomonas aeruginosa; bronchial epithelial cells; epithelial-mesenchymal transition; integrin αvβ6.

Introduction: Pre-injury and post-injury anxiety are prevalent and important to consider in the medical management of concussions in youth. We examined the association between anxiety and other physical, cognitive, and emotional symptoms in injured adolescents and young adults undergoing an initial evaluation in a specialty concussion clinic.

Methods: Participants were 158 adolescents and young adults presenting to a multidisciplinary concussion clinic for evaluation and treatment (54.4% girls and women; mean age = 17.3 years; SD = 2.9). Their median days post injury was 29 (interquartile range = 14-49; range = 7-349). They were divided into binary groups based on whether they had a pre-injury history of anxiety diagnosis or treatment and whether they were experiencing current anxiety in the week prior to the evaluation, and then compared on the Post-Concussion Symptom Scale.

Results: Youth with a pre-injury history of anxiety reported greater post-concussion symptoms (Md total score = 36.0, IQR = 21.5-53.0) compared to youth with no pre-injury history of anxiety (Md total score = 20.5, IQR = 6.0-36.0; MW U = 1,520.00 p = 0.001, r = 0.26, small-medium effect size). They reported significantly worse headaches, nausea, balance difficulty, dizziness, vision problems, fatigue, concentration difficulty, irritability, nervousness, sadness, feeling more emotional, trouble falling asleep, and sleeping more than usual. Youth with high post-injury anxiety reported greater post-concussion symptoms (Md total score = 55.0, IQR = 33.0-62.5) compared to youth with low post-injury anxiety (Md total score = 19.0, IQR = 6.0-35.0; MW U = 681.00, p < 0.001, r = 0.49, large effect size). They reported significantly worse headaches, nausea, vomiting, dizziness, vision problems, fatigue, sensitivity to light, feeling mentally foggy, feeling slowed down, concentration difficulty, memory difficulty, irritability, sadness, feeling more emotional, drowsiness, trouble falling asleep, sleeping less than usual, and sleeping more than usual. Logistic regressions revealed that both pre-injury and post-injury anxiety were strong predictors of persistent post-concussion symptoms, with high post-injury anxiety presenting the strongest independent predictor, while attention-deficit hyperactivity disorder and pre-injury migraines were not significant predictors. Essentially all adolescents with high post-injury anxiety (97.1%) and nearly 9 of 10 adolescents with pre-injury treatment for anxiety (87.8%) met criteria for persistent post-concussion symptoms.

Discussion: Pre-injury and post-injury anxiety are important risk factors for greater post-concussion symptoms among adolescents and young adults. Elevated post-injury anxiety was the strongest predictor of persistent post-concussion symptoms. Assessment of anxiety is important among adolescents presenting for concussion care and delivery of evidence-supported treatments for anxiety are important considerations for treatment planning for these youth.

Keywords: adolescents; anxiety; concussion; head injury; sports; traumatic brain injury.

Convalescent plasma is a suggested treatment for Coronavirus disease 2019 (Covid-19), but its efficacy is uncertain. We aimed to evaluate whether the use of convalescent plasma is associated with improved clinical outcomes in patients with Covid-19.In this systematic review and meta-analysis, we searched randomized controlled trials investigating the use of convalescent plasma in patients with Covid-19 in Medline, Embase, Web of Science, Cochrane Library, and medRxiv from inception to October 17^th, 2021. Two reviewers independently extracted the data. The primary efficacy outcome was all-cause mortality. The Cochrane Risk of Bias Tool and GRADE (Grading of Recommendations Assessment, Development and Evaluation) method were used. This study was registered with PROSPERO, CRD42021284861. Of the 8874 studies identified in the initial search, sixteen trials comprising 16 317 patients with Covid-19 were included. In the overall population, the all-cause mortality was 23.8% (2025 of 8524) with convalescent plasma and 24.4% (1903 of 7769) with standard of care (risk ratio (RR) 0.97, 95% CI 0.90-1.04) (high-certainty evidence). All-cause mortality did not differ in the subgroups of noncritically ill (21.7% [1288 of 5929] vs. 22.4% [1320 of 5882]) and critically ill (36.9% [518 of 1404] vs. 36.4% [455 of 1247]) patients with Covid-19. The use of convalescent plasma in patients who tested negative for anti-SARS-CoV-2 antibodies at baseline was not associated with significantly improved survival (RR 0.94, 95% CI 0.87-1.02). In the overall study population, initiation of mechanical ventilation (RR 0.97, 95% CI 0.88-1.07), time to clinical improvement (HR 1.09, 95% CI 0.91-1.30), and time to discharge (HR 0.95, 95% CI 0.89-1.02) were similar between the two groups. In patients with Covid-19, treatment with convalescent plasma, as compared with control, was not associated with lower all-cause mortality or improved disease progression, irrespective of disease severity and baseline antibody status.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier PROSPERO (CRD42021284861).

Keywords: SARS-CoV-2; antibodies; convalescent plasma (CP) therapy; coronavirus – COVID-19; hyperimmune globulin; passive immunization; serotherapy.

Systemic lupus erythematosus (SLE) is a prototypical systemic autoimmune disease of unknown etiology. The epigenetic regulation of N6-methyladenosine (m6A) modification in immunity is emerging. However, few studies have focused on SLE and m6A immune regulation. In this study, we aimed to explore a potential integrated model of m6A immunity in SLE. The models were constructed based on RNA-seq data of SLE. A consensus clustering algorithm was applied to reveal the m6A-immune signature using principal component analysis (PCA). Univariate and multivariate Cox regression analyses and Kaplan-Meier analysis were used to evaluate diagnostic differences between groups. The effects of m6A immune-related characteristics were investigated, including risk evaluation of m6A immune phenotype-related characteristics, immune cell infiltration profiles, diagnostic value, and enrichment pathways. CIBERSORT, ESTIMATE, and single-sample gene set enrichment analysis (ssGSEA) were used to evaluate the relative immune cell infiltrations (ICIs) of the samples. Conventional bioinformatics methods were used to identify key m6A regulators, pathways, gene modules, and the coexpression network of SLE. In summary, our study revealed that IGFBP3 (as a key m6A regulator) and two pivotal immune genes (CD14 and IDO1) may aid in the diagnosis and treatment of SLE. The potential integrated models of m6A immunity that we developed could guide clinical management and may contribute to the development of personalized immunotherapy strategies.

Keywords: bioinformatic analyses; immune; immune cell infiltrations; m6A; systemic lupus erythematosus.

Glioblastomas (GBM) are the most frequent and aggressive brain tumors. 17β-estradiol (E2) increases proliferation, migration, and invasion of human GBM cells; however underlying mechanisms are no fully understood. Zeste 2 Enhancer Homologous enzyme (EZH2) is a methyltransferase part of Polycomb 2 repressor complex (PRC2). In GBM, EZH2 is overexpressed and involved in the cell cycle, migration, and invasion processes. We studied the role of EZH2 in the pro-oncogenic actions of E2 in human GBM cells. EZH2 gene silencing and pharmacological inhibition of EZH2 blocked proliferation, migration, and invasion of GBM cells induced by E2. We identified in silico additional putative estrogen response elements (EREs) at the EZH2 promoter, but E2 did not modify EZH2 expression. In silico analysis also revealed that among human GBM samples, EZH2 expression was homogeneous; in contrast, the heterogeneous expression of estrogen receptors (ERs) allowed the classification of the samples into groups. Even in the GBM cluster with high expression of ERs and those of their target genes, the expression of PCR2 target genes did not change. Overall, our data suggest that in GBM cells, pro-oncogenic actions of E2 are mediated by EZH2, without changes in EZH2 expression and by mechanisms that appear to be unrelated to the transcriptional activity of ERs.

Keywords: 17β-estradiol; EZH2; PRC2; estrogen receptor α; estrogen receptor β; glioblastoma.

Objective: The current study examined whether compliance with anti-pandemic measures during the COVID-19 pandemic relates to (a) importance of the fulfillment of core psychological needs, namely, relationship, self-esteem, efficacy, and pleasure; (b) coping behavior styles, namely, surrender, self-soothing, divert attention, and confrontation; and (c) worries or concerns beyond COVID-19 which may impair wellbeing.

Methods: This study used a cross-sectional design and online survey data from responses to a structured questionnaire developed within the theoretical framework of schema-based psychotherapy on psychological needs and coping behavior styles from 740 participants in Central Europe and West Africa.

Results: Analysis indicated that people with the psychological needs of "pleasure" and "efficacy" and the coping style of "surrender" were more likely to comply with anti-pandemic measures. We also found that people with the coping style of "confrontation" were less likely to comply. There were no statistically significant relationships between compliance and "relationship," "self-esteem," "self-soothing," "divert attention," and "existential concerns."

Discussion: Our findings indicate that how likely a given individual is to comply with prescribed pandemic countermeasures varies based on their specific psychological needs and behavior styles. Therefore, to control contagion during a pandemic, authorities must recognize the relevance of human need fulfillment and their behavior styles and accordingly highlight and encourage admissible and feasible actions. The findings demonstrate that some individual differences in core psychological needs and coping behavior patterns predict compliance behavior.

Keywords: COVID-19 pandemic; compliance; coping; core psychological needs; schema-based psychotherapy.

We recently reported the recovery of a novel IncI1 type conjugative helper plasmid which could target mobile genetic elements (MGE) located in non-conjugative plasmid and form a fusion conjugative plasmid to mediate the horizontal transfer of the non-conjugative plasmid. In this study, interactions between the helper plasmid pSa42-91k and two common MGEs, IS<i>Ecp1</i> and IS<i>15DI</i>, which were cloned into a pBackZero-T vector, were monitored during the conjugation process to depict the molecular mechanisms underlying the plasmid fusion process mediated by insertion sequence (IS) elements. The MinION single-molecule long-read sequencing technology can dynamically reveal the plasmid recombination events and produce valuable information on genetic polymorphism and plasmid heterogeneity in different multidrug resistance (MDR) encoding bacteria. Such data would facilitate the development of new strategies to control evolution and dissemination of MDR plasmids.

Keywords: IS15DI; ISEcp1; helper plasmid; plasmid fusion; polymorphism.

Childhood obesity remains a major public health issue and priority area for action. Promisingly, obesity prevention interventions in the first 2000 days of life have shown modest effectiveness in improving health behaviours and healthy weight status in children. Yet, researchers in this field face several challenges. This can lead to research waste and impede progress towards delivering effective, scalable solutions. In this perspective article, we describe some of the key challenges in early childhood obesity prevention and outline innovative and collaborative solutions to overcome these. Combining these solutions will accelerate the generation of high-quality evidence that can be implemented into policy and practice.

Keywords: children; family; innovative methods; intervention; obesity prevention.

This study investigated the perception of Mandarin tonal alternations in disyllabic words. In Mandarin, a low-dipping Tone3 is converted to a high-rising Tone2 when followed by another Tone3, known as third tone sandhi. Although previous studies showed statistically significant differences in F0 between a high-rising Sandhi-Tone3 (T3) and a Tone2, native Mandarin listeners failed to correctly categorize these two tones in perception tasks. The current study utilized the visual-world paradigm in eye-tracking to further examine whether acoustic details in lexical tone aid lexical access in Mandarin. Results showed that Mandarin listeners tend to process Tone2 as Tone2 whereas they tend to first process Sandhi-T3 as both Tone3 and Tone2, then later detect the acoustic differences between the two tones revealed by the sandhi context, and finally activate the target word during lexical access. The eye-tracking results suggest that subtle acoustic details of F0 may facilitate lexical access in automatic fashion in a tone language.

Keywords: Mandarin Chinese; eye-tracking; neutralization; tonal alternations; tone sandhi.

Background After the emergence of the novel coronavirus disease pandemic, Saudi Arabia implemented lockdown restrictions to counter this infection and prevent its spread. There have been a lot of challenges to the majority of people, especially diabetic patients, which might result in an increased risk of developing complications and significant lifestyle changes, including physical inactivity, unhealthy diet, and psychological distress. Objective This study aims to assess the impact of coronavirus disease lockdown on children with type 1 diabetes (T1D) mellitus in Al-Khobar, Saudi Arabia. Methods This is a questionnaire-based cross-sectional study which was conducted in pediatric patients, aged ≤18 years old, with type I diabetes, who were attending the endocrine clinic at the King Fahd Hospital of the University (KFHU) in Al-Khobar, Saudi Arabia. A total of 250 patients were identified from the hospital databases, a total of 164 patients were included in the study, and one of the parents/guardians was interviewed through mobile phone after taking their consent. Results The medication compliance during the lockdown has significantly increased as the percentage of children who did not miss any dose of medications increased to 92.7% in comparison to 70.7% before the lockdown (P=0.000). Also, diabetic ketoacidosis (DKA)-related intensive care unit admission had significantly decreased during the lockdown (P=0.001). Regarding the number of consumed meals, it increased from 53.7% up to 68.3% before and during the lockdown period, respectively (P=0.005). In addition, there was no significant change in children's psychological health during the lockdown period (p= 0.123). Conclusion The study indicates that there was an increase in compliance to medications, a significant decrease in intensive care unit and emergency department admission due to hypo/hyperglycemia during the lockdown period. Medical practitioners are encouraged to educate diabetic patients regarding the importance of self-blood glucose monitoring, healthy lifestyle, psychological wellbeing, and regular follow-up through virtual clinics.

Keywords: al-khobar; covid-19 lockdown; pediatrics; saudi arabia.; type 1 diabetes.

Background: Pseudomembranous necrotizing laryngotracheobronchitis refers to an acute diffuse necrotizing inflammation in the mucosa of the larynx, trachea, and bronchus. It often occurs in infants and children having viral infections secondary to bacterial infections. Mycoplasma pneumoniae (M. pneumoniae) is a common pathogen that causes pneumonia in children. In recent years, serious complications due to M. pneumoniae infection, including necrotizing pneumonia, pulmonary embolism, and pleural effusion, have been increasingly reported.

Case presentation: An 11-year-old girl was admitted to our unit with cough, fever, and hoarseness persistent for a week. The results of the M. pneumoniae serological test, PCR examination with bronchial aspirate and bronchoalveolar lavage fluid (BALF), next-generation sequencing (mNGS) for BALF, all suggested the presence of M. pneumoniae infection. High-resolution CT scanning of the chest showed inflammation of the middle and lower lobes of the right lung. By bronchoscopy, the necrosis of the vocal cords, trachea, and bronchial mucosa was observed; each bronchial lumen contained a large amount of white viscous sputum. Pathological findings for bronchial mucosa suggested inflammatory necrosis. After administration of azithromycin and glucocorticoids, the symptoms of the patients were ameliorated. After 2 weeks post-discharge, the X-ray scan of her chest indicated the pneumonia resolution in the right lung.

Conclusions: In patients with pneumonia due to M. pneumoniae infection, which causes obvious hoarseness, bronchoscopy is necessary even if the lung lesions are not massively consolidated. When necrotizing lesions of the larynx, trachea, and bronchi are detected by bronchoscopy, the necrotic tissues in the corresponding parts should be conducted tissue biopsy for pathological examination. Apart from macrolide antibiotics, the administration of small doses of glucocorticoids is necessary.

Keywords: Bronchoscopy; Children; Glucocorticoid; Mycoplasma pneumoniae; Pseudomembranous necrotizing laryngotracheobronchitis.

Background: Golden 2-Like (G2-like) transcription factors play an important role in plant development. However, the roles of these G2-like regulatory genes in response to abiotic stresses in tomato are not well understood.

Results: In this study, we identified 66 putative G2-like genes in tomato (Solanum lycopersicum) and classified them into 5 groups (I to V) according to gene structure, motif composition and phylogenetic analysis. The G2-like genes were unevenly distributed across all 12 chromosomes. There were nine pairs of duplicated gene segments and four tandem duplicated SlGlk genes. Analysis of the cis-regulatory elements (CREs) showed that the promoter regions of SlGlks contain many kinds of stress- and hormone-related CREs. Based on RNA-seq, SlGlks were expressed in response to three abiotic stresses. Thirty-six differentially expressed SlGlks were identified; these genes have multiple functions according to Gene Ontology (GO) analysis and are enriched mainly in the zeatin biosynthesis pathway. Further studies exhibited that silencing SlGlk16 in tomato would reduce drought stress tolerance by earlier wilted, lower superoxide dismutase (SOD), peroxidase (POD) activities, less Pro contents and more MDA contents.

Conclusions: Overall, the results of this study provide comprehensive information on G2-like transcription factors and G2-like genes that may be expressed in response to abiotic stresses.

Keywords: Abiotic stresses; Bioinformatics analysis; Expression patterns; G2-like family; Tomato.

Limb-girdle muscle dystrophy (LGMD) is the fourth most common genetic cause of muscle weakness, with LGMD type 2A (LGMD2A) being one of the most common adult-onset muscular dystrophies presenting with limb-girdle weakness, while LGMD type 2B (LGMD2B) being the most common distal myopathy. This study includes two cases. The first case is a 13-year-old male, with no family history of similar symptoms, who presented with lower extremity weakness at the age of nine, starting with proximal weakness of the lower extremities, progressively involving the upper extremities. He had scapular winging and contracture of both Achilles tendons. The second case involves a 19-year-old male, with a distant family history of weakness, who presented with lower extremity weakness at the age of 10. He had distal myopathy, mainly as foot drop and atrophic gastrocnemii. In both cases, cardiac, intelligence, and bulbar function are spared. Electroneuromyography (ENMG) for both revealed myopathic process. Genetic testing results revealed calpain 3 (CAPN3) and dysferlin (DYSF) abnormality, confirming the diagnosis of LGMD2A and LGMD2B, respectively. This will be the first of its kind adequately documenting two of the most common LGMD subtype in our locale. Clinical phenomenology and preferential muscle involvement lead one to the gold standard genetic testing in heritable myopathies, which was well established in this report.

Keywords: calpainopathy; capn3; dysf; dysferlinopathy; leyden-mobius; lgmd2a; lgmd2b; miyoshi myopathy.

The Actinomyces bacteria are associated with cervicothoracic disease in immunocompromised patients; however, Actinomyces odontolyticus cervical infection with extensive spread to the mediastinum in a previously healthy patient was not reported before in Qatar. The patient underwent drainage of collections in synchrony with intravenous antibiotics and recovered with an excellent outcome.

Keywords: Actinomyces odontolyticus; Bacteraemia; Descending mediastinitis; Mediastinoscopy; Parapharyngeal abscess.

Kaposiform hemangioendothelioma is a rare, borderline tumor that typically occurs during early childhood. Kasabach-Merritt phenomenon is a complication characterized by a consumptive coagulopathy resulting from the localized intravascular coagulation. Hypercalcemia generation is a rare association that was related in our case to parathyroid hormone-related protein produced by this angioma.

Keywords: dermatology; hematology; pediatrics and adolescent medicine.