Non-muscle invasive urothelial bladder cancer in a 17-year-old male: A rare case report.

INTRODUCTION AND IMPORTANCE: Urothelial carcinoma of the bladder predominantly affects adults with rare cases in young patients. This manuscript presents a rare case of urothelial carcinoma highlighting clinical characteristics, diagnosis, treatment, and prognosis in this age group. Our aim is to raise awareness among healthcare professionals for improved outcomes in children and adolescents with bladder urothelial carcinoma. CASE PRESENTATION: A 17-year-old male presented with hematuria and urinary symptoms. No history of smoking, alcohol, surgeries, family conditions, or medications. The patient had environmental chemical exposure near an oil refinery. An initial ultrasound and Cystoscopy showed a sizable bladder tumor. A complete TURBT was done, followed by cauterization and catheter placement. The tumor was diagnosed as low-grade urothelial carcinoma (pT1). Follow-up cystoscopies after 3 and 9 months showed no recurrence. CLINICAL DISCUSSION: Urothelial bladder carcinoma (UBC) is linked to occupational exposure and smoking. Limited research exists on UBC in young patients, but genetic factors and environmental exposure may play a role. In young individuals, UBC typically presents as low-grade, non-muscle invasive tumors (NMIBC). Transurethral resection may be sufficient for low-grade tumors, and postoperative follow-up with ultrasound is important. Larger tumors have a higher risk of recurrence and progression. CONCLUSION: The present case emphasizes the need to consider urothelial bladder carcinoma as a potential cause of hematuria in young patients and conduct a thorough evaluation of all risk factors. Future research is needed to establish evidence-based guidelines for managing this condition in pediatric and adolescent patients.

Hawthorne Effect in Gait Analysis of Children with In-Toeing Caused by Increased Femoral Anteversion.

Background: In-toeing is one of the main reasons children are applying to the orthopedics clinic. In the clinical settings, during in-toeing gait assessment parents often define that their child does not walk same at the clinic as at home, linked possibly to Hawthorne effect. Research Question: How does the in-toeing angle differ when children are aware, versus when they are not aware of their gait inspection? Methods: This single center, clinical, cross-sectional, observational study looked into the variation in gait pattern of twelve children with in-toeing, with and without their awareness. Two videos for each child was recorded with a smart phone, once at the clinic while aware and once by the family without awareness, and uploaded into Kinovea software for gait analysis. The angle of foot in-toeing was measured and analyzed using SPSS comparison of means and correlations. Results: The gait pattern evaluated with the angle of in-toeing showed a significant difference between the two videos of the same child. The angle difference returned a p value of 0.000 using paired sample t test and a Cohen's d value of 1.4, representing the large significance between clinic and family recorded videos. The initial foot in-toeing angle showed a moderate positive Pearson's correlation of 0.031 when compared with the angle difference in both settings. Significance: These results highlight the importance of including family recorded videos in gait pattern analysis without the patient's awareness. The study not only shows the significant difference found which can be explained by Hawthorne Effect but also suggests a clearer path of understanding the child's condition with the family.

A case report of giant prostatic hyperplasia in a resource-challenged center.

A benign enlargement of the prostate with weight measured above 500 gr is a rare entity that is not characterized with specific clinical findings, and requires simple open prostatectomy as the chosen management for such cases especially, in low resource context. Hereby we present a rare case of 570 gr weighted prostate hyperplasia, managed within resource-challenged hospital.

Xanthogranulomatous pyelonephritis, and emphysematous pyelonephritis: Two rare conditions in one patient.

INTRODUCTION: What makes this case unique are combined features of two rare renal disease processes in one patient within one kidney which are Xanthogranulomatous pyelonephritis,and emphysematous pyelonephritis. CASE PRESENTATION: The patient had main general symptoms like fever, chills, fatigue,and right abdominal pain. He had urea = 77, White Blood Cells = 15,46, and urine culture was positive for Klebsiella. He had right total nephrectomy as a therapeutic intervention. CONCLUSION: It is important to note that it could we have two diseases or more in one case related to one systemic organ so, we have to evaluate all possible causes of current status of the patient.

Inflammation and Elevation of Interleukin-12p40 in Patients with Schizophrenia.

Schizophrenia is a serious mental illness with chronic symptoms and significant impairment in psychosocial functioning, which suggests that it likely has neurodegenerative characteristics. Inflammatory markers such as pro-inflammatory cytokines are well-known etiological contributors for psychiatric disorders, including schizophrenia. Although, the role of inflammation in schizophrenia is becoming evident, the number of studies in this area is relatively scarce, especially in Lebanon, and increased procedural thoroughness is needed. Cytokines play a key role in the activation of the immune system and strongly influence neurotransmission. Previous investigation of plasma levels showed dysregulation of interleukin (IL)-12. However, genotypical variations of this interleukin have not been investigated for patients with schizophrenia yet. Thus, in this paper, we aimed to compute and assess IL-12p40 levels in the sera of individuals with schizophrenia from different provinces in Lebanon and compare it to controls. Healthy subjects comprised 60 individuals with a male/female (M/F) ratio of 31/29, whereas patients with schizophrenia consisted of 63 subjects with an M/F ratio of 30/33. The mean age for healthy controls was 30 years, whereas that for patients with schizophrenia was 35 years. A standardized enzyme-linked immunosorbent assay (ELISA) technique was used to measure the concentration of IL-12p40 in all collected sera (n = 123). The mean IL-12p40 levels in patients with schizophrenia were significantly higher than in healthy controls (p = 0.002). Healthy females had a significantly higher concentration of IL-12p40 than healthy males (p = 0.009). Female patients with schizophrenia had significantly higher concentrations of IL-12p40 than their male counterparts (p < 0.001), healthy females (p = 0.018), and healthy males (p < 0.001), respectively. Male patients with schizophrenia had significantly higher concentrations of IL-12p40 than healthy males (p = 0.023). The study's results suggest that IL-12p40 has a putative role as a potential marker in schizophrenia and that its elevation may participate in its pathogenesis. IL-12p40 may be included in a panel to be evaluated in the sera of patients with schizophrenia and an appreciation of its independent function is important for improving our understanding of both protective and pathogenic immune responses. Future research should aim to assess this interleukin and understand its role in other mental illnesses that share a similar etiology to schizophrenia.

Electrochemical degradation of the antibiotic sulfachloropyridazine by hydroxyl radicals generated at a BDD anode.

The treatment of aqueous solutions of the antibiotic sulfachloropyridazine (SCP) was carried out at the natural pH of the solution (pH 4.5) with hydroxyl radicals (OH) generated at a BDD anode surface by electro-oxidation using an undivided electrochemical cell equipped with a three-dimensional carbon-felt cathode. Hydroxyl radicals are powerful oxidants and react with the antibiotic leading to its overall mineralization. The kinetic study showed that oxidative degradation of SCP follows pseudo first-order reaction kinetics, with a relatively short degradation time. The degree of mineralization of SCP solutions increased with the applied current, being higher than 95% after 8 h of electrolysis at 350 mA or higher current. To determine the degradation pathway upon the action of hydroxyl radicals, the cyclic and aliphatic by-products, as well as the released inorganic ions, were identified and quantified over electrolysis time. The values of the rate constants of reactions between OH and the SCP and its intermediates were determined by the competition kinetics method using p-hydroxybenzoic acid. The absolute rate constant for the OH-mediated degradation of SCP was found to be 1.92 × 10(9)M(-1)s(-1). Toxicity assessment by the Microtox method during the electro-oxidation of SCP solutions revealed the formation of compounds that can be more toxic than the parent molecule, but the overall results confirm the effectiveness of this electrochemical process for the removal of the antibiotic SCP and its by-products from aqueous media.