Bouveret's syndrome: A rare case of gallstone causing gastric outlet obstruction.

Key Clinical Message: The case highlights the importance of decisive action in addressing large gallstones causing gastric outlet obstruction. The chosen single-stage surgical approach reflects the need to manage both obstruction and the gallstone simultaneously. Abstract: Bouveret's syndrome is a rare cause of gastric outlet obstruction secondary to gallstones entering the enteric system through an acquired cholecystoduodenal fistula. Here, we present the case of an 85-year-old female who presented to our emergency department with gastric outlet obstruction secondary to a large gallstone in the third part of the duodenum. Abdominal X-ray did not demonstrate air-fluid levels but revealed a dilated gastric shadow, suggesting gastric outlet obstruction. EGD showed a dilated stomach and a hard, golf ball-sized gallstone in the duodenum. CT scan showed a distended stomach with a large gallstone obstructing the DJ junction and air in the biliary tree. Findings were suggestive of perforation of the gallbladder with stone impaction in the duodenojejunal (DJ) junction. The patient was managed surgically with a one-stage procedure comprising enterotomy, fistula closure, and cholecystectomy. Although Bouveret's syndrome is rare, it is important for practicing surgeons to have a high index of suspicion for this condition due to the high mortality associated with it.

Perianal Tailgut Cyst: An Unusual Presentation.

A tailgut cyst (TGC) is a rare congenital lesion that occurs due to failure of involution of the distal hindgut, leading to the development of a mucus-secreting cyst. The clinical presentation is nonspecific, and often the diagnosis can be missed. We present the case of a 20-year-old female with a TGC in the perianal region. Surgical excision of the cyst was performed, followed by an uneventful recovery. The young age of our patient and the anatomical location of the TGC make our case a rare entity, highlighting the need for practicing surgeons to keep TGC as a differential in mind while examining masses in the perianal region.

Jasmonic acid and methyl jasmonate modulate growth, photosynthetic activity and expression of photosystem II subunit genes in Brassica oleracea L.

The effects of jasmonic acid (JA) and methyl jasmonate (Me-JA) on photosynthetic efficiency and expression of some photosystem (PSII) related in different cultivars of Brassica oleracea L. (var. italica, capitata, and botrytis) were investigated. Plants raised from seeds subjected to a pre-sowing soaking treatment of varying concentrations of JA and Me-JA showed enhanced photosynthetic efficiency in terms of qP and chlorophyll fluorescence. Maximum quantum efficiency of PSII (Fv/Fm) was increased over that in the control seedlings. This enhancement was more pronounced in the Me-JA-treated seedlings compared to that in JA-treated ones. The expression of PSII genes was differentially regulated among the three varieties of B. oleracea. The gene PsbI up-upregulated in var. botrytis after treatment of JA and Me-JA, whereas PsbL up-regulated in capitata and botrytis after supplementation of JA. The gene PsbM showed many fold enhancements in these expressions in italica and botrytis after treatment with JA. However, the expression of the gene PsbM increased by both JA and Me-JA treatments. PsbTc(p) and PsbTc(n) were also found to be differentially expressed which revealed specificity with the variety chosen as well as JA or Me-JA treatments. The RuBP carboxylase activity remained unaffected by either JA or Me-JA supplementation in all three varieties of B. oleracea L. The data suggest that exogenous application of JA and Me-JA to seeds before germination could influence the assembly, stability, and repair of PS II in the three varieties of B. oleracea examined. Furthermore, this improvement in the PS II machinery enhanced the photosynthetic efficiency of the system and improved the photosynthetic productivity in terms of saccharides accumulation.

Consequences of copper treatment on pigeon pea photosynthesis, osmolytes and antioxidants defense.

An attempt was made to explore the effect of copper sulphate treatment on growth, photosynthesis, osmolytes and antioxidants in 15 days old seedlings of C. cajan (Pigeonpea). C. cajan seedlings were grown in 0, 1, 5 and 10 mM concentrations of copper sulphate in petriplates lined with Whatman filter paper for 15 days. Root length and shoot length was decreased in a dose dependent manner with highest decrease of 82.80 and 45.92% in 10 mM Cu stress. Photosynthetic efficiency (qP, qN and Y) was decreased in a dose dependent manner whereas NPQ was increased in 1 and 5 mM and decreased in 10 mM Cu. Photosynthetic pigments viz total chlorophyll and carotenoids were increased in low concentrations and decreased in high concentrations of Cu. Osmolytes such as proline, glycine betaine and sugars were found to be increased in a dose dependent manner. Similarly antioxidants such as superoxide dismutase and catalase increased to 129.17 and 169.7%, respectively under Cu stress. Vitamin C and vitamin E was also increased in different concentrations of Cu to a significant level. It can be concluded from the present study that C. cajan can tolerate Cu stress up to 5 mM by adjusting the proportion of proline, glycine betaine, sugars and vitamins along with increasing the activity of some of the antioxidant enzymes.