Design, synthesis and anticancer evaluation of some novel 7-hydroxy-4-methyl-3-substituted benzopyran-2-one derivatives.

Aim: 22 derivatives of 7-hydroxy-4-methyl-3-substituted benzopyran-2-one were designed, synthesized and evaluated for their anticancer activity. Materials & methods: The prepared compounds were screened for their cytotoxicity against the MCF-7 breast cancer cell line. The best five were then evaluated against MCF10a to check their safety and then tested for their PI3K and Akt-1 inhibitory action. The best two derivatives were further analyzed through cell cycle analysis, caspase 3/7 activation, increasing BAX level and decreasing BCL-2. Docking and absorption, distribution, metabolism and excretion prediction studies were also performed. Results & conclusion: Compounds 3b, 3c, 3j, 7 and 8 were the most active. Compounds 3c and 8 showed remarkable inhibitory action against PI3K and Akt-1 enzymes, and both are promising candidates for treatment of breast cancer.

Streptomyces biostimulants: an effective sustainable approach to reduce inorganic N input and maintain high yield of wheat crop in different soil types.

AIMS: This study aimed to isolate and characterize endophytic plant growth-promoting (PGP) actinomycetes from the wild medicinal plant Zygophyllum album. METHODS AND RESULTS: Eight actinomycetes were isolated, identified, and screened for their PGP activities to improve the growth and production of wheat plants under low N-inputs. Based on 16S rRNA analysis, the isolated actinobacteria showed high diversity and had multiple in vitro PGP attributes. In pot experiments, Streptomyces sp. NGB-Act4 and NGB-Act6 demonstrated the highest significant PGP activities to enhance the growth of wheat plants under reduced N-inputs. Under various field conditions (high-fertility clay soils and low-fertility sandy soils), in combination with 50% N-dose, the two streptomycetes showed significant increases in grain N% and grain yield of the wheat crop compared with the 50% N-fertilized treatment. Irrespective of soil type, wheat plants inoculated with strain NGB-Act4 produced grain yield and grain N% significantly greater than or comparable to the full N-dose treatment. CONCLUSIONS: This is the first field report on the successful use of endophytic streptomycetes as an effective strategy to improve wheat yield and reduce the use of synthetic N fertilizers.

Native Rhizospheric and Endophytic Fungi as Sustainable Sources of Plant Growth Promoting Traits to Improve Wheat Growth under Low Nitrogen Input.

Wheat crops require effective nitrogen fertilization to produce high yields. Only half of chemical N2 fertilizers are absorbed into plants while the rest remains in the soil, causing environmental problems. Fungi could maximize nitrogen absorption, and from an environmental and biodiversity point of view, there is an urgent necessity for bioprospecting native fungi associated with wild plants growing in harsh environments, e.g., St. Katherine Protectorate (SKP) in the arid Sinai. Recovered taxa, either endophytic and/or rhizospheric, were screened for their plant growth-promoting (PGP) traits. Eighteen fungal isolates (15 rhizospheric and 3 endophytic) belonging to anamorphic ascomycetes were recovered from 9 different wild plants, and their PGP traits (indole-3-acetic acid [IAA] production, phosphate solubilization, siderophore production, and hydrolytic enzyme production) were measured. Rhizospheric isolate NGB-WS14 (Chaetosphaeronema achilleae) produced high levels of IAA (119.1 µg mL-1) in the presence of tryptophan, while NGB-WS 8 (Acrophialophora levis) produced high IAA levels (42.4 µg mL-1) in the absence of tryptophan. The highest phosphate-solubilizing activity (181.9 µg mL-1) was recorded by NGB-WFS2 (Penicillium chrysogenum). Endophytic isolate NGB-WFE16 (Fusarium petersiae) exhibited a high percentage level of Siderophore Unit (96.5% SU). All isolates showed variability in the secretion of extracellular hydrolytic enzymes. Remarkably, all isolates had antagonistic activity (55.6% to 87.3% suppression of pathogen growth) against the pathogenic taxon Alternaria alternata (SCUF00001378) in the dual-assay results. Out of the 18 isolates, 4 rhizospheric and 1 endophytic isolate showed significant increases in shoot dry weight and shoot nitrogen and chlorophyll content of wheat plants subjected to low inputs of chemical nitrogen (N) fertilizers (50% reduction) compared with the non-inoculated control in a pot experiment. Potent taxa were subjected to sequencing for molecular confirmation of phenotypic identification. The retrieved ITS sequences in this study have been deposited in GenBank under accession numbers from LC642736 to LC642740. This study considered the first report of endophytic fungi of Cheilanthes vellea, a wild plant with PGPF which improves wheat growth. These results recommend using PGPF as inoculants to alleviate low nitrogen fertilization.

Comparative Analysis of the Cultured and Total Bacterial Community in the Wheat Rhizosphere Microbiome Using Culture-Dependent and Culture-Independent Approaches.

Rhizosphere and root-associated bacteria are key components of crop production and sustainable agriculture. However, utilization of these beneficial bacteria is often limited by conventional culture techniques because a majority of soil microorganisms cannot be cultured using standard laboratory media. Therefore, the purpose of this study was to improve culturability and investigate the diversity of the bacterial communities from the wheat rhizosphere microbiome collected from three locations in Egypt with contrasting soil characteristics by using metagenomic analysis and improved culture-based methods. The improved strategies of the culture-dependent approach included replacing the agar in the medium with gellan gums and modifying its preparation by autoclaving the phosphate and gelling agents separately. Compared to the total operational taxonomic units (OTUs) observed from the metagenomic data sets derived from the three analyzed soils, 1.86 to 2.52% of the bacteria were recovered using the modified cultivation strategies, whereas less than 1% were obtained employing the standard cultivation protocols. Twenty-one percent of the cultivable isolates exhibited multiple plant growth-promoting (PGP) properties, including P solubilization activity and siderophore production. From the metagenomic analysis, the most abundant phyla were Proteobacteria, Actinobacteria, Chloroflexi, Bacteroidetes, and Firmicutes. Moreover, the relative abundance of the specific bacterial taxa was correlated with the soil characteristics, demonstrating the effect of the soil in modulating the plant rhizosphere microbiome. IMPORTANCE Bacteria colonizing the rhizosphere, a narrow zone of soil surrounding the root system, are known to have beneficial effects in improving the growth and stress tolerance of plants. However, most bacteria in natural environments, especially those in rhizosphere soils, are recalcitrant to cultivation using traditional techniques, and thus their roles in soil health and plant growth remain unexplored. Hence, investigating new culture media and culture conditions to bring "not-yet-cultured" species into cultivation and to identify new functions is still an important task for all microbiologists. To this end, we describe improved cultivation protocols that increase the number and diversity of cultured bacteria from the rhizosphere of wheat plants. Using such approaches will lead to new insights into culturing more beneficial bacteria that live in the plant rhizosphere, in so doing creating greater opportunities not only for field application but also for promoting sustainability.

Diverse Rhizobium strains isolated from root nodules of Trifolium alexandrinum in Egypt and symbiovars.

Berseem clover (T. alexandrinum) is the main forage legume crop used as animal feed in Egypt. Here, eighty rhizobial isolates were isolated from root nodules of berseem clover grown in different regions in Egypt and were grouped by RFLP-16S rRNA ribotyping. Representative isolates were characterized using phylogenetic analyses of the 16S rRNA, rpoB, glnA, pgi, and nodC genes. We also investigated the performance of these isolates using phenotypic tests and nitrogen fixation efficiency assays. The majority of strains (<90%) were closely related to Rhizobium aegyptiacum and Rhizobium aethiopicum and of the remaining strains, six belonged to the Rhizobium leguminosarum genospecies complex and only one strain was assigned to Agrobacterium fabacearum. Despite their heterogeneous chromosomal background, most of the strains shared nodC gene alleles corresponding to symbiovar trifolii. Some of the strains closely affiliated to R. aegyptiacum and R. aethiopicum had superior nodulation and nitrogen fixation capabilities in berseem clover, compared to the commercial inoculant (Okadein®) and N-added treatments. R. leguminosarum strain NGB-CR 17 that harbored a nodC allele typical of symbiovar viciae, was also able to form an effective symbiosis with clover. Two strains with nodC alleles of symbiovar trifolii, R. aegyptiacum strains NGB-CR 129 and 136, were capable of forming effective nodules in Phaseolus vulgaris in axenic greenhouse conditions. This adds the symbiovar trifolii which is well-established in the Egyptian soils to the list of symbiovars that form nodules in P. vulgaris.

A systematic review of risk assessment tools for contaminated sites - Current perspectives and future prospects.

Health and safety hazards associated with the redevelopment of contaminated sites can be complex and pose considerable risks. A systematic literature review was conducted on risk assessment tools for contaminated sites. These tools have been identified from searching through leading academic databases and other professional sources. For each of the identified tools the relevant risk assessment stages, harm type, hazard category, receptor type and pathways are reported. Findings reveal that despite growing interest in the development of risk assessment tools, there are persistent knowledge gaps identified in this study, which serve as a basis for future research direction to where more advanced practical tools could be invented. For instance, it is evidenced there is a shortfall in practical tools available to contaminated site assessors conducting investigations at the preliminary risk assessment stage. Addressing this opening can benefit the planning process, coordinated between relevant stakeholders and, moreover, reduce uncertainty in the decision-making of contaminated site developers.

Improved tribological properties, thermal and colloidal stability of poly-α-olefins based lubricants with hydrophobic MoS2 submicron additives.

HYPOTHESIS: Newtonian liquids, usually used as base oil lubricants, exhibit low viscosity under extreme thermal conditions, needed for the functioning of wind turbines. This is directly affecting the colloidal stability and the tribological properties of the formulations containing additives, such as MoS2. Here, it was hypothesized that the surface hydrophobization of MoS2 particles will allow for an increased colloidal stability of the resulting formulations, for temperatures as high as 80 °C. EXPERIMENTS: The antifriction properties and the thermal stability of the designed formulations were determined on submicron MoS2 particles dispersed in poly-α-olefins (PAO) base oils of different dynamic viscosities (from 32 to 1650 mPa·s at 25 °C). The submicron particles of MoS2 (300-500 nm in diameter) were synthesised by a simple one-pot solvothermal method under mild conditions. The resulting particles were hydrophobized in situ in PAO base oils using alkyltrichlorosilane grafting agents with two chain lengths (C8 and C18). FINDINGS: The covalent grafting of alkylsilanes through Mo-O-Si bonds was confirmed by DFT calculations and FT-IR measurements. Turbiscan optical analysis revealed that thermal and colloidal stabilities can be significantly improved depending on oil viscosity and chain length of the grafting agent. The formulations in the PAO65 oil remained highly stable (TSI < 1), even at 80 °C. Herein, we demonstrate the impact of hydrophobization degree on the tribological properties of the lubricants, which, importantly, could reach ultra-low friction coefficients, less than 0.02.

Serum trace elements in insulin-dependent and non-insulin-dependent diabetes: a comparative study.

BACKGROUND: Diabetes mellitus is associated with imbalance in body trace elements. The aim of the current investigation was to compare the levels of trace elements (Zn, Mg, Mn, Cu, Na, K, Fe, Ca, Cr, and Se) in insulin dependent (IDDM) and non-insulin dependent (NIDDM) diabetes. METHODS: A total of 100 patients with diabetes (40 IDDM and 60 NIDDM) and 50 healthy subjects were recruited in the study from both genders. Biochemical measures include glucose, lipids, and HbA1C. RESULTS: The results showed that Zn, Mg, Cu and Cr were significant lower in patients with diabetes compared to the control group (P<0.01). In addition, Zn and Cr were significantly lower in IDDM than NIDDM (P<0.05). Moreover, Zn and Mg levels were inversely correlated with HbA1c in IDDM and NIDDM (P<0.05). Zn was inversely correlated with fasting blood glucose in IDDM (P<0.05). Finally, no correlation between trace element levels with BMI was found (P>0.05). CONCLUSION: Disturbance in trace element profile among IDDM and NIDDM is similar.

Overcoming Limitations of LoRa Physical Layer in Image Transmission.

As a possible implementation of a low-power wide-area network (LPWAN), Long Range (LoRa) technology is considered to be the future wireless communication standard for the Internet of Things (IoT) as it offers competitive features, such as a long communication range, low cost, and reduced power consumption, which make it an optimum alternative to the current wireless sensor networks and conventional cellular technologies. However, the limited bandwidth available for physical layer modulation in LoRa makes it unsuitable for high bit rate data transfer from devices like image sensors. In this paper, we propose a new method for mangrove forest monitoring in Malaysia, wherein we transfer image sensor data over the LoRa physical layer (PHY) in a node-to-node network model. In implementing this method, we produce a novel scheme for overcoming the bandwidth limitation of LoRa. With this scheme the images, which requires high data rate to transfer, collected by the sensor are encrypted as hexadecimal data and then split into packets for transfer via the LoRa physical layer (PHY). To assess the quality of images transferred using this scheme, we measured the packet loss rate, peak signal-to-noise ratio (PSNR), and structural similarity (SSIM) index of each image. These measurements verify the proposed scheme for image transmission, and support the industrial and academic trend which promotes LoRa as the future solution for IoT infrastructure.

Bile Duct Injury in Children: Is There a Role for Early Endoscopic Retrograde Cholangiopancreatography?

Introduction Liver injury is common among pediatric abdominal trauma. Nonoperative management is the standard of care in isolated stable liver injuries. Bile leak is not an uncommon complication in moderate- and high-grade injuries. Case series Three pediatric patients (age: 10-15 years) suffered grade IV liver injuries secondary to blunt abdominal trauma. All developed significant bile leak treated nonoperatively with endoscopic retrograde cholangiopancreatography (ERCP), and patients 1 and 2 were treated with bile duct stent alone. Patient 3 required laparotomy for bile peritonitis and abdominal compartment syndrome followed by interval ERCP and bile duct stent. Conclusion Traumatic bile leaks if not recognized and managed early can result in significant morbidity. This paper describes the presentation and treatment of three pediatric patients with blunt liver trauma complicated by significant bile leaks that were managed successfully with ERCP and bile duct stent. This paper demonstrates the importance of early detection of bile leak to prevent bile peritonitis. Abdominal imaging 4 to 5 days postinjury can help in detecting bile accumulation. We believe that ERCP and bile duct stent are becoming the standard of care in diagnosing and treating traumatic bile leak. This paper confirms the safety and feasibility of this technique in the pediatric population.

The prevalence and characteristics of overweight and obesity among students in Qatar.

OBJECTIVES: To estimate the prevalence of overweight and obesity using World Health Organisation (WHO) cut-offs for the body mass index (BMI) among students of the general population living in Qatar in the period 2015-2016. STUDY DESIGN: Cross-sectional study. METHODS: The study includes 164,963 students aged 5-19 years. The body weight and height were measured to calculate the BMI. The WHO standard cut-offs were used to categorise the BMI into severe thinness (BMI z-score <-3), thinness (BMI z-score ≥-3 to <-2), normal (BMI z-score ≥-2 to <1), overweight (BMI z-score ≥+1 to <+2) and obese (BMI z-score >+2). RESULTS: Overweight and obesity prevalence was 44.8% and 40.4% among males and females and 45.6% and 40.9% among Qatari and non-Qatari students, respectively. Odds of obesity and overweight status were significantly higher among 10-14 and 15-19 age groups than 5-9 years age group (P < 0.001). By sex, males had 1.48 times higher odds of having obesity than females (P < 0.001), and Qatari nationals had 1.4 times higher odds of obesity than non-Qataris (P < 0.001). Although non-Qatari males also had higher odds of being overweight than females (odds ratio [OR] = 1.05, P = 0.0006), the opposite was seen among Qatari students (OR = 0.95, P = 0.01). CONCLUSION: The result of this survey provides evidence of a high prevalence of overweight and obese students living in Qatar. Therefore, preventive strategies are essential in this population to lower the incidence of being overweight and obesity.

Prevalence of physical activity and sedentary-related behaviors among adolescents: data from the Qatar National School Survey.

OBJECTIVES: To investigate the prevalence of physical activity (PA) and sedentary behaviors among adolescents in Qatar by selected demographic characteristics. STUDY DESIGN: Cross-sectional study. METHODS: A total of 5862 students (2938 boys and 2924 girls) in the age group 12-17 years were included in the analyses. PA and sedentary-related measures were obtained from the self-reported survey questions. RESULTS: Only 35.4% of students were performing 60 min of PA ≥3 days/week. The proportion of students with >2 hr screentime ranged from 43% to 57% (weekdays) and 50% to 62.5% (weekends). Girls had less odds of being physically active than the boys (odds ratio [OR] = 0.61, P < 0.001). Qatari students were less likely to be physically active than non-Qataris (OR = 0.79, P < 0.001). Age was inversely correlated with PA ([r = -0.113, P < 0.001 for participation with sports team] and [r = -0.139, P < 0.001 for school physical education classes]). Participation in sports teams positively correlated with 60 min of PA number of days in a week (r = 0.317, P < 0.001). CONCLUSIONS: The study describes insufficient PA among youth as a public health issue of concern in the State of Qatar that requires multipronged health promotion initiatives.

Oral health status of six-year-old children in Qatar: findings from the national oral health survey.

INTRODUCTION: Oral health has a significant impact on physical, social and mental well-being of an individual. Qatar, like the rest of the world, is experiencing higher prevalence of oral health-related problems. OBJECTIVES: To examine the oral health status and extent of preventive and curative needs among six-year-old school children in Qatar by key demographic indicators. METHODS: Secondary data analysis of 1124 six-year-old private and government primary school children from the 2011 Qatar National Oral Health Survey was performed. Dental caries lesions status of primary dentition was assessed according to the WHO criteria. Descriptive statistics were carried out, and comparison among groups was executed by running t statistics. Logistic regression was performed to interpret the impact of various predictors. RESULTS: Overall, 71.4% children presented with dental caries lesions with a higher prevalence among girls versus boys (73.8% versus 68.9%). The mean overall dmft was recorded as 4.2 with ±4.2 SD. Qatari children had 3.8 time odds of having dental caries lesions compared with non-Qatari children (P < 0.001). Overall, 18.9% of children showed signs of poor periodontal health. Odds of having more periodontal disease were significant in Qatari boys (OR = 3.1 CI = 2.0, 4.7, P < 0.001) compared to non-Qatari boys. On average, 3.6 teeth per student were in need of any treatment. CONCLUSION: This study indicated that only 28.6% of children aged six were free from caries lesions. The results urge to further strengthen the strategies and to improve oral hygiene by various evidence-based interventions.

Localization of beta and high-frequency oscillations within the subthalamic nucleus region.

Parkinsonian bradykinesia and rigidity are typically associated with excessive beta band oscillations in the subthalamic nucleus. Recently another spectral peak has been identified that might be implicated in the pathophysiology of the disease: high-frequency oscillations (HFO) within the 150-400 Hz range. Beta-HFO phase-amplitude coupling (PAC) has been found to correlate with severity of motor impairment. However, the neuronal origin of HFO and its usefulness as a potential target for deep brain stimulation remain to be established. For example, it is unclear whether HFO arise from the same neural populations as beta oscillations. We intraoperatively recorded local field potentials from the subthalamic nucleus while advancing DBS electrodes in 2 mm steps from 4 mm above the surgical target point until 2 mm below, resulting in 4 recording sites. Data from 26 nuclei from 14 patients were analysed. For each trajectory, we identified the recording site with the largest spectral peak in the beta range (13-30 Hz), and the largest peak in the HFO range separately. In addition, we identified the recording site with the largest beta-HFO PAC. Recording sites with largest beta power and largest HFO power coincided in 50% of cases. In the other 50%, HFO was more likely to be detected at a more superior recording site in the target area. PAC followed more closely the site with largest HFO (45%) than beta power (27%). HFO are likely to arise from spatially close, but slightly more superior neural populations than beta oscillations. Further work is necessary to determine whether the different activities can help fine-tune deep brain stimulation targeting.

Staged closure of a giant omphalocele with amnion preservation, modified technique.

Closure of a giant omphalocele can be challenging. Preservation of the amnion in staged closure is not commonly practiced. Here, we describe 2 cases of giant omphalocele treated with a modified amnion preservation, staged closure technique. This paper demonstrates the feasibility and safety of this technique, and the versatility of amnion to adapt to an escharization strategy if closure is not achievable.

Early Versus Late Tracheostomy for Patients with High and Low Cervical Spinal Cord Injuries.

OBJECTIVES: This study aimed to evaluate the effects of early versus late tracheostomies among patients with cervical spinal cord injuries (CSCIs). METHODS: This retrospective study included 69 adult CSCI patients who underwent bedside percutaneous tracheostomies at the Intensive Care Unit of Khoula Hospital, Muscat, Oman, between January 2011 and October 2015. The tracheostomy was considered early if the procedure took place within one week of the CSCI. The impact of an early tracheostomy on patient outcomes was analysed in terms of duration of mechanical ventilation and intensive care unit (ICU) stay among patients with high (C1-C2 vertebrae) and low (C3-C7 vertebrae) CSCIs. Ventilator dependence, bradycardia episodes and surgical intervention outcomes were also examined. RESULTS: Patients with a high CSCI who underwent an early tracheostomy spent significantly fewer days on mechanical ventilation compared to those who underwent a late tracheostomy (9.3 ± 7.2 days versus 13.7 ± 3.2 days; P = 0.041). Low CSCI patients who received an early tracheostomy also experienced significantly fewer days on mechanical ventilation compared to those undergoing a late tracheostomy (12.1 ± 10.4 days versus 25.2 ± 17.7 days; P = 0.035). Moreover, ICU mortality was significantly lower for high CSCI patients who underwent an early tracheostomy (P = 0.015). However, there was no association between length of ICU stay and either type of CSCI or timing of the tracheostomy procedure. CONCLUSION: An early tracheostomy is beneficial in reducing the duration of mechanical ventilation among patients with CSCIs, irrespective of the level of injury.

The timing of deep brain stimulation for Parkinson disease in the UK from 1997 to 2012.

BACKGROUND AND PURPOSE: Deep brain stimulation (DBS) for Parkinson disease (PD) has traditionally been reserved for the late stages of the disease. There is evidence that DBS is also effective if applied earlier in the disease course. Changes in the frequency of DBS procedures in the UK over a 15-year period were investigated. METHODS: A retrospective review was performed of patient age and disease duration for DBS surgery for PD in UK neurosurgical units from 1997 to 2012 using departmental databases. RESULTS: The number of DBS procedures in the UK increased from three in 1997 to over 80 per year during this period. The mean age at the time of surgery (60 years) and the mean duration of PD at the time of DBS (11 years) remained unchanged over 15 years. CONCLUSIONS: The age and disease duration at which DBS is performed for PD in the UK has been static over a 15-year period and DBS appears to remain a therapy for PD applied late in its course. This may change in the light of clinical evidence suggesting a benefit for earlier DBS.

Varying time-course of effects of high frequency stimulation of sub-regions of the globus pallidus in patients with parkinson's disease.

INTRODUCTION: Deep brain stimulation of the globus pallidus can be a highly effective treatment for patients with Parkinson's disease (PD), experiencing Levodopa-induced-dyskinesia (LID). Stimulation programming can focus simply on eliminating dyskinesia, or can also attempt to relieve the rigidity, tremor or akinesia of PD itself. METHODS: In this study, we explored whether additional benefit on the "off" symptoms and signs of PD, could be achieved in post-operative PD patients with good LID control, by making further adjustment to existing stimulation parameters directed towards the more superior electrode contacts, located in the Globus Pallidus pars externa (GPe). RESULTS: Acutely, GPe-DBS led to clear improvement in the akinesia, rigidity and tremor of PD in the off-medication state compared with Globus Pallidus pars interna (GPi) DBS (p = 0.003), however this was accompanied by the development of off-medication dyskinesia. Combined GPi-GPe DBS allowed maintained improvement but without dyskinesia. Follow up of patients over the subsequent 6-12 weeks showed gradual loss of this initial improvement. Switching back to GPi-DBS alone provided greater improvement in off medication symptoms than had been observed using the same GPi-DBS setting, 6-12 weeks previously. CONCLUSIONS: Benefits on the off-medication symptoms of PD obtained acutely with GPe-DBS are in general not sustained. Similarly, the effects of GPi-DBS on the off medication symptoms of PD, can evolve over short periods of time presumably as a result of changes in network-wide neuronal plasticity. These clinical observations provide further insight into DBS mechanism of action, and can also help inform optimal methods of GPi-DBS programming.

Vesical calculus formation on non-absorbable sutures used for open inguinal hernia repair.

INTRODUCTION: Iatrogenic injuries to the urogenital tract are rare, with the bladder being the organ most affected. We describe a case of a vesical calculus that formed on non-absorbable sutures that were used to repair an inguinal hernia. PRESENTATION OF CASE: A 45-year-old male presented with frank haematuria and dysuria 2 years following an open left inguinal hernia repair. A CT urography showed a vesical calculus adherent to the left anterio-lateral wall of the bladder. Cystoscopy revealed that the calculus formed on non-absorbable sutures. Cystolapaxy was performed followed by cystoscopic excision of the sutures. The patient's post-operative course was uneventful. DISCUSSION: Foreign bodies in the urinary bladder always act as a nidus for formation of a calculus. Iatrogenic bladder injuries are common during hernia repair. It is however rare for sutures used to repair an inguinal hernia to involve the urinary bladder wall. The patient most likely had a full bladder at the time of hernia repair or the bladder was part of the contents of the hernia sac. CONCLUSION: This case illustrates the need to ensure that the bladder is empty prior to pelvic surgery and for surgeons to have a good understanding of inguinal anatomy to avoid injuring the contents of the hernia sac.

Wandering ascaris coming out through the abdominal wall.

A rare case of ascaris coming out through the anterior abdominal wall is reported here. A 40-year-old female had undergone dilatation and curettage by a quack. On the second day she presented with presented with features of peritonitis. She was explored. Resection anastomosis of the ileum was done for multiple perforations of the ileum. Patient developed a fistula in the anterior abdominal wall which was draining bile-colored fluid. On the 12(th) postoperative day a 10-cm-long worm was seen coming out through the fistulous tract which was found to be Ascaris lumbricoids. Ascaris lumbricoids can lead to many complications ranging from worm colic to intestinal obstruction, volvulus, peritonitis, pancreatitis, cholangiohepatitis, liver abscess and many more. Worm has been reported to come out through mouth, nostrils, abdominal drains, T-tubes etc. But ascaris coming out through the anterior abdominal wall is very rare hence reported here.