Gastric myeloid sarcoma mimicking pseudoachalasia in non-leukemic context: a singular case report.

Introduction and importance: Myeloid sarcoma (MS) is a rare tumour associated with acute myeloid leukaemia (AML) and occasionally occurs independently. It typically affects skin, bone, lymph nodes, and rarely the gastrointestinal tract, with gastric cases being extremely rare. Notably, no reported instances associate pseudoachalasia with gastric myeloid sarcoma. Case presentation: A 20-year-old male presented with severe dysphagia, refractory vomiting, and weight loss. Diagnosed with type III achalasia via oesophageal tests, subsequent gastroscopy revealed a large gastric mass, later identified as gastric myeloid sarcoma through histopathology. Clinical discussion: MS, characterized by immature blast cells, poses diagnostic challenges without typical leukaemia symptoms. Diagnosis involves immunohistochemistry, employing markers like CD33, CD34, and CD43. Optimal treatments, such as chemotherapy or stem cell transplantation, aim to delay leukaemia progression. Gastric primary de-novo myeloid sarcoma is exceedingly rare, emphasizing the need for tailored treatment strategies. Conclusion: Gastric myeloid sarcoma is an exceptionally rare tumour, especially without concurrent acute myeloid leukaemia (AML), complicating its diagnosis. This case represents the first globally documented instance of gastric myeloid sarcoma causing pseudoachalasia. Documenting this unique clinical presentation is crucial for a better grasp of gastric myeloid sarcoma's diverse manifestations.

Effect of tomato consumption on inflammatory markers in health and disease status: A systematic review and meta-analysis of clinical trials.

BACKGROUND AND AIMS: Inflammation is a major cause of chronic diseases. Several studies have investigated the effects of tomato intake on inflammatory biomarkers; however, the results are equivocal. Therefore, the present study aimed to systematically review and analyses randomized clinical trials (RCTs) assessing the effects of tomato intake on inflammatory biomarkers in adults. METHODS: A systematic search was performed in PubMed, Scopus, ISI Web of Science, and Cochrane Library databases to find RCTs related to the effect of tomato intake on inflammatory markers, including C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α), up to November 2021. Meta-analyses were performed using the random-effects model. RESULTS: A total of 465 subjects sourced from seven eligible RCTs (8 treatment arms) were entered into the analysis. Pooled effect size of articles indicated that tomato intake was not significantly effective on CRP (WMD: 0.13 mg/dL, 95% CI: -0.09 to 0.36; P = 0.23, I2: 83.9%) and IL-6 (Hedges' g = -0.12; 95% CI -0.36, 0.13; P = 0.34, I2: 0.0%) levels compared to the control group. But it can significantly reduce TNF-α (Hedges' g = -0.45; 95% CI -0.76, -0.13; P = 0.005, I2: 0.0%) levels. CONCLUSION: Generally, the present study showed that tomato intake has no significant effect on serum CRP, and IL-6 concentrations, but can reduce serum TNF-α levels significantly. However, additional well-designed studies that include more diverse populations and longer duration are warranted.

Injuries sustained in falling fatalities in relation to different distances of falls.

BACKGROUND: Falling from a distance is an important issue worldwide, which happens in different ages, genders and circumstances. It is usually not considered a medicolegal case in many countries hence no autopsy is performed. This study focused on analyzing injuries sustained in victims of falling in relation to different distances of fall. METHODS: Retrospective study of 352 autopsy reports of falling victims brought to the forensic pathology department at Jordan University Hospital during the period from January 1990 to March 2016. RESULTS: Among 352 cases, 256 (72.7%) were males and 96 (27.3%) were females. 303 (86.1%) cases showed accidental fall, 31 (8.8%) were suicidal, 2 (0.6%) were homicidal and un-clarified death in 16 (4.5%). Time of death was directly proportionate with the distance of fall. Victims fell from distances less than 3 m were 123 (35%), most of them were children less than 7 years 50 (40.5%) and unemployed adults more than 45 years were 48 (39.1%). They showed multiple abrasions (62.6%), few contusions (64.2%) and absent laceration of the skin (84.5%). Victims fell from distances of 3-9 m were 123 (35%), most of them were male workers 56 (60.2%). They showed multiple abrasions (63.5%), few contusions (71%) and few lacerations of skin (50.5%). Victims fell from distances more than 9 m were 136 (38.6%), most of them were male workers 71 (52.2%) and female servants 23 (17%). They showed few abrasions (80.9%), multiple contusions (64.7%) and few lacerations of skin (48.5%). The number of fractured limbs increases obviously with distances more than 3 m. Skull vault fractures were found in all distances, while skull base fractures showed in distances of 3-9 m and more than 9 m. Head injury was the most common fatal injury in all distances. Chest injuries were prominent mainly in distances more than 3 m. While abdominal injuries were mainly prominent in distances more than 9 m. CONCLUSIONS: This study showed the effect of different distances of fall in causing different types of injuries in falling fatalities. Internal injuries were in a direct proportion with distances of fall, while external injuries showed a great importance in interpretation of the way of fall.