Acute Pancreatitis Likely Due to Semaglutide.

Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA) that has gained recent popularity in its effective management of type 2 diabetes mellitus (T2DM) and obesity. Minimal evidence has reported the link between Semaglutide use and acute pancreatitis. In this case report, we discuss the case of a 36-year-old female presenting to the Emergency Department with sudden-onset epigastric pain, subsequently diagnosed with acute pancreatitis. Moreover, she had recently started subcutaneous semaglutide injections for weight loss, which she had procured from one of her acquaintances without seeking medical advice. Semaglutide was thus stopped and her lipase levels normalized with significant improvement of her symptoms, making semaglutide the likely causative factor for her acute pancreatitis. Given the increased use of GLP-1RA, we aim to increase awareness among patients taking this medication whether prescribed or not and increase clinician awareness when prescribing this medication.

Complexities in the Diagnosis and Management of Anti-Hu Antibody-Associated Paraneoplastic Syndrome.

Anti-Hu is the most commonly associated antibody in paraneoplastic syndromes (PNS) - mainly secondary to small cell lung cancer (SCLC), breast cancer, thymoma, and lymphoma. This case is about a 65-year-old female patient presenting with slurred speech, headache, and loss of balance for one day. On examination, she was found to have downbeat and bilateral gaze-evoked nystagmus, dysarthria, and bilateral intention tremors. The rest of the neurological examination was unremarkable. Upon investigation, a CT scan showed a pre-sacral mass and a PET scan showed a lobulated soft tissue mesenteric mass at L5/S1, thought to possibly be a gastrointestinal stromal tumour, and mediastinal lymph nodes including right lower pre-tracheal, subcarinal and right hilar lymph nodes. Additionally, paraneoplastic antibody testing was positive for anti-Hu antibodies. She was given a five-day course of intravenous immunoglobulin without significant clinical improvement. The patient was discharged on a fast-track pathway and did not undergo chemotherapy, radiotherapy or surgical resection as the primary tumour could not be diagnosed.  Paraneoplastic antibodies are a family of autoantibodies occurring as a result of malignancy that act to recognize antigens in the brain, resulting in a variety of neurological manifestations. Despite well-known literature on this entity, PNS is notoriously difficult to diagnose and manage. The first step in the management of PNS is to treat the underlying malignancy. Beyond this, the other key component of PNS treatment is immune modulation which may involve immunosuppression with high-dose corticosteroids, IV immunoglobulins, plasma exchange or plasmapheresis. It is therefore important for PNS to be diagnosed early and to adopt a comprehensive multidisciplinary approach to improve the outcomes of those presenting with PNS.

Susceptibility of Blood Groups Infection with COVID-19 Disease Among Sudanese Patients Suffering from Different Chronic Diseases.

<b>Background and Objective:</b> Coronavirus disease (COVID-19) has spread throughout the world. Several studies have indicated that ABO blood group polymorphism could be connected to COVID-19 vulnerability and clinical outcomes, nevertheless, the findings are debatable. The aim of this study was to determine the most blood groups susceptible for COVID-19 infection among Sudanese patients suffering from different chronic diseases. <b>Materials and Methods:</b> The research included 200 participants. A total of 100 samples were collected as a case study from patients who had been found to have COVID-19 and a total of 100 samples were collected as a control from non-COVID-19 patients. The data was then gathered using a formal interview questionnaire and analyzed using the Statistical Package for Social Sciences (SPSS). <b>Results:</b> A total of 200 individuals were involved 100 of them was Patients and 100 were control. 51.4% were female and 48.6% were male. Current study revealed statistically significant difference between cases and controls. Blood group distribution was O positive as 59 (42.1%) followed by A Positive as 36 (25.7%), B positive 16 (11.4%), AB was 9 (6.4%) and only one (0.7%) was AB negative. In this study, the most common of other disease of COVID-19 patients were Asthma (6%), stomach ulcer (1%), renal failure (10%), diabetes (12%), hypertension (24%), vein thrombosis (1%), thrombosis (1%), heart disease (2%) and sinusitis (1%). <b>Conclusion:</b> There is a relation between ABO blood grouping and COVID-19 virus infection. The blood group distribution was O positive at 59 (42.1%), A positive at 36 (25.7%), B positive at 16 (11.4%), AB positive at 9 (6.4%) and AB negative at one (0.7 %). Blood group AB is the least likely to be infected with the COVID-19 virus, although blood group O Positive is the most likely.

Concordance Between Immunohistochemistry (IHC) and Silver Situ Hybridization (SISH) in Endometrial Carcinoma Diagnosis: Using HER-2/neu.

BACKGROUND AND OBJECTIVE: Human epidermal growth factor receptor 2 (Her-2/neu) has been demonstrated as biomarker in Endometrial Carcinoma (EC). This study was conducted to assess the concordance between Sudanese women between immunohistochemistry (IHC) and Silver Situ Hybridization (SISH) for EC diagnosis using HER-2/neu. MATERIALS AND METHODS: This was a retrospective cross sectional study performed in the state of Khartoum, Sudan. This research used eighty-eight samples of embedded blocks of formalin fixed paraffin referred to the histopathology lab from 2007-2013. The technique of tissue microarray (TMA) was used in which paraffin blocks were prepared before IHC and SISH were subjected. RESULTS: In this analysis, 88 specimens were previously diagnosed as endometrial adenocarcinoma. The number of Her-2/new oncogene positive cases among Sudanese women by using IHC were (15.9%), however Her-2/neu amplification in EC were 11.5% by using SISH analysis and strong correlation between Her-2/neu IHC and Her-2/neu SISH is existed, since p-value is 0.,000. CONCLUSION: SISH is a reliable technique that can be used for detecting Her-2/neu oncoprotein and it has many advantages over other methods, also SISH can be used as an alternative to FISH technique.