Sinonasal metastases from prostatic adenocarcinoma are exceptional and may represent a major diagnostic challenge, particularly in the presence of neuroendocrine differentiation. Ethmoidal involvement is especially rare and may mimic a primary sinonasal malignancy clinically, radiologically, and histologically. We report the case of an elderly man presenting with sinonasal symptoms related to a destructive ethmoidal mass. Histopathological examination revealed an infiltrative malignant proliferation composed of irregular glandular structures associated with a focal neuroendocrine component arranged in solid nests and trabeculae. Tumor cells displayed enlarged nuclei with conspicuous nucleoli. Immunohistochemically, tumor cells were negative for CK7 and CK20, while Prostein expression supported a prostatic origin. Synaptophysin and chromogranin were positive within the neuroendocrine component. Subsequent prostate biopsies confirmed the diagnosis of prostatic adenocarcinoma with neuroendocrine differentiation. This case highlights the importance of integrating morphology, immunohistochemistry, and clinicoradiological findings when evaluating unusual sinonasal tumors. Metastatic prostate carcinoma should be considered in destructive sinonasal lesions occurring in elderly men, even in the absence of a known prostatic malignancy.

Low-grade oncocytic tumor (LOT) of the kidney has recently emerged as a distinct diagnostic entity among eosinophilic renal neoplasms. Due to its notably slow clinical progression and "mismatch" immunoprofile (CK7+/CD117-), LOT must be differentiated from renal oncocytoma and chromophobe renal cell carcinoma (chRCC). In this report, we discuss the case of a 69-year-old male patient who presented with a solid enhancing mass in the right kidney, clinically suspected to be renal cell carcinoma. A right radical nephrectomy was performed, and histological and immunohistochemical features were consistent with LOT.

Antenatal care (ANC) is important care or attention given to a pregnant mother to ensure safety of the mother and child from time of conception to delivery. Antenatal care is the medical attention, monitoring, education, and support given to a pregnant woman from conception until the onset of labor. However, certain factors may hinder the smooth take up of the ANC. Therefore, barriers to antenatal booking are factors that delay or prevent pregnant women from registering for antenatal care (ANC), especially within the first trimester in rural areas. These barriers are usually interconnected. This study aimed to Assesse the Barriers to Early Antenatal Booking Among Women of Reproductive Age in Rural Areas of South-South, Nigeria. This was a cross-sectional study involving 250 pregnant women. Participants’ age is between 18 to 47 years. A well-structured questionnaire was administered to participants. The study lasted for a period of 3 months. Statistical analysis was done using SPSS version 25.0 and p < 0.05 was significant. The results revealed that 76% of the pregnant women are not aware that antenatal care should start in the first trimester of pregnancy, 72% are not aware that early antenatal booking helps detect pregnancy complication, 76% are prevented from early ANC booking due to cost, 68% is due to lack of money, 80% had low level of education, 80% prefer traditional birth attendants, poor roads, long waiting time, cultural belief, and permission from husband. The study revealed that educational and awareness barriers, sociocultural barriers, geographical and transportation barriers, socioeconomic barriers, health system–related barriers, psychosocial factors, pregnancy-related factors are major barriers to early ANC booking in rural areas.

We present the case of a 33 year old patient who has been followed since the age of 16 for autosomal dominant spondyloepiphyseal dysplasia (SED), in an evocative familial context (his sister has the same clinical picture). The disease began in adolescence with disabling mechanical pain in the hips and knees, with a walking distance limited to 500 metres. Clinical examination showed bilateral knee flexion contracture, generalised stiffness of the hips, shoulders, elbows, wrists and fingers, girdle muscle wasting, and a BMI of 16 (47 kg for 1.67 m). The patient walks with a cane. Symptomatic treatment combining analgesics, NSAIDs and physiotherapy was initiated. The article details the diagnostic arguments, indications for bilateral hip arthroplasty, anaesthetic precautions and the role of genetic counselling. Medium term outcome was favourable, with improvement in pain and walking distance after total hip replacement.

Neurologic symptoms during recovery from spinal anesthesia may reflect residual neuraxial block, but severe pain or persistent motor block can also indicate a compressive neuraxial emergency. A 49-year-old man underwent right knee arthroscopic surgery under spinal anesthesia with 14 mg of 0.5% hyperbaric bupivacaine. The neuraxial procedure was uncomplicated, and perioperative coagulation status was normal. At 225 minutes after intrathecal injection, he developed severe bilateral lower-extremity tightening and twisting pain extending to the buttock/saddle region, with Medical Research Council grade 0 motor strength in bilateral hip, knee, and ankle movements. Gross distal sensation in both feet was documented as present. Because cauda equina syndrome, spinal epidural hematoma, or another acute compressive neuraxial lesion could not be excluded clinically, urgent lumbosacral magnetic resonance imaging was obtained. Magnetic resonance imaging demonstrated left-sided disc extrusion at L4-L5 and L5-S1 with compression of the left L4 and S1 nerve roots; no epidural hematoma, central canal compression, or acute cauda equina compression was reported. The patient was managed conservatively with close observation and symptomatic treatment. Motor function recovered within hours, and at outpatient follow-up 29 days after surgery, no specific abnormality was documented. Severe bilateral leg pain with persistent motor block after spinal anesthesia should prompt structured neurologic reassessment and urgent imaging when compressive neuraxial pathology cannot be excluded clinically.

Background: Chronic caregiver stress is a frequently under-recognised contributor to physical and mental health morbidity. Sustained caregiving imposes significant psychosocial burden that often remains unaddressed within conventional biomedical frameworks. Case Presentation: We present the case of a 57-year-old married woman who has served as the primary caregiver for her adult daughter with cerebral palsy since birth. Over decades of caregiving, she developed multiple chronic gastrointestinal and systemic health problems, including gastroesophageal reflux disease (GERD), gastritis, hiatus hernia, irritable bowel syndrome (IBS), fatigue, and generalised musculoskeletal discomfort largely attributed to chronic stress and prolonged self-neglect. Management and Outcome: A holistic, psychosocially informed management plan incorporating pharmacological therapy, dietary counselling, stress management strategies, and connection to community and governmental social support services led to significant and sustained improvements in her gastrointestinal symptoms, fatigue, sleep quality, and overall well-being. Conclusion: This case highlights the critical importance of integrating psychosocial assessment and social support into routine primary care practice. Recognition of caregiver burden as a driver of physical illness is essential for delivering comprehensive, patient-centred care.

The research examined the changes in the gut microbiome in relation to acute diarrhea in Al-Qadisiyah Province, Iraq, which is the subject of a high public health burden in low- and middle-income communities where the regional patterns of the microbiome are scarcely known. The proposed cross-sectional case-control study was to be conducted at three hospitals in Al-Diwaniyah between March and November 2025, including 100 acutely diarrhea hospitalized patients and 100 controls who perfectly matched them in terms of age, sex, and residency. Analysis of fecal samples was conducted with the 16S rRNA V3-V4 sequencing on the Illumina MiSeq platform and bioinformatics analysis with QIIME2 2023.11. The findings showed that the microbial alpha diversity of cases relative to controls was significantly reduced and the Shannon index was significantly lower, which reveals a breakdown in microbial richness and evenness. Beta diversity analysis also showed distinct patterns of separation in compositions between groups. At the phylum level, patients showed a strong increase in Proteobacteria and a decrease in Firmicutes and Bacteroidetes, which indicates a change in microbiome towards a dysbiotic and inflammation-related one. Differential abundance analysis revealed the enriched presence of the important bacterial genera in patients, including Escherichia-Shigella and Streptococcus, and the positive taxa such as Faecalibacterium were more abundant in controls. It is noteworthy that microbial diversity was negatively correlated with the severity of dehydration and therefore the clinical implications of microbial diversity. The diagnostic potential of microbiome profiles was supported by the high accuracy in classification by a Random Forest model. Also, the presence of urban-rural gradients in the abundance of Proteobacteria suggests environmental factors, especially water quality, as the potential cause of dysbiosis. On the whole, these results have created a specific microbial profile of acute diarrhea in this area and have justified the creation of microbiome-based diagnostics and specific therapeutic interventions like probiotics.