Background and Objectives: Very low birth weight (VLBW) neonates are at risk of feed intolerance (FI) and necrotising enterocolitis. We planned this study to evaluate the risk factors for FI in VLBW neonates. Methods: Medical records of VLBW neonates admitted to the neonatal intensive care unit (NICU) during the study period were retrieved. Demographic and clinical characteristics of neonates with and without FI were studied. FI was defined as the presence of one or more of the following: Vomiting more than three times during the previous 24-h period, any episode of bile or blood-stained vomitus, an increase in abdominal girth of more 2 cm from baseline, abdominal wall erythema or tenderness, blood in stools. Factors associated with FI were identified by univariate analysis and those found significantly associated with FI were investigated using logistic regression analysis. Characteristics of neonates with Absent or reversed end diastolic doppler flow (AREDF), started on feeds within 24 h and after 24 h were also investigated. Results: Of 129 VLBW neonates enrolled in the study, 72 (55.8%) neonates experienced FI during NICU stay. The mean (standard deviation) birth weights and gestation of neonates in FI and No-FI groups were 1075 (231) and 1265 (201) grams (P < 0.01) and 29.5 (2.1) and 31.2 (2.5) weeks (P < 0.01), respectively. On univariate analysis, birth weight, gestational age and male gender were significant risk factors associated with FI. On multivariate analysis, gestational age and male gender were independent risk factors for FI in VLBW neonates. Among neonates with AREDF, there was no difference in the incidence of FI in those initiated on feeds within 24 h, versus those initiated after 24 h; 47.4%, 69.2%, respectively (P = 0.14). Conclusions: Lower gestation and male gender are significant risk factors for FI in VLBW infants. Early feeding <24 h in infants with abnormal Doppler flows is not associated with an increased risk of FI.

Background: COVID-19 has become a big challenge for the humanity and the public health; it is progressing in all the world and the number of cases exceeded the millions with a high rate of mortality. The disease is presented with a variety of symptoms and in different extents but predominantly with respiratory symptoms such as fever and shortness of breath. Methodology: It is a preliminary, descriptive cross-sectional study that includes 503 patients from four counties and more than ten isolation centres. It includes all the patients who were presented with frequency of urination in addition to the other disease's symptoms. The frequency of urination was identified by micturition frequency for more than 10 times a day with exclusion of the hormonal diseases related to the micturition. Results: 96.23% of the patients were presenting with fever and 89.28% of them with dry cough, only 39.68% of them were with mild to no symptoms. 59.72% of them urinated for 10–13 times per 24 h and 49.6% of them have the symptom for 3-day duration. 82.43% of the patients have a small amount of urine (<300 cc) for each micturition. Some of them were recognised to have diabetes mellitus, hypertension and urinary tract infections. Conclusion: Frequent urination can be considered a new symptom for COVID-19 with some criteria of presentation The duration of the symptom ranging from 3 days to 10 days, and it depends on the case and the patient's age and gender in addition to the severity of the disease.

Myofascial Pain Syndrome (MPS) is a general term indicating a widespread muscular pain that arises from the musculoskeletal system and showing the characteristics of trigger points. MPS is the primary cause of disability, and a common complaint among the working-class and the middle-aged population. It has been estimated to affect 25 million persons in the US alone, and three-fourths of the general population at some point in their lifetime. The various causative factors associated with this chronic muscular pain disorder are yet indecisive and still ambiguous. Up till now, the primary notion for the development of MPS occurs through mechanical trauma; either indirectly through chronic repetitive stress disorder as a result of overloading of muscle, or directly as a result of external force such as muscle contusion. Among other probable causes, lack of physical activities and dietary nutrient-associated conditions on health may too, be responsible for the development of MPS. Although there is a dearth of evidence and information to suggest the integrated role of physical activities and dietary nutrients on MPS; this study suggests the possible link between sedentary lifestyle-physical inactivity and nutritional deficiencies, and MPS. Food and nutrition, coupled with physical activity richly serve as the foundation for optimizing the overall health status. Eating the right food and staying physically active helps maintain a healthy body, reduces the overall risks of developing MPS and other associated chronic diseases such as cardiovascular diseases, hypertension, stroke and diabetes.

This report describes the development of deep vein thrombosis (DVT) and pulmonary embolism (PE) in a young healthy adult male who was driving an automatic car without interruption. There is mounting evidence that prolonged cramped sitting increases the risk of DVT of the legs and PE. We propose that a newer risk factor of seated immobility syndrome is the reason for this catastrophic development of DVT and PE in this patient.

Gastrointestinal stromal tumours (GISTs) are the most frequent mesenchymal tumours of the gastrointestinal tract, but they are rare in children. We report a case of a recurrent GIST that was first diagnosed in a 10 years old girl and underwent antrectomy. After 11 years, she again complained of vomiting and abdominal pain. Upper gastrointestinal endoscopy revealed a submucosal lesion in the posterior gastric wall. Computed tomography of the chest, abdomen and pelvis confirmed the absence of distant metastasis or enlarged lymph nodes. She underwent wide local excision with a safety margin and reconstruction. Pathologic examination of the excised mass confirmed the diagnosis of recurrent GIST. She is doing well without evidence of third recurrence or metastasis after 13 months of follow-up with a multidisciplinary team till present. GISTs are very uncommon in paediatric patients and patients should be managed in the context of a clinical trial and in tertiary centres familiar with the treatment of the disease.

Familial Mediterranean fever (FMF) is a hereditary auto-inflammatory disorder characterised by repeated attacks of fever associated with polyserositis. The association between multiple myeloma (MM) and FMF has been rarely reported. Here, we describe a 39-year-old male with a long history of FMF presenting with acute kidney injury that has been proved to be caused by myeloma cast nephropathy. To the best of our knowledge, this is the fourth case to be reported with such association in the literature.