is frequent, loose, or watery bowel movements (BMs) that differ from a child's normal
pattern, as is a very common problem, leading cause of child mortality and morbidity worldwide.
In children acute watery diarrhea (several hours or days), acute bloody diarrhea (dysentery), and
persistent diarrhea, which lasts 14 days or longer. Gastroenteritis most common symptoms regardless
of cause, are vomiting, diarrhea, and sometimes abdominal cramps, fever, and poor appetite.
The risky complication of gastroenteritis is dehydration. The dehydrated children become listless,
irritable, or sluggish (lethargic), but dehydrated infants develop serious side effects with hospitalized
medical care. The causative agents of diarrhea in children are viruses, particularly rotavirus
(preventable with a vaccine) and norovirus, as well as adenovirus and arbovirus, bacteria
like E. coli, salmonella and cholera. Protozoal parasites causing diarrhea as Cryptosporidium, Entamoeba,
Giardia, Balantidium coli and Cystoisospora belli as well as helminths as Strongyloides,
Schistosoma and Trichuris may cause chronic diarrhea especially in immunocompromised individuals.
Apart from microorganism agents, diet, antibiotics and others can cause children diarrhea.
Key words: Children, Diarrhea, Pathogenesis, Bacteria, Parasites, Viruses, Others

Background: Bladder cancer preservation treatment achieved 5/10-year overall survival rates comparable to those of radical cystectomy. Bladder-preserving trials have recommended coverage of pelvic lymph nodes (LN) in radiation portals (micrometastases in pelvic LN 25 to 44%). Gemcitabine-based radiotherapy did not include the pelvic LN in the radiation portals to minimize bowel toxicity. However, the pelvic LN irradiation debate has been highlighted. The present study aimed to evaluate the role of pelvic LN irradiation in negative node, bladder cancer.
 
Method: A prospective study was conducted from October 2017 to February 2020 at the South Egypt Cancer Institute. Bladder cancer Patients with cT1-3, N0, and M0 underwent maximum TURBT and were then randomized into two arms: Group A: Bladder-only irradiation (52.5 GY/20 frs); Group B: Pelvic nodal irradiation with weekly gemcitabine 100mg/m2 
Statistical analysis: SPSS Statistics (version 26.0, IBM), descriptive (means and SD), chi-square test for qualitative variables, independent student t-test, and survival analysis (Kaplan-Meier). 
Results: Patients aged 37 to 76 years old and 32 to 82 years old in groups A and B, respectively. Cases were Stage III in groups A, II, and III in B. Both groups showed similar local control rates (90% and 92%, respectively). Favorable toxicity profile group A schedule emphasizes high local control with low-grade intestinal toxicity (no G3 enteritis). Unexpectedly, Group A showed significantly higher progression free survival (PFS over Group B (P < 0.034).
Conclusion: Bladder-only chemoradiation has non-inferior local control of node-negative bladder cancer with significantly higher PFS. The pelvic nodal radiation field has an unfavorable toxicity profile (higher G2 enteritis).

Highlights

Keywords

• Pelvic radiation
• Radiotherapy
• Urologic neoplasms
• Muscle invasive carcinoma
• Hypofractination

Main Subjects

• Cancer Imaging and non-surgical Interventions

Keywords

• Bowel ultrasound
• Ulcerative Colitis
• Elastography

Main Subjects

• Diagnostic Radiology.
• Internal Medicine.

Cardiovascular diseases have become a leading global health burden, with rising mortality worldwide. WNT and JAK/STAT have been highlighted as emerging biomarkers in cardiovascular disease pathogenesis. This study assessed the Wnt/JAK-STAT signaling pathway in relation to SFRP5 and genetic polymorphisms in cardiac patients. This prospective case–control study included 100 patients with various cardiac diseases (IHD, valvular heart disease, HF, cardiomyopathy, and arrhythmia) and 50 matched healthy controls. Clinical and echocardiographic assessments were performed. Plasma SFRP5, Wnt5a, and JAK levels were measured using ELISA; STAT5A expression by flow cytometry; and SFRP5 (rs780369540) gene polymorphism by TaqMan real-time PCR were also performed in all participants. Cardiac patients showed significantly higher median BMI (33 vs. 28.5 kg/m², p = 0.001) and markedly increased median value of each Wnt5a (16.85 vs. 5.6 pg/mL, p < 0.001), median JAK (9.45 vs. 2.4 pg/mL, p < 0.001), and STAT5A expression (87.55% vs. 33%, p < 0.001), with lower SFRP5 levels (4 vs. 6.7 ng/L, p < 0.001) compared to control. The SFRP5 (rs780369540) T allele was more frequent in patients (51.5% vs. 32%, p = 0.001), and dominant TT + TC genotypes were higher (66% vs. 42%, p = 0.005) compared to the control group. TT carriers showed higher median Wnt5a, lower median SFRP5, and reduced ejection fraction compared to other genotypes (TC, CC) carriers. Multivariate analysis identified elevated Wnt5a, JAK, and decreased SFRP5 as independent predictors of cardiovascular disease (p < 0.05). Cardiac patients …