Background Pancreatic cancers of the tail have an especially poor prognosis due to their late detection. An earlier diagnosis depends on a better understanding of the clinical course of the disease; however, much of the current literature focuses on pancreatic head adenocarcinomas owing to their higher incidence. Thus, we add our case report to the current literature of pancreatic tail cancers in the hope of aiding earlier detection. We present an interesting case of a patient who initially presented with innocuous abdominal pain and a single episode of vomiting who was subsequently diagnosed with metastatic pancreatic tail cancer. Case presentation A 56-year-old Hispanic man with a past medical history of alcohol and cocaine abuse was initially evaluated in our clinic after presenting to the emergency department with sudden onset of abdominal pain and one episode of emesis. On further questioning, he stated that he had been experiencing dull, intermittent left back pain for the past 2–3 years. Laboratory tests were performed, which showed that the patient had new-onset diabetes, and imaging revealed a pancreatic tail mass with metastases to the liver. Biopsy confirmed the diagnosis of stage IV metastatic pancreatic tail adenocarcinoma. During follow-up 1 month later, the patient reported that he had been largely asymptomatic since his hospital admission; however, his left back pain had increased in severity. He was then started on a FOLFIRINOX chemotherapy regimen (5-fluorouracil/leucovorin, irinotecan, and oxaliplatin). Conclusions There are many pitfalls in the diagnosis of pancreatic cancer, especially pancreatic tail cancer due to its vague symptoms. Thus, pancreatic cancer of the tail often presents late with a very poor prognosis. Because there is currently no widespread screening for pancreatic cancer, it is often difficult for practitioners to identify pancreatic tail cancers. Current research suggests that there is a strong association between new-onset diabetes after the age of 50 and pancreatic cancer, and tumors detected at the onset of diabetes are favorable to resection. Pancreatic cancer has also been shown to be associated with certain risk factors, such as smoking, high body mass index, chronic pancreatitis, and a family history of pancreatic cancer. Thus, when patients with presentations similar to our patient’s with new-onset diabetes after the age of 50, along with vague symptoms such as back or abdominal pain as well as the presence of risk factors, we suggest that it is beneficial for practitioners to maintain a high index of suspicion for pancreatic cancer.

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Results Preterm birth occurred in 15.6% (19/122), low birth weight (LBW) in 22.1% (27/122) and small for gestational age fetal weight in 19.7% (24/122) of cases, without significant variation due to the HIV-status (only infected or Aids) or antiretroviral use.Perinatal death occurred in 4.1% (5/122) of the cases. The Apgar score of less than or equal to 7 in the first minute was observed in 7.4% (9/120) and Zidovudine intravenous in prepartum was used in 92.5%(110/120) of cases. After a followup of more than 18 months of post:natal life, vertical transmission (TV) was verified in 6 cases (4.9%; 6/122). Conclusion LBW, small for gestational age fetal weight, preterm birth and perinatal death occurrences were higher than the expected values in this research, indicating the need for preventive actions. Disclosure No significant relationships.

Background; neuro-behavioral illness is the most common in both children and adolescents. It is characterised by carelessness and hyperactivity, which often cause behavioural and academic difficulties. It affects 3-12% of newborns with a male/female ratio of 3:1 to 9:1. Objectives and objectives; to evaluate the prevalence of ADHD in pre-school Governorate Al-Qalyubiya children; Themes and technology; This is a transversal study conducted in the governorate of Al-Qalyubiya with 1345 pre-school children. Field work was carried out throughout the first half of 2020, Results; ADHD subtypes and sex have had a significantly higher connection than ADHD-C and ADHD-HI in children than girls and ADHD-I subtypes in women compared to boys; Conclusion; ADHD is a major problem that young people between the ages of 3 and 6 frequently suffer from. Early detection and parenting programmes should be developed to enhance parental skills in the control of their child's behaviour.

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