Rare coexistence of disease or pathology Background:Situs inversus totalis (SIT) is an uncommon condition characterized as a congenital disorder in which the visceral organs are inverted relative to their typical anatomical position. SIT with double superior vena cava (SVC) is an even rarer presentation. Due to the underlying anatomical difference, the diagnosis and treatment of gallbladder stones in patients with SIT are challenging. Case Report:We report the case of a 24-year-old male patient who presented with an intermittent history of epigastric pain for 2 weeks. Clinical assessment and radiological investigations confirmed gall bladder stones with evidence of SIT and double superior vena cava (SVC). The patient underwent elective laparoscopic cholecystectomy (LC) with an inverted laparoscopic approach. The recovery from the operation went smoothly, the patient was discharged from the hospital the following day, and the drain was removed on the third postoperative day. Conclusions:Because anatomical variations in the SIT can affect localization of symptoms in patients with complicated gallbladder stones, the diagnosis of patients who have abdominal pain and SIT necessitates both a high index of suspicion and a thorough assessment. Although LC is considered to be a technically challenging surgery and calls for modification of the standard protocol, it is nevertheless feasible to perform the procedure effectively.To the best of our knowledge, this is the first time that LC has been documented in a patient who has SIT and double SVC.

Abstract Introduction Human Monkeypox (HMP) is an infectious disease attributed to the orthopoxvirus. HMP was firstly documented in humans in 1970 in the Congo. Since May 2022, multiple cases of HMP were identified in several non-endemic countries including some Middle Eastern countries.  Objective  This study aims to assess the knowledge about HMP among medical students in Jordan. Methodology  A cross-sectional study was conducted using online based questionnaire. A sample of 565 medical students completed the questionnaire during May 2022. The questionnaire collected data regarding source of knowledge, causative organism, natural host, mode of transmission, incubation period, signs and symptoms, duration diagnosis prevention, treatment and complications of the disease. Results Males constituted (39.6 %) of the total sample. Significantly higher rate of knowledge was detected among males (35.7%) vs. females χ2 =10.0, P = 0.002, fifth (60.9%) and sixth (43.8%), vs. first, second and third academic years, χ2 = 83, P<0.001. Correct knowledge about signs and symptoms showed the highest rate (43.0%), followed by an Incubation period, duration and prevention of disease, (33.3%, 32.6% & 31.0%, respectively). On the other hand lowest knowledge exhibited regarding; natural host (5.0%), mode of transmission, (9.2%), psychosocial impact, (9.2%), vulnerable age group (14.2%), and complications (14.2%). Majority of students (82.3%) claimed that their knowledge was earned from social media followed by TV (16.3 %,), and the    university (8,5%).TV had the highest rate (47.8%) with adequate knowledge, χ2 =20.6, p <0.001            interestingly, 71,7% of the respondents had inadequate knowledge about the outbreak and 70,7% of them, the social media was their source of knowledge.   Conclusion Gender and higher academic year are significantly associated with adequate knowledge. Social media is significantly associated with inadequate knowledge among students.   Key words: Knowledge, Monkeypox, Social Media, Infectious Disease

Pompe disease, or type II glycogen storage disease, is a lysosomal storage disorder in which a deficiency in alpha-glucosidase results in the accumulation of glycogen, which eventually causes weakness to progressively increase and heart enlargement.  Infantile-onset and late-onset forms of Pompe illness are distinguished. The heart is the organ most impacted by glycogen buildup in infantile-onset Pompe illness. A late-onset form, however, frequently presents as a weakening of the skeletal muscles that worsens over time. The key factor used to make the diagnosis of Pompe illness is enzymology, which shows a lack of lysosomal acid alpha-glucosidase (GAA) activity, although molecular genetic testing for GAA mutations can also be used to confirm the diagnosis. Recombinant human a glucosidase alfa and a large multidisciplinary team are required for the treatment of patients with Pompe disease (rhGAA, MyozymeR). Two cases of Pompe disease are presented in this case-report. A 13-year-old female patient who is still alive and receiving enzyme replacement therapy, and a 5-month-old newborn who died from cardiomyopathy.

Dumping syndrome (DS) is a typical side effect of stomach surgery, which includes cancer, non-cancer esophageal and gastric surgery, and bariatric surgery. It is marked by the fast evacuation of undigested food from the stomach into the small intestine, which causes a variety of symptoms. Early dumping symptoms include gastrointestinal symptoms such as stomach discomfort, diarrhea, and nausea, as well as vasomotor symptoms such as drowsiness and face flushing, and occur within the first hour following a meal. Late dumping symptoms appear one to three hours after a meal and are related to reactive hypoglycemia, resulting in hypoglycemia, sweating, palpitations, and confusion.Early dumping pathophysiology involves abnormalities in stomach structure and function, which result in rapid transit of stomach contents to the duodenum, insufficient digestion, and fluid transfers from the vascular compartment to the intestine. Late dumping occurs as a result of hyperinsulinemia caused by the fast passage of undigested foods to the gut. Symptom-based questionnaires and diagnostic testing such as plasma glucose measurement and stomach emptying studies can be used to confirm a diagnosis of DS.The primary approach to managing DS is dietary modifications, including eating smaller, more frequent meals and avoiding high glycemic index carbohydrates. Dietary supplements and medications may be used to slow down gastric emptying or control blood glucose levels. Pharmacological options include alphaglycosidase inhibitors, somatostatin analogs, glucagon-like peptide-1 analogs, and sodium-glucose cotransporter inhibitors. In severe cases, refractory to conservative measures, surgical interventions may be considered.DS can arise in children following gastric surgery for obesity or corrective surgery for congenital abnormalities. It is frequently misdiagnosed and can have serious implications, such as hypoglycemiarelated cognition deficits. Screening and early identification using glucose tolerance testing and continuous glucose monitoring (CGM) are critical in at-risk youngsters. Children's treatment techniques are similar to those used in adults, with dietary changes and medication therapies serving as the cornerstone of care.Overall, DS is a complex condition that requires a multidisciplinary approach to diagnosis and management. Further research is needed to improve understanding of its pathophysiology and optimize treatment strategies, particularly in children.This review aims to provide a well-rounded informative summary of the most recent literature on the underrecognized clinical and scientific aspects of DS among the children age group. It incorporates the quality of life, pathophysiology, diagnosis, prevalence, and treatment.