A better understanding of the impact of habitat loss on population density can be achieved by evaluating effects of both, parameters within remnant habitat patches and parameters of the landscape surrounding those patches. The integration of predictors at the patch and landscape level is scarce in animal ecological studies, especially for reptiles. In this study, a patch-landscape approach was applied to evaluate the combined effects of within patch habitat quality, patch geometry and landscape configuration and composition on the density of remnant populations of the eastern green lizard, Lacerta viridis, in a highly modified landscape in Bulgaria. Landscape composition variables (proportion of different land covers) were measured at different spatial scales surrounding patches. Single scale models were built to evaluate combined effects of all predictors on density, when including all landscape composition variables at a specific spatial scale. Multiscale models were applied to analyze combined effects when including landscape composition variables at the scale of their strongest effect (scale of effect, SoE). Results showed that the SoE of proportion of cropland and urban areas was small (50 m), while for proportion of habitat was large (1.5 Km). The overall effect of habitat loss was better explained by the multiscale model. Population density increased with patch area and decreased with patch shape irregularity and with the proportion of three land cover types surrounding patches -cropland, urban areas and habitat. Combining patch and landscape parameters is important to identify ecological processes that occur simultaneously at different spatial levels and landscape scales, and which would imply the application of multiscale approaches for the protection of wild animal populations. Results are contrasted with what is known about occupancy patterns of the species in the same region, and approaches to integrate both, occupancy and density, in the field design of animal ecological studies are suggested.

IntroductionInvasive mucinous adenocarcinoma (IMA) is a special subtype of adenocarcinoma according to World Health Organization classification. IMA accounts for an estimated 2–10% of all lung cancers [1, 2]. Overall, 60–90% of IMA cases present with solitary nodules, mass shadows, or ground-glass opacity lesions, but there are also cases of extensive extension with multiple nodules or diffuse alveolar shadows. Therefore, it is sometimes necessary to distinguish the lesions from benign pulmonary diseases such as pulmonary tuberculosis, sarcoidosis, lipoid pneumonia, and alveolar proteinosis [3, 4]. In addition, it is often detected at an advanced stage, which makes it difficult to treat surgically; however, limited reports of such cases have been described [2]. Here we describe a case of IMA that was detected preoperatively as an infiltrative shadow over the entire right lower lung lobe and treated with surgical resection along with a review of the literature.

Cervical Spinal Injury as a Presentation of Multiple Myeloma: A Case ReportLeon Smith, Vicky Li and Simon ChanRehabilitation and Aged Care Services, Hornsby Ku-Ring-Gai Hospital, Hornsby 2077, NSW AustraliaKeywordsCase Report Spinal Injury Multiple MyelomaAbstractSpinal cord injury is a devastating complication of cancers that exert physical compression on the spinal cord. Multiple myeloma is known predominantly as a condition that involves bony structures and can manifest with complications such as pathological fractures. However, involvement of other structures including the CNS or the spinal cord is a possible complication, with potentially catastrophic consequences. We describe a case of multiple myeloma presenting initially as spinal cord compression in a 79-year-old man.IntroductionMultiple myeloma is a condition characterized by malignant proliferation of plasma cells, with production of monoclonal immunoglobulin (most commonly of the IgG variety), affecting over 100 000 individuals worldwide per year(1). Approximately 2500 Australians are diagnosed with multiple myeloma every year(2). Median age at diagnosis in Australia is 67, and 60% of patients are male(3). Initial treatment in Australia usually consists of bortezomib based treatments, with the most common first line regimen being bortezomib, cyclophosphamide, and dexamethasone(3). Overall survival from diagnosis is averages approximately 5 years(3).Interactions between malignant plasma cells and osteocytes results in decoupling of bone absorption and formation, mediated through a number of pathways including RANK/L, OPG and Wnt, which leads to the presence of lytic bone lesions(4). Pathological fractures can result from skeletal disease; as such, skeletal surveillance is recommended in multiple myeloma and pathological fractures are a potential complication of skeletal disease(1). However, involvement of other organ systems by expansion of myeloma lesions is also a potential complication, with severe consequences. In the case of the spinal cord, compression from vertebral myeloma can lead to significant neurological compromise and functional impairment(5,6).We describe a case of multiple myeloma of T1 resulting presenting with severe paraplegia in a previously healthy 79-year-old man.Case PresentationA 79-year-old Caucasian man presented to the emergency department of his local hospital with a 4 week history of atraumatic thoracic back pain, localized between the scapulae, complicated by acute-onset paraplegia in the preceding 48 hours. He described 2 days of lower leg weakness and difficulty mobilizing with an unsteady gait, before developing severe lower limb weakness and inability to mobilise. At the time of presentation, he reported no bladder or bowel incontinence. He reported about 6 kg of unintentional weight loss in the preceding 4 weeks, and some months of atraumatic right elbow pain.His only medical history was hypertension and stable coronary artery disease. His medications at the time of presentation were rosuvastatin 20 mg daily, metoprolol 25 mg twice daily, amlodipine 5 mg daily, aspirin 100 mg daily, and Olmesartan 20 mg daily. He lived with his partner, had never smoked and consumed an average of 2 standard drinks of alcohol per night.On examination in the emergency department, he had MRC grade 5/5 power bilaterally in the upper limbs, but grade 0 in all movement in the lower limbs. Reduced sensation to light touch was present below the level of the umbilicus. Reflexes were absent in the left lower limb, and only the patellar reflex was present in the right lower limb. No anal tone was apparent on digital rectal exam. Saddle anaesthesia was also present.An urgent CT scan in emergency revealed a T1 vertebral lesion with involvement of the vertebral body and posterior elements with epidural extension causing severe canal narrowing, and numerous bony lesions suggestive of myeloma. The patient was urgently transferred to the nearest tertiary referral centre for neurosurgical involvement. A spinal MRI performed upon arrival confirmed the presence of severe cord compression at the T1 level, with complete infiltration of the T1 vertebra, and pathological T1 fracture with 50% loss of body height (Figure 1). An urgent posterior cervical decompression and fusion occurred within 12 hours of presentation.

Aim To evaluate the performance of ChatGPT in key areas of clinical pharmacy practice, including prescription review, patient medication education, adverse drug reaction (ADR) recognition, ADR causality assessment, and drug counseling. Methods Quantitative and qualitative analyses were conducted to assess the accuracy and quality of ChatGPT in comparison to those of the clinical pharmacist. Results The results indicate that ChatGPT is excellent in drug counseling and weak in prescription review, patient medication education, ADR recognition, and ADR causality. Conclusions While ChatGPT holds promise in clinical pharmacy practice as a supplementary tool, the ability of ChatGPT to handle complex problems needs further improvement and refinement.

In this study, It was aimed to determine the effects of different production and preservation methods on the shelf life and quality of the Gemlik variety natural black table olives produced with low salt (2%). For this purpose the olives processed with traditional Turkis turning black olive using starter culture The MAP (Modified athmosphere packaging), vacuum and gamma irradiation method (1, 3 and 5 kGy) was applied for the first time in the preservation of table olives. The reducing effect of 5 kGy dose on total phenolic substance and DPPH antioxidant activity was found to be higher than other doses. During storage, pH (4.30-4.83) and titratable acidity (0.68-1.02%) values of black table olives changed in normal course. At the and of the fermentation and storage, total phenolic substance and DPPH antioxidant activity decreased and were found statistically significant (p<0.01). During the storage period, the total amount of phenolic matter in olives in normal production (without starter culture) decreased from 232 to 144 mgCAE/100g and in starter culture added table olives from 200 to 138 mgCAE/100g. As a result of the study, it was ensured that table black olives produced with less salt (2%) could be stored on the shelves for at least 6 months without using any preservatives. In addition, radiation effect on quality was relatively similar to other applications.

Introduction: Coronavirus disease-2019 (COVID-19) is a novel infection, that first appeared in Wuhan, China. It has been well established that different organs including the heart, kidney, pulmonary and gastrointestinal systems might be involved during or post COVID-19 infection. A possible reason is that the virus enters host cells through the angiotensin-converting enzyme 2 (ACE 2) receptor and this receptor is expressed by different human organs [1]. ACE 2 receptor is also expressed in different parts of the eyes including the conjunctiva, cornea, limbus, aqueous humor, and retina [2].In addition, COVID-19-associated multisystem inflammatory syndrome in children (MIS-C) can affect different organ systems including skin, renal, cardiac, hematological, and gastrointestinal systems. But ocular involvement is not still a part of the world health organization (WHO) criteria or the Center for Disease Control and Prevention criteria for MIS-C [3].Whether uveitis or optic disk edema would be manifestations of acute COVID-19 infection or they can occur as a part of COVID-19-associated MIS-C is still unknown.

Fish often spawn eggs with ovarian fluids that have been hypothesized to support sperm of some males over others (cryptic female choice). Alternatively, sperm reactions to ovarian fluids could reveal male strategies. We used wild-caught lake char (Salvelinus umbla) to experimentally test whether sperm react differently to the presence of ovarian fluid, depending on male breeding coloration, male inbreeding coefficients (based of 4,150 SNPs), or the kinship coefficients between males and females. Male coloration was positively linked to body size and current health (based on lymphocytosis and thrombocytosis) but was a poor predictor of inbreeding or kinship coefficients. We found that sperm of more colorful males were faster in diluted ovarian fluids than in water only, while sperm of paler males were faster in water than in ovarian fluids. We then let equal numbers of sperm compete for fertilizations in the presence or absence of ovarian fluids and genetically assigned 1,464 embryos (from 70 experimental trials) to their fathers. The presence of ovarian fluids significantly increased the success of the more colorful competitors. Sperm of less inbred competitors were more successful when tested in water only than in diluted ovarian fluids. The kinship coefficients had no significant effects on sperm traits or fertilization success in the presence of ovarian fluids, although parallel stress tests on embryos had revealed that females would profit more from mating with least related males rather than most colored ones. We conclude that sperm of more colorful males are best adapted to ovarian fluids, and that the observed reaction norms suggest male strategies rather than cryptic female choice.

Aims Information on breastfeeding and the safety of biologics in infants is lacking due to difficulties in case collection. We evaluated a method for determining the concentration of biologics in breast milk using a dry filter method that can simplify the collection, storage, and transport of breast milk. Methods To generate dried filter paper (DFP) samples, approximately 30 L of breast milk was placed onto a Whatman 903 card and punched out. After extraction, the supernatant was measured using an enzyme-linked immunosorbent assay. Three concentrations of each drug were prepared in liquid breast milk (LBM) and DFP samples for stability testing, which confirmed that samples were stable up to 28 days after storage at 2–8 ºC or -20 ºC for LBM and at 25±5 ºC for DFP. LBM and DFP samples were provided by lactating mothers using biologics during lactation. Drug concentrations were compared. Results Breast milk was provided by 12 lactating mothers (tocilizumab, n=4; abatacept, n=2; etanercept, n=1; golimumab, n=1; sarilumab, n=1; and belimumab, n=3). The accuracy and precision of measurements for the six drugs were within acceptable limits. After 28 days, concentrations remained at more than 90% under all storage conditions. The quantitative values of the provided LBM and DFP samples were similar. The maximum relative infant dose ranged from 0.09% to 1.12%, which was an acceptable range. Conclusion A method for determining the concentration of biologics using DFP is expected to help improve pharmacotherapy for lactating women.

The purpose of inter-animal communication is to allow signals released by the animal to be perceived by others. Scent marking, with its characteristics of specificity and delay, is thought to be the primary mode of communication in giant pandas (Ailuropoda melanoleuca). The “signal detection theory” predicts that animals choose the substrate and location of their scent marks so that the signals released are transmitted more widely and remain longer. As an energetically marginal species, the cost of generating and marking chemical signals is costly for pandas, so they are predicted to make trade-offs in scent marking. However, existing studies do not account for the selective preferences of pandas for marking, as they are only explained by the density of marks at a certain location. Our study wanted to investigate whether the marking behavior of pandas is indeed consistent with signal detection theory. For the first time, we propose to use fecal counts to reflect the intensity of habitat use by pandas, combined with mark counts to determine the selective preference for marking. Our findings show that the scent marking behavior of pandas is consistent with signal detection theory, and that they go out of their way to ensure that their marks are detected. The results of the study will help us to further develop the conservation of pandas and their habitats.

This review presents a comprehensive examination of fully conjugated covalent organic frameworks (COFs), which constitute an emerging class of porous materials with immense potential for diverse applications. This article focuses on diversified fully conju-gated COFs, including sp2 carbon-carbon linkages, pyrazine linkages, benzobisoxazole linkages, dioxin linkages, β-aminoalkenone linkages, etc. The synthesis techniques and structural attributes of these COFs are expounded upon in great detail, along with their potential applications in various fields. The review thus provides a valuable resource for researchers keen on delving into the synthe-sis and applications of fully conjugated COFs, thereby highlighting their potential for developing novel functional materials with dis-tinctive properties.

Hydrological models require a complete and accurate time series of weather inputs to adequately represent watershed-scale responses. The Global Historical Climatology Network (GHCN) is the most comprehensive ground-based global weather database and is often used in hydrological modeling studies. Since higher density, lower reliability precipitation measurements from private citizens collected by the Community Collaborative Rain, Hail, and Snow (CoCoRaHS) network data were integrated into the GHCN, hydrological modelers in the U.S. have access to a much greater amount of weather data. However, the benefit of using CoCoRaHS data has not been assessed. The objectives of this work were to develop a method for generating a complete weather data time series based on the combination of data from multiple GHCN monitors and to assess several methods for estimation of missing weather data. Weather data from GHCN monitors located within a specific radius of a watershed were obtained and interpolated using three estimation methods (Inverse Distance Weighting (IDW), Inverse Distance and Elevation Weighting (IDEW), and Closest Station), creating a seamless time-series of weather observations. To evaluate the performance of the methodologies, weather data obtained from each estimation method was used to force the Soil and Water Assessment Tool (SWAT) models of 21 U.S. Department of Agriculture-Conservation Effects Assessment Project watersheds in different climate regions to simulate daily streamflow for 2010-2021. Except for three watersheds, all SWAT models had Nash-Sutcliffe Efficiency above 0.5, the ratio of the root mean square error to the standard deviation of observations below 0.7, and percent bias from -25% to 25% with a satisfactory performance rating. Overall, IDEW and IDW performed similarly, and the Closest Station method resulted in the poorest streamflow simulation. A comparison with published SWAT model results further corroborated improved model performance using newly combined GHCN data with all Closest Station, IDW, and IDEW methods.

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Background: Small air filled peripheral subpleural cysts are a well described feature of pulmonary anatomy at computerised tomographic (CAT) scan in children with Trisomy 21, yet only anecdotally described in association with other pathologies. The significance of these cysts is unknown. Objective: To investigate and explore the pathogenesis of these subpleural cysts in children. Materials and Methods: A retrospective review of 16 cases with subpleural cysts diagnosed on CT chest was performed. The distribution, location and ancillary CT findings were recorded. Hospital charts were reviewed for clinical details, especially cardiac abnormalities, pulmonary artery hypertension (PAH) and genetic associations. Histopathological and clinical correlative data were recorded. Results: 11/16 children (69%) were found to have an underlying chromosomal or genetic abnormality, six of whom had Trisomy 21. The remaining 5/16 cases (21%) had miscellaneous disorders without an identifiable genetic basis. The most common co-morbidities were cardiac abnormalities (81%) and PAH (62.5%). Regardless of their underlying etiologies, the cysts were present bilaterally in most cases (14/16, 88%). We observed both the postnatal development and the progression of cysts in our cohort . On long term follow-up, there were five deaths (31%) and six cases (38%) requiring maintenance oxygen therapy due to chronic hypoxia. Two cases (12.5%) became completely asymptomatic after correction of their underlying abnormalities. Conclusion: Subpleural cysts are not exclusive to Trisomy 21 and may be seen in other inherited or acquired causes, likely due to altered alveolar growth. We suspect these cysts are a sign of an underlying developmental disorder with variable clinical effect, especially in children with congenital cardiac disease.

A photo-triggered cascade cyclization of silyl enolate to prepare angularly fused tricyclic scaffold is developed. The reaction demonstrates good substrate scope and stereo-selectivity. The excellent stereo- and regio-selectivity for this cascade reaction is elucidated via conformational analysis and DFT calculation, respectively.

IntroductionMultiple Sclerosis (MS) is a chronic autoimmune disorder causing nerve sheath demyelination and symptoms such as muscle weakness, mobility decline, and lack of coordination 1,2, generating unique health challenges and an economic burden 3-5. Patients experience reductions in bone and skeletal muscle mass6, muscle strength and function 7,8, and increased fracture risk 9, negatively impacting quality of life 10. Lower limb strength impairments8, poor balance 11 and spasticity12 also contribute to a lower quality of life10. Pharmacological treatments have been the primary option for patients with MS 13.Recent research has explored non-pharmacological treatments such as exercise, nutritional supplementation, and improved sleep quality14-21. Resistance exercise (RE) is particularly beneficial for MS rehabilitation, as it improves muscle strength and function, mobility, quality of life 22,23, and the immune system 24. High-dose vitamin D supplementation raises interleukin-10 (IL-10) levels in MS patients19, who tend to have lower levels of IL-10, which may contribute to the disease’s development 25. However, RE and vitamin D may not always improve physical fitness20,21. This could be due to unsatisfactory energy and protein intake, containing essential amino acids (EAA), which are necessary to stimulate muscle protein synthesis (MPS) and ultimately address sarcopenia 26, a condition prevalent in MS patients 27. EAA-based supplements enriched with L-leucine increase protein intake and optimise MPS in healthy older adults without compromising total energy intake during mealtimes28,29 and plasma EAA concentration is associated with muscle function in older women in the community 30. A higher protein intake, including specific amino acids, may positively impact bone health through mechanisms such as increasing insulin-like growth factor 1 (IGF-1) 31,32. Therefore, addressing dietary protein deficiencies alongside RE may optimise musculoskeletal health and function in female MS patients. This case study evaluated the effects of a 24-week home-based intervention, including EAAs and vitamin D3 supplementation, on muscle, bone, muscle strength, and function in a female patient with MS.

Indiscriminate use of antibiotics has led to the emergence of antibiotic resistant microbes and the loss of natural flora in aquaculture systems ultimately necessitating the ban of many of the chemotherapeutants in aquaculture. Actinobacteria play a profound role in the biogeochemical cycling in the marine environment and they represent the principal source of secondary metabolites with antimicrobial property. In the present study, 98 marine derived actinomycete isolates were screened for antimicrobial activity against the common aquatic pathogens. A potent actinomycete isolate S26, identified as Streptomyces variabilis based on 16S rRNA gene sequencing was used for further study. Optimization of the fermentation medium for secondary metabolite production was carried out by response surface methodology (RSM) using DESIGN EXPERT. The ANOVA of the quadratic regression model demonstrated that the model was highly significant for the response concerned i.e., antimicrobial activity as evident from the Fisher’s F- test with a very low probability value [(P model>F) = 0.0001]. Of the 10 different solutions suggested by the software, the most suitable composition was found to be starch, 1.38 %; soy powder, 0.88 %; ammonium sulphate, 0.16 % and salinity, 27.76 ‰. S. variabilis S26 cultured in the optimized production medium was applied in the Penaeus monodon larval rearing system and the total Vibrio count and survival rate were estimated. S. variabilis S26 treatment showed a significant reduction in Vibrios and better survival in the Penaeus monodon culture system compared to the control.

A hunting arrow traumatism to the head: a case report from NigerAssoumane Issa Ibrahim1,2, Roméo Bujiriri Murhega1,2,3 , Sanoussi Samuila1,21. Department of Neurosurgery, National Hospital of Niamey, Niamey, Niger 2. Faculty of Health Sciences of the Abdou Moumouni University of Niamey, Niger 3. Faculty of medicine, catholic university of Bukavu, Democratic Republic of Congo Corresponding author : Roméo Bujiriri Murhega, quartier Harobanda, ville de Niamey, Niger, +22782078866,[email protected], ORCID: 0000-0002- 0022-6355Key clinical message Arrow injuries have not disappeared in our environment despite the advances in the development of warfare tools in the world. All regions of the body can be the target of these arrows and in particular the cephalic region whose gravity will depend on the structures reached. Abstract With the development of modern weapons of war, arrow wounds have become rare in developed countries, but they are still common in developing countries, including Niger. These injuries are often serious and life-threatening when they are in the head and neck region, due to the presence of major vessels and vital organs in these areas of the body. Extraction of these arrows is usually difficult due to the proximity of major vital structures. Unskilled extraction can aggravate the injury or result in unintentional damage to vital structures with imminent risk of death. We present the case of a patient with a homemade arrow to the head in the left periorbital region that we successfully extracted at the National Hospital in Niamey. Our objective is to highlight the experience with this patient and review some reports in the literature.Keywords: Arrow wounds, head wounds, NiameyIntroduction Since ancient times, since prehistoric times, arrows have been used as weapons of war in many civilizations, including African civilizations.1 With advances in technology, arrows as weapons of war are now almost abandoned in developed countries. Nevertheless, in developing countries, arrow injuries are still a reality.1,2In developing countries, for example, penetrating head injuries occur most often after fights and conflicts between farmers, and these situations are much more frequent in practice than the rarity of reported cases would suggest.2,3Arrow injuries are very rare.4,5 All areas of the body can be targets, including the cephalic region, and the severity of which depends on several factors. Among these factors, we cite, the distance at which the arrow was shot, the degree of penetration of the arrow and the application or not of poison on the arrowhead, which is a common practice.1 These injuries can affect any part of the human body, including the head and neck and can be fatal.6 These head and neck injuries are often life-threatening due to the presence of major vessels and vital organs. Management of these injuries is not always easy due to the proximity of major vital structures. We report on a patient who received a left periorbital arrow and was successfully treated.Case Report A 42-year-old patient from a region far from Niamey (the Diffa region), located 1,318.8 kilometers from the city of Niamey, was referred to the surgical emergency room of the national hospital in Niamey five days after a fight between farmers over agricultural land. On admission, he presented with an impacted arrow in the left orbital rim 1 cm lateral to the medial canthus (Figure 1). The patient was conscious, without signs of intracranial hypertension or focal signs. His vision was normal. The CT scan performed showed the extracranial path of the arrow. It crossed the left orbital rim, the base of the nose to the right external canthus without penetrating the cranium (Figure 2 ). The patient had received antibiotics and tetanus prophylaxis. He underwent wound exploration with arrow removal under general anesthesia(Figure 3). The arrow was approached through a left eyebrow incision. Dissection was completed to the tip of the arrow, and the arrow was gently removed. The patient did well after surgery, no complications were recorded, and he was discharged 1 week after admission. Postoperative follow-up has not noted any particularities to date and the wound has healed well (Figure 4). Discussion Head injuries are a major global public health problem. These traumas encompass a wide range of etiologies.7 Among these etiologies we can mention, accidents on the public road, accidents at work, sports, trauma by bullets, trauma by arrows etc. Head injuries from arrows are too rare in developed countries, but in developing countries they have not disappeared despite advances in the field of tools of war. In developing countries, peasants still value their agricultural land, which is a source of wealth and economy.2 Nevertheless, conflicts between them are frequent and are the source of fights that most often involve bladed weapons, including arrows. In this work we report the case of a patient suffering from an arrow trauma to the head after agricultural conflicts in his village. In the literature, very few cases are reported on head injuries by arrow. The clinical manifestation of penetrating arrow injuries in the head area depends on the structure affected and the severity of the injury. The degree and severity of the injuries depend on the distance at which the arrow was fired, the trajectory it followed, the degree of penetration and the possible application of poisons to the tip of the arrow.8 Poisoned arrows cause paralysis or severe infection of the wound depending on the nature of the poison.2,9 Poisoned arrows cause paralysis or severe infection of the wound depending on the nature of the poison.2 Brain and spinal cord injuries can lead to paraplegia, quadriplegia, ventricular hemorrhage, or immediate death.1 The good news is that our patient the path of the arrow was exclusively extracranial and the large vessels were not affected. The emergency action to be taken will depend on the clinical condition of the patient at admission. Patients whose injuries are immediately life-threatening should be treated urgently, while those who are clinically stable and have optimal hemodynamic status are examined before the decision to explore is made.10,11 Our patient was clinically stable and had received a complete and unremarkable clinical examination. CT scan is an essential examination for the lesion assessment of patients with arrow trauma to the head.1It is usually indicated in patients who are hemodynamically stable, which was the case for our patient. The scanner is a non-invasive diagnostic tool that determines the trajectory of the arrow and its relationship with vital structures.12 An attempt at blind extraction can lead to a serious disaster, especially if major vessels have been hit. Our patient was able to perform the cranioencephalic CT scan which clearly showed us the extracranial trajectory of the arrow.Conclusion Arrow wounds to the head have never disappeared in developing countries despite advances in the manufacture of tools of war. Care is difficult when noble structures are affected. The prognosis is life-threatening when there is damage to the large vessels, especially in a context of limited resources. The urgency of the emergency always depends on the patient’s clinical condition at the time of admission to hospital.ACKNOWLEDGMENT NoneCONFLICTS OF INTEREST NoneAUTHOR CONTRIBUTIONS Assoumane Issa Ibrahim and Roméo Bujiriri Murhega have designed, conceptualized the study, and written the first draft under the supervision of Sanoussi Samuila .ETHICAL STATEMENT This case report received ethical clearance from the Ethical committee of the university of the first author.CONSENT Written informed consent was signed by the patient prior to the publication of this paperDATA AVAILABILITY STATEMENT All the materials used in this study are available on request.Bibliography 1. Abdullahi H, Adamu A, Hasheem MG. Penetrating Arrow Injuries of the Head and-Neck Region: Case Series and Review of Literature. Niger Med J J Niger Med Assoc. 2020;61(5):276-280. doi:10.4103/nmj.NMJ_17_20 2. Olasoji HO, Tahir AA, Ahidjo A, Madziga A. Penetrating arrow injuries of the maxillofacial region. Br J Oral Maxillofac Surg. 2005;43(4):329-332. doi:10.1016/j.bjoms.2004.10.026 3. Olasoji HO, Tahir A, Arotiba GT. Changing picture of facial fractures in northern Nigeria. Br J Oral Maxillofac Surg. 2002;40(2):140-143. doi:10.1054/bjom.2001.0716 4. Peloponissios N, Halkic N, Moeschler O, Schnyder P, Vuilleumier H. Penetrating thoracic trauma in arrow injuries. Ann Thorac Surg. 2001;71(3):1019-1021. doi:10.1016/S0003-4975(00)02179-2 5. Brywczynski JJ, Barrett TW, Lyon JA, Cotton BA. Management of penetrating neck injury in the emergency department: a structured literature review. Emerg Med J EMJ. 2008;25(11):711-715. doi:10.1136/emj.2008.058792 6. Hain JR. Fatal arrow wounds. J Forensic Sci. 1989;34(3):691-693. 7. Menezes JM, Batra K, Zhitny VP. A Nationwide Analysis of Gunshot Wounds of the Head and Neck: Morbidity, Mortality, and Cost. J Craniofac Surg .:10.1097/SCS.0000000000009268. doi:10.1097/SCS.00000000000092688. Madhok BM, Roy DDD, Yeluri S. Penetrating arrow injuries in Western India. Injury. 2005;36(9):1045-1050. doi:10.1016/j.injury.2005.05.032 9. Milner GR. Nineteenth-Century Arrow Wounds and Perceptions of Prehistoric Warfare. Am Antiq. 2005;70(1):144-156. doi:10.2307/40035273 10. Ngakane H, Muckart DJJ, Luvuno FM. Penetrating visceral injuries of the neck: Results of a conservative management policy. Br J Surg. 2005;77(8):908-910. doi:10.1002/bjs.1800770822 11. Biffl WL, Moore EE, Rehse DH, Offner PJ, Franciose RJ, Burch JM. Selective management of penetrating neck trauma based on cervical level of injury. Am J Surg. 1997;174(6):678-682. doi:10.1016/S0002-9610(97)00195-5 12. Gracias VH. Computed Tomography in the Evaluation of Penetrating Neck Trauma: A Preliminary Study. Arch Surg. 2001;136(11):1231. doi:10.1001/archsurg.136.11.1231

1. INTRODUCTIONIntramuscular myxoma (IMM) are benign soft tissue that account for 0.1 to 0.13 per 100,000 populations (1). Various theories have been described regarding the mechanism of IMM occurrence. Some researchers suggest that the reason is fibroblasts (unable to synthesize collagen fibers) that are not well differentiated from mesenchymal stem cells, which cause the synthesis of myxoid stroma without reticular fibers. Others consider the etiology of IMM to be caused by traumatic mechanisms or the growth of polysaccharide-producing cells in the neoplastic process (2). IMM is rare and can occur in the buttocks, thigh, upper extremities and shoulder muscles. Epidemiologically, its occurrence rate is higher in women (70%), increases with age (6th and 7th decade of life) and the most common sites of IMM is upper extremities muscles (50%-60%) (3). According to the location of the masses, soft-tissue myxomas are classified into superficial angiomyxoma, intramuscular myxoma, nerve sheath myxoma and aggressive angiomyxoma. From the clinical point of view, IMM is a palpable mass, painless, without inflammatory secretions and symptoms, which has no contractile properties and no stretch-contraction changes during flexion-extension of the adjacent muscles (4).From a diagnostic point of view, IMM is observed as a non-calcified mass in plain radiograph, which is seen in the supplementary findings with the help of ultrasonography as echogenic cystic lesions among the muscle tissue. The most important diagnostic method of IMM from other soft tissue lesions is magnetic resonance imaging (MRI), which can be seen as hypointense homogeneous mass in T1-weighted sections and hyperintense in T2-weighted sections (5). In case of edema with IMM in MRI sections (T1-weighted sections), it should be differentiated from other fluid-containing lesions (such as cystic teratoma, hematoma, myxoid sarcoma, cystic hygroma and even normal lymph nodes). Also, IMM should be differentiated from proliferative lesions, other myxoid neoplasms, myxochondroma, myxochondroma and myxoid liposarcoma (6). Cytology-histopathology findings with the help of intraoperative frozen section and needle biopsy help the information of MRI sections in the diagnosis of IMM. Density and ratio of cells/ collagen fibers, mucoid material secretion, nodular-vesicular pattern and fat density in histopathological sections contribute to IMM (7). In the present case, forearm intramuscular myxoma was observed inter-supinator muscle.