Unusual location of gouty arthritis with shoulder joint involvement in an elderly male patient: a rare case report.

Gout is a metabolic disease characterized by recurrent episodes of acute arthritis. Gout has been reported in many locations but is rarely localized in the shoulder joint. Case presentation: A 73-year-old man who visited an outpatient clinic with the main complaint of a right shoulder ache lasting 2 weeks came to our attention. The patient reports his discomfort as being of an unbearable character, happening largely at night and preventing him from falling asleep. In the previous 6 months, he had two episodes of the same ailment that lasted around 3-5 days each and spontaneously resolved. Due to the pain's continuance without improvement, the patient now seeks medical assistance. Gout with right shoulder involvement was identified as the cause. Prednisolone 40 mg/day for 10 days, allopurinol 300 mg/day, and colchicine 0.5 mg/day were all prescribed for the patient. After 6 months of follow-up, the patient had significantly improved. Discussion and conclusions: The condition of gout affecting the shoulder joint is quite rare. According to past medical history and clinical manifestations, doctors and orthopedic surgeons should take gouty shoulder arthritis into consideration when there is serious erosion.

Severe Carbamazepine Toxicity Treated with Continuous Venovenous Hemofiltration at Palestine Medical Complex: Two Case Reports.

Carbamazepine intoxication is not uncommon and accounts for many cases of poisoning among anticonvulsive medications users. Since there is no specific antidote for carbamazepine overdose, management is limited to gastric decontamination and supportive therapy. With its high protein binding, the role of extracorporeal elimination in carbamazepine intoxication is still questionable. Here two cases of severe carbamazepine intoxication are presented; the cases were brought to the emergency department after the ingestion of 12,000 mg of controlled release carbamazepine for the first case, and unknown amounts of the same drug for the second case. Both cases were presented with altered mental status, convulsion, and high serum carbamazepine levels of more than 20 mcg/mL. They were intubated and treated with continuous venovenous hemofiltration, after which carbamazepine levels declined significantly along with subsequent clinical improvement and complete neurological recovery. Both cases were discharged home for further psychiatric care.