Spontaneous splenic pseudocyst: Case report of a rare entity.

Splenic cysts are classified on the basis of epithelial lining, either primary or secondary. Primary cysts are further divided as parasitic and nonparasitic. The secondary cysts are usually post traumatic or after a splenic extension of pancreatic pseudocyst. However, not all pseudocysts are associated with trauma. Mostly, they are asymptomatic (30%-60%) and usually grow in size to cause compressive symptoms. Splenic pseudocysts should be differentiated with other malignant and nonmalignant pathology, specifically hydatid cysts, in order to manage them correctly. The walls of pseudocysts may be degenerative or calcified, which may resemble hydatid cysts. Here, we present a case of a non-traumatic splenic cyst masquerading as a hydatid cyst preoperatively. The patient was taken up for surgery and intraoperatively noted to be a hemorrhagic cyst with a non-splenic cyst wall. We decided to preserve the spleen with marsupialisation of cyst and omentoplasty. On histopathology, the diagnosis of a pseudocyst of spleen was made in view of absent epithelial lining. We would like to report this case because of the diagnostic dilemma, its clinical rarity and, even more, in the absence of any history of trauma.

Optimization of a microfluidic spiral channel used to separate sperm from blood cells.

Assisted reproductive technology includes medical procedures that confront the problem of infertility. In some cases of male infertility, blood cells are present in the sperm containing samples and must be removed. Spiral-channel devices have been developed to perform this task, but there is a strong need to increase their throughput. In this work, the theory behind the separation is employed to optimize the device for increased throughput. An existing device that is known to separate sperm and blood cells with a rectangular cross section of 600 × 100 µm2 was used as the baseline. Using its physics, theoretical models were generated to explore theoretical performances of larger-size channels. The models suggested that a channel of size 800 × 133 µm2 would likely work. This geometry enabled the throughput to be increased by 50%, from 2 ml/min in the case of the baseline-size to 3 ml/min in the designed device. Experiments using the larger device resulted in a recovery of more than 90% of sperm cells while removing 89% of red blood cells (RBCs). In comparison, the reference device results in a 90% recovery of sperm cells while removing 74% of white blood cells (WBCs). The length of the channel was also reduced to reduce the pressure required to operate the chip. Literature has shown the removal of WBCs to be higher than that of RBCs due to their larger size, spherical shape, and comparatively low deformability, suggesting that the revised chip would be faster and better for the separation of sperm and all blood cells.

An Unusual Case of Tetanus Masquerading as an Acute Abdomen: A Case Report.

INTRODUCTION: Tetanus is an acute onset neurological disease that is often lethal. It has a high disease burden in low and middle-income countries. Tetanus is caused by a toxin made by spores of the bacterium Clostridium tetani, which are found in soil, dust, and animal feces. The toxin impairs the motor neurons leading to muscle stiffness. However, with the development of a toxoid vaccine, the incidence has sharply declined and is now categorized as a vaccine-preventable disease. The treatment of tetanus is primarily supportive and focuses on managing the complications until the effects of toxins resolve. CASE REPORT: We report the case of a 67-year-old farmer who previously sustained a laceration injury approximately 45 days prior to presenting to the emergency department with abdominal pain and rigidity. After a comprehensive evaluation to rule out other items in the differential diagnoses, he was diagnosed with tetanus based on clinical symptoms and ultimately required mechanical ventilation. The patient was then managed in the intensive care unit and later made an uneventful recovery. CONCLUSION: This case illustrates an uncommon presentation of tetanus and the latency of the infectious process. Often when patients present with atypical symptoms, it poses a diagnostic dilemma to the clinicians. Thus, it is very important to carefully elicit a history of contaminated injury. This case also highlights the importance of prophylactic vaccine in low and middle-income countries, which can reduce disease-related mortality and morbidity.