An Unexpected Encounter With Miliary Tuberculosis in a Young Man With a Remote Exposure History.

Miliary tuberculosis (TB) represents a rare escalation of TB stemming from the hematogenous dissemination of Mycobacterium tuberculosis . Common extrapulmonary infection sites include the lymphatic system, musculoskeletal system, and central nervous system. The nonspecific motif of clinical symptoms involving joint pain, fever of unknown origin, and night sweats make the diagnosis of disseminated TB quite challenging. Long-term outcomes remain bleak. Untreated miliary TB is estimated to be fatal within one year. Here, we present a case of miliary TB in a 21-year-old male with a remote exposure history who was not immunocompromised.

Mysteriously Puffy Extremities: An Unintended Consequence of Intravenous Drug Abuse.

Puffy hand syndrome is a rare manifestation due to continuous intravenous drug abuse. It is a form of lymphedema caused by the sclerosing nature of intravenously administered drugs. It typically presents with bilateral, non-pitting edema at the dorsum of the hands. Proper identification of puffy hand syndrome represents a crucial junction of interest to physicians as the syndrome can be used to recognize a patient's past or ongoing drug addiction. Here, we present the case of a homeless 27-year-old presenting with erythema and edema in his extremities.

Analgesic and anti-inflammatory activities of the ethanol extract of Hibiscus rosa sinensis Linn (roots).

The current study aimed to evaluate the analgesic and anti-inflammatory effects of the ethanolic extract of roots of Hibiscus rosa sinensis (HRS). The ethanolic extract was studied on tail flick test, acetic acid induced writhing test, tail immersion test, carrageenan induced paw edema test, formalin induced paw licking test and dextran induced paw edema test at different doses i.e. 250 mg/kg and 500 mg/kg. The oral administration of Hibiscus extract respectively has been shown significant (p<0.05) dose dependent analgesic (prolongation of the reaction time) and anti-inflammatory (inhibition of edema) effects at all the treated and standard groups when compared with the control group. These findings of analgesic and anti-inflammatory testing have revealed that root extract of this plant possesses remarkable analgesic and anti-inflammatory effects.

Acute oxalate nephropathy due to pancreatic atrophy in newly diagnosed pancreatic carcinoma.

Acute oxalate nephropathy can occur due to primary hyperoxaluria and secondary hyperoxaluria. The primary hyperoxalurias are a group of autosomal recessive disorders of endogenous oxalate overproduction. Secondary hyperoxaluria may occur as a result of excess dietary intake, poisoning with oxalate precursors (ethylene glycol), or enteric hyperoxaluria. The differential diagnosis of enteric hyperoxaluria includes inflammatory bowel disease, short bowel syndrome, bariatric surgery (with jejunoileal bypass or Roux-en-Y gastric bypass), celiac disease, partial colectomy, and chronic pancreatitis. The common etiology in all these processes is fat malabsorption, steatorrhea, saponification of calcium, and absorption of free oxalate. Hyperoxaluria causes increased urinary oxalate excretion, urolithiasis (promoted by hypovolemia, decreased urinary pH caused by metabolic acidosis, and decreased citrate and magnesium concentrations in urine), tubulointerstitial oxalate deposits, and tubulointerstitial nephritis. We report a rare case of acute oxalate nephropathy due to pancreatic atrophy and exocrine insufficiency caused by newly diagnosed pancreatic cancer.