Spontaneous resolution of Mycobacterium kansasii presenting as a spiculated lung mass.

A 68-year old woman with a long smoking history underwent lung cancer screening by low-dose computed tomography. This detected a 3.0 cm spiculated mass in the left upper lobe. Transbronchial biopsy revealed necrotizing granulomatous inflammation and cultures grew Mycobacterium kansasii. Given lack of symptoms and concerns over drug toxicity, the patient declined antimicrobial therapy and she was monitored radiographically. Serial CT scans at six and twenty-two months showed progressive resolution of the mass. We present the first report of Mycobacterium kansasii presenting as a solitary lung nodule that spontaneously resolved without treatment.

Vasculitic neuropathy associated with Rheumatoid Arthritis, a case report.

Rheumatoid vasculitis which affects small-to-medium-sized vessels is a rare and late complication of rheumatoid arthritis. It is defined histologically as immune complex deposition in venules, capillaries and arterioles.1 Vasculitis in the vasa nervorum leads to infarction of peripheral nerves which leads to neuropathy. We present a case of mononeuritis multiplex due to rheumatoid vasculitis.

Cast of the left bronchial tree.

A 59-year old woman presented with hemoptysis of thick blood clots and fever of two days duration. Her medical history included sarcoidosis for which she was on chronic steroids. Computed tomography imaging revealed stage IV sarcoidosis with diffuse cystic and fibrotic changes bilaterally, worse in the right lung. She underwent bronchoscopy to attempt to localize a source but none was clearly found; no biopsies were performed. Immediately post-procedure she developed massive hemoptysis with hypoxia leading to cardiopulmonary arrest. She was intubated and stabilized with the spontaneous cessation of her bleeding. Immediate angiography revealed no active extravasation, but localized embolization was performed on the right main and right accessory bronchial arteries because these appeared hypertrophied and irregular. Two days later, she again developed spontaneous massive hemoptysis leading to cardiopulmonary arrest. Manual ventilation through the endotracheal tube became impossible. Immediate bronchoscopy identified a blood clot extending from the main carina into the left main stem bronchus. This was removed with a cryoprobe and ventilation could then be achieved easily. Examination of the blood clot demonstrated it to be a cast of the proximal left bronchial tree. Despite the return of spontaneous circulation via resuscitative efforts, the patient developed acute respiratory distress syndrome and later expired.

Dietary and Lifestyle Factors Associated with Dyspepsia among Pre-clinical Medical Students in Ajman, United Arab Emirates.

INTRODUCTION: Dyspepsia is a common gastrointestinal diseases worldwide with a prevalence ranging from 7 to 40%. Dyspepsia, more commonly known as heartburn or indigestion, is defined as one or more of the following symptoms: postprandial fullness, early satiation (the inability to finish a normal size meal), or epigastric pain or burning for at least 3 months in the past year. Dyspepsia has been studied extensively, but little is known of factors associated with dyspepsia among medical students. OBJECTIVES: The purpose of this study was to analyze the prevalence of dyspepsia and to evaluate the association between lifestyle and dietary factors associated with dyspepsia among pre-clinical medical students in Ajman, United Arab Emirates. METHODS: A cross-sectional survey study was conducted among pre-clinical medical students at Gulf Medical University, Ajman and collected basic demographic data, dyspepsia prevalence, dietary factors, and lifestyle factors. Data was analyzed using Microsoft Excel and SPSS software. Descriptive statistics were used to summarize the participant characteristics. Chi-square tests were used to test the association between dietary and lifestyle factors and dyspepsia. Logistic regression was used to measure the association of predictors (dietary and lifestyle factors) on the odds of having dyspepsia, independently. Multinomial logistic regression was used to examine the full association of predictors on the odds of having dyspepsia. RESULTS: The resulting sample was 176 pre-clinical medical students, with a mean age of 20.67 ± 2.57 years. A total of 77 (43.8%) respondents reported having dyspepsia while 99 (56.2%) did not. There was a significant association between smoking and dyspepsia (p<0.05), as well as a marginally significant association between inadequate sleep and dyspepsia (p<0.10). There was no significant association with alcohol or analgesic use on dyspesia. Dietary habits showed no association with dyspepsia. CONCLUSION: Dyspepsia was reported by 43.8% of the repondents. These findings emphasize the importance of improving lifestyle and dietary factors associated with dyspepsia and raising awareness of reducing risk factors associated with dyspepsia. Further studies are needed on dyspepsia in a larger cohort of students in order to fully understand the complexity of this problem and be able to generalize the findings to other cohorts.