Erythema nodosum leprosum (type 2 reaction) in a patient with neurofibromatosis type 1.

Being a region endemic for leprosy, clinical practitioners in India often encounter myriad manifestations and diverse complications of the disease. However, the masking of the obvious clinical presentations due to the coexistence of a closely resembling unrelated disorder, a 'mimicker', would indeed pose a serious diagnostic predicament unless a high degree of clinical suspicion is maintained. Leprosy, also known as Hansen's disease is a chronic infectious disease caused by complex that involves the skin and peripheral nerves.

Microbial dysbiosis in irritable bowel syndrome: A single-center metagenomic study in Saudi Arabia.

Background: The focus of this study was to explore potential differences in colonic mucosal microbiota in irritable bowel syndrome (IBS) patients compared to a control group utilizing a metagenomic study.

Methods: Mucosal microbiota samples were collected from each IBS patient utilizing jet-flushing colonic mucosa in unified segments of the colon with distilled water, followed by aspiration, during colonoscopy. All the purified dsDNA was extracted and quantified before metagenomic sequencing using an Illumina platform.

Fibroscan as a non-invasive predictor of hepatic steatosis in women with polycystic ovary syndrome.

Background & Objectives: There is limited data on non-alcoholic fatty liver disease (NAFLD) among Indian women with polycystic ovary syndrome (PCOS), and there are no data on the utility of fibroscan in its assessment. The objective of this study was thus to investigate the frequency of hepatic steatosis in young women with PCOS and evaluate the utility of transient elastography (TE) in its assessment.

Methods: Seventy women diagnosed with PCOS and 60 apparently healthy women (controls) were enrolled in this pilot study.

Microbial dysbiosis in inflammatory bowel diseases: results of a metagenomic study in Saudi Arabia.

Background: The intestinal microbiota plays an essential role in the pathogenesis of ulcerative colitis (UC)and Crohn disease (CD).

Methods: Metagenomic studies were used to study microbiota in the diagnosed cases of UC and CD at King Fahad Medical City, Riyadh, Saudi Arabia. Each segment of the colon was flushed with distilled water during colonoscopy, and the material was aspirated, immediately frozen for the study.

Sero Conversion of Viral Hepatitis among End Stage Renal Disease Patients on Hemodialysis in Kashmir: Results of a Prospective Study.

Background: The seroconversion is a significant health concern in patients with end-stage renal disease undergoing hemodialysis particularly in high endemic zones of HBV and HCV.

Patients And Methods: This prospective study was conducted from January 2009 to April 2018 at Sheri Kashmir Institute of Medical Sciences, Srinagar, Kashmir. A cohort of 459 end-stage renal disease patients on hemodialysis was enrolled from four dialysis centres and followed in a longitudinal manner.

Predictors of Mortality in Pulmonary Haemorrhage during SLE: A Single Centre Study Over Eleven Years.

Background: Pulmonary haemorrhage (PH) is a serious complication during Systemic Lupus Erythematosus (SLE).

Aim: The aim was to present data on 12 patients of SLE with classic symptoms and signs of PH admitted throughout eleven years.

Methods: This retrospective study was carried out at King Abdul Aziz Specialist hospital in Taif-a tertiary care hospital in the western region of Saudi Arabia.

Colonic Mucosal Microbiota in Colorectal Cancer: A Single-Center Metagenomic Study in Saudi Arabia.

Background And Aim: Because genetic and geographic variations in intestinal microbiota are known to exist, the focus of this study was to establish an estimation of microbiota in colorectal cancer (CRC) patients in Saudi Arabia by means of metagenomic studies.

Methods: From July 2010 to November 2012, colorectal cancer patients attending our hospital were enrolled for the metagenomic studies. All underwent clinical, endoscopic, and histological assessment.

The Spectrum of Glomerulopathies in Kashmir: A Tertiary Care Experience.

Background: There is a paucity of data on the spectrum of renal diseases prevalent in the Jammu and Kashmir region.

Objectives: To determine the spectrum of glomerulopathies in adult patients attending a tertiary care centre.

Methods: Two hundred and twenty-one adequate biopsies from native kidneys of adult patients who presented with features suggestive of glomerular diseases at Sheri Kashmir Institute of medical sciences Srinagar Kashmir for the last 8 years were studied in a retrospective manner.

Pancreatic Rest - An Unusual Cause of Dyspepsia: A Case Report with Literature Review.

Ectopic pancreatic tissue, also known as a pancreatic rest, is an uncommon congenital anomaly defined as extrapancreatic tissue located far from the pancreas and without any connection via vascular or anatomical means. The pancreatic rests are usually asymptomatic, but a variety of clinical symptoms have been described in the literature. This report describes the clinical scenario of severe dyspeptic symptoms of eight weeks duration in a young female.

Acute Fatty Liver of Pregnancy Mimicking Puerperal Sepsis: Report of a Case with Literature Review.

Puerperal pyrexia is defined as fever in a woman within 6 weeks of giving birth, which is ≥38°C. We describe the clinical scenario of fever and progressive jaundice in a 32-year-old female in the postpartum period. The laboratory data showed normal leukocytic counts and all her septic screen was noncontributory.

Occult foreign body in the lung mimicking bronchogenic carcinoma.

Undiagnosed and retained foreign bodies in lungs may result in serious complications such as pneumonia, atelectasis or bronchiectasis. We describe a clinical scenario of chronic and recurrent cough in a 41-year-old woman with no comorbidities. Her chest CT scan was suggestive of a mass lesion in the right main bronchus.

The simultaneous incidence of acute pancreatitis and autoimmune hemolytic anemia: a rare duo in a patient with SLE.

A young female presented with acute abdominal pain of two days duration consistent with acute pancreatitis. During her stay in the hospital she had a sudden drop in hemoglobin to 6 g/dl without any overt blood loss. On evaluation, it was evident that she had acute pancreatitis, in addition to displaying features of autoimmune hemolytic anemia.

Spirocheatal shock syndrome.

In this paper we describe a clinical scenario of high grade fever, jaundice, hypotension and multi-organ dysfunction syndrome in a 30-year-old homeless male without radiological biliary obstruction. He was brought to our hospital by the emergency medical service of Saudi Arabia (Red Crescent) from the street. After an initial resuscitation he proved to have Borrelia recurrentis.

Combining corticosteroids and acyclovir in the management of varicella pneumonia: a prospective study.

Background: Studies found in the literature which describe the treatment of varicella pneumonia with a combination of acyclovir and corticosteroids tend to be retrospective in nature and limited with regard to the data supplied.

Methods: This prospective study was performed at King Abdul Aziz Specialist Hospital in Taif, Saudi Arabia. The study covered adult patients admitted with a diagnosis of varicella pneumonia over a period of 10 years (January 2003 to December 2012).

Population dynamics and tuberculosis: a cross sectional study of an overlooked disease in Saudi Arabia.

Background: International travel, migration and human population movements facilitate the spread of tuberculosis (TB).

Objective: To study the impact of poorly screened expatriates working in Saudi Arabia on the local incidence of TBs.

Patients And Methods: This cross sectional study was carried out in the Chest Disease Hospital, Taif.

Esophagitis dissecans superficialis presenting with massive haematemesis in a patient with bullous pemphigoid.

The stratified squamous epithelial lining of the esophagus is similar to that of the skin, and occasionally conditions that affect the skin tend to have esophageal manifestations. Autoimmune dermatological conditions that present with blisters are referred to as bullous dermatoses and have been found to rarely present with esophageal involvement. Esophageal epithelium is thought to be involved in rare occasions because of its identical epithelial lining to the skin and tends to be more frequent among patients with pemphigus vulgaris than in those with pemphigoid.

Idiopathic colonic calcification: a case report.

We describe diffuse colonic calcification detected on CT scan of the abdomen in a young female patient who presented to our clinic with vague intermittent abdominal pain of four weeks duration. Her investigative profile was normal and her colonoscopy did not reveal any mucosal changes. Colonic calcification has been known to occur mostly as a result of ischemic phenomenon but the index case had no such features or any other predisposing factor.

Inflammatory bowel disease register: Steps towards Crohn's & colitis foundation of Saudi Arabia (CCFSA).

Inflammatory bowel diseases (IBD) are among the leading cause of financial burden, morbidity and employee absenteeism in developed countries because of their chronic remitting and relapsing courses. IBD is estimated to affect the Canadian economy to the tune of 100 million dollars per year. The data regarding exact prevalence in Asian countries, including Saudi Arabia, is still incomplete as there is underreporting and lack of proper registry of the diagnosed cases.

Acute autoimmune hepatitis mimicking metastatic liver disease: A case report.

We report progressive painless jaundice in a 39 year old female with a suspicion of metastatic liver disease on ultrasound and computed tomography scan of the abdomen. Although the most frequent liver lesions are liver metastasis because of dual blood supply of the liver and the impact of hormones, the index case proved to have acute autoimmune hepatitis (AIH) after liver biopsy was undertaken. AIH, an unresolving inflammation of liver, occurs predominantly among females worldwide.

Fish bone migration: an unusual cause of liver abscess.

Treating a pyogenic liver abscess is a therapeutic challenge when a patient presents with atypical symptoms. One of the rare causes of treatment failure of these abscesses is the unrecognised migration of a foreign body from the gastrointestinal tract. The authors describe a pyogenic liver abscess in a 45-year-old male who presented with a 10 day history of fever, and abdominal pain.

Biliary fascioliasis--an uncommon cause of recurrent biliary colics: report of a case and brief review.

Biliary parasitosis is one of the important causes of biliary obstruction in endemic areas, however due to migration and travel the disease is known to occur in non endemic zones as well. The spectrum of biliary fascioliasis ranges from recurrent biliary colics to acute cholangitis. The long term complications are gall stones, sclerosing cholangitis and biliary cirrhosis.

Evaluation of fecal myeloperoxidase as a biomarker of disease activity and severity in ulcerative colitis.

Background: Subclinical inflammation in ulcerative colitis (UC) can predispose to relapses and biomarkers can detect mucosal inflammation.

Aims: To study the role of fecal myeloperoxidase (FMPO) in assessing disease activity and response to therapy in UC.

Methods: Patients with UC attending our hospital from July 2005 to September 2006 were studied.

Bee sting therapy-induced hepatotoxicity: A case report.

The use of bee venom as a therapeutic agent for the relief of joint pains dates back to Hippocrates, and references to the treatment can be found in ancient Egyptian and Greek medical writings as well. Also known as apitherapy, the technique is widely used in Eastern Europe, Asia, and South America. The beneficial effects of bee stings can be attributed to mellitinin, an anti-inflammatory agent, known to be hundred times stronger than cortisone.

Mantle cell lymphoma of the colon with massive splenomegaly: A case report.

We describe colonoscopic features in a 77-year-old female with relapse of mantle cell lymphoma, who presented with a history of rectal bleeding of 2 months' duration. Her initial colonoscopy 3 years prior to the current presentation had revealed no gross lesions of mantle cell lymphoma; however, there was evidence of microscopic disease at that time as well. The patient had now developed classical lesions following relapse of the disease.

Endoscopic glue injection with application of hemostatic clips: a novel method of closing a gastro colonic fistula after PEG tube complication.

Gastrocolonic fistula after percutaneous endoscopic gastrostomy (PEG tube) placement is an uncommon but a serious complication of the procedure. These fistulous tracts are often fibrotic and require surgical intervention if the spontaneous closure fails. We describe development of gastroclonic fistula in an old man who presented with history of post feeding diarrhea of 2 weeks duration three months after placement of PEG tube.