Sterile water injections for managing abdominal labour contraction pain: A randomised double blind placebo-controlled trial.

Pain patterns in patients with irritable bowel symptoms - A longitudinal observational time series approach.

Introduction: Acute non-traumatic abdominal pain is a frequent emergency presentation, associated with a wide range of possible differential diagnoses. While Ultrasonography (USG) is widely available and radiation-free, its diagnostic accuracy is limited by the patient’s habitus and bowel gas. Multi-slice Computed Tomography (MSCT) offers a comprehensive evaluation but comes with a higher cost and increased radiation exposure. Aim: To assess the diagnostic accuracy of MSCT in adult patients with acute non-traumatic abdominal pain negative or inconclusive for USG. Materials and Methods: The present prospective observational study was conducted in the Department of Radiodiagnosis at Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India over a period of one year from June 2024 to July 2025. In this study, 81 adult patients who were referred for CT after an inconclusive/negative USG report underwent contrast-enhanced MSCT using a 128-slice scanner. CT findings were compared with surgical and histopathological outcomes when available, and with clinical follow up in conservatively managed cases. The sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV), as well as the diagnostic accuracy of MSCT in cases of non-traumatic acute abdominal pain were calculated. Results: The mean age was 41.3±15.8 years, out of which 47 (58%) patients were male. MSCT diagnosed 16 (25.9%) cases of pancreatitis, 7 (16%) cases of appendicitis, and 5 (13.6%) cases of ureteric calculi among the most common pathologies. Among the 47 patients who got operated, CT findings were concordant with intraoperative results in 37 (90.2%) patients and with histopathology in all 41 patients (100%). MSCT provided new or alternative diagnosis in 66 out of 81 (81%) cases, significantly altering the management plans. Conclusion: The prompt use of MSCT in cases of an acute abdomen with equivocal USG findings significantly improves diagnostic accuracy and ensures appropriate management, outweighing its higher cost and radiation risks.

Vonoprazan-based triple therapy for Helicobacter pylori resistant to first-line regimens: A guideline-compliant 14-day multicenter study in Egypt.

Outcomes of Management Strategies for Primary Infected Abdominal Aortic Aneurysm: A Single-Center Retrospective Study.

A 52-year-old lady, with hypothyroidism and hypertension for the last 2 months, presented with complaints of low-grade fever, gum hypertrophy, abdominal pain, palpable purpura, bilateral knee joint swelling, and bruising of both lower legs for the last 1 month. She had a significant fall in haemoglobin, a high Reticulocyte count, increased bilirubin level, and persistently high potassium with a positive Direct Coombs test. After the initial assessment, she was clinically diagnosed with an Adult-onset Henoch-Schonlein Purpura. She underwent skin biopsy, suggestive of Drug Rash- Amlodipine being implicated as the drug causing multisystemic manifestations. She was treated conservatively. Amlodipine was discontinued, and oral ketone and bilastine were started. She had a complete recovery.

Chrysophanein of Rhubarb rescues ILC3-Derived IL-22 by blocking CCDC25/ILK/HIF-1α for mucosal healing in ulcerative colitis mice.

Biomaterial-based therapeutic strategies for inflammatory bowel disease.

Two days after eating beef steak grilled rare, a 28-year-old man developed a fever, abdominal pain, and diarrhea. The diarrhea resolved after 5 days of ciprofloxacin treatment (200 mg). Stool cultures obtained at the time of the onset were subsequently confirmed as enterotoxigenic Escherichia coli type O6. However, the renal dysfunction worsened, and the patient developed proteinuria and urinary occult blood. A kidney biopsy revealed necrotizing glomerulonephritis in the majority of glomeruli. An enzyme-linked immunosorbent assay was negative for myeloperoxidase/proteinase 3 anti-neutrophil cytoplasmic antibody (ANCA), but indirect immunofluorescence (IIF) was positive for cytoplasmic ANCA (C-ANCA). This case suggests a relationship between necrotizing glomerulonephritis and IIF-positive C-ANCAs.

Mechanistic insights into the effects of Norisoboldine on intestinal immunity and neuroinflammation in a mouse model of slow transit constipation with depression.

Leptospirosis is a common zoonotic disease with a 10-fold higher incidence in tropical regions compared to temperate zones. The disease is endemic to the Indian subcontinent, particularly prevalent in the southern states. It has a wide spectrum of presentations, most commonly high-grade fever, myalgia, conjunctivitis, haematuria, jaundice, abdominal pain, and vomiting. Severe infection manifests as multisystemic vasculitis and Weil's disease. Here we describe an atypical presentation which posed a diagnostic dilemma. Considering the age of the patient and the presenting symptoms, colonic malignancy with hepatic metastasis was suspected, and further investigations were conducted, which indeed revealed a colonic growth in the descending colon, consistent with the clinical suspicion. However, the colonic growth was found to be an inflammatory mass caused by leptospiral infection, confirmed by various investigation modalities and response to antibiotic therapy. Few publications have reported cases of leptospirosis presenting with episodes of bleeding per rectum with colonic growth.

Helicobacter pylori antimicrobial resistance and CYP2C19 genotypes in a paediatric cohort with initial eradication failure: A study from Henan, China (2019-2024).

Cholecystocutaneous fistula (CCF) is defined as a pathological communication between the gallbladder and/or its ducts directly with the skin. It is a rare complication of chronic calculous cholecystopathy. Its clinical presentation ranges from gastrointestinal symptoms such as nausea and vomiting, abdominal pain, jaundice, and acute pancreatitis to the drainage of biliary secretion and gallstones through the abdominal wall. The mainstay of treatment involves surgical reconstruction of the biliary anatomy. The incidence of new CCF cases appears to be decreasing due to earlier medical intervention and definitive treatments. This case report presents a patient with acute-on-chronic calculous cholecystitis who developed a CCF with externalization of a gallstone, requiring surgical management.

Jasminum sambac: Progress in research on ethnopharmacology, phytochemistry, pharmacological actions and other applications.

Effectiveness and mechanisms of curcumin for colorectal cancer in preclinical models:A systematic review and meta-analysis.

The present case describes a 42-year-old previously healthy male who presented with two weeks of dull epigastric pain, nausea, and melena. On examination, he was pale but haemodynamically stable. Laboratory evaluation revealed iron deficiency anaemia, while other haematological, renal, and liver parameters were within normal limits. Upper gastrointestinal endoscopy demonstrated two large antral ulcers with irregular margins, necrotic bases, and surrounding mucosal oedema. Histopathology confirmed gastric mucormycosis, showing broad aseptate fungal hyphae with right-angle branching, highlighted by Periodic Acid-Schiff (PAS) and Grocott’s Methenamine Silver (GMS) staining. The patient was treated with intravenous liposomal amphotericin B (5 mg/kg/day) for 21 days, followed by oral posaconazole (300 mg daily) for six weeks. Clinical improvement occurred within 10 days. Followup endoscopy at three months showed complete ulcer healing, and at six months, the patient remained asymptomatic with no evidence of recurrence. The present case emphasises that gastric mucormycosis, although rare, can occur in immunocompetent individuals. Early endoscopic biopsy and prompt initiation of antifungal therapy are crucial, and selected cases may achieve successful outcomes with medical management alone, without surgical intervention.

Characteristics of U.S. emergency department visits for altered mental status, 2016-2022.

Roundworm (Ascaris lumbricoides) is a nematode known in Latin America as the roundworm. It belongs to the group of parasites transmitted through contact with contaminated soil and is the most common helminthiasis worldwide, especially in children aged 2 to 10 years. In Paraguay, the prevalence of intestinal parasitosis in school-aged children is high, mainly due to poor sanitary conditions and adverse socioeconomic factors. In this context, we present the case of a 3-year-old female patient, a resident of a rural area, who presented with severe abdominal pain, vomiting, fever, and abdominal distension. The physical examination revealed signs of peritoneal irritation, and stool examination confirmed the presence of Ascaris lumbricoides eggs. Imaging studies showed intestinal obstruction and abundant worms in the small intestine. Due to the severity of the condition, emergency surgery was performed, removing the parasites and performing peritoneal lavage. The patient made a favorable outcome after treatment. This case highlights the importance of timely diagnosis and comprehensive management of ascariasis complications, as well as the need to strengthen prevention strategies, health education, and access to treatment in vulnerable communities to reduce the incidence and complications associated with this parasitic infection.

Acute abdomen requires urgent intervention for potentially life-threatening conditions. We report the case of a 59-year-old male with acute abdominal pain and bloody stools treated at the Regional Hospital of Pilar, Paraguay. Exploratory laparotomy revealed intestinal ischemia with necrosis, congestive appendicitis, inguinal hernia, colocolic intussusception, and diverticulosis. A comprehensive surgical approach resulted in favorable postoperative recovery. This case highlights the critical role of timely diagnosis and multidisciplinary management in optimizing outcomes for complex acute abdomen presentations.

Background: Acute Fatty Liver of Pregnancy (AFLP) is a rare obstetric condition that can lead to maternal and perinatal complications. Aim and Objectives: This study aimed to study the pregnancy outcome in Acute fatty liver of Pregnancy (AFLP). In particular, this study aimed to study the clinical features of the condition and its effect on maternal and perinatal outcomes. Materials and Methods: A retrospective analysis of seven cases diagnosed with AFLP over a span of three years was performed. The clinical records of these women were reviewed for clinical features, laboratory investigations, and maternal and perinatal outcomes. Results: The incidence of AFLP was 4/10,000 births. A total of 6(85.7%) women presented during the third trimester of pregnancy. A total of 4(57%) of them presented after 36 weeks of gestation. A total of 6(85.7%) women presented with jaundice, and all presented with sudden onset nonspecific symptoms, including abdominal pain and vomiting. Pregnancy was terminated by cesarean section in 6 cases. Maternal mortality was noted in 6(85.7%) of women. All six women were diagnosed with Acute kidney injury and coagulopathy. One woman had developed encephalopathy and altered sensorium. Further, 2(28.5%) women had intrauterine fetal demise at the time of presentation, and 1(14.3%) had an early neonatal death. Conclusion: AFLP is a rare clinical syndrome with rapid and dramatic progression, beginning initially with non-specific symptoms and evolving into coagulopathy, acute kidney injury, and death, resulting in alarming maternal and perinatal mortality. Early diagnosis is challenging due to the non-specificity of symptoms, but crucial and prompt termination of pregnancy is the need of the hour. Nonetheless, supportive treatment and a multidisciplinary approach may significantly improve prognosis.