Leukocytoclastic Vasculitis Masquerading as Chronic Idiopathic Thrombocytopenic Purpura.

Background: Idiopathic thrombocytopenic purpura and leukocytoclastic vasculitis can present in a similar fashion and can be very hard to differentiate clinically without a biopsy. This can cause diagnostic dilemma and delay in management. A thorough evaluation is recommended to determine etiology, although about half are idiopathic. Case Presentation: A patient aged 79 years with longstanding thrombocytopenia secondary to chronic idiopathic thrombocytopenic purpura presented with a rash. Although it was thought to be secondary to idiopathic thrombocytopenic purpura, a biopsy revealed presence of leukocytoclastic vasculitis. Conclusions: Although most leukocytoclastic vasculitis cases are mild and resolve without intervention, many go undiagnosed due to biopsy delays. Health care professionals should determine and treat the underlying cause.

Reversible Decerebrate Posture in Hepatic Encephalopathy: Case Report and Literature Review.

Decerebrate posturing is commonly associated with a global brain insult as in massive strokes, brain stem infarction, or hypoxic brain injury. The clinical presentation of hepatic encephalopathy is variable. ranging from an abnormal sleep pattern to somnolence and deep coma. Decerebrate or decorticate posturing is a rare manifestation of hepatic encephalopathy. We report a patient with liver cirrhosis who presented with a mild degree of hepatic encephalopathy that rapidly progressed to coma with decerebrate posturing. Although the pathophysiology of hepatic encephalopathy is unknown, it appears to be reversible as in our patient who completely recovered with the management of encephalopathy. Despite being uncommon, it should be considered in patients presenting with hepatic encephalopathy progressing to coma since it might save unnecessary workup.

Dihydropyridines as potential α-amylase and α-glucosidase inhibitors: Synthesis, in vitro and in silico studies.

Dihydropyridine derivatives 1-31 were synthesized via one-pot solvent free condition and screened for in vitro against α-amylase and α-glucosidase enzyme. The synthetic derivatives 1-31 showed good α-amylase inhibition in the range of IC50 = 2.21 ± 0.06-9.97 ± 0.08 µM, as compared to the standard drug acarbose (IC50 = 2.01 ± 0.1 µM) and α-glucosidase inhibition in the range of IC50 = 2.31 ± 0.09-9.9 ± 0.1 µM as compared to standard acarbose (IC50 = 2.07 ± 0.1 µM), respectively. To determine the mode of binding interactions of synthetic molecules with active sites of enzyme, molecular docking studies were also performed. Different spectroscopic techniques such as 1H, 13C NMR, EI-MS, and HREI-MS were used to characterize all the synthetic compounds.

Atypical Presentation of Gastric Cancer Approached Via Retrograde Single Balloon Enteroscopy.

The paradigm for the diagnosis and management of gastric cancer is changing with advanced diagnostic and therapeutic interventions. Prior gastric surgery (20 years or more) is one of the risk factors for gastric cancer. Increased intragastric carcinogen formation is thought to contribute toward gastric cancer development in the remaining portion of the stomach. This case illustrates the importance of a thorough clinical and pathologic workup and highlights the advanced technique of single-balloon enteroscopy (SBE) and its role in managing patient's health.