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INTRODUCTION AND IMPORTANCE: The co-occurrence of Mycobacterium tuberculosis (MTB) affecting both the lungs and abdominal viscera is quite common, but instances of isolated Hepatic tuberculosis (TB) without concurrent clinical signs of TB are exceedingly rare. CASE PRESENTATION: We present a case of a 55-year-old woman who complained of abdominal pain, weight loss, fever and changes in bowel habits. A definitive diagnosis of hepatic TB was made through microscopic examination, revealing necrotizing granulomatous inflammation accompanied by caseous necrosis. The patient received antitubercular therapy without experiencing any noticeable side effects during follow-up. CLINICAL DISCUSSION: Hepatic TB without active pulmonary TB is quite rare case. The patient presents with abdominal pain, fever, weight loss and jaundice. The diagnostic process includes CT (computerize tomography) imaging and subsequent biopsy to confirm it histopathologically. Following the same approach, we did biopsy from the targeted hepatic lesion that showed hepatic tuberculosis. In most cases it is treated with anti-tubercular drugs. However, some complicated cases might need surgical intervention. CONCLUSION: This case report highlights the significance of considering TB into account as a potential cause in patients with lower gastrointestinal symptoms in TB endemic areas by emphasizing the diagnostic challenges posed by hepatic tuberculosis with isolated liver involvement. In order to prevent serious complications of abdominal TB, early diagnosis and timely treatment is crucial.
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INTRODUCTION: One of the most serious complications associated with antiplatelet agents is antiplatelet-associated intracranial hemorrhage (AA-ICH). Desmopressin is a synthetic antidiuretic hormone (ADH) analog. It has been linked to improving patient outcomes in antiplatelet-induced intracranial hemorrhage. The secondary outcomes included the incidence of thrombotic complications and neurological outcomes. METHODS: A systematic search was conducted on three databases (PubMed, Cochrane, and ClinicalTrials.gov) to find eligible literature that compares desmopressin (DDAVP) versus controls in patients with AA-ICH. The Mantel-Haenszel statistic was used to determine an overall effect estimate for each outcome by calculating the risk ratios and 95% confidence intervals (CI). Heterogeneity was measured using the I2 test. The risk of bias in studies was calculated using the New Castle Ottowa Scale. RESULTS: Five studies were included in the analysis with a total of 598 patients. DDAVP was associated with a nonsignificant decrease in the risk of hematoma expansion (RR = .8, 95% CI,.51-1.24; p = .31, I2 = 44%). It was also associated with a non-significant decrease in the risk of thrombotic events (RR,.83; 95% CI,.25-2.76; p = .76, I2 = 30%). However, patients in the DDAVP group demonstrated a significant increase in the risk of poor neurological outcomes (RR, 1.31; 95% CI, 1.07-1.61; p = .01, I2 = 0%). The risk of bias assessment showed a moderate to low level of risk. CONCLUSION: DDAVP was associated with a nonsignificant decrease in hematoma expansion and thrombotic events. However, it was also associated with a significantly poor neurological outcome in the patients. Thus, until more robust clinical trials are conducted, the use of DDAVP should be considered on a case-to-case basis.