No abstract

Human brucellosis is caused by one of the three species of Brucella: Brucella mellitensis, B. abortus, and B. suis. Worldwide, the incidence of human brucellosis ranges from <0.01 to >200 per 100,000 population. Cardiovascular complications occur in <2%, but accounts for most of the mortality. Brucella endocarditis usually involves normal native aortic valves in 75% of cases. A combination of antibiotics and valve replacement is the most acceptable treatment. So far only 15 adult cases have been reported as having been cured with medical therapy alone. We report another case treated successfully with antibiotics alone.

Percutaneous endoscopic gastrostomy (PEG) tube often remains to be used as a primary modality for feeding in patients with advanced dementia, perhaps due to misconceptions regarding the outcomes. Physicians' perceptions regarding the PEG tubes could be a significant contributing factor globally. A multidisciplinary approach involving the ethics committee can help address the issue. Our survey is focused on gauging physicians' perceptions regarding PEG tube utilization and its global impact on outcomes in dementia.

Infected pancreatic necrosis (IPN) is associated with high morbidity and mortality. It is increasingly being recognized that noninvasive management, radiological guided drainage, and minimally invasive procedures rather than the traditionally advocated open necrosectomy are associated with a better outcome in IPN. We present a patient with IPN who was managed with the now popular "step up" approach and describe the procedure of Minimal access retroperitoneal pancreatic necrosectomy.