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Intestinal tuberculosis (TB) is a rare condition comprising a majority of the extra-pulmonary TB cases. Owing to a similar clinical presentation, ultrasonographic and biopsy findings of intestinal TB with that of other abdominal pathologies such as carcinoma colon, their clinical delineation is very difficult unless aided with other modalities of investigations such as colonoscopy, culture of the biopsy material, etc. and even advanced methods such as polymerase chain reaction and gene X-pert of the biopsy material. Having all these investigations may not even lead to a correct diagnosis of intestinal TB as evidenced in the reported cases in the literature, advocating the need of diagnostic laparoscopy in the diagnosis of intestinal TB to eliminate extensive and unnecessary surgeries. Here, we present a case of intestinal TB in a 51-year-gentleman who got diagnosed in the course of treatment for a suspected carcinoma colon.

Introduction and importance: Spontaneous bilateral intracerebral haemorrhage is a rare surgical occurrence, especially in young populations with poor prognosis. Hypertension is the leading cause but vascular malformations, infections and rare genetic conditions are also responsible. Case presentation: Twenty-three-year-old male with no prior comorbidities presented to emergency with sudden onset loss of consciousness and 1 episode of seizure. No history of intoxication or trauma was given. Glasgow Coma Scale at presentation was E1V2M2. CT scan head revealed bilateral basal ganglia haematoma along intraventricular haemorrhage. Clinical discussion: The patient was managed conservatively in the Neurosurgical Intensive care unit. Supportive management was provided. The patient’s motor response was improving and a repeat CT scan showed a resolving haematoma. However, due to poor economic conditions, the patient party left against medical advice. Conclusion: Spontaneous bilateral basal ganglia haemorrhage is a rare surgical emergency with no clear consensus on a management approach. This case highlights the importance of undiagnosed hypertension in causing intracerebral haemorrhage in poor economic groups.

The outbreak of novel corona virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019 in Wuhan, China caused a worldwide pandemic. Both symptomatic and asymptomatic carriers were responsible for the transmission of the diseases. Many studies showed high infectivity of the virus. It is therefore urgent to control the transmission of the virus and treat patients infected with SARS-CoV-2 virus. Many evidences have suggested that involvement of human hyperactivation and severe acute respiratory syndrome plays an important role in pathogenesis of critically ill patients with COVID-19. Therefore, repurposing of approved drugs has been used to tackle COVID-19 as the pharmacokinetic and safety profile of these drugs are known. Several immunomodulatory drugs such as disease modifying anti-rheumatic drugs (DMARD) have been proposed as potential therapies for treatment of COVID-19. In this Review we discuss human immune response to virus, pathogenesis of COVID-19 and potential drugs for COVID-19.

Leukemoid reaction may result from acute stressors such as a major surgery but other etiologies such as lymphoproliferative disorders, infections and neoplasia must be ruled out. Individualized intensive care prevents multi organ damage and lowers the counts.