Introduction: Reports regarding severe neonatal hypertriglyceridemia are scarce, and there is no consensus regarding its management. This report describes the successful management of a neonatal case of hypertriglyceridemia managed successfully. Case report: A 2-day-old male neonate born to consanguineous parents presented with yellow skin discoloration. The mother had moderate hypertriglyceridemia. While testing for jaundice, the neonate’s blood was noticed to be milky. Blood lipid profile test showed highly elevated triglyceride (1,000-10,000 mg/dl), very-low-density lipoprotein level (1,800 mg/dl), and low-density lipoprotein (206 mg/dl) levels, and a low level of high-density lipoprotein (12 mg/dl). Further laboratory diagnosis revealed apolipoprotein A1 deficiency (39 mg/dl). The patient was put on a statin tablet of 0.25 mg twice daily and a formula diet (Monogen – Nutricia) low in triglycerides and rich in medium-chain triglycerides, and was given 1 ml Omega-3 syrup twice daily. After a dramatic decline in serum level, he was put on a 50% medium-chain-triglyceride formula and Gemfibrozil triglyceride-lowering agent. Conclusion: Early diagnosis of severe hypertriglyceridemia in the neonatal period aids in the early initiation of treatment and prevention of severe complications. Conservative treatment via dietary modifications and supplementation can be associated with satisfactory outcomes.

Introduction Brucella epididymo-orchitis is a complication that occurs in 5.7% of patients with brucellosis and can rarely mimic a testicular tumor. We here report a case of a 25-year-old man with a testicular brucellosis that presented as a testicular mass that responded to conservative treatment using antibiotic therapy. Case report A 25-year-old patient presented with left testicular pain, abdominal pain, easy fatiguability, and feeling unwell. Physical examinations were normal. A testicular tumor was suggested by a scrotal color Doppler US scan and testicular MRI. However, tumor markers were all within the normal range. A serum Brucella agglutination test (Rose Bengal test) was done, and it was positive. The patient received anti-brucella antibiotics. An ultrasound scan 3 months later revealed complete recovery after completing antibiotic treatments. Discussion Brucella orchitis can be determined based on the triad of serology, ultrasonography, and the presence of the common symptoms like fever, testicular pain, redness, and enlargement. The early diagnosis of this phenomenon is crucial due to the morbidity and complications that may be encountered. Moreover, it has several differential diagnoses, such as testicular tumor, epididymitis, trauma, torsion of the testis, and hematocele. Failure to obtain an adequate diagnosis, particularly if a testicular tumor is suspected, may result in unnecessary intervention like orchiectomy. Conclusion Brucella orchitis is a complication of brucella infection that may mimic a testicular tumor. Several techniques of diagnosis are required for an accurate assessment.

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Introduction Lymphedema affects the extremities of breast cancer patients post-surgical or radiation therapy. This study aims to report a case of primary lymphedema of breast. Case presentation A 41-year-old female presented with right breast swelling. It associated with hotness and intermittent mastalgia for the past 8 years. Ultrasound (US) examination showed diffuse trabeculate, skin thickening and edematous with normal glandular tissue. Magnetic resonance imaging (MRI) showed diffuse homogeneous parenchymal enhancements with diffuse tranecular and skin edema (high signal on Short-TI Inversion Recovery (STIR)). The result of the biopsy showed normal breast tissue and lymph node. Discussion The major risk factors of lymphedema are breast cancer surgery, radiation therapy, axillary lymph node dissection, length and location of breast incision, taking biopsy, trauma, wound infection. Forearm is the most common site of swelling. Primary lymphedema of the breast is a very rare condition without a known risk factor. Conclusion Although it is rare, primary lymphedema can affect the breast. US and MRI are necessary to exclude other pathologies. It is managed conservatively.

Introduction: May-Thurner syndrome as a presenting symptom of Behcet’s disease is rare in the literature. The aim of the current study is to report a rare case of Behcet's disease which has been presented with May-Thurner syndrome. Case report: A 26-year-old woman presented with left leg pain for a one-year duration. On examination, there were dilated superficial veins and edema in the calf. A computed tomography scan of the pelvis showed a markedly narrowed left common iliac vein which was compressed by the right common iliac artery, suggesting May-Thurner syndrome. After a period of not responding to medications, she had been referred to a rheumatologist. The patient was diagnosed with Behcet's disease. She received immunosuppressant agents and glucocorticoids. The patient's symptoms improved after two months of follow-up. Conclusion: May-Thurner syndrome could be an early manifestation of Behcet's disease, which may further complicate the clinical picture of Behcet's disease.