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Highlights • Splenic abscess is one of the rarer findings which is commonly seen in immunocompromised individuals. • Splenic abscess may present with features of pleural effusion along with empyema if gets infected. • Pleural empyema needs tube drainage. • Splenic entity if unilocular, can be managed with broad spectrum antibiotics along with percutaneous aspiration or drainage. • Open drainage or splenectomy is mandatory in case percutaneous techniques fail., Introduction Splenic abscess generally occurs through hematogenous spread and typically follows endocarditis or seeding from contiguous sites of infection. This can be complicated by empyema thoracis. We present a rarer case of chronic alcoholic with splenic abscess along with empyema thoracis. Presentation of a case A 39-year old alcoholic male presented with history of pain at left hypochondrium and difficulty breathing for 7 days. Abdominal examination revealed tenderness at left hypochondrium along with enlarged spleen and liver associated with decreased air entry of left chest. Chest X-ray showed complete white out lung field on left side. Contrast enhanced tomography abdomen and pelvis revealed splenic abscess involving lower pole of spleen along with peri splenic extension. Tube thoracostomy drainage on left chest was done followed by ultrasonography guided repeated aspiration of splenic entity. Pus culture sensitivity showed growth of Streptococcus pyogenes while splenic aspirate remained sterile. Patient got discharged on 8th day of admission with full recovery. Discussion Splenic abscess is the rare entity which is commonly seen in immunocompromised individuals that might get complicated as empyema thoracis and management includes broad spectrum antibiotics along with tube thoracostomy and percutaneous drainage of splenic abscess if possible, in view of spleen being salvageable. Pleural collection revealed growth of Streptococcus pyogenes in our case which itself is the rare finding. Conclusion Splenic abscess can be managed with percutaneous aspiration/drainage if lesion is unilocular in the view of salvaging spleen. Complicated empyema can be managed with tube thoracostomy along with broad spectrum antibiotics.

The possibility of the existence of mesons with two or more quark-antiquark pairs is investigated with a new application of the Thomas-Fermi (TF) statistical quark model. Quark color couplings are treated in a mean field manner similar to a previous application to baryons, and short and concise expressions for energies are derived. We find that, on average, quarks only interact with antiquarks in such systems. The TF differential equation is constructed and systems with heavy-light quark content are examined. Three types of mesonic systems are defined. In the case of charm quarks, multi-charmonium, multi-$Z$ meson and multi-$D$ meson family types are examined. System analogs for bottom quarks are also constructed. Quantitative trends for system energies of mesonic quark matter are extracted as a function of the number of quark pairs. We find indications from energy plots that multi-$Z$ type mesons (and their bottom quark analogs) are actually stable for a range of quark number pairs. At this initial stage we have not yet included explicit spin interaction couplings between quarks, but we can take one level of degeneracy into account in our two-inequivalent TF function construction., Comment: 53 pages, 20 figures, accepted in Nucl. Phys. A

Penile strangulation is one of the rarest clinical findings. So, we aimed to present the clinical case of two cases that we encountered at our institute.Case 1. A 26-year-male with bipolar disorder presented to emergency room with complaints of metallic ring entrapment in the penis for 4 days. A gold-plated metallic ring measuring 1 × 0.25 cm was found encircling the coronal sulcus along with foul-smelling pus and slough underneath as a result of necrosis of the skin. Jumbo cutter was used to cut the ring. Loose sutures were applied to the injured part with debridement.A 66-year-old man presented to emergency with complaints of penile swelling and poor urinary stream for the last 2 days. Local examination showed a plastic ring of water bottle seen stuck at the root of penis. Distal penis was edematous with multiple areas of skin discoloration and petechia. The ring was cut with simple surgical scissor.This clinically emergency condition may lead to wide range of vascular and mechanical injuries if the treatment is delayed. Plastic rings can be easily cut out whilst metallic objects which are thick and hard are difficult to remove. Pliers' application or use of jumbo cutter as in one of our cases is beneficial for prompt release of edematous pressure and salvage of the penis.Penile strangulation due to foreign body is a rare clinically emergency condition. Urgent intervention is necessary to remove the object causing constriction along the penis.

Hypercarotenaemia develops in person consuming high amount of carotenoid rich foods. It is also known that person with hypothyroidism and diabetes mellitus tend to develop hypercarotenaemia with the normal intake of carotenoid rich foods. This case is of hypercarotenaemia in adult Nepalese hypothyroid women who consumed excess amount of food rich in carotene in order to get rid of her jaundice. Our common food habits can cause ill health effects if not monitored.