Mycotic aneurysm is defined as the dilatation of the vessel wall. It is a rare entity especially the mycotic pseudoaneurysm of iliac artery due to the underlying infection of the artery wall. Due to the nonspecific signs and symptoms there is often a delayed diagnosis that can lead to high morbidity and mortality. We present a case of a 4 year old patient with B-cell lymphoblastic lymphoma who developed a mycotic aneurysm of the right internal iliac artery while undergoing chemotherapy. The patient underwent the radiological imaging CT scan and MRI for nonspecific symptoms of fever, abdominal pain and lymphadenopathy and aneurysm was found on the scans. Patient health deteriorated fast and he died of cardiopulmonary complications before receiving any surgical or endovascular therapy. This case is unique in its kind as the fast and progressive nature can prove fatal. Therefore, the role of radiological imaging is crucial in making an early diagnosis that can improve the already poor prognosis of this clinical situation.

Patients with chronic hepatitis B often require prolonged nucleos(t)ide analogue since functional cure is rarely achieved. Medication nonadherence can trigger life-threatening hepatitis B virus (HBV) reactivation. We report a 58-year-old Asian man with HBeAg-negative chronic hepatitis B and cirrhosis. After 10 years of entecavir therapy, he achieved undetectable HBV DNA and fibrosis regression, but quantitative hepatitis B surface antigen remained >1200 IU/mL. He self-discontinued medication and presented with severe hepatitis reactivation. Liver condition gradually improved on restarting nucleos(t)ide analogue. This case highlights that medication cessation with a high hepatitis B surface antigen titer can precipitate severe hepatitis and liver failure, even after long-term HBV DNA suppression.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) affects nearly one-fourth of the world population and is closely linked to obesity, metabolic syndrome, and poor diet. We conducted a systematic review and meta-analysis to evaluate the impact of exercise on key clinical outcomes in MASLD patients. Methods: A systematic literature search was conducted until 202 September 5, to identify randomized controlled trials (RCTs), post-hoc analyses, and quasi-experimental designs comparing exercise versus standard therapy in MASLD. A random-effects model pooled data as mean differences (MD) or risk ratios (RR) with 95% confidence intervals (CI). Analyses were conducted using R (version 4.5.1). Results: Our meta-analysis included 21 RCTs, 4 post-hoc analyses, and 1 quasi-experimental study (1124 patients; mean age 52.24 ± 7.24 years). Exercise reduced BMI (MD −0.82), serum cholesterol (MD −14.31), ALT (MD −6.56), AST (MD −5.32), FIB-4 (MD −0.19), and NAFLD fibrosis score (MD −0.59), and increased HDL (MD 4.36) versus standard therapy. Weight (MD −2.11) and HOMA-IR (MD −0.59) were not significantly different. Meta-regression showed age increased HOMA-IR (estimate 0.032) and higher BMI reduced HDL (estimate −0.71). Conclusions: Exercise significantly improves key clinical outcomes in MASLD, including BMI, cholesterol, liver enzymes, and fibrosis markers, supporting physical activity as a core component of MASLD management.