Background On 7th May 2022, human monkeypox was identified in the United Kingdom, a non‐endemic zone, with subsequent multi‐country outbreaks. About 6 weeks later, the European Centre for Disease Prevention and Control reported 1158 confirmed cases in non‐endemic countries scattered within the European Economic Area (EEA), and a total of 1882 cases confirmed worldwide, inclusive of the EEA. These numbers are expected to increase with high alert and amplified surveillance established in non‐endemic regions. In light of a looming epidemic, current understanding of the virus, and identification of gaps in the literature remain critical hence warranting a scoping review of available literature. Methods Literature searches were performed through PubMed, SCOPUS, ScienceDirect and Hinari to identify studies eligible for inclusion in accordance with PRISMA guidelines. Results Seventy‐seven articles were included in the review. Majority of the cases were from the Central African clade (n = 29,905) versus the West African clade (n = 252). 6/16 articles that reported vaccination status stated that none of the cases were vaccinated. In the remaining articles, approximately 80%–96% cases were unvaccinated. It was noted that 4%–21% of the vaccinated individuals got infected. The secondary attack rate ranged from 0% to 10.2%, while the calculated pooled estimated case fatality rate was 8.7%. Conclusion This scoping review provides an extensive look at our current understanding on monkeypox disease. Further studies are needed to better understand its risk factors, genetics and natural history, in order for public health strategists to generate prevention strategies and management decisions.

Background : Tuberculosis (TB) is common form of communicable disease in India. Abdominal TB is one of the most common yet misdiagnosed forms of extrapulmonary TB. It is missed due to its similarity to other conditions such as Crohn's disease and nonspecific clinical presentation. Methods: Medical records of 317 patients who were diagnosed with abdominal TB from August 2015 to December 2020 were reviewed retrospectively from our prospectively maintained database. Results: Among 317 patients, 167 (52.7%) were male. Median age of presentation was 45 (8–85) years. Luminal involvement was seen in most of the patients (n = 157, 49.5%), followed by peritoneal (n = 63, 19.8%), mixed (n = 42, 13.2%), solid visceral (n = 30, 9.4%), and nodal (n = 25, 7.8%) involvement. Two hundred and sixty-one (82.3%) showed complete response. Seven (2.2%) patients died and 5 (1.6%) patients lost to follow-up. Median duration of treatment was 28 (25–52) weeks. Drug-induced liver injury was identified in 30 (9.5%) patients. Median follow-up duration was 32 (1–70) months. Conclusion: Abdominal TB is quite a diagnostic challenge due its vague clinical symptoms, nonspecific radiological features, and poor sensitivity and specificity of diagnostic tests. Hence, clinicians should have a high index of suspicion to diagnose and treat this treatable yet lethal condition promptly. Most cases respond very well to medical management and a small fraction requires surgical intervention if diagnosed early.

Introduction Brunner's gland hamartomas (BGH) are rare benign lesions with an incidence of <0.01%, accounting for 5 to 10% of all benign tumors of the duodenum. It requires expeditious management by a multidisciplinary team. The aim of the study is to report our experience with surgery for BGH. Methodology Data of all patients who underwent surgical intervention for duodenal polypoidal mass between August 2007 and March 2020 were retrieved from our prospectively maintained gastrointestinal (GI) surgery database. All patients whose histopathology report of the resected specimen confirmed BGH (n = 9) were included in the present study. Other pathological diagnosis like duodenal lipoma (n = 2), ganglioneuroma (n = 1), adenoma (n = 10), and adenocarcinoma (n = 4) were excluded. Results Nine patients had confirmatory histopathological diagnosis of BGH and met our inclusion criteria. Three (33.3%) of them were men with a median age of 45 (range: 24–61) years. The median interval between onset of symptoms and diagnosis of duodenal polyp was 14 (range: 4–180) days. Five patients (55.5%) presented with upper GI hemorrhage. Three (33.3%) patients presented with abdominal pain, and one (11.1%) patient presented with episodes of bilious vomiting. Diagnostic endoscopy could detect the lesion in all (100%) patients. Contrast-enhanced computed tomography detected duodenal polypoidal lesion in five (55.5%) patients. The mean size of tumor was 4.78 ± 1.36 cm. These lesions were symptomatic in all the patients and warranted intervention. In view of failed endoscopic intervention (n = 7, 77.7%), or extramural extension of the tumor (n = 2, 22.2%), surgical intervention was considered. Most commonly performed operation was duodenal polypectomy (n = 6, 66.6%). Three postoperative complications developed in two (22.2%) patients. There was no surgery-related mortality. After a median follow-up of 60 (12 -78) months, no patient developed GI bleed or intestinal obstruction. Conclusion In this study, the clinical profile of BGH was explored from the surgeon's point of view. Although endoscopic management is the first-line treatment, surgery plays an important role, particularly, if this fails or is not feasible. In experienced hand, surgery can be performed with acceptable perioperative morbidity and mortality and long-term satisfactory outcomes.

Herein, we report a case of primary small cell neuroendocrine tumor (NET) of the gallbladder in a 45-yearold female who presented with complaints of fever accompanied by abdominal pain on the right upper quadrant for one month. Contrast-enhanced computed tomography abdomen showed a large gallbladder mass. It was infiltrating the segments IVa, IVb, and V of the liver. Ultrasound-guided fine-needle-aspirationcytology was performed. Based on preoperative pathological and immunohistochemical investigations, it was diagnosed to be a primary small cell NET of the gallbladder. The patient underwent radical cholecystectomy after three cycles of cisplatin-based neoadjuvant chemotherapy. She had an uneventful recovery and received adjuvant chemo-radiotherapy. The patient was well at the 18-month follow-up.

Brunner's gland hamartoma (BGH) is a rare benign small bowel tumor, mostly encountered in the duodenum. Massive upper gastrointestinal (UGI) hemorrhage is an unusual presentation rarely reported in English literature. Symptomatic patients mostly present with features of gastric outlet obstruction, occult bleeding, or intussusception. Herein, we report a case of BGH presenting with overt UGI bleed and features of gastric outlet obstruction. Esophagogastroduodenoscopy revealed a smooth polypoidal swelling in the posterior wall of the duodenal bulb. An endoscopic ultrasound (EUS) guided fine-needle-aspiration was performed, which was inconclusive. Contrast-enhanced computed tomography showed the absence of any extraluminal component of the lesion. Endoscopic polypectomy was attempted but failed due to the broad base of the lesion, and hence the patient was managed by open surgical excision. Histological examination of the resected specimen confirmed the diagnosis to be BGH. The patient had an uneventful recovery and was doing well at the 15-month follow-up. BGH should be considered as a differential diagnosis of a polypoidal lesion of the duodenum. Any lesion larger than 2 cm or symptomatic should be removed either by endoscopic or surgical intervention.