Role of aqueous extract of saffron in ameliorating effect of sofosbuvir on the cerebellar cortex in rat

Sofosbuvir is a promising antiviral drug against chronic hepatitis C virus. Although it is characterized by its high efficacy, its adverse effects on nervous tissue are still unclear. Saffron is known for its neuroprotective property. This is a biochemical, histological and immunohistochemical study of the effect of sofosbuvir on the cerebellar cortex of rat and the possible ameliorating role of saffron's aqueous extract. Twenty-four adult male Wistar albino rats were equally divided into four groups; control, saffron extract-treated, sofosbuvir-treated (41.1 mg/kg/day for 6 weeks) and group concomitantly treated with saffron extract and sofosbuvir. Sofosbuvir-treated group recorded a significant increase in cerebellar malondialdehyde level coupling with a significant decrease in tissue glutathione and superoxide dismutase. Light microscopy revealed reduced number of Purkinje cells. The granular layer depicted many granular cells and Bergmann astrocytes with nuclear and cytoplasmic alterations. Electron microscopy revealed disorganized molecular layer with disarranged myelinated axons and disrupted mitochondria. Few shrunken Purkinje cells showed electron-dense cytoplasm and rarefied nuclei, indistinct nuclear envelope and dilated perinuclear space, areas of vacuolated cytoplasm, fragmented rough endoplasmic reticulum and few dark mitochondria. Some axons with tiny mitochondria were detected. A significant upregulation in immunohistochemical expression of GFAP-positive astrocytes was recorded. Concomitant administration of saffron extract significantly improved all studied parameters. Saffron extract is beneficial in ameliorating sofosbuvir-induced cerebellar morphological changes mainly through its antioxidant and neuroprotective properties.     

Painless long-segmental aortic dissection diagnosed by echocardiography: a case report of a diagnostic conundrum with potentially poor outcome

Aortic dissection is a life-threatening condition with a higher mortality rate. Early diagnosis enhances the prognosis of this disease; however, while chest pain is the most common symptom, we can occasionally find asymptomatic patients, making diagnosis more difficult and even missed, it is an uncommon entity with few data in the literature based exclusively on reported cases. Here, we report a case of completely asymptomatic long segmental aortic dissection in a 66-year-old male, with a recent history of controlled hypertension. The diagnosis was made by noninvasive methods, and the patient was referred for surgical treatment. Aortic dissections that are painless provide a significant challenge to physicians in terms of improving prognosis for this frequently misdiagnosed yet lethal illness. The main goal of this report is to bring attention to the misdiagnosed signs and symptoms of aortic dissection.     

18F-NaF positron emission tomography/computed tomography in voriconazole-induced periostitis

Clinical Rheumatology -     

Early bilateral pulmonary embolism following a moderate blunt chest trauma: A case report

Post-traumatic pulmonary embolism (PE) remains a major problem in cardio-pulmonary diseases and represent the third most common cause of death in trauma patients. Traditional PE occur most commonly between the fifth and the seventh day after a major trauma and are rare before the fourth day. Here, we report a case of acute pulmonary embolism developing 1 day after a moderate thoracic injury in a previously well young man. The diagnosis was made by non-invasive methods and the patient was given anticoagulation therapy with good outcome. The circumstances and the early occurrence of PE in this case is at odds with what is generally reported after trauma.     

Concomitant renal and splenic infarctions in a COVID-19-patient with a catastrophic thrombotic syndrome

Since the outbreak of the COVID-19 pandemic, thrombotic events have been accurately described in patients infected by the SARS-CoV-2, especially venous thromboembolism. However, the mystery of arterial thrombosis is still unclear. Here, we report the case of a 59-year-old man with diabetes mellitus, admitted for COVID-19-pneumonia complicated by pulmonary embolism, a thrombus in the aortic isthmus, the descending thoracic aorta associated with splenic and left renal infarctions, and an acute right limb ischemia. The etiological assessment of this catastrophic thrombotic syndrome showed no evidence for preexisting inherited or acquired thrombophilia. Our case emphasizes the hypercoagulability state in COVID-19-patient leading to both arterial and venous thromboembolisms and the need to establish adequate strategies for the diagnosis and management of thrombo-embolisms to prevent these potentially fatal complications.     

Cardiac hydatid cyst: 2 case reports

Hydatidosis is a parasitic disease that is still prevalent in regions that rear farm animals, notably along the Mediterranean coast. The liver and lungs are most commonly involved. Cardiac hydatidosis has been reported infrequently even in countries in which hydatid disease is endemic. This entity must be known because when undiagnosed and untreated, the risk of fatal complications increases. We report 2 cases of cardiac echinococcal cysts in young men. The first case is an incidentaloma in a patient admitted for pancreatitis. The second case is about a patient admitted for dyspnea. CT scan and MRI were performed showing intraventrucular cystic mass with a calcified wall which was very suggestive of a hydatid cyst diagnosis. We would like to emphasize the relevance of imaging in this context and shade some light on imaging diagnostic tools.