Amiodarone-Induced Leukocytoclastic Vasculitis in a Decompensated Heart Failure Patient: A Case Report

Leukocytoclastic vasculitis (LCV) is a small-vessel vasculitis characterized by inflammation and damage to the walls of small blood vessels. It typically presents with palpable purpura and can be associated with various systemic conditions. Although its etiology is diverse, LCV has been associated with systemic diseases, infections, medications, and autoimmune disorders. Here, we present a case of LCV in a patient with decompensated heart failure. A 58-year-old man presented with progressively deteriorating swelling in both his lower limbs and scrotum, a persistent dry cough associated with minor ulcerative lesions on his shins, and a patchy rash with pustules and flat reddish spots. He was hospitalized three days prior due to atrial fibrillation and rapid ventricular rate, for which he was commenced on amiodarone. This rash persisted for three days, yet he denied experiencing any discomfort or itchiness along with it. Based on his clinical picture, laboratory evaluations, and imaging findings, he was diagnosed with LCV induced by amiodarone.

Association of Pioglitazone With Major Adverse Cardiovascular Events, All-Cause Mortality, and Heart Failure Hospitalizations: A Systematic Review

Modern diabetic treatment has gone beyond glycemic control, with the choice of different medications to attain therapeutic targets also affected by the risk of long-term outcomes and safety profiles. The effect of diabetes on increased morbidity and mortality and its relationship to cardiovascular outcomes and coronary artery diseases have driven recent diabetes studies toward medications that improve cardiovascular outcomes and reduce all-cause mortality. This is attained by holistically treating cardiovascular complications in type 2 diabetic patients beyond glycemic control. Moreover, both diabetes and pre-diabetes are considered risk factors for both microvascular and macrovascular cardiac events. Despite the fact that initial research acknowledged fluid retention as a safety issue in pioglitazone use, clinical trial data have not presented conclusive proof of a positive or negative impact on cardiac function. This comprehensive literature review aims to evaluate the effect of pioglitazone on all-cause mortality, hospitalizations for heart failure, and major adverse cardiovascular outcomes, including the individual outcomes of non-fatal stroke, non-fatal myocardial infarction, and cardiovascular mortality.

Hyperthyroidism Masquerading as an Anxiety Disorder: A Report on a Misdiagnosed Case

Hyperthyroidism is an endocrine disorder characterized by excess thyroid hormone production. Its classic symptoms include weight loss, palpitations, tremors, and anxiety. We present a case of a 33-year-old female who initially presented with anxiety-like symptoms, leading to a misdiagnosis of generalized anxiety disorder. Upon further evaluation, the patient was diagnosed with hyperthyroidism, highlighting the importance of evaluating endocrine causes in patients presenting with anxiety-like symptoms. This case report underscores the significance of a comprehensive medical evaluation in patients with anxiety to avoid misdiagnoses and ensure appropriate management.

A Rare Case of Chronic Photophobia Associated With Oral Vancomycin Therapy: Exploring the Relationship

Vancomycin is a widely used tricyclic glycopeptide antibiotic for treating various Gram-positive infections, including Clostridium difficile colitis. Although considered generally safe, it has been associated with several side effects. In this case report, we highlight a rare adverse effect in which a patient experienced chronic photophobia following treatment with oral vancomycin. This sheds light upon a potential relationship between oral vancomycin therapy and photophobia, emphasizing the need for increased awareness in clinical practice and urging further investigation into this association.

Systemic Lupus Erythematosus and Cardiovascular Diseases: A Systematic Review

Systemic lupus erythematosus (SLE) is an autoimmune condition characterized by multi-organ involvement. The clinical presentation often varies from mild to moderate to severe. The cardiovascular system may also be affected, often portending a poor prognosis for patients. Although the relationship between SLE and cardiovascular disorders has been extensively explored through case reports and literature reviews, few systematic reviews explicitly focusing on this association have been conducted. In light of this, this systematic review aims to analyze the extent of the association between SLE and cardiovascular diseases (CVDs), by exploring the risk of developing CVDs, including myocardial infarction (MI), atherosclerosis, myocarditis, pericarditis and arrhythmias, in SLE patients vs. non-SLE patients. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to perform the systematic review. A detailed search was done covering the period from March 2003 to March 2023 using three databases: PubMed, Google Scholar, and Cochrane. The PubMed search identified 597 articles, while Google Scholar and Cochrane searches yielded 559 and three articles, respectively. Of the 1159 articles retrieved, we chose eight for final consideration, after excluding papers that did not discuss the role of SLE in CVDs, papers published earlier than 2003, and papers with incomplete data. The eight studies chosen included two narrative reviews, two systematic reviews, and four observational studies. In this systematic review, SLE was proven to have a strong relationship with diverse CVDs, including rare ones scarcely discussed in the literature, such as vasculitis and aortic dissection. All eight of the final papers indicated a connection between SLE and CVDs, based on the systematic analysis of these articles, which revealed that most recent research supports a higher risk of peripheral arterial occlusive disease (PAOD), MI, pericarditis, myocarditis, and other cardiovascular disorders in individuals with SLE. These associations may have certain gray areas, as patient characteristics and comorbidities often affect the extent of illness and long-term prognosis. Larger-scale studies are required to probe this relationship further and research the etiopathogenesis involved in order to improve patient outcomes. The effects of SLE on the heart are, however, unequivocal.

PTEN/PI3K/VEGF signaling pathway involved in the protective effect of xanthine oxidase inhibitor febuxostat against endometrial hyperplasia in rats

Endometrial hyperplasia (EH) is a medical condition that affects many females as it increases their uterine carcinogenic potential. EH results from entangling hormonal imbalance and inflammatory response. The study examined the role of a xanthine oxidase inhibitor, febuxostat, in a rat model of EH. Adult female Wistar albino rats were subjected to estradiol valerate (EV) 2 mg/kg for 10 days to induce EH. Another group was treated concomitantly with febuxostat 10 mg/kg for the same period. The uterine malondialdehyde, reduced glutathione (GSH), and superoxide dismutase (SOD) were assessed by chemical methods. Gene expressions of phosphatidylinositol-3-kinase (PI3K), Akt, and hypoxia-inducible factor 1 alpha were assessed by the quantitative real-time polymerase chain reaction. Moreover, the vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay. Histopathology and immunohistochemical techniques were used for the detection of phosphatase and tensin homolog (PTEN). The results revealed that EV administration induced complex EH with focal atypia and loss of PTEN expression by the histological examination. Uteri of the EV group showed a significant drop in GSH content and SOD activity and rise in the expressions of PI3K, Akt, VEGF, and IL-6. Febuxostat administration significantly improved the uterine GSH and SOD levels. It decreased the expressions of PI3K, Akt, VEGF, and IL-6. The endometrium showed a regression of the proliferative epithelium with the restoration of PTEN expression and the absence of the atypical features. In conclusion, febuxostat protected the endometrium against estrogen-induced EH and may be beneficial in the management along with the hormonal therapy.

Effect of biochars produced from solid organic municipal waste on soil quality parameters

New value-added uses for solid municipal waste are needed for environmental and economic sustainability. Fortunately, value-added biochars can be produced from mixed solid waste, thereby addressing solid waste management issues, and enabling long-term carbon sequestration. We hypothesize that soil deficiencies can be remedied by the application of municipal waste-based biochars. Select municipal organic wastes (newspaper, cardboard, woodchips and landscaping residues) individually or in a 25% blend of all four waste streams were used as feedstocks of biochars. Three sets of pyrolysis temperatures (350, 500, and 750 °C) and 3 sets of pyrolysis residence time (2, 4 and 6 h) were used for biochar preparation. The biochar yield was in the range of 21-62% across all feedstocks and pyrolysis conditions. We observed variations in key biochar properties such as pH, electrical conductivity, bulk density and surface area depending on the feedstocks and production conditions. Biochar increased soil pH and improved its electrical conductivity, aggregate stability, water retention and micronutrient contents. Similarly, leachate from the soil amended with biochar showed increased pH and electrical conductivity. Some elements such as Ca and Mg decreased while NO₃-N increased in the leachates of soils incubated with biochars. Overall, solid waste-based biochar produced significant improvements to soil fertility parameters indicating that solid municipal wastes hold promising potential as feedstocks for manufacturing value-added biochars with varied physicochemical characteristics, allowing them to not only serve the needs for solid waste management and greenhouse gas mitigation, but also as a resource for improving the quality of depleted soils.

Effect of intercropping Panicum maximum var. Ntchisi and Lablab purpureus on the growth, herbage yield and chemical composition of Panicum maximum var. Ntchisi at different harvesting times

The study was conducted to evaluate the effect of intercropping Panicum maximum var. Ntchisi and Lablab purpureus on the growth, herbage yield and chemical composition of P. maximum var. Ntchisi at different harvesting times at the Teaching and Research farm, Federal University of Agriculture, Abeokuta in a randomized complete block design. Samples were collected at different harvesting times (8, 10, 12, 14 weeks after planting). The growth parameters which were plant height, leaf length, leaf number and tiller number measured showed that the intercropping of grass with legume were higher than in the sole plot of P. maximum var. Ntchisi. The plant yield was consistently higher (p < 0.05) in intercropped forages than in sole throughout the harvesting times. The crude protein contents of the forages were also higher for the intercropped across the treatments. The values of the fibre components were significantly different (p < 0.05) at different harvesting times and it was increasing as the harvesting time was increasing. From this study, considering the herbage yield and chemical composition of intecropping Panicum maximum var. Ntchisi and Lablab purpureus, they can be grazed by ruminant animals or harvested at 12 weeks after planting when the quality and quantity will support livestock productivity and can be conserved to be fed to ruminant animals during dry season when feed availability and quality are extremely low.

Tonsilar toxoplasmosis

One hundred cases were suffering from chronic tonsillitis, aged between 4-12 years, of both sexes (60 males and 40 females), from outpatient clinic of E.N.T. unit at Benha Faculty of Medicine. They were examined serologically by indirect haemagglutination--antibody technique (IHAT) for toxoplasmosis. After tonsillectomy, histopathological and electronmicroscopical studies were done. Ten percent of cases were positive serologically, among males (11.71%) and females (7.5%). The positivity rate was high among age group 10-12 years than others. Two cases showed histopathological and ultrastructural changes indicating toxoplasmosis.