Cause Of Pathology Research Articles

Odontogenic Factors Associated with Maxillary Sinus Schneiderian Membrane Thickness and their Relationship to Chronic Sinonasal Symptoms: An Ambispective Cohort Study.

Odontogenic sinusitis is a common maxillary sinus disease. It develops due to the violation of the Schneiderian membrane due to pathological, iatrogenic, or traumatic causes from dental and dentoalveolar structures. The aim of this cohort study was to investigate local and systemic factors associated with Schneiderian mucosal thickening (MT) in patients referred for evaluation of apical periodontitis (AP) and examine their relationship with chronic sinonasal symptoms. Cone-beam computed tomography (CBCT) scans of 197 patients referred for evaluation of endodontic diseases were reviewed. Mucosal thickening in relation to the affected tooth was measured in the coronal section in millimeters at the maximum area perpendicular to the bone. Based on this measurement, the sinus floor was categorized for MT as present (>1 mm) or absent (<1 mm). The sociodemographic and clinical characteristics of the study participants were assessed and compared according to the presence or absence of MT. Furthermore, the relationship between odontogenic sinusitis and chronic sinonasal symptoms was assessed using a chronic sinusitis survey. Male patients had a higher MT than female patients. The presence of periapical lesions and inadequate endodontic treatment were significantly associated with MT. The multivariate logistic regression model showed that the presence of AP increased the odds of MT by approximately 2.5 times (p = 0.028), and nasal obstruction was significantly higher in patients diagnosed with mucosal thickness at different times of their follow-up period (p = 0.018). MT was 2.5 times more likely in the presence of apical periodontitis, and nasal obstruction was the most significant factor associated with the presence of MT.

Gossypetin prevents the progression of nonalcoholic steatohepatitis by regulating oxidative stress and AMP-activated protein kinase.

Nonalcoholic steatohepatitis (NASH) is severe liver metabolic disorder, however, there are still no effective and safe drugs for its treatment. Previous clinical trials used various therapeutic approaches to target individual pathological mechanisms, but these approaches were unsuccessful because of the complex pathological causes of NASH. Combinatory therapy in which two or more drugs are administered simultaneously to patients with NASH, however, it carries the risk of side effects associated with each individual drug. To solve this problem, we identified gossypetin as an effective dual-targeting agent that activates AMP-activated protein kinase (AMPK) and decreases oxidative stress. Administration of gossypetin decreased hepatic steatosis, lobular inflammation and liver fibrosis in the liver tissue of mice with CDHFD and MCD diet-induced NASH. Gossypetin functioned directly as anti-oxidant agents, decreasing hydrogen peroxide and palmitate-induced oxidative stress in the AML12 cells and liver tissue of MCD diet fed mice without regulating the antioxidant response factors. In addition, gossypetin acted as a novel AMPK activator by binding to the allosteric drug and metabolite (ADaM) site, which stabilizes the activated structure of AMPK. Our findings demonstrate that gossypetin has the potential to serve as a novel therapeutic agent for NAFLD/NASH. Significance Statement This study demonstrates that gossypetin has preventive effect to progression of NASH as a novel AMPK activator and antioxidants. Our findings implicate that simultaneous activation of AMPK and oxidative stress using gossypetin has the potential to serve as a novel therapeutic approach for NAFLD/NASH patients.

Role of Circular RNAs in Atherosclerosis through Regulation of Inflammation, Cell Proliferation, Migration, and Apoptosis: Focus on Atherosclerotic Cerebrovascular Disease.

Atherosclerosis (AS) is a disease dangerous to human health and the main pathological cause of ischemic cardiovascular diseases. Although its pathogenesis is not fully understood, numerous basic and clinical studies have shown that AS is a chronic inflammatory disease existing in all stages of atherogenesis. It may be a common link or pathway in the pathogenesis of multiple atherogenic factors. Inflammation is associated with AS complications, such as plaque rupture and ischemic cerebral infarction. In addition to inflammation, apoptosis plays an important role in AS. Apoptosis is a type of programmed cell death, and different apoptotic cells have different or even opposite roles in the process of AS. Unlike linear RNA, circular RNA (circRNA) a covalently closed circular non-coding RNA, is stable and can sponge miRNA, which can affect the stages of AS by regulating downstream pathways. Ultimately, circRNAs play very important roles in AS by regulating inflammation, apoptosis, and some other mechanisms. The study of circular RNAs can provide new ideas for the prediction, prevention, and treatment of AS.

Viruses - a major cause of amyloid deposition in the brain

ABSTRACT Introduction Clinically, Alzheimer’s disease (AD) is a syndrome with a spectrum of various cognitive disorders. There is a complete dissociation between the pathology and the clinical presentation. Therefore, we need a disruptive new approach to be able to prevent and treat AD. Areas Covered In this review, the authors extensively discuss the evidence why the amyloid beta is not the pathological cause of AD which makes therefore the amyloid hypothesis not sustainable anymore. They review the experimental evidence underlying the role of microbes, especially that of viruses, as a trigger/cause for the production of amyloid beta leading to the establishment of a chronic neuroinflammation as the mediator manifesting decades later by AD as a clinical spectrum. In this context, the emergence and consequences of the infection/antimicrobial protection hypothesis are described. The epidemiological and clinical data supporting this hypothesis are also analyzed. Expert opinion For decades, we have known that viruses are involved in the pathogenesis of AD. This discovery was ignored and discarded for a long time. Now we should accept this fact, which is not a hypothesis anymore, and stimulate the research community to come up with new ideas, new treatments, and new concepts.

Manual Therapy for a Chronic Non-Specific Low Back Pain Rat Model.

Chronic low back pain (CLBP) is a highly prevalent condition worldwide and a major cause of disability. The majority of patients with CLBP are diagnosed with chronic non-specific low back pain (CNLBP) due to an unknown pathological cause. Manual therapy (MT) is an integral aspect of traditional Chinese medicine and is recognized as Tuina in China. It involves techniques like bone-setting and muscle relaxation manipulation. Despite its clinical efficacy in treating CNLBP, the underlying mechanisms of MT remain unclear. In animal experiments aimed at investigating these mechanisms, one of the main challenges is achieving normative MT on CNLBP model rats. Improving the stability of finger strength is a key issue in MT. To address this technical limitation, a standardized procedure for MT on CNLBP model rats is presented in this study. This procedure significantly enhances the stability of MT with the hands and alleviates common problems associated with immobilizing rats during MT. The findings of this study are of reference value for future experimental investigations of MT.

Hyperechogenic fetal bowel: Current evidence-based prenatal diagnosis and management.

Echogenic fetal bowel (EB) is a prenatal ultrasound finding (0.2%-1.4% of all pregnancies) defined as bowel of similar or greater echogenicity than surrounding bone. In fact, the ultrasound assessment is strongly subjective with inter-observer variability. The pathophysiology depends on the underlying condition, apparently related with meconium stasis and hypercellularity. It is often an isolated finding, with possible association with other structural anomalies. About the origin, it was observed in fetuses with cystic fibrosis, congenital infections, thalassemia, intraamniotic bleeding, fetal growth restriction. Fetuses with EB are at increased risk of adverse perinatal outcome, such as intrauterine growth restriction, placental dysfunction and perinatal death, highlighting the need for a thorough antenatal management and post-natal follow-up. It seems to be associated with a plenty of conditions, such as a poor fetal outcome, fetal growth restriction and placental dysfunction. Therefore management requires a multidisciplinary approach with different specialties' involvement and the prognosis is influenced by the underlying pathophysiology. In this complex scenario, the present review aims to define the clinical pathway which should be offered to pregnant women in case of finding of fetal EB ultrasound marker, to rule out any suspected pathological cause.

Translated article] Imaging diagnosis of vertebral metastasis

The spine is the third most frequent location for metastatic disease, after the lung and liver. On the other hand, the most frequent bone tumours are metastases and the spine is the main location. A review of the different imaging techniques available, both radiological and nuclear medicine, and the morphological appearance of spinal metastases in each of them is performed. Magnetic resonance imaging is the best imaging modality for detection of spinal metastases. It is important to make the differential diagnosis between vertebral fracture of osteoporotic and pathological cause. Spinal cord compression is a serious complication of metastatic disease and its assessment by imaging through objective scales is decisive for estimating spinal stability and therefore establishing treatment. Lastly, percutaneous intervention techniques are briefly discussed.

Advances in the Structure of GGGGCC Repeat RNA Sequence and Its Interaction with Small Molecules and Protein Partners.

The aberrant expansion of GGGGCC hexanucleotide repeats within the first intron of the C9orf72 gene represent the predominant genetic etiology underlying amyotrophic lateral sclerosis (ALS) and frontal temporal dementia (FTD). The transcribed r(GGGGCC)n RNA repeats form RNA foci, which recruit RNA binding proteins and impede their normal cellular functions, ultimately resulting in fatal neurodegenerative disorders. Furthermore, the non-canonical translation of the r(GGGGCC)n sequence can generate dipeptide repeats, which have been postulated as pathological causes. Comprehensive structural analyses of r(GGGGCC)n have unveiled its polymorphic nature, exhibiting the propensity to adopt dimeric, hairpin, or G-quadruplex conformations, all of which possess the capacity to interact with RNA binding proteins. Small molecules capable of binding to r(GGGGCC)n have been discovered and proposed as potential lead compounds for the treatment of ALS and FTD. Some of these molecules function in preventing RNA-protein interactions or impeding the phase transition of r(GGGGCC)n. In this review, we present a comprehensive summary of the recent advancements in the structural characterization of r(GGGGCC)n, its propensity to form RNA foci, and its interactions with small molecules and proteins. Specifically, we emphasize the structural diversity of r(GGGGCC)n and its influence on partner binding. Given the crucial role of r(GGGGCC)n in the pathogenesis of ALS and FTD, the primary objective of this review is to facilitate the development of therapeutic interventions targeting r(GGGGCC)n RNA.

Feasibility and efficacy of PCSK9 inhibitors in cases of statin therapy limitation or intolerance

Cardiovascular diseases are a common cause of death throughout the world, and in Russia this figure reaches high values as well. The main cause of cardiovascular pathologies is atherosclerosis, which develops against the background of lipid metabolism disorders, in particular, the accumulation of low-density lipoprotein cholesterol. Statins are the main drug in the complex therapy of dyslipidemia, however, their limited use in patients with diagnosed diabetes mellitus and statin intolerance reduces the possibilities and effectiveness of adequate long-term therapy for hyperlipidemia. PCSK9 inhibitors are promising drugs in terms of efficacy, nevertheless, the question of the possibility of using these drugs in patient groups with statin limitations arises. The purpose of the review. This article provides information on the use of PCSK9 inhibitors in the largest populations with limitations to statin therapy (patients with diabetes mellitus and patients with statin intolerance). We identified potentially relevant studies by searching the electronic databases MEDLINE, SCOPUS, PubMed, Google Scholar, and the Cochrane Database of Systematic Reviews over the last 5 years up to March 2023 using the terms: dyslipidemia, hyperlipidemia, atherosclerosis, PCSK9 inhibitor, statins, low-density lipoproteins, cholesterol, efficacy, safety, therapy. Further, according to the inclusion and exclusion criteria, as well as independent selection, all authors of this article selected the sources that met the criteria and compiled this review. Results. PCSK9 inhibitors are generally a safe, well tolerated, and effective therapeutic strategy with an established role in the therapeutic treatment of hyperlipidemias. Theoretically, PCSK9 inhibitors can be used as an alternative to statin therapy for groups of patients with statin intolerance and those with diagnosed diabetes mellitus, as well as in risk groups. As the experience with using PCSK9 inhibitors in the Russian Federation is growing rapidly, future trials are expected to shed light on their long-term safety and tolerability. On the other hand, other potential therapeutic strategies targeting PCSK9 are being developed, including inclisiran, already registered in the Russian Federation, which is also promising in the treatment of lipid metabolism disorders.

Effects of doxycycline dose rate and pre-adulticide wait period on heartworm-associated pathology and adult worm mass

BackgroundThe American Heartworm Society canine guidelines recommend treatment with doxycycline prior to adulticide administration to reduce levels of Wolbachia and its associated metabolites, which are known to be a leading cause of pulmonary pathology. Studies have determined that doxycycline administered at 10 mg/kg BID for 28 days is an effective dose for eliminating Wolbachia, but what has not been determined is the clinical relevance of this elimination. The current guidelines also recommend a 30-day wait period following administration of doxycycline to allow for clearance of metabolites, such as Wolbachia surface protein, and for further reduction in heartworm biomass before administration of adulticide. Reducing the doxycycline dose and eliminating the wait period may carry practical benefits for the animal, client, and practitioner.MethodsTo investigate these treatment practices, Dirofilaria immitis adults were surgically transplanted into each of 45 dogs, which were divided into nine study groups of five dogs each. Seventy-five days after transplantation, two groups each were administered 5, 7.5, or 10 mg/kg BID doxycycline orally for 28 days and 6 µg/kg ivermectin monthly, with three untreated groups serving as controls. Study animals were necropsied and examined prior to treatment as well as 30 and 60 days post-treatment.ResultsMean worm weight was unaffected by dosage but exhibited a significant increase at 30 days and significant decrease at 60 days post-treatment, including in control groups. Histopathology lesion scores did not significantly differ among groups, with the exception of the lung composite score for one untreated group. Liver enzymes, the levels of which are a concern in doxycycline treatment, were also examined, with no abnormalities in alanine aminotransferase or alkaline phosphatase observed.ConclusionsNo consistent worsening of tissue lesions was observed with or without the AHS-recommended 30-day wait period, nor did reduced dosages of doxycycline lead to worsening of pathology or any change in efficacy in depleting worm weight. Mean worm weight did significantly increase prior to, and decrease following, the wait period. Future work that also includes adulticide treatment (i.e. melarsomine) will study treatment recommendations that may improve both animal health and owner compliance.Graphical abstract

Length and saturation of fatty acids in phosphatidylserine determine the rate of lysozyme aggregation simultaneously altering the structure and toxicity of amyloid oligomers and fibrils.

Abrupt aggregation of misfolded proteins is the underlying molecular cause of numerous severe pathologies including Alzheimer's and Parkinson's diseases. Protein aggregation yields small oligomers that can later propagate into amyloid fibrils, β-sheet-rich structures with a variety of topologies. A growing body of evidence suggests that lipids play an important role in abrupt aggregation of misfolded proteins. In this study, we investigate the roles of length and saturation of fatty acids (FAs) in phosphatidylserine (PS), an anionic lipid that is responsible for the recognition of apoptotic cells by macrophages, in lysozyme aggregation. We found that both the length and saturation of FAs in PS contribute to the aggregation rate of insulin. PS with 14-carbon-long FAs (14:0) enabled a much stronger acceleration of protein aggregation compared to PS with 18-carbon-long FAs (18:0). Our results demonstrate that the presence of double bonds in FAs accelerated the rate of insulin aggregation relative to PS with fully saturated FAs. Biophysical methods revealed morphological and structural differences in lysozyme aggregates grown in the presence of PS with varying lengths and FA saturation. We also found that such aggregates exerted diverse cell toxicities. These results demonstrate that the length and saturation of FAs in PS can uniquely alter the stability of misfolded proteins on lipid membranes.

Transannular Selenocyclofunctionalization of 1,5-cyclooctadiene: The Antioxidant Properties of 9-selenabicyclo[3.3.1]nonane Derivatives and the Discovery of Increasing Both GPx and GR Activities

Oxidative stress is the cause of various pathologies and disorders of cellular functions. Substances that reduce the pathological effect of oxidative stress on homeostasis include organoselenium compounds of natural and synthetic origin. Depending on the structure, organoselenium compounds can exhibit different biological activities, for example, reducing oxidative stress, participating in the regulation of signaling systems, influencing the synthesis of cytokines, etc. This makes them promising products for the development of new means of metabolic correction and drugs with enzyme-like activity. This study is aimed at developing an effective method for the synthesis of functional organoselenium compounds and studying their antioxidant effect in vivo under stress conditions. A one-pot catalyst-free method of transannular addition-functionalization of cis,cis-1,5-cyclooctadiene with selenium dihalides in the presence of nucleophiles was developed. For the first time, the antioxidant activity of functionalized 9-selenabicyclo[3.3.1]nonanes was studied in vivo. Quantitative characteristics of the effect on the level of lipid peroxidation and the activity of glutathione peroxidase and glutathione reductase under stress conditions were obtained. The effect of substituents in the selenium-containing scaffold on the biological activity of the compounds was studied. The water-soluble 9-selenabicyclo[3.3.1]nonane derivatives, containing hydroxyl and 2-hydroxyethoxy groups, which increased the activity of both glutathione peroxidase and glutathione reductase, were discovered.

Evaluation of the relationship between clinical and laboratory risk factors in atherosclerosis patients with coronary slow flow: a case–control analysis

BackgroundCoronary slow flow (CSF) is an angiographic entity distinguished by the delayed filling of the epicardial coronary arteries in the lack of significant obstructive artery disease. The pathological causes are still unknown. This study aimed to elucidate the relationship between clinical and laboratory-related risk factors in atherosclerosis patients diagnosed with CSF.ResultsThe research encompassed a study group of 142 individuals, with a mean age of 52.47 ± 10.62, and a male representation of 47.7%. A thorough statistical analysis was conducted, indicating that there were no noteworthy variations in age, gender, smoking history, hematocrit, blood sugar, and HDL levels between the groups of cases and controls (P > 0.05). Subsequent analysis of the data indicated that there were significant differences in history of hypertension, LDL, and BMI measurements between the groups of subjects who were designated as cases and those who were designated as controls. Our study revealed that male gender, a history of hypertension, and BMI were identified as independent predictors of CSF (P < 0.05).ConclusionsAfter modeling regression, we were able to conclude that male gender, BMI, and history of hypertension are reliable predictors of slow coronary flow. These findings add to our growing understanding of the complex interplay between clinical and laboratory risk factors in the development and progression of CSF.

Novel frameshift mutations in SALL4 in two Chinese families with Okihiro syndrome

In the present study, clinical manifestations of two Chinese Okihiro syndrome families were analyzed, and genetic detections were performed on the two probands by exome sequencing and verified by Sanger sequencing for family members to determine the biological pathogenesis. Prenatal diagnoses were provided for three high-risk fetuses. The affected members exhibited a wildly spectrum of phenotypes, including ultrasound abnormalities of skeletal system (radius deformity and abnormal posture), and cardiac system (persistent common arterial trunk and ventricular septal defect) in the prenatal period of family 1, the severe phenotypes (grossly shortened and deformed forearm, Duane's anomaly and hearing loss), and the mild ones (usually only thenar dysplasia, or short radius styloid process). Two SALL4 variants, c.844delC p.(Q282Kfs*8) and c.2210delG p.(G737Vfs*23), have been identified respectively in two probands, and c.2210delG of SALL4 gene was unreported previously. The two variants were verified in all affected individuals, not in normal family members. Genotyping results of three fetuses indicated that one fetus was normal, and the two fetuses with heterozygous variation were affected. The two variants of SALL4 gene, c.844delC p.(Q282Kfs*8) and c.2210delG p.(G737Vfs*23), were the molecular pathological cause of Okihiro syndrome in the present study and enriched the spectrum of SALL4 variants. Our study provides accurate prenatal genetic diagnosis for the two families to avoid the birth of affected children.

Electrostimulation as a method of correction of respiratory disorders in patients with cervical spinal cord injury: A review

BACKGROUND:Patients with cervical spinal cord injury have the highest risk of developing respiratory dysfunction and associated complications such as pneumonia, atelectasis, and respiratory failure. Respiratory dysfunction is the leading cause of comorbid, somatic, and infectious pathology, and mortality following traumatic cervical spinal cord injuries. Mechanical ventilation of the lungs is the standard treatment for such patients; however, it is associated with atrophy and diaphragm dysfunction.&#x0D; AIM:To analyze literature data on the use of electrical stimulation techniques of the spinal cord, nerves, and muscles for the correction of respiratory disorders in patients with cervical spinal cord trauma.&#x0D; MATERIALS AND METHODS:This study presented the results of the search and analysis of peer-reviewed articles that examined the effects of various electrical stimulation techniques on respiratory function in patients with cervical spinal cord injury. ScienceDirect, Google Scholar, and PubMed were searched from 2000 to 2022.&#x0D; RESULTS:Currently, new treatment options are available for patients with tetraplegia, with reduced ventilatory function. Many studies have shown the positive effect of electrostimulation techniques on ventilatory function such as reduced time spent on mechanical ventilation and reduced incidence of infections and other lung complications.&#x0D; CONCLUSIONS:Electrical stimulation promotes neuromuscular plasticity and results in improved spontaneous activation of the diaphragm and respiratory muscles. Electrostimulation inacomprehensive rehabilitation program of patients with traumatic spinal cord injuries at the cervical level is currently employed to promote weaning from mechanical ventilation and prevent accompanying complications such as respiratory failure, pneumonia, and atelectasis. In addition to invasive electrical stimulation of the diaphragmatic nerve and/or spinal cord, existing less invasive electrostimulation techniques require further investigation in patients with spinal cord injury and respiratory dysfunction.

Hyperandrogenism.

Hyperandrogenism is a common condition encountered by pediatric and adolescent physicians. Most girls with hyperandrogenism represent physiological pubertal variation; pathology may be present in a substantial minority. Systematic evaluation is essential to avoid unnecessary work-up in physiological causes while not missing pathological causes. Polycystic ovarian syndrome (PCOS), unexplained, persistent hyperandrogenism of ovarian origin, is the most common form in adolescent girls. The high prevalence of physiological peripubertal hirsutism, anovulation, and polycystic ovarian morphology results in mislabeling many girls as having the polycystic ovarian syndrome, a disorder with lifelong implications. The use of strict criteria of age-specific anovulation, hyperandrogenism, and duration is essential to reduce their stigmatization. The exclusion of secondary causes by screening tests (cortisol, thyroid profile, prolactin, and 17OHP) is essential before undertaking treatment for PCOS. Lifestyle measures, estrogen-progesterone preparations, antiandrogens, and metformin are the cornerstone of managing the disorder.

Randomly incorporated genomic N6‐methyldeoxyadenosine delays zygotic transcription initiation in a cnidarian

N6‐methyldeoxyadenosine (6mA) is a chemical alteration of DNA, observed across all realms of life. Although the functions of 6mA are well understood in bacteria and protists, its roles in animal genomes have been controversial. We show that 6mA randomly accumulates in early embryos of the cnidarian Hydractinia symbiolongicarpus, with a peak at the 16‐cell stage followed by clearance to background levels two cell cycles later, at the 64‐cell stage—the embryonic stage at which zygotic genome activation occurs in this animal. Knocking down Alkbh1, a putative initiator of animal 6mA clearance, resulted in higher levels of 6mA at the 64‐cell stage and a delay in the initiation of zygotic transcription. Our data are consistent with 6mA originating from recycled nucleotides of degraded m6A‐marked maternal RNA postfertilization. Therefore, while 6mA does not function as an epigenetic mark in Hydractinia, its random incorporation into the early embryonic genome inhibits transcription. In turn, Alkbh1 functions as a genomic 6mA “cleaner,” facilitating timely zygotic genome activation. Given the random nature of genomic 6mA accumulation and its ability to interfere with gene expression, defects in 6mA clearance may represent a hitherto unknown cause of various pathologies.

Psychosocial impact of being diagnosed with mild cognitive impairment: patient and carer perspective.

Mild cognitive impairment (MCI) may represent an intermediate, prodromal phase of dementia. Although persons with MCI (PwMCI) are able to function independently, they often experience reduced ability to carry out their usual activities. This can result in social, emotional and functional challenges. To explore the understanding and psychosocial impact of receiving a diagnosis of MCI on patients and carers. A cross-sectional cohort study was conducted at St James's Hospital Memory Clinic involving patients who attended the clinic for assessment from 1 January 2020 to 30 April 2021 and received a diagnosis of MCI. We completed questionnaires with patients and a nominated family member or friend of each patient (FwMCI). Forty-seven PwMCI participated in the study, and 36 nominated family members and/or friends completed the FwMCI questionnaire. In our cohort of PwMCI, most of the participants were not aware of their diagnosis; only 21% used the term MCI, and only 25% attributed their problems to a pathological cause. The majority of participants had no recollection of any discussion around the likelihood of progression. One-third of participants expressed relief that they did not have dementia. Most PwMCI reported positive psychological well-being and did not endorse symptoms of depression or anxiety. There was slight discordance of illness perception among the PwMCI-FwMCI dyads. Forty-seven per cent of FwMCI reported at least a mild degree of carer burden on the Zarit Burden Scale. Patients' awareness of being diagnosed with MCI is relatively limited. Public education campaigns raising awareness about MCI can help influence the 'illness representation' for MCI and enable people to seek timely advice and support.

Frosted branched angiitis due to viral meningo-encephalitis and ocular toxoplasmosis; a rare case report from Nepal.

An 18-year-old young boy hospitalized with the diagnosis of acute viral meningo-encephalitis presented with the complaint of diminution of vision and floaters in both eyes for a week. Herpetic infection was confirmed with the cerebro-spinal fluid analysis and was under antiviral drugs. His presenting visual acuity was 20/80 in both eyes and ocular features were suggestive of FBA. The vitreous sample analysis revealed raised toxoplasma titre so intravitreal clindamycin was administered twice. The ocular features resolved in the subsequent follow ups with intravenous antiviral treatment and intravitreal antitoxoplasma treatment. FBA is a very rare clinical syndrome secondary to many immunological or pathological causes. So, possible etiologies must be ruled out for timely management and good visual prognosis.

Spontaneous Pseudoaneurysm of the Left Superficial Femoral Artery: An Unusual Case Report and Review of Literature

Pseudoaneurysms are rare to occur and the rarest to occur in those who have not undergone surgical/endovascular procedures like catheterization. Such pseudoaneurysms are known as spontaneous pseudoaneurysms which are very less reported and reviewed. This generally occurs due to underlying pathological causes, the most common being atherosclerotic disease. The most common clinical presentation is a femoral artery pseudoaneurysm. Other less common presentations include aortic and visceral pseudoaneurysms. We describe here the occurrence of a pseudoaneurysm in a patient who has no history of endovascular procedures in the past and has a pseudoaneurysm showing a secondary change along with superadded infection of Acinetobacter baumannii. The case was radiologically diagnosed by a computed tomography scan of the abdomen and thigh, after which a surgical excision of the pseudoaneurysm was performed and the specimen was sent for the histopathological examination, which revealed secondary changes.