The Covid-19, a threatening pandemic, was originated from China in December 2019 and spread quickly to all over the world. The pathogenesis of coronavirus is linked with the disproportionate response of the immune system. This involves the systemic inflammatory reaction which is characterized by marked pro-inflammatory cytokine release commonly known as cytokine release storm (CRS). The pro inflammatory cytokines are involved in cascade of pulmonary inflammation, hyper coagulation and thrombosis which may be lethal for the individual. That’s why, it is very important to have understanding of pro inflammatory cytokines and their pathological role in SARS-CoV-2. The pathogenesis of Covid is not the same in every individual, it can vary due to the presence of pre-existing comorbidities like suffering from already an inflammatory disease such as rheumatoid arthritis (RA), inflammatory bowel disease (IBD), chronic obstructive pulmonary disease (COPD), an immune-compromised patients suffering from Diabetes Mellitus (DM) and Tuberculosis (TB) are more vulnerable morbidity and complications following COVID-19. This review is particularly related to COVID-19 patients having comorbidity of other inflammatory diseases. We have discussed the brief pathogenesis of COVID-19 and cytokines release storm with reference to other co-morbidities including RA, IBD, COPD, DM and TB. The available therapeutic regimens for COVID-19 including cytokine inhibitors, anti-viral, anti-biotic, bronchodilators, JAK- inhibitors, immunomodulators and anti-fibrotic agents have also been discussed briefly. Moreover, newly emerging medicines in the clinical trials have also been discussed which are found to be effective in treating Covid-19.

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Objective: To develop and validate in-house HEp-2 cell slides for the detection of ANA by indirect immunofluorescence.

Objective: To determine the diagnostic accuracy of plain computed tomography using the ratio between hounsfield unit and hematocrit of cerebral venous sinuses in cases of acute cerebral venous sinus thrombosis taking magnetic resonance venography as the gold standard. Method: The cross-sectional validation study was conducted at the Department of Diagnostic Radiology, Combined Military Hospital, Rawalpindi, Pakistan, from March 9 to September 8, 2021, and comprised patients regardless of age and gender presenting with acute neurological and visual signs and symptoms of cerebral venous sinus thrombosis for <5 days. The patients were brain-imaged on 128-slice computed tomography scanner, and the image was assessed and the attenuation values in terms of Hounsfield unit of dural venous sinuses were calculated by taking appropriate region of interest. Haemoglobin and hematocrit values were noted from blood reports, and then the ratio between Hounsfield unit and hematocrit ratio was calculated. Magnetic resonance venography of the patients were performed and the patients were assessed for dural venous thrombosis. Data was analysed using SPSS 23. Results: Of the 201 patients, 98(48.8%) were males and 103(51.2%) were female. The overall mean age was 35.32±19.707 years (range: 1 month-70 years). According to the Hounsfield unit-hematocrit ratio, acute cerebral venous sinus thrombosis was detected in 173(86.01%) patients, while magnetic resonance venography detected 178(88.6%). The Hounsfield unit-hematocrit ratio had sensitivity 91.01%, specificity 52.17% and diagnostic accuracy 86.57%. Conclusion: Computed tomography attenuation value and Hounsfield unit-hematocrit ratioon unenhanced computed tomography could be used as a reliable method to detect acute cerebral venous sinus thrombosis in emergency settings. Key Words: Computed tomography, Acute cerebral venous sinus thrombosis, Magnetic resonance venography.

Post-traumatic sphenoid sinus pseudoaneurysm arising from the cavernous segment of the internal carotidartery (ICA) is rare, and even rarer occurrence is an associated carotid-cavernous fistula (CCF). Here we presentthe case of a young male patient presenting with intractable epistaxis due to a post-traumatic sphenoid sinuspseudoaneurysm of the internal carotid artery and a simultaneous carotid-cavernous fistula. How to cite this: Ibrahim MI, Nisar T, Tanveer A, Suhail S, Khan R, Ahmed. Traumatic Internal Carotid Artery Aneurysm with a Concomitant Carotid Cavernous Fistula. Life and Science. 2022; 3(4): 200-202. doi: http://doi.org/10.37185/LnS.1.1.252