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Byline: A. Apisarnthanarak (1), B. Razavi (1), T. Bailey (1) Keywords: Key Words Nocardiosis; Waldenstrom macroglobulinemia; Pulmonary granuloma; Psoas abscess; Diskitis Abstract: Disseminated nocardiosis has never been described before in a patient with Waldenstrom macroglobulinemia. We report an unusual case of disseminated nocardiosis in a patient with Waldenstrom macroglobulinemia who presented with pulmonary non-caseating granulomas. The patient was successfully treated with trimethoprim-sulfamethoxazole (TMP-SMX) for 1 year. Author Affiliation: (1) Division of Infectious Disease, Washington University School of Medicine, 660 South Euclid Ave. CM 8051, St. Louis, MO 63110, USA Phone: (+1/314) 454-8214, Fax: -5392, e-mail: anucha@gwu.edu, US Article note: Received: May 20, 2001 * Revision accepted: September 25, 2001

Byline: B. Razavi (1), B. Lund (2), B. L. Allen (3), L. Schlesinger (4) Keywords: Key Words Treatment; Antibiotic; Prophylaxis; Pneumocystis carinii pneumonia (PCP); AIDS; Trimethoprim/Sulfamethoxazole (TMP/SMX); Leucovorin Abstract: Pneumocystis carinii is a common cause of pneumonia in patients with AIDS, however, the incidence has dropped with the availability of effective prophylactic regimens. First-line treatment for both acute Pneumocystis pneumonia and chronic prophylaxis is trimethoprim/sulfamethoxazole (TMP/SMX). This combination can cause hypersensitivity reactions as well as myelosuppression. The simultaneous administration of leucovorin during acute treatment has bee shown to reduce the incidence of neutropenia, but may interfere with the efficacy of TMP/SMX. We report a case of P. carinii pneumonia in a patient with AIDS who failed TMP/SMX prophylaxis while taking leucovorin. Author Affiliation: (1) Dept. of Medicine, Washington University School of Medicine, St. Louis, MO, USA, US (2) University of Iowa College of Pharmacy, Iowa Citiy, IA, USA, US (3) Dept. of Internal Medicine, Indianapolis VAMC and Indiana University School of Medicine, Division of Infectious Diseases, EH 435,545 Barnhill Drive, Indianapolis, IN 46202, USA Phone: (317) 274-2898, Fax: -1587, e-mail: bradalle@iupui.edu, US (4) Dept. of Internal Medicine, Iowa City VAMC and University of Iowa Hospitals and Clinicx, Iowa City, IA, USA, US Article note: Received: October 25, 2000 * Revision accepted: October 4, 2001

Byline: B. Razavi (1), M. Razavi (2) Keywords: Key Words Herpes simplex virus; Viral encephalitis Abstract: Herpes simplex virus (HSV) is a common cause of viral encephalitis. Herpes simplex encephalitis (HSE) typically presents with acute neurologic changes and the initial cerebrospinal fluid examination is nearly always abnormal. We report a case of a patient with HSE and normal initial CSF analysis. This resulted in delayed diagnosis and therapy with subsequent severe neurolgical sequelae. Herpes simplex infection should be included in the differential diagnosis of encephalopathic patients and a normal CSF examination. Author Affiliation: (1) Division of Infectious Diseases, Washington University, 660 South Euclid Ave, Campus mail 8051, St. Louis, MO 63110, USA Phone: (+1/314) 454-8354, Fax: -5392 e-mail: behzadr@hotmail.com, US (2) Dept. of Neurology, University of Iowa, Iowa City, Iowa, USA, US Article note: Received: August 16, 2000 * Revision accepted: August 27, 2001

Background: Metabolic syndrome is an important risk factor for cardiovascular disease (CVD) occurrence and mortality. CVDs are leading cause of death worldwide. Recently, there has been an increasing interest in the use of herbal medicines with more efficiency and minimal undesirable effects than chemical drugs for a variety of disorders including CVD. Nigella sativa and its active constituent, thymoquinone, have been documented to exhibit antidiabetic, antiobesity, hypotensive and hypolipidemic properties., Aim: In this review, we discussed the most relevant articles to find out the role of N. sativa in different components of metabolic syndrome and CVD risk factors including high blood pressure, obesity, dyslipidemia and high blood glucose., Conclusions: This review suggests a potential role of N. sativa and TQ in the management of metabolic syndrome, however more studies should be conducted to evaluate their effectiveness.