Breast cancer has recently been known as the first lethal malignancy in women worldwide. Despite the existing treatments that have improved the patients’ prognosis, some types of breast cancer are serious challenges to treat. Therefore, efforts are underway to provide more efficient therapy. Cryptotanshinone (CPT) is a liposoluble diterpenoid derivation of a traditional Chinese herbal medicine called Salvia miltiorrhiza Bunge. It has been considered in the past decades due to its vast therapeutic properties, including anti-tumor, anti-inflammatory, and anti-fibrosis. Recently, studies have found that CPT showed a significant anti-breast cancer effect in vivo and in vitro through different physiological and immunological mechanisms. This study summarized the latest research findings on the antitumor effect of CPT in breast cancer. Further, the main molecular mechanisms based on breast cancer types and combination with other drugs were reviewed to provide essential evidence for future longitudinal research and its clinical application in breast cancer treatment.

Introduction: In the coronavirus disease 2019 (COVID-19) era, kidney transplantation recipients (KTRs) are at high risk due to using immunosuppressive drugs. Considering the lack of definitive cure for COVID-19, repurposing existing pharmaceuticals is a way to find an immediate medication. Objectives: This study aimed to evaluate the COVID-19 outcomes in KTRs, receiving combination of sofosbuvir and daclatasvir (SOF-DAC) treatment. Patients and Methods: This research was an observational study of 12 adult kidney transplant recipients with COVID-19, admitted to Shariati hospital, Tehran, Iran (October to December 2020). All the patients received a once-daily combination pill of SOF-DAC at a dose of 400/60 mg for 10 days. Results: Around October to December 2020, 12 adult KTR patients were recruited; four patients (33.3%) died and eight patients survived (66.7%). Acute kidney injury (AKI) secondary to COVID-19 was seen in 11 patients of the study population (91.7%), including four dead cases. Two of the three patients who underwent dialysis due to kidney complications, died. The laboratory results showed that the mean level of each parameter white blood cells (WBC), international normalized ratio (INR), C-reactive protein (CRP), ferritin, D-dimer on the last day of hospital stay was significantly different between two groups of survived and dead patients at a 95% confidence level (P<0.05). Conclusion: Sofosbuvir combined with DAC for treatment of KTRs with COVID-19 infection reduced the mortality rate. Further, this medication was safe. Patients tolerated it well, and no serious adverse effects were observed. Larger studies are needed to validate these results.

A 75-year-old man was admitted with a diagnosis of diabetic ketoacidosis and hyperkalemia. During the treatment, he developed refractory hyperkalemia. Following our review, diagnosis of pseudohyperkalaemia secondary to thrombocytosis was made. We report this case to remind the importance of clinical suspicion of this phenomenon to prevent its serious consequences.

Introduction: Rare cases of autoimmune hemolytic anemia (AHA) associated with using ciprofloxacin or hydrochlorothiazide (HCTZ) alone have been reported before. However, simultaneous use of both drugs could lead to a severe clinical condition. This study presents the combination of acute kidney injury (AKI) and AHA following the simultaneous use of ciprofloxacin and HCTZ for three days. Case Description: A 42-year-old Iranian woman presented to the emergency department with symptoms of fatigue, lethargy, nausea and vomiting, ataxia, oliguria, dark urine, and jaundice. The patient reported using HCTZ due to high blood pressure and ciprofloxacin for a urinary tract infection three days before presentation. Early laboratory findings revealed hemolytic anemia with a hemoglobin of 7 g/dl, the strongly positive direct and indirect Coombs test, high level of lactate dehydrogenase (820 IU/L), and hyperbilirubinemia (total: 3 mg/dL and direct: 1.2 mg/dL). Furthermore, hyperkalemia (5.2 mEq/ L), hyperphosphatemia (6.2 mg/dL), high levels of BUN (100 mg/dL), and creatinine rise (6.8 mg/dL) were found. Urine analysis showed 2+ blood, 4-6 red blood cells, and cola-colored urine. Based on the findings, druginduced AHA, followed by AKI, was diagnosed. Following, the drugs were stopped and steroid therapy was initiated. The patient underwent four sessions of hemodialysis to improve the AKI. Conclusion: Healthcare providers should be aware of the life-threatening adverse effects of commonly used drugs such as ciprofloxacin or HCTZ. The timely diagnosis of the offending drugs leads to avoiding the persistence of the risk factor and the deterioration of the patient's clinical condition.acute kidney injury, autoimmune hemolytic anemia, ciprofloxacin, hydrochlorothiazide Highlights• The combination of hemolytic anemia and acute kidney injury following the concomitant use of ciprofloxacin and hydrochlorothiazide is a rare and severe complication presented in this study. • Healthcare providers should be aware of the life-threatening drug-induced autoimmune hemolytic anemia that may occur with commonly used drugs. • The treatment mainly includes cessation of the offending drug, steroid therapy, blood transfusion if needed, and supportive care.