ABSTRACT
Hyperinflammation and cytokine storm has been noted as a poor prognostic factor in patients with severe pneumonia related to coronavirus disease 2019 (COVID-19). In COVID-19, pathogenic myeloid cell overactivation is found to be a vital mediator of damage to tissues, hypercoagulability, and the cytokine storm. These cytokines unselectively infiltrate various tissues, such as the lungs and heart, and nervous system. This cytokine storm can hence cause multi-organ dysfunction and life-threatening complications. Mavrilimumab is a monoclonal antibody (mAb) that may be helpful in some cases with COVID-19. During an inflammation, Granulocyte-macrophage colony-stimulating factor (GM-CSF) release is crucial to driving both innate and adaptive immune responses. The GM-CSF immune response is triggered when an antigen attaches to the host cell and induces the signaling pathway. Mavrilimumab antagonizes the action of GM-CSF and decreases the hyperinflammation associated with pneumonia in COVID-19, therefore strengthening the rationale that mavrilimumab when added to the standard protocol of treatment could improve the clinical outcomes in COVID-19 patients, specifically those patients with pneumonia. With this review paper, we aim to demonstrate the inhibitory effect of mavrilimumab on cytokine storms in patients with COVID-19 by reviewing published clinical trials and emphasize the importance of extensive future trials.
ABSTRACT
Hyperinflammation and cytokine storm has been noted as a poor prognostic factor in patients with severe pneumonia related to coronavirus disease 2019 (COVID-19). In COVID-19, pathogenic myeloid cell overactivation is found to be a vital mediator of damage to tissues, hypercoagulability, and the cytokine storm. These cytokines unselectively infiltrate various tissues, such as the lungs and heart, and nervous system. This cytokine storm can hence cause multi-organ dysfunction and life-threatening complications. Mavrilimumab is a monoclonal antibody (mAb) that may be helpful in some cases with COVID-19. During an inflammation, Granulocyte-macrophage colony-stimulating factor (GM-CSF) release is crucial to driving both innate and adaptive immune responses. The GM-CSF immune response is triggered when an antigen attaches to the host cell and induces the signaling pathway. Mavrilimumab antagonizes the action of GM-CSF and decreases the hyperinflammation associated with pneumonia in COVID-19, therefore strengthening the rationale that mavrilimumab when added to the standard protocol of treatment could improve the clinical outcomes in COVID-19 patients, specifically those patients with pneumonia. With this review paper, we aim to demonstrate the inhibitory effect of mavrilimumab on cytokine storms in patients with COVID-19 by reviewing published clinical trials and emphasize the importance of extensive future trials.
ABSTRACT
The aim of this study was to determine the frequency of postoperative pain after cleaning and shaping of root canals using chlorhexidine irrigant for debridement.Study designwasRandomized Controlled Trial. The study was conducted in Operative Dentistry Department, Armed Forces Institute of Dentistry, Rawalpindi from October 2013 to October 2014 over a period of 12 months. A total of 220 patients with mandibular first premolar teeth having symptomatic irreversible pulpitis were divided into two equal groups. Group A patients were treated with 2% Chlorhexidine solution and Group B patients were treated with normal saline solution, that is, Control Group. Patient's pain response was recorded immediately after procedure and after 6 hours of treatment, using Visual Analogue Scale. Data was analyzed using SPSS version 20. The studied subjects were 220 with mean age 32.84 [SD +8.836]. Each Group had 110patients. There was no statistically significant difference in the gender of the patients among both groups.Mild pain immediately after treatment was noted in 54.1% [n=119] of patients whereas 45.9% [n=101] patients had moderate pain. Mild pain after 6 hours of treatment was noted in 76.4% [n=168] of patients and 23.6% [n=52] had moderate pain. Within the limitations of this study, it is concluded that the use of 2% Chlorhexidine solution did not had significant effect on the reduction of post-operative pain