A rare case of abdominal cocoon associated with internal hernia in an adult.

A transmesenteric internal hernia (TIH) is a protrusion of a viscus through the mesenteric defect. It is secondary to previous gastrointestinal surgery in an adult. Early diagnosis and management are warranted to prevent the strangulation of the bowel in a TIH. Here, we are reporting a case of a 24-year-old gentleman with COVID-positive status who has presented with cough, abdominal cocoon, and features of subacute intestinal obstruction (SAIO) without any previous history of abdominal surgery. A nonoperative trial is given in the management of abdominal cocoon with SAIO. In contrast, delay in surgical intervention in TIH leads to bowel gangrene. Surprisingly even on contrast-enhanced computed tomography of the abdomen, TIH was not picked up. We have diagnosed this case intraoperatively with gangrene of the bowel. In an abdominal cocoon without any history suggestive of tuberculosis or previous surgery, or any other condition that leads to an intra-abdominal reaction, an internal hernia should be kept as a differential diagnosis. The delay in diagnosis and surgical intervention is associated with potentially disastrous complications.

Pharmaceutical, biological agents, and vaccines under clinical trials for COVID-19 and roles of pharmacists to combat COVID-19, an update

Due to the high mortality rate and rapid spread in the early phase of the COVID-19 pandemic, the healthcare system used various treatment options. The pathology associated with COVID-19 includes inflammatory responses which ultimately lead to multi-system organ failure or "cytokines storm". Treating COVID-19 at the initial stage of pandemic has become a challenge as there are no medications that have yet been approved by the FDA or other regulatory agencies. There are many medications have been used by the practitioners to combat the severity of the inflammatory responses. This article summarized the repurposed medications that have received attention during the COVID-19 pandemic and provided an outline of the therapeutic agents, which are under clinical trial that may be helpful to treat COVID-19. This article also emphasizes on pharmacist roles and responsibilities during disasters and pandemics and discussed various vaccines undergoing clinical trials currently.

Pharmaceutical, biological agents, and vaccines under clinical trials for COVID-19 and roles of pharmacists to combat COVID-19, an update

Due to the high mortality rate and rapid spread in the early phase of the COVID-19 pandemic, the healthcare system used various treatment options. The pathology associated with COVID-19 includes inflammatory responses which ultimately lead to multi-system organ failure or "cytokines storm". Treating COVID-19 at the initial stage of pandemic has become a challenge as there are no medications that have yet been approved by the FDA or other regulatory agencies. There are many medications have been used by the practitioners to combat the severity of the inflammatory responses. This article summarized the repurposed medications that have received attention during the COVID-19 pandemic and provided an outline of the therapeutic agents, which are under clinical trial that may be helpful to treat COVID-19. This article also emphasizes on pharmacist roles and responsibilities during disasters and pandemics and discussed various vaccines undergoing clinical trials currently. Copyright © 2022 Marmara University Press.