ABSTRACT
With the ongoing pandemic declared by the World Health Organization,the number of hospitalizations and deaths caused by COVID-19 is increasing dramatically. As new variants of SARS-CoV-2 emerge, new combination therapies are needed to reduce the risk of COVID-19spreadduring this time of increased transmission risk. In this case, it is vitalto strengthen the immune system against highly inflammatory conditions such as the cytokine storm caused by COVID-19. This brief review highlights the benefits of taking melatonin and the new antiviral drug molnupiravir together in the treatment of COVID-19. Webelieve that this combination therapy against COVID-19 would be of great benefit and should be considered as an adjuvant therapy in the treatment of this disease. Copyright © 2023, Ibn Sina Trust. All rights reserved.
ABSTRACT
Introduction: This study was aimed to assess the clinical features and electrophysiological subtypes of patients with Guillain-Barre syndrome (GBS) in Istanbul, as well as to analyze the probably different characteristics of COVID-associated GBS. Method(s): From the patients who were admitted to the major hospitals in Istanbul between April 2019 and November 2021, those aged over 18 years and diagnosed as having GBS within the 21 days after the initial symptoms were selected for the study. Electrophysiologic examinations were performed twice within the first 6 weeks along with close clinical observation throughout the acute illness. The patients were divided into groups as those admitted in the pre-pandemic and pandemic periods. The characteristics of the patients who developed GBS after COVID infection (C-GBS) were also evaluated separately. Axonal and demyelinating subtypes were determined according to the previously described electrophysiologic criteria. Result(s): From 12 centers, 134 patients were included in the study. The number of patients diagnosed in the pre-pandemic and pandemic periods were 61 and 73, respectively. Eighteen patients developed C-GBS in the pandemic era. According to Uncini's criteria, 33.6% of the patients were classified as axonal GBS (29/45 patients had reversible conduction failure) and electrophysiological distinction could not be made in 8.2% of the patients. In the second electrophysiological examination performed in 116 patients, the subtype diagnosis was changed in 29 who had been classified according to the Hadden's criteria in the first examination and in 17 who had been categorized by using Rajabally's criteria. Sensory symptoms were found in all C-GBS patients and in only 67.9% of all patients diagnosed during the pandemic (p = 0.006). The frequency of demyelinating subtype was 83.3% in the C-GBS group, and this rate was 47.8% in the patients without recent COVID infection (p = 0.026). While MRC sum score, Hughes score, and modified Erasmus outcome score were not found to be different in the pre-pandemic and post-pandemic groups, C-GBS had lower Hughes score (<3) than the other patients diagnosed during the pandemic (p = 0.040). Conclusion(s): The frequency of axonal GBS in Istanbul, a large metropole inhabiting people from every region of Turkey, seems to be placed in between the values reported from high and low incidence countries. The second electrophysiologic examination is important for precise determination of the subtypes. C-GBS seems to cause more frequent sensory symptoms, demyelinating electrophysiologic characteristics, and moderate clinical features. Copyright © 2022
ABSTRACT
Therapeutic plasma exchange (TPE) can be applied as an effective therapeutic option in children with hematological, neurological, nephrological, and autoimmune/rheumatic disorders. We aimed to report our TPE experience in pediatric patients. In this article, we retrospectively reviewed the records of pediatric patients who underwent TPE between 2019 and 2021. A total of 128 TPE sessions were performed in 25 patients (13 males,12 females;mean age 59.6 +/- 11.7 [3-198] months). The TPE indications were sepsis with/without multiorgan dysfunction syndrome in five patients, acute liver failure, hemolytic uremic syndrome caused by Shiga toxin, and autoimmune hemolytic anemia in three patients, respectively, multiple sclerosis, autoimmune encephalitis, and multisystem inflammatory syndrome in children (MIS-C) in two patients each, and myasthenia gravis crisis, meningococcemia, hemolytic uremic syndrome caused by coronavirus disease 2019, hemophagocytic lymphohistiocytosis, autoimmune encephalitis, and metabolic disease (fatty acid oxidation defect, liver failure) in one patient each. Based on our findings, we proposed that the American Society for Apheresis criteria should be updated according to newly described clinical conditions such as MIS-C.
ABSTRACT
Regulations, measures and restrictions implemented by state authorities on public events and mass gatherings due to fear, anxiety, and panic caused by COVID-19 pandemic have made religious field more open to state intervention since the global pandemic started and religious practices underwent radical changes. Governments' public health measures concerning the places of mass worship and religious gatherings to stop the spread of the pandemic and the reactions of religious groups against their orders and imposed restrictions emerged as a new dimension of the debates on state-religion and state-individual relations. In this regard, the main purpose of the study is to discuss the new global religious trends that emerged with the outbreak of COVID-19 pandemic, which reshapes state-religion relations through the regulations and measure for containing the virus, in light of the experiences in different regions and religious traditions, and to analyze the relationship between the religion and the state in the Middle East, specifically the cases of Israel and Iran as religious character is dominant and orthodox religious groups play a significant role within the social and political structure in both countries.