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Studies about headaches associated with acute ischemic stroke in patients suffering from migraine were limited, and therefore we present a clinical case of central post-stroke pain (CPSP) in a 47-year-old woman with migraine and lacunar infarcts in the medulla oblongata and also possible mechanisms of CPSP in patients with migraine. Magnetic resonance imaging of the brain revealed lacunar infarction in the medulla oblongata on the right (vertebral artery basin) and a single focus of gliosis in the parietal lobe on the right. Magnetic resonance angiography of cerebral vessels showed the fetal type of structure of both posterior cerebral arteries. This clinical case is a complex clinical situation of a combination of secondary headaches (post-stroke) in a patient with a primary headache (migraine), which was successfully treated by the combined administration of first-line drugs for the treatment of neuropathic pain in a patient with lacunar infarcts in the medulla oblongata. The treatment of CPSP is a difficult task due to the insufficiently unexplored mechanisms of development, the most effective approaches are those aimed at reducing the increased excitability of neurons.Copyright © 2023, Indian Association of Biomedical Scientists. All rights reserved.
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In this case series of two male and one female patient with an age range of 2-12 years, only one patient had a history of neurological disorder and underwent ventriculoperitoneal shunt for a medulloblastoma, which describes coronavirus disease-associated neurological manifestations in pediatric patients, among which seizures and sensory disturbances are noticeable. In order to describe the various clinical and neurological manifestations that appeared earlier or developed over the course of illness, a series of cases of pediatric patients with coronavirus disease was documented. Copyright © 2022, Indian Association of Biomedical Scientists. All rights reserved.
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Introduction and Aim: We examined the effect of pre-and/or post-infection doxycycline on human nasal epithelial cell viability and SARS-CoV-2 (clinical strain IHUMI-3) replication in vitro. Materials and Methods: Human nasal epithelial cells, an in vivo SARS-CoV-2 target, were derived from healthy donor nasal epithelial stem/progenitor cells via in vitro differentiation. The cells were exposed to doxycycline at 0, 0.1, 0.5, 1, 5, 10, 50, and 100 μM before and/or after IHUMI-3 inoculation to determine the optimal inhibitory concentration. Viral replication was evaluated using quantitative reverse-transcription PCR, and doxycycline 50% cytotoxic concentration (CC50) and half-maximal effective concentration (EC50) were calculated. The peak serum concentration (Cmax) resulting from typical oral (100 or 200 mg) or intravenous (100 mg) doxycycline doses was estimated, and the Cmax/EC50 ratio was calculated as an index of potential clinical utility. Results: Doxycycline exhibited low cytotoxicity (CC50 > 100 μM) in human nasal epithelial cells and inhibited SARS-CoV-2 replication (EC50: 5.2 ± 3.3 μM) in a dose-dependent manner when administered pre-and/or post-infection. Reasonable oral or intravenous doses will help achieve effective concentrations in vivo. Conclusion: Early administration of this well-characterized, safe, and accessible drug may limit person-to-person transmission and prevent progression to severe coronavirus disease.
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Introduction and Aim: In Kyrgyzstan, there are still no studies on the prevalence of chemical burns of the esophagus in children, and there are also few studies aimed at studying the causative agents. The present study aimed to assess the prevalence of burns of the esophagus due to the accidental use of various chemicals by children and the chemical composition of cauterizing substances over a 10-year period of admission of children to the clinic. Materials and Methods: An analysis of 1081 cases of chemical burns of the esophagus in children who received inpatient treatment for the period 2011–2020 is presented. Results: In our study, caustic substances were used more often by boys (56.9%) than girls (43.1%), most of the children were under the age of 3 years. There is a tendency for an annual increase in chemical burns of the esophagus. Among the causal factors, there is an increase in the use of alkalis, which are part of the cleaning agents for dishes and plumbing pipes-Krot;recently, the cleaning agent for cauldrons-Aurora is gaining momentum. Conclusion: The emerging situation indicates not only the need for further medical research in this area, but also the tightening of requirements for the packaging and use of household chemicals, and the solution of this problem at the state level.
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Introduction and Aim: Although coronavirus disease 2019 (COVID-19) causes respiratory illness, it can even develop hypercoagulation and thrombotic complications. The main objective is to study the clinical features of acute ischemic stroke (AIS) with COVID-19 in moderately and severely ill patients. Materials and Methods: A retrospective analysis of thirty-four (34) patients who were infected with COVID-19 and even diagnosed with AIS in September 2020 was assessed. The main clinical and neurological characteristics of stroke, the results of clinical, laboratory, biochemical, coagulation, lipid metabolism, and clinical examination studies of COVID-19 were assessed. Results: The stroke severity, severity of brain damage, and degree of disability were reported more in the severely ill patients than in the moderately ill patients (p < 0.001, p = 0.002, and p = 0.7). Data from clinical-laboratory and biochemical parameters in moderately and severely ill patients showed that a more significant parameters are C-reactive protein (0.93 ± 0.03) and (5.79 ± 0.1), D-dimer (0.39 ± 0.11) and (0.76 ± 0.14), leukocytes (4.2 ± 1.69) and (3.6 ± 1.32), respectively (p < 0.001) and slightly altered values for fasting blood glucose levels (8.61 ± 2.41) and (7.21 ± 3.15). After clinical and pathomorphological analysis, acute respiratory distress syndrome signs were observed only in severely ill patients in 14 (41.1%). Conclusion: Among all the parameters characterizing clinical-laboratory and biochemical differences, inflammatory and infectious markers, and fasting glucose were higher. In moderately and severely ill patients with AIS and COVID-19 has a significantly favorable outcome with a longer hospital stay.
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In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) occurred in Wuhan, China. The disease, which is now a global pandemic, is reportedly associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this study, we report a case of COVID-19 in a 31-year-old pregnant woman who showed symptoms that included fever, a four-day history of dry cough, and myalgia. Real-time reverse transcriptase-polymerase chain reaction analysis of naso-and oropharyngeal samples was positive for the SARS-CoV-2. A cesarean section was performed during the acute phase of COVID-19;the full-term infant was isolated from his mother and underwent formula feeding. He was healthy and negative for the SARS-CoV-2. This report describes the clinical features, diagnosis, and treatment of the mother’s illness and its effects on her live-born infant. © 2020, Indian Association of Biomedical Scientists. All rights reserved.
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The coronavirus disease (COVID-19) outbreak was initially reported in Wuhan, China in December 2019. Many cases of pneumonia without any apparent cause were described to be associated with seafood and wet markets in Wuhan. At present, there are no effective antiviral drugs to treat COVID-19. Umifenovir is a broad-spectrum antiviral drug used for treating several viral infections, and it reportedly inhibits SARS-CoV replication in vitro. This exploratory randomized and controlled study recruited 30 COVID-19 patients admitted to the hospital until May 18, 2020. Fifteen (15) eligible patients ran-domly allocated underwent umifenovir therapy (600 mg/d). Time to clinical recovery (TTCR), clinical characteristics, and tomographic results were ana-lyzed at baseline and five days after treatment to assess the effect of umifen-ovir. Thirty (30) COVID-19 patients (mean age: 36.5 years [SD: 12.1, range: 19-59]), including 18 (60%) males and 12 (40%) females, were recruited for the study. There were no significant differences in age or gender, but there were significant differences in TTCR among the two categories. Body temper-ature (BT) and cough recuperation time [2.8 (0.6) and 2.6 (0.6) days, respec-tively] were highly reduced in the umifenovir category at 2.4 and 2.1 days, respectively. Moreover, many patients treated with umifenovir exhibited no side effects. In this study, pneumonia was ameliorated in 76.6% (23/30) of the patients, with moderate and potential amelioration in 36.6% and 40% of the patients, respectively. In addition, 66.6% of the patients in the umifenovir category had potential pneumonia absorption. © International Journal of Research in Pharmaceutical Sciences.
ABSTRACT
At present, there are no effective treatments for coronavirus disease 2019 (COVID-19) and the therapeutic interventions are limited to supportive care, varying from symptomatic management to critical care support. Corticoids are administered to reduce host inflammatory responses in the lungs. The potential harm and the lack of proven benefit of corticosteroids cautions against their routine administration in COVID-19 patients outside the Randomized Clinical Trials (RCTs), with an exception of a concomitant indication, such as a refractory shock. The amplified immune response and Cytokine Release Syndrome (CRS) are known to cause significant organ damage (lungs), providing a rationale for the use of monoclonal Antibody (mAb). Hyperimmune Immunoglobulins (Igs) from the recovered patients may also assist with improving the immune response and virus clearance. Human Normal Immunoglobulins (HNIGs) can be administered in the early seven to ten days of infection, during peak viremia or in the absence of a primary immune response. Ultimately, a vaccine could provide a potential permanent strategy, creating protective immunity for people and preventing future outbreaks. ©Copyright (c) 2020
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Hydroxychloroquine (HCQ) has previously been shown to inhibit coronavirus replication in vitro. But antiviral properties mechanisms are not well known, HCQ is a weak base that accumulates in lysosomes, modifies their pH, and interferes with some enzymes. In the lack of confirmed efficacy, the initial potential risk is not to expose patients to adverse effects. However, results from preliminary clinical studies have drawn inconclusive results regarding the efficacy of HCQ in coronavirus disease 2019 (COVID-19), due to sev-eral important weaknesses in research methodologies. Hypokalemia often occurs in patients infected with severe acute respiratory syndrome coron-avirus 2 (SARS-CoV-2), possibly due to the particular tropism of SARS-CoV-2 with regard to Angiotensin-converting enzyme 2 (ACE2). The wide use of HCQ, even against medical advice, will show an impact on ongoing clinical trials. It is important that we can recruite COVID-19 patients in these research studies to generate appropriate data regarding drugs that show promising efficacy against COVID-19. Currently, only doctors should be allowed to prescribe HCQ, and treatment should be confined to hospital settings, with proper car-diac and therapeutic drug monitoring.