Potential Interactions of Remdesivir with Pulmonary Drugs: a Covid-19 Perspective.

In this letter, we discuss the potential interactions of remdesivir, the newly approved Covid-19 drug with pulmonary medications. These interactions have been summarized keeping the busy clinician in mind. While remdesivir has proven to be a safe medication generally, we here have enlisted the potential interactions of remdesivir that a clinician needs to be mindful of while prescribing the medication.

A Case of a COVID-19-positive Patient.

The coronavirus (COVID-19), discovered in 2019, has been creating havoc since it first emerged in China and is now spreading worldwide. Its presentation is somewhat similar to influenza. We hereby discuss the salient features of the coronavirus and present the case of a 33-year-old male who was tested positive for COVID-19.

National prevalence, trends and outcomes of takotsubo syndrome in hospitalizations with prior history of mediastinal/intrathoracic cancer and radiation therapy.

BACKGROUND: Radiation therapy (RT) for cancers in thoracic/mediastinal region has been linked with heart damage following years of radiation exposure. However, prevalence of takotsubo syndrome (TTS) in patients with prior intrathoracic/mediastinal malignancies treated with RT has never been analyzed on a large scale. METHODS: We identified adult hospitalizations with prior mediastinal/intrathoracic cancer and RT and TTS using ICD-9 CM codes and the National Inpatient Sample (2007-2014) after excluding current admissions for chemotherapy. We then assessed the prevalence, odds, trends and in-hospital outcomes of TTS-related admissions in patients with vs. without prior intrathoracic cancer and RT. RESULTS: We identified a total of 5,991,314 hospitalizations with prior intrathoracic/mediastinal malignancies and RT (~73 yrs., 85.2% female), of which 7663 (0.13%, 128 per 100,000) were diagnosed with TTS (~74 yrs., 95.8% females, 88.1% white). Higher odds and rising trends in TTS per 100,000 hospitalizations (from 31 to 241) were seen among patients with prior intrathoracic malignancies and RT as compared to those without (from 19 to 104) (ptrend < 0.001). All-cause in-hospital mortality (4.6% vs 2.8%; OR 1.45; 95%CI 1.29-1.63, p < 0.001), cardiogenic shock (4.3% vs 0.2%), cardiac arrest (3.1% vs 0.9%), arrhythmia (34.3% vs 24.6%), stroke (3.6% vs 2.8%), respiratory failure (14.5% vs 4.6%), and median length of stay and hospital charges were significantly higher in the TTS cohort. CONCLUSIONS: This study showed higher odds and increasing trends in TTS-related admissions with worse in-hospital outcomes among patients with prior intrathoracic/mediastinal cancer and RT, irrespective of the time interval from cancer diagnosis or RT to TTS occurrence.

Intraoral schwannoma in retromolar region.

Schwannomas of the intra oral region are relatively uncommon; these are benign nerve sheath tumors that arise from schwann cells of the neural sheath. They are solitary, slow-growing, smooth-surfaced, usually asymptomatic, and encapsulated tumors, about 25% of all schwannomas are located in the head and neck, but only 1% show intraoral origin. We are contributing a report of 24 years old woman with slow progressive swelling over the right retromolar region. Magnetic resonance imaging presented a well defined mass over the right retromolar area measuring 19 × 19 mm(2) and fine needle aspiration cytology revealed that it was a tumor mass of neurogenic origin. Diagnosis was confirmed by excisional histological identification of Antoni A areas with marked palisading of nuclei. Although these rare entities of oral cavity are routinely not encountered in practice, they should be added in differential diagnosis of intraoral tumors.

Lag screw fixation of fracture of the anterior mandible: a new minimal access technique.

OBJECTIVE: Purpose of this study to introduce a new minimal access technique for management of anterior mandible fracture with several advantages over conventional methods. METHOD: Four cases of undisplaced anterior mandibular fracture were selected. Tension band was achieved either by arch bar fixation to mandible or placement of interdental wire followed by intermaxillary fixation. With a 1 cm vertical incision was placed adjacent to fractured line. Fractured segment was immobilized with lag screw with minimal stripping. All patients were followed for 6 months. RESULTS: All four cases shown good stable segment after 6 months of post operative follow up. OPG revealed well placed lag screw and there were no surgical complications, for example parasthesia, scarring and odema. CONCLUSION: Fixation of anterior mandible fracture using this technique can achieve good stability and appropriate compression. The technique is simple and easily performed, reducing the surgical time, reduce the chances of infection due to less exposure and promote the healing process by producing stress in the fracture lines.

Dermoid cyst of the floor of the mouth with abundant hair: a case report.

Dermoid cysts are developmental cysts and considered to develop from enslavement of epithelial debris in the midline during closure of the mandibular and hyoid brachial arches. These cysts are painless, slow growing and most commonly occur in young adults with no gender predilection. They are uncommon in the head and neck region. Oral dermoid cysts are found usually in the submental or sublingual triangle in variable relation to mylohyoid, geniohyoid, and genioglossus muscle. The cyst is lined by epidermis like epithelium and contains dermal adnexal structures in the cyst wall. We report a case of dermoid cyst arising in the sublingual region of a young adult male with abundance of hair which is rare finding.