Debate on the Effectiveness of Hydroxychloroquine for Treatment of Coronavirus Disease 2019 (COVID-19) | Author : Muhammad Shariq Mukarram | Abstract | Full Text | Abstract :The recent outbreak of Coronavirus disease (COVID-19) caused by novel SARS-CoV-2 has raised global health concerns putting many lives at stake. Such condition calls for an urgent demand for effective, available and affordable drugs to control the viral illness. Several different therapies are under study and no definite treatment has yet been approved. Hydroxychloroquine, an antimalarial agent with immunomodulatory and anti-viral properties, remains the hot topic of discussion. The drug has demonstrated potent in vitro activity against SARS-CoV-2. This article presents a review of published literature from the year 2020 (Jan-Apr). This aimed article aimed to review the effectiveness of Hydroxychloroquine in treating patients with COVID-19. Based on the available literature, we recommend the use of this agent in treating patients with active SARS-CoV-2 infection. |
| Full-thickness skin grafts (FTSG) with a new technique | Author : Raphael Staubach | Abstract | Full Text | Abstract :Introduction: Full-thickness skin grafts (FTSG) have long been an indispensable and frequently practiced standard procedure in plastic surgery. The defatting and thinning of the grafts with scissors or scalpel to a thickness of 0,8 – 1,2 mm is very time-consuming even for experienced surgeons in the case of large transplants. Devices for full-thickness skin graft defatting are not available on the market. For this reason, we developed a relatively simple device that enables complete and safe degreasing and thinning of the graft in the shortest possible time.
Materials and Methods: The machine has a dimension of 38cm width, 24cm length, 23cm height. The cutting thickness can be set to 0.6mm, 0.8mm, and 1.0mm. The central part is a crimper run manually with a crank to guide the specimen through a cutting blade. The machine is made of stainless steel, can be completely disassembled, and is easy to sterilize.
Results: With this device small and very large skin grafts up to 15 cm in width can get completely defatted within a few seconds.
Discussion: The time for defatting is reduced by many times. Precious operating time is spared. It can be assumed that the healing of the graft is improved due to a more complete defatting, a much shorter manipulating time of the skin and a more even cut surface compared to the manual procedure. The risk of defects in the graft and of injury of the surgeon is minimized compared to manual preparation. |
| Standardized Plant Immunomodulator Increases the Effect of MEK and BRAF Inhibitors with Clinical Benefit. Case Report of a Patient with Carcinoma in Biliary Duct | Author : Tibor Hajto | Abstract | Full Text | Abstract :Background: Targeting hyperactive mitogen-activated protein kinase (MAPK) signaling cascade has proven to be an effective treatment for a variety of different cancers. Using an important member of this cascade, namely MEK (mitogen-activated extracellular signal regulation kinase) inhibitors, the clinical responses are often transient and complete remission is rarely observed. It was shown that growth factor receptor signaling pathway inhibitors can increase the immune sensitivity of tumor cells but they can’t activate the down regulated immune effectors. Consequently, the combination of MAPK cascade signaling pathway inhibitors and the immune effectors activating immunomodulators may be a promising new strategy.
Material and Methods: In a now 59 years old patient with inoperable (BRAF-mutant) low differentiated adenocarcinoma of biliary ducts after 30GY radiotherapy and two cycles (Gemcitabin+ Cisplatin) chemotherapy a rapid progression of lung, liver and brain metastases were by CT and MR established. A treatment was tarted with BRAF+MEK inhibitors (2x150 mg dabrafenib and 1 x 2 mg trametinib). These inhibitors were combined with daily 45 mg/kg rice bran arabinoxylan concentrate (using Biobran/MGN-3) which was shown to be a pathogenic associated molecular pattern (PAMP)-like molecule and can stimulate the type-1 innate immune cells against tumor cells.
Results: After the chemotherapy and before the start of second-line treatment, the patient had a nearly terminal state of her rapidly progressive disease. Eight months after the combination of MEK / BRAF inhibitor and immunomodulator therapy nearly complete remissions of all metastases were established in CT and MR.
Conclusion: This case report may support a hypothesis that MEK/BRAF inhibitors and type-1 immune cells activating immunomodulators together may synergistically inhibit the tumor growth. Further clinical investigations are necessary to clarify this question. |
| Evaluation of the effectiveness of hyaluronic acid for the treatment of seborrheic dermatitis of the face | Author : Gagik Hakobyan | Abstract | Full Text | Abstract :Objectives: The aim of the study was to assess the efficacy of 5% hyaluronic acid crem for the treatment of seborrheic dermatitis of the face.
Materials and methods: A total of 49 patients (28 men and 21 women, age from 31 to 64 years) with seborrheic dermatitis of the face were selected for the study. A single-site, prospective observational study of 5% hyaluronic acid cream for the treatment of facial seborrheic dermatitis was conducted from 2016 to 2020.
All patients underwent a thorough clinical examination according to the generally accepted scheme. Treatment planning includes a thorough history and physical examination, preoperative laboratory examination. At each visit, degrees of scale, erythema, and pruritus were evaluated.
To assess the effectiveness of patients were given a questionnaire to fill out the questions. The questionnaire evaluated the 5% hyaluronic acid crem effectiveness of the treatment.
Outcome was the evolution of the Investigator Global Assessment (IGA) scale, assessing erythema, scale / scaling, seborrhea and pruritus, all measured on a five-point scale, from 0: no signs / symptoms to 4: very severe sign / symptom. Subjects were assessed at baseline after 4 and 8 weeks.
Results: Baseline IGA scores (mean ± SD) were 9 ± 3 (range: 5-13). The use of the EDS significantly reduced the IGA score by 67% at 4 week and by 83% at 8 week. The condition improved from baseline in 92.3% of subjects.
Conclusion: 5% hyaluronic acid crem has been effective in reducing erythema, scales, seborrhea, and itching. No local side effects were reported. |
| Deep Vein Thrombosis and Pulmonary Embolism in Sickle Cell Disease | Author : Satyajit Patra | Abstract | Full Text | Abstract :Sickle Cell Disease (SCD) is considered a group of genetic red blood cell (RBC) disorders. Healthy red blood cells (RBC) are round in shape and migrates throughout the body to carry oxygen in the small blood vessels. In SCD, the RBC turns into hard and sticky, and the shape is similar to a C-Shaped tool called "SICKLE." Because of the early death of the sickle cells, a constant shortage of red blood cells arises. Because of the typical shape of the sickle cells, their movement in the blood vessel is not as smooth as normal RBC and get stuck and clog the blood flow leading to anemia. The changes in shape make the cells more easily destroyed, causing anemia. Defective hemoglobin is the primary cause of SCD. |
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