Tocilizumab in Severe Covid-19 Infection, Early Experiences at a Community Hospital

The COVID-19 global pandemic has resulted in more than 118 million cases and more than 2.5 million deaths. Most fatalities are related to severe pulmonary disease caused by a severe inflammatory response to the virus in the lungs. As yet there is no uniformly successful therapeutic agent. Tocilizumab is a monoclonal antibody that binds to IL-6 receptor thus inhibiting IL-6 mediated signaling of the inflammatory cascade. Early trials did not show a mortality benefit in patients treated with this agent. Newer studies have shown a benefit when Tocilizumab is used in conjunction with corticosteroids. This is a brief report on 7 patients with severe COVID-19 infection who received Tocilizumab therapy at our community hospital in the early period of the pandemic.

India Program Against Cancer

Worldwide, one in eight deaths is due to cancer. Projections based on the GLOBOCAN 2012 estimates predict a substantive increase new cancer cases per year by 2035 in developing countries if preventive measures are not widely applied. According to the World Health Organization (WHO), millions of lives could be saved each year if countries made use of existing knowledge and the best cost-effective methods to prevent and treat cancer. Therefore, the aim of this study is to estimate a provisional budget against cancer in low and middle incomes countries, according the GNI-PPP, the cancer incidence and the number of population. Economically country classification is determining with the Gross national income (GNI), per capita, Purchasing power parity (PPP), according the administrations of the International Monetary Fund (IMF), the World Bank (WB) and the Central Intelligence Agency (CIA). Cancer incidence data presented are based on the most recent data available at IARC. However, population compares estimates from the US Bureau of the Census. The provisional budget is establishing among the guidelines developed by WHO for regional and national cancer control programs according to national economic development. Provisional budget against cancer is estimated to 17,036,185.5 (thousands of U.S $) for a population of 1,281,935,911 persons in India.

Indonesia Program Against Cancer

Worldwide, one in eight deaths is due to cancer. Projections based on the GLOBOCAN 2012 estimates predict a substantive increase new cancer cases per year by 2035 in developing countries if preventive measures are not widely applied. According to the World Health Organization (WHO), millions of lives could be saved each year if countries made use of existing knowledge and the best cost-effective methods to prevent and treat cancer. Therefore, the aim of this study is to estimate a provisional budget against cancer in low and middle incomes countries, according the GNI-PPP, the cancer incidence and the number of population. Economically country classification is determining with the Gross national income (GNI), per capita, Purchasing power parity (PPP), according the administrations of the International Monetary Fund (IMF), the World Bank (WB) and the Central Intelligence Agency (CIA). Cancer incidence data presented are based on the most recent data available at IARC. However, population compares estimates from the US Bureau of the Census. The provisional budget is establishing among the guidelines developed by WHO for regional and national cancer control programs according to national economic development. Provisional budget against cancer is estimated to 8,110,095.41 (thousands of U.S $) for a population of 260,580,739 persons in Indonesia.

The Role of Retrobulbar Liposomal Amphotericin in Orbital Apex Syndrome in a COVID – 19 Positive Diabetic

Coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been seen to have varied presentation affecting multiple organ systems. Mucormycosis is a rapidly progressive disease often seen in immunocompromised patients or those with diabetes mellitus with guarded prognosis. This report is based on an interesting case of a 37-year-old man with orbital apex syndrome secondary to mucormycosis and co-infection with COVID-19. We discuss the benefit of administering liposomal amphotericin via retrobulbar injection in addition to systemic antifungals in the setting of rhino-orbital-mucormycosis.

Ophthalmic Manifestations of Neurologic, Rheumatologic, and Infectious Diseases in the Context of the novel Coronavirus Disease 2019 Pandemic: A Case Series

The novel Coronavirus Disease 2019 (COVID-19) is known to present with a broad range of clinical manifestations. While symptoms such as fever, cough, dyspnea, myalgias, diarrhea, anosmia, and ageusia predominate, less common manifestations involving multiple systems have also been described. Some reported ocular manifestations include symptoms associated with keratoconjunctivitis, such as chemosis, ocular pain, photophobia, dry eye and tearing [1]. Neurological symptoms in addition to smell and taste dysfunction have been commonly described as well, and include headache, ataxia, dizziness, altered level of consciousness, and stroke [2]. Whether these neuro-ophthalmologic findings reflect direct involvement of these systems or a more generalized response to SARS-CoV-2 infection remains uncertain. Many other neurologic, rheumatologic, and infectious diseases also present with similar clinical findings as those described in COVID-19, further complicating the diagnostic picture. In this case series, we examine several patients presenting with unusual neuro-ophthalmological manifestations and discuss similarities of these findings with those seen in SARS-CoV-2 infection, and review current literature describing possible mechanisms underlying similar findings in patients with confirmed COVID-19.

To Determine Preference of Shoulder Pain Management by General Physicians in Lahore

Objective: To determine the preference of general practitioners how they diagnose and treat the shoulder pain. Methodology: Descriptive cross sectional study were carried out among general physicians of the Lahore. Total 268 physicians were enrolled in the study and only 221 physicians responded. Data was collected by convenient sampling technique and physician were inquired about different aspects (diagnosis, investigation, treatment and referral) of management of shoulder pain. Results: Total 221 physicians participated in the study that included 133 male and 88 female physicians. Result showed 68 and 83 physician were confident in the diagnosis of glenohumeral osteoarthritis and rotator cuff tear respectively. The most recommended investigation was radiographs of affected joint. Study revealed that 58 physicians also refer the patients to the physiotherapists for management. Conclusion: Results of this study showed the preference of general physician about the management of shoulder pain. They diagnosed the patients of rotator cuff tear and glenohumeral arthritis and as an investigation they mostly recommend the radiograph. Their patients were being improved with physiotherapy in addition to symptomatic treatments.

The Investigation of Exposure to Silicate Powders in Patients Diagnosed Silicosis

Silicosis, in the textile sector in 2005, was first reported and defined as an occupational disease in Turkey. The process of spraying the sea sand through the fabric with the help of a compressor is called “sandblasting” to bleach, abrading, and aging the jeans. Exposure to sand dust in the working environment, the absence of occupational health and safety measures at the workplace, causes silicosis disease to be observed in the employees who perform denim sandblasting. Within the scope of this thesis, a descriptive epidemiological study was carried out aiming to reach with 45 persons who worked in Istanbul for a certain period in sandblasting and were subsequently diagnosed with silicosis. The main data of this thesis are the socio-economic conditions, demographic characteristics, working conditions as well as information about the working conditions of the patients, and the duration of the disease are also included. All the individuals in the thesis study are male and average 39.40 ± 8.65 years old. All employees (100%, n = 45) have not been subjected to an employment examination. All the employees work 6 days a week, 42.9% work in two shifts, and 57.1% work in three shifts. The distribution of the daily working time of the employees is 8-9 hours of 84.4%, 10-11 hours of 13.3%, and over 12 hours of 2.2%. The proportion of employees without insurance is 93.3% (n = 42) and the rate of insured employees is 6.7% (n = 3) for a while. During the medical examination, 71.1% (n = 32) of the employees started after work, 17.8% (n = 8) after quitting the job and 11.1% (n = 5) before the military service. It has received. Also, 8.9% (n = 4) of the patients were diagnosed with tuberculosis. The rate of those who document that the disease is an occupational disease is 2.2%. (N = 1). In the thesis, especially silicosis and tuberculosis has been shared literature about lung cancer diseases, powdery substance in Turkey and is given to current regulations for crystalline silica. Besides, the results obtained from the survey conducted within the scope of the thesis were shared. The importance of occupational health and safety rules has been emphasized to prevent occupational diseases among those working in workplaces applying the “sandblasting” process

Evaluation of Hematological Changes in Tre-En-En and Vitamin C Dietary Supplementation to Wistar Rats

In recent times, hematological health indictors have been the focus of most debates, even though several researches on different animal models have been conducted relative to it. In this study, we evaluated the effects of dietary supplementation with Tre-en-en concentrates on full blood count [packed cell volume (PCV), total white blood cell count (TWBCC), total red blood cell (TRBCC) count and total Platelet count (TPC)]. Twenty (20) acclimatized (for two weeks) male rats between 150-200 g were procured and grouped into four of five rats each. Group I animals were fed with standard rat chow and water ad-libitum (normal control), while group II rats received 5µm each of Tre-en-en grain concentrate daily for five weeks. Whereas, groups III and IV respectively received vitamin C and Tre-en-en (5µm) + vitamin C (Co-administration) daily for five weeks. Following period of administration, animals were euthanized under chloroform anaesthesia and blood sample obtained for haematological analysis. Full blood count was then performed and comparisons made between groups to ascertain the changes in hematological health markers. Results from one-way analysis of variance (ANOVA) showed a statistically significant increase (p < 0.05) in Tre-en-en and Tre-en-en + Vit. C. treated groups (II and IV) compared to control group. Also, Tre-en-en Supplement fed groups (II and IV) showed a statistically significant increase in body weights than control and vit. C. groups (I and III). There was also a statistically insignificant increase (p < 0.05) in the PCV of Tre-en-en and Vit. C treated groups (II and III) compared to control, while TWBCC increased insignificantly across groups; whereas TRBCC increased significantly as compared to control. More corroborative works relative to this is recommended to validate the result of this study.

Knowledge, Attitudes and Perception of the Public on Female Genital Mutilation

Despite global concerns, awareness, and campaigns against Female Genital Mutilation (FGM), prevalence remains high in most countries of the globe, especially Africa. Current study investigated the knowledge, attitude and public perception on FGM of Bini indigenes who reside in Oredo Local Government Area of Edo State, Southern Nigeria. A total of one hundred and fifty (150) participants were ethically recruited from Benin City, Nigeria. An open ended questionnaire of about the same number (n = 150) was carefully structured, validated and distributed to participants in order to ascertain their level of awareness and understanding of the socio-cultural implications of FGM. An oral interview was also conducted on participants to determine the effect of their level of education on possible promulgation of FGM within the study area. Sociodemographic data of respondents were also collected and comparisons made across gender, age and religious lines on beliefs and practices of FGM. Sections of the questionnaire were subjected to statistical analysis after data collection, results expressed in simple percentages. After careful observation, study found that about 74.5% of the respondents were ill-informed on the cultural norms and principles of FGM in line with global best practices of the World Health Organizations (WHO). However, not fewer than 36.3% of the respondents show adequate knowledge on the concept of FGM. Study also observed that a great percentage of educated respondents strongly opposed to the idea of FGM. This implies that educational health campaigns against FGM could be useful in combating the hazardous implications of FGM on the socio-cultural well-being of the female child. Continuous education geared towards global best practices in study area is highly recommended.

Panoramic Radiographic Analysis of Signs of Proximity to the Third Molar Roots of the Mandibular Canal in Yemen

Objectives: The objectives of this study were to assess the relationship between the third molar and the mandibular canal, to identify the radiographic markers most prevalent in predicting connectivity between these structures, and to associate these signs and proximity with the position of the third molar according to Bell, Gregory’s and Winter’s classifications. Subjects and methods: A retrospective cross-sectional study was conducted in the city of Sana’a on a sample of Yemeni patients in Ammar Dental Clinics who underwent panoramic radiography in the year 2019 until September 2020. The study consisted of panoramic radiographs of 597 patients with third molars with a total of 1017 third molars; the number of males was 216 (36.2%) and 381 females (63.8%). The panoramic radiographs were evaluated for proximity signs. Inclusion criteria were patients of both sexes who had at least a fully formed third molar of the mandible that was adjacent to the second molar. The radiographs were excluded if evidence of cystic, neoplastic, or extensive caries processes was detected. Seven radiological signs were used to determine if there was contact between the third molar and the mandibular canal. Results: A proximity to the mandibular canal was verified for 620 (61%) of 1017 third molars. The most frequent radiographic signs of proximity were darkened roots (315 teeth [31%]) and discontinuity of the mandibular canal (267 teeth [26.3%]). Third molar/mandibular canal proximity was found significantly more frequently in female patients and in patients aged 24 years and younger (P < 0.001). The tooth positions most frequently associated with proximity between the third molar and the mandibular canal were position C (highest point of the third molar located at or below the cervical margin of the second molar) and the mesioangular position (long axis of the third molar angled mesially toward the second molar). Conclusions: The frequency of third molar/ mandibular canal proximity was greater in female patients and patients aged 24 years or younger. The most frequently observed signs of proximity were darkening of the roots and discontinuity of the mandibular canal. The tooth positions most frequently associated with proximity of the third molar to the mandibular canal were position C and the mesioangular position.