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Journal of Ayurveda and Integrative... 2023Allergic Rhinitis is an immunological inflammatory response of the nasal mucosa to airborne allergens. Although Allergic Rhinitis is not a life-threatening disease, the...
Allergic Rhinitis is an immunological inflammatory response of the nasal mucosa to airborne allergens. Although Allergic Rhinitis is not a life-threatening disease, the symptoms of Allergic Rhinitis can be particularly bothersome and disruptive to a patient's sleep and overall quality of life. The coexistence of other allergic conditions like Asthma is very common. No satisfactory treatment is available in modern medicine for this disease. There is a need to search for satisfactory treatment available in another medical system. We present a case of Allergic Rhinitis that was successfully treated with Ayurvedic medicines. Allergic Rhinitis is characterized by watery nasal discharge, nasal obstruction, nasal mucosal pallor, sneezing, and itching in the eyes, palate, and pharynx. A 18-year-old female patient presented with complaints of sneezing (80-100/day), rhinorrhea (watery discharge from nose), heaviness in the head region, weakness, and loss of concentration hampering daily life activity for one year. The patient's clinical findings and symptoms were suggestive of Allergic Rhinitis, which is of perennial type. According to Ayurveda diagnosis was done as Vata-Kaphaj Pratishyay. Rajanyadi Churna was given to the patient for 15 days along with Guduchi Kwath (∼Guduchi decoction) followed by Shaman Snehapan (∼internal oleation) with Mahatiktak Ghrita. The patient experienced a reduction in all the symptoms after 15 days. Allergy markers i.e. Absolute Eosinophil Count reduced to 360 cells/cu mm from 704 cells/cu mm and eosinophils in CBC reduced to 4.1%. The primary complaint of sneezing was significantly reduced to 3-4 times/day after completing the treatment. Ayurvedic therapeutic interventions other than Nasya (∼Nasal oleation), and Dhoompana (∼medicated smoke) modalities showed encouraging results in managing Allergic Rhinitis in a short duration of time. This approach may be taken into consideration for further treatment and research work for Allergic Rhinitis.
PubMed: 37478634
DOI: 10.1016/j.jaim.2023.100740 -
European Archives of... Nov 2023Early detection of mucosal neoplastic lesions is crucial for a patient's prognosis. This has led to the development of effective optical endoscopic diagnostic methods...
PURPOSE
Early detection of mucosal neoplastic lesions is crucial for a patient's prognosis. This has led to the development of effective optical endoscopic diagnostic methods such as narrow band imaging (NBI) and autofluorescence (AFI). Independent of each other, both of these methods were proven useful in the detection of mucosal neoplasias. There are limited reported data comparing both methods for oropharyngeal cancer diagnostics. The aim of the study was to compare NBI and AFI endoscopic visualization of signs in identifying tonsillar squamous cell carcinoma (SCC) and assessing its extent and to determine whether the score was related to the evaluator's experience.
METHODS
Patients with tonsillar SCC underwent endoscopic pharyngeal examination using NBI and AFI. Fiftyseven video sequences of examinations of lesions proven to be SCC were evaluated by three reviewers. The accuracy of determination of lesion extent and visualization of its endoscopic signs of malignancy were evaluated.
RESULTS
Endoscopic visualization of tumour spread was significantly better using AFI than NBI (p = 0.0003). No significant difference was found between NBI and AFI in the visualization of endoscopic malignancy determining signs (p = 0.1405). No significant difference was found among the three reviewers in the visualization of tumour spread and for identifying malignancy-determining signs in NBI endoscopy or AFI endoscopy.
CONCLUSIONS
The results show that AFI obtained better results for assessing the extent of tonsillar cancers than NBI. Both methods were proven to be equal in the visualization of endoscopic malignancy-determining signs. Both are useful even for less experienced evaluators.
Topics: Humans; Narrow Band Imaging; Palatine Tonsil; Optical Imaging; Endoscopy, Gastrointestinal; Carcinoma, Squamous Cell
PubMed: 37464156
DOI: 10.1007/s00405-023-08111-9 -
Endoscopy Dec 2023
Topics: Humans; Endoscopic Mucosal Resection; Pharyngeal Neoplasms; Carcinoma, Squamous Cell; Treatment Outcome; Retrospective Studies
PubMed: 37442178
DOI: 10.1055/a-2109-0561 -
Cureus Jun 2023is the microorganism responsible for the second-most reported sexually transmitted disease in the world, commonly infecting mucosal surfaces such as the endocervix,...
is the microorganism responsible for the second-most reported sexually transmitted disease in the world, commonly infecting mucosal surfaces such as the endocervix, urethra, and pharynx. Gonococcal disease is generally non-symptomatic or pauci-symptomatic, but if untreated, it can progress to a more serious disease with joint, cardiac, or nervous system involvement. Disseminated gonococcal infection occurs in 0.5 to 3% of patients with gonorrhea and can present with purulent arthritis or a combination of dermatitis, tenosynovitis, and migratory polyarthralgia. This article presents the case of a 45-year-old woman examined in the emergency room for fever and acute pain in her right shoulder and knee. A few days later, the patient developed petechiae and vesiculopustular lesions on her right hand. Blood analysis showed elevated inflammation markers, and cultures yielded gram-negative diplococcus identified as The patient was successfully treated with ceftriaxone, with complete remission of signs and symptoms of infection. The article then examines a series of 42 cases of gonococcal disease diagnosed in a tertiary hospital, their microbiologic susceptibilities, and the antibiotics chosen to treat them.
PubMed: 37425543
DOI: 10.7759/cureus.40095 -
International Journal of Surgery Case... Jul 2023Branchial fistulas and cysts are uncommon anomalies of embryonic development that involve soft tissues of the neck. According to Bailey-Proctor classification, second...
INTRODUCTION & IMPORTANCE
Branchial fistulas and cysts are uncommon anomalies of embryonic development that involve soft tissues of the neck. According to Bailey-Proctor classification, second BCCs are classified into four types: Type-I cysts are situated along the anterior border of the sternocleidomastoid muscle beneath the superficial cervical fascia. Type-II ones are the most common and lie just laterally to great vessels beneath enveloping fascia of the neck. Type-III ones pass between internal and external carotid arteries. Type-IV cysts are situated in the pharyngeal mucosal space just deep to the palatine tonsil and medial to great neck vessels, often extending upward towards the skull base. Most second BCCs comprise the first three types, while type-IV cysts are extremely rare.
CASE PRESENTATION
17 years old male patient from Baghdad/Iraq, single, a student, and living with his family.
CLINICAL DISCUSSION
The patient presented to Al-kindy Teaching Hospital for general surgery consultation due to the presence of a lump in the upper third of the anterior border of the sternocleidomastoid muscle for several years ago, the lump was painless but gradually increase in size with discomfort but without fever, anorexia or weight loss. There were no relieving factors. Regarding the review of systems nothing positive and the history was negative also patient had no past drug history and no psychological illness. Physical examination of the lump showed a smooth, non-tender, fluctuant cyst located at the upper third of the anterior border of the left sternocleidomastoid muscle about 7 × 4 cm and there were no enlarged lymph nodes. Regarding examination of the other systems there was nothing positive. Laboratory and radiological investigation showed that the cystic lesion mostly was a branchial cyst, so the operation is done for the patient by complete excision of the cyst with its tract which was located between external and internal carotid vessels. A histopathological study revealed a squamous epithelium-lined cyst with lymphoid infiltration, consistent with a branchial cleft cyst. The patient was discharged without any complication or any evidence of recurrence for 14 months follow-up.
CONCLUSION
Branchial anomalies remain asymptomatic and can present later in life. They can be misdiagnosed. CT scans and MRI neck are helpful in the diagnosis of the cyst and its anatomical extensions. A proper history and physical examination are required to look for other anomalies like craniofacial syndromes. The treatment of branchial cyst is complete surgical excision to prevent recurrence and removal of these lesions at an earlier stage will increase the quality of life of the patient. In addition, since they are rarely malignant, more successful results will be obtained with early diagnosis and treatment.
PubMed: 37364465
DOI: 10.1016/j.ijscr.2023.108429 -
Drugs in Context 2023Although extensive research has been conducted on the role of local immunity in patients with SARS-CoV-2, little is known about the production and concentrations of...
Changes in nasal, pharyngeal and salivary secretory IgA levels in patients with COVID-19 and the possibility of correction of their secretion using combined intranasal and oral administration of a pharmaceutical containing antigens of opportunistic microorganisms.
BACKGROUND
Although extensive research has been conducted on the role of local immunity in patients with SARS-CoV-2, little is known about the production and concentrations of secretory IgA (SIgA) in different mucosal compartments. This article aims to assess the secretion of SIgA in the nasal and pharyngeal compartments and saliva of patients with COVID-19 and to investigate the possibility and efficiency of correction of their secretion using combined intranasal and oral administration of a pharmaceutical containing antigens of opportunistic microorganisms.
METHODS
This study included 78 inpatients, aged between 18 and 60 years, who had confirmed COVID-19 with moderate lung involvement. The control group (=45) received basic therapy, and the treatment group (=33) was additionally administered the bacteria-based pharmaceutical Immunovac VP4 from day 1 to day 10 of hospitalization. SIgA levels were measured by ELISA at baseline and on days 14 and 30.
RESULTS
No systemic or local reactions associated with Immunovac VP4 were reported. We observed a statistically significant reduction in the duration of fever and hospitalization in patients who received Immunovac VP4 compared with those from the control group (=0.03 and =0.05, respectively). Changes over time in SIgA levels in nasal swabs were found to be significantly different in the two treatment groups (F=7.9, [78.0]<0.001). On day 14 of observation, patients in the control group showed a statistically significant reduction in SIgA levels from baseline (=0.02), whereas patients in the Immunovac VP4 group had stable SIgA levels (=0.07). On day 30 after the start of treatment, there was a statistically significant increase in SIgA levels in the Immunovac VP4 group compared with baseline (from 77.7 (40.5-98.7) μg/L to 113.4 (39.8-156.7) μg/L; =0.05) and the levels measured on day 14 (from 60.2 (23.3-102.9) μg/L to 113.4 (39.8-156.7) μg/L; =0.03). The control group showed a statistically significant decrease in levels of nasal SIgA (to 37.3) on day 30 (=0.007 for comparison with baseline values and =0.04 for comparison with levels measured on day 14). Changes over time in SIgA levels measured in pharyngeal swabs were also different between the two treatment groups, and this difference reached statistical significance (F=6.5, [73.0]=0.003). In the control group, this parameter did not change throughout the study (=0.17 for a comparison between the levels measured on day 14 and the baseline values, and =0.12 for a comparison between the levels measured on day 30 and the baseline values). In the Immunovac VP4 group, there was a statistically significant increase from baseline in SIgA levels on study day 30: from 1.5 (0.2-16.5) μg/L to 29.8 (3.6-106.8) μg/L (=0.02). Changes over time in salivary SIgA did not show a significant difference between study groups (F=0.3, [66.3]=0.75).
CONCLUSION
As part of combination therapy, the bacteria-based immunostimulant agent Immunovac VP4 increases SIgA levels in the nasal and pharyngeal compartments and induces clinical improvement. Induced mucosal immunity is central to the prevention of respiratory infections, particularly in patients with post-COVID-19 syndrome.
PubMed: 37342460
DOI: 10.7573/dic.2022-10-4 -
International Journal of Infectious... Sep 2023We analyzed the expression of inflammatory and antiviral genes in the nasopharynx of SARS-CoV-2 infected patients and their association with the severity of COVID-19...
OBJECTIVES
We analyzed the expression of inflammatory and antiviral genes in the nasopharynx of SARS-CoV-2 infected patients and their association with the severity of COVID-19 pneumonia.
METHODS
We conducted a cross-sectional study on 223 SARS-CoV-2 infected patients. Clinical data were collected from medical records, and nasopharyngeal samples were collected in the first 24 hours after admission to the emergency room. The gene expression of eight proinflammatory/antiviral genes (plasminogen activator urokinase receptor [PLAUR], interleukin [IL]-6, IL-8, interferon [IFN]-β, IFN-stimulated gene 15 [ISG15], retinoic acid-inducible gene I [RIG-I], C-C motif ligand 5 [CCL5], and chemokine C-X-C motif ligand 10 [CXCL10]) were quantified by real-time polymerase chain reaction. Outcome variables were: (i) pneumonia; (ii) severe pneumonia or acute respiratory distress syndrome. Statistical analysis was performed using multivariate logistic regression analyses.
RESULTS
We enrolled 84 mild, 88 moderate, and 51 severe/critical cases. High expression of PLAUR (adjusted odds ratio [aOR] = 1.25; P = 0.032, risk factor) and low expression of CXCL10 (aOR = 0.89; P = 0.048, protective factor) were associated with pneumonia. Furthermore, lower values of ISG15 (aOR = 0.88, P = 0.021), RIG-I (aOR = 0.87, P = 0.034), CCL5 (aOR = 0.73, P <0.001), and CXCL10 (aOR = 0.84, P = 0.002) were risk factors for severe pneumonia/acute respiratory distress syndrome.
CONCLUSION
An unbalanced early innate immune response to SARS-CoV-2 in the nasopharynx, characterized by high expression of PLAUR and low expression of antiviral genes (ISG15 and RIG-I), and chemokines (CCL5 and CXCL10), was associated with COVID-19 severity.
Topics: Humans; COVID-19; SARS-CoV-2; Cross-Sectional Studies; Ligands; Chemokines; Antiviral Agents; Immunity, Innate; Pneumonia; Interleukin-6; Respiratory Distress Syndrome; Nasopharynx
PubMed: 37290572
DOI: 10.1016/j.ijid.2023.06.001