When Shall Coronavirus Disease-19 Stop? Review of Literature

In December 2019, a new coronavirus, now labeled as severe acute respiratory syndrome coronavirus 2, induced an episode of acute atypical respiratory illness started in Wuhan, Province of Hubei, China. The illness triggered by this virus was called coronavirus disease-19 (COVID-19). The infection is spread within humans and has triggered a global pandemic. The amount of death tolls continues to increase and a growing number of countries have been driven to create social barriers and lock-ups. The shortage of tailored counseling remains an issue. Epidemiological researches have shown that elderly patients are more vulnerable to serious diseases, while children tend to have milder symptoms. Here, we checked the latest understanding of this disease and found a possible explanation of the potential sequel and the expectations for the future

COVID-19 specialized diabetes clinic model for excellence in diabetes care: scientific perspective

While diabetes centers are well established by the Ministry of Health, there is no separate specialized diabetes clinics for COVID-19 patients (SDCs). There are several clinical diabetes centers throughout the Kingdom of Saudi Arabia, several of which have been developed through philanthropy funding; nevertheless, it is not obvious what distinguishes SDCs from a therapeutic viewpoint and what the potential would be for such centers. Through this context, we suggest a structure to direct the progress of SDCs. Defining protocols for wider adoption of SDCs as a means to enhance public safety and COVID-19 patient care efficiency (including consistency and satisfaction) and minimize health care expenses becomes increasingly essential when moving towards value-based sales and reimbursements away from service charges. It is wise to introduce innovative financial mechanisms to pay for diabetes that cannot be covered by fiscally limited private and university medical centers. We foresee potential clinical SDCs to be made up of a well-defined framework and six areas or foundations that act as basic guiding principles for the advancement of diabetes treatment skills that can be easily illustrated by stakeholders, including insurance facilities, consumers, payers and government departments

How to manage the IVF during COVID-19 pandemic among diabetic females: a scientific perspective

Diabetes is a challenging clinical problem facing ob-stetricians and gynecologists when it comes to in vitro fertilization and embryo transfer (IVF-ET). During the COVID-19 pandemic we are living nowadays, COVID-19 becomes a new superimposing challenge for diabetic females need IVF-ET procedures. The persistent lock-down of diabetic health facilities already advised by numerous organizations and con-tributing to challenging diabetes treatment is harmful to the whole population and in particular to patients with infertilities. Around 0.3% of all babies born last year were conceived with IVF-ET therapies worldwide. We recommend remedies to foresee more delicate infertility cases so as to prepare for a resumption of temporarily suspended fertility treatment.. In an age of crucial challenges for our national health services, complication prevention and tension management can help competent agencies and health providers identify patients that should be preferred to begin fertility treatment in a healthy environment.What we consider as a possible possibility is the gradual restart of IVF, which needs many measures for diabetic patients. The problem of restarting IVF installations after the current lockdown is real since each nation follows a certain recovery curve. Especially as a result of silent dissemination, attention should be provided to COVID-19 infection among patients and health-care staff after the restart of IVF therapy.

Risk of General Anesthesia in Pediatric Skin Procedures with Projection on Tumescent Anesthesia

Background. Uses of general anaesthesia in outpatient invasive procedures have increased, especially in dermatology. Being uncooperative, children often require general anaesthesia, since surgical skin operations are mostly painful. Aim. The purpose of this study is to evaluate the safety, significant adverse events, and the complication rates related to general anaesthesia, when used among pediatric population undergoing skin procedures. Methods. We conducted a first retrospective cohort study of patient chart review during the period from September 1, 2017 through September 2019. All patients admitted for pediatric skin procedures during this period have participated in our study. We reviewed selected charts to document any unexpected admissions, adverse events, or complications. Surgical outcomes and anaesthesia complications were reviewed by three anesthesiologists. We assessed inter-rater reliability. Results. A total of 211 procedures were reported for 211 patients with 19 diagnoses. No adverse events related to anaesthesia were recognized, apart from minor complications noticed in twelve patients. The kappa value range is between 0.78 and 1.00 (95% C.I., 0.46809 to 1.00). Conclusion. Dermatologist and pediatricians can safely do necessary procedures under general anaesthesia with the supervision of pediatric-trained anesthesiologists while considering other safety and risk precautions and the pediatric age group

Inflammation and Treatment-Resistant Depression from Clinical to Animal Study: A Possible Link?

The aim of this study was to investigate the relationship between treatment-resistant depression (TRD) and inflammation in humans and experimental models. For the human study, a retrospective cohort study was conducted with 206 participants; half were on antidepressants for major depressive disorder. The patients were divided into healthy and depressed groups. Inflammation was assessed based on the values of the main inflammatory biomarkers (CRP, WBC and ESR). For the animal experiments, 35 adult male Wistar rats were assigned to stressed and non-stressed groups. Inflammation and stress were induced using lipopolysaccharide and chronic unpredictable mild stress. A 10 mg/kg intraperitoneal injection of fluoxetine (FLX), a known antidepressant, was simultaneously administered daily for 4 weeks. Behavioral tests were performed. The plasma levels of inflammatory and stress biomarkers were measured and were significantly higher in the stressed and non-responsive groups in both studies. This study provides evidence of the link between inflammation and TRD. We further observed a possible link via the Phosphorylated Janus Kinase 2 and Phosphorylated Signal Transducer and Activator of Transcription 3 (P-JAK2/P-STAT3) signaling pathway and found that chronic stress and high inflammation hinder the antidepressant effects of FLX. Thus, non-response to antidepressants could be mitigated by treating inflammation to improve the antidepressant effect in patients with TRD

Evidence-based clinical practice guidelines for the management of psoriasis: systematic review, critical appraisal, and quality assessment with the AGREE II instrument

Background Psoriasis is considered one of the stubborn lifelong dermatologic diseases, making the patients seized in their social cage. Evidence-based clinical practice guidelines (CPGs) and expert opinions ensure that patients with psoriasis render the most recent and developed care. This systematic review assessed and compared the most recently approved international CPGs with the AGREE II instrument. Methods After we identified our research question, we searched the bibliographic international databases to identify and screen for relevant and eligible guidelines that address the topic of interest. Four independent reviewers (Senior Expert Dermatologist in Psoriasis) have critically appraised the selected guidelines via the AGREE II instrument. We conducted inter-rater analysis and percent agreement among raters and calculation of intra-class correlation coefficient (ICC) ‘Kappa’. Results Out of 33 articles for CPGs, only Four eligible CPGs fulfill the inclusion criteria. Selected CPGs were critically appraised; first from the American College of Rheumatology that is also National Psoriasis Foundation (ACR/NPF-2018), second from the UK’s National Institute for Health and Care Excellence (NICE-2017) for Psoriasis: Assessment and Management, third from the Saudi practical guidelines on the biologic treatment for Psoriasis (Saudi CPGs, 2015), and lastly from the American Academy of Dermatology (AAD/NPF-2019) Management and Treatment of Psoriasis with Awareness and Attention to Comorbidities. The complete assessments (OA) of two CPGs (AAD/NPF and NICE) scored greater than 80%; ‘six domains’ of AGREE II had greater score that is congruent with results; (1) scope and motive, (2) shareholder involvement, (3) rigor of growth, (4) clarity of speech, (5) validity, and (6) journalistic independence domains. Domain (3) scored (84, 71, and 90%), domain (5) (51%, 47, and 90%), domain (6) (70, 52, and 90%) for (Saudi CPGs, AAD/NPF, and NICE), respectively. Generally, the clinical recommendations were significantly better for NICE CPGs. Conclusions Four evidence-based ‘CPGs’ introduced a high-quality methodological analysis. NICE indicated the greatest quality followed by Saudi CPGs and AAD/NPF and all four CPGs were suggested for practice

Bioactive-Based Cosmeceuticals: An Update on Emerging Trends

Cosmetic-containing herbals are a cosmetic that has or is claimed to have medicinal properties, with bioactive ingredients purported to have medical benefits. There are no legal requirements to prove that these products live up to their claims. The name is a combination of “cosmetics” and “pharmaceuticals”. “Nutricosmetics” are related dietary supplements or food or beverage products with additives that are marketed as having medical benefits that affect appearance. Cosmetic-containing herbals are topical cosmetic–pharmaceutical hybrids intended to enhance the health and beauty of the skin. Cosmetic-containing herbals improve appearance by delivering essential nutrients to the skin. Several herbal products, such as cosmetic-containing herbals, are available. The present review highlights the use of natural products in cosmetic-containing herbals, as natural products have many curative effects as well as healing effects on skin and hair growth with minimal to no side effects. A brief description is given on such plants, their used parts, active ingredients, and the therapeutic properties associated with them. Mainly, the utilization of phytoconstituents as cosmetic-containing herbals in the care of skin and hair, such as dryness of skin, acne, eczema, inflammation of the skin, aging, hair growth, and dandruff, along with natural ingredients, such as for hair colorant, are explained in detail in the present review