Treatment of Multiple Common Warts by Intralesional Immunotherapy: Review Article

Background: Human papillomavirus (HPV) is the most prevalent cause of warts on the skin and mucous membranes of the human body. With the aid of a variety of destructive and immunotherapeutic methods, wart therapy remains a major difficulty. Antigen immunotherapy by intralesional technique uses the immune system's ability to recognize viral, bacterial, and fungal antigens that elicit a delayed-type hypersensitivity reaction, not only to the antigen but also to the wart virus, which in turn boosts the immune system's ability to recognize and remove HPV. All lesions on the body, not just the injected one, could be destroyed by this boosted immune response. Different antigens, including Candida and pure protein derivative (PPD), have been shown to be useful in the treatment of various wart forms. Objective: Intralesional immunotherapy for numerous common warts is to be evaluated for its effectiveness. Conclusion: There has been substantial research into the use of intralesional vaccinations and organic antigens to treat warts, with good results of effectiveness

Methotrexate in the Treatment of Non-Melanoma Skin Cancers

Background: There are three types of non-melanoma skin cancer (NMSC): basal (BCC), keratoacanathoma (KA), and cutaneous squamous cell carcinoma (cSCC). These three malignancies account for 99 percent of all tumors in this category. Because it slows DNA synthesis in quickly proliferating cells, methotrexate (MTX) is an effective treatment for tumors that are fast developing. To prevent the production of the purine nucleotide thymidine, it inhibits the development of tetrahydrofolate by binding to the dihydrofolate reductase. Objective: To assess the efficacy and safety of MTX in the treatment of NMSCs.Conclusion: When used as a less intrusive and less expensive treatment for NMSCs, MTX has the potential to be a very effective and safe alternative treatment, especially in patients who are elderly or have other medical conditions

New insight in the treatment of wide facial pores: review article

Background: Having large face pores is a frequent cosmetic and dermatological issue for many people. Due to its complex pathophysiology and poor influence on patients' quality of life, treatment is challenging. Because of this, reducing the size of face pores is a hot topic in the cosmetics world. Skin rejuvenation, and reduction in sebum production are just a few of the treatment options available for treating facial pores. The effectiveness and safety of any of the presently offered medications or therapies have not been studied in humans in a lot of clinical studies. Hormonal medication, including cyproterone acetate, spironolactone, and combination of oral contraceptives, are among the treatment possibilities in addition to isoretinoin. Medications applied topically, such as L-carnitine, niacinamide at a concentration of 2 percent, tretinoin or tazarotene, glycolic acid and salicylic acid peels, moisturisers, and sunscreens, require formulations free of occlusive, comedogenic, and oil-free substances. Laser diodes, non-ablative radiofrequency technologies, and photodynamic therapy all showed promising results.Objective: To make an overview of updated guidelines for treating wide facial pores.Methods: The databases were searched for articles published in English in 3 data bases [PubMed – Google scholar and Egyptian bank of knowledge] and Boolean operators had been used such as [Wide facial pores AND Novel Treatment OR hair removal] and in reviewed articles.Conclusion: Treatment of enlarged facial pores aims at reducing sebum production and/or reducing folliculler size. The treatment options include oral and topical medication, diet modification, laser, Botulinum toxin as well as hair removal

Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host Disease

Background. Oral chronic graft versus host disease (cGVHD) is a major complication in transplantation community, a problem that can be addressed with topical intervention. Topical corticosteroids are the first line of treatment although the choice remains challenging as none of the available treatments is supported by strong clinical evidence. Objective. This systematic review aims to determine the clinical efficacy and safety of topical corticosteroids for the management of the mucosal alterations of oral cGVHD. Data Sources. Electronic search of different databases was conducted: PubMed, Cochrane library, Grey literature, WHO, and clinical trials.gov for clinical trial registration as well as hand search in the references of relevant articles up to November 2016. Data Extraction. Extracted pieces of information were intervention, population, sample sizes, and outcomes. Data Synthesis. Six studies were included: 2 randomized clinical trials (RCTs), 3 cohort studies, and 1 pre-post clinical trial. Results. There is a limited evidence concerning clinical efficacy of topical corticosteroids. Clobetasol, dexamethasone, and budesonide were the topical corticosteroid of choice. The highest level of evidence score was given to clobetasol followed by budesonide with a lower evidence level. Conclusion. All three topical corticosteroid preparations are effective for management of oral chronic GVHD with minimal easily avoided side effects

Toxoplasma gondii Suppresses Th2-Induced by Trichinella spiralis Infection and Downregulates Serine Protease Genes Expression: A Critical Role in Vaccine Development

Background: Toxoplasma gondii coinfection can modify host immune responses and the severity and spread of other parasites. We investigated how T. gondii and Trichinella spiralis infections counter-regulate each other's immune responses. Methods: The parasite burden, the expression of T. gondii rhoptry kinase ROP18 and T. spiralis putative serine protease (TsSP), the IgG1 and IgG2a responses, besides histopathological and immunohistochemical staining with iNOS and arginase were used to evaluate the dynamics of coinfection. Results: Through their effects on host immune responsiveness, coinfection with T. gondii modified the virulence of T. spiralis infection. Coinfected animals with high and low doses of T. gondii demonstrated significant reductions in the T. spiralis burden of 75.2% and 68.2%, respectively. TsSP expression was downregulated in both groups by 96.2% and 86.7%, whereasROP18 expression was downregulated by only 6% and10.6%, respectively. In coinfected mice, elevated levels of T. gondii-specific IgG2a antibodies were detected. Th1 induced by T. gondii inhibits the Th2 response to T. spiralis in coinfected animals with high iNOS expression andlow-arginine1 expression. Conclusion: T. gondii infection induces a shift toward a Th1-type immune response while suppressing a helminth-specific Th2 immune response, paving the way for developing novel vaccines and more efficient control strategies

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The Interaction Effect of Laser Irradiation and 6-Benzylaminopurine Improves the Chemical Composition and Biological Activities of Linseed (Linum usitatissimum) Sprouts

Even though laser light (LL) and 6-benzylaminopurine (BAP) priming are well-known as promising strategies for increasing the growth and nutritional value of several plants, no previous studies have investigated their synergistic effect. Herein, we investigated the effects of laser light, 6-benzylaminopurine (BAP) priming, and combined LL-BAP treatment on the nutritional value, chemical composition, and the biological activity of Linum usitatissimum sprouts. The fresh weight, leaf pigments, primary and secondary metabolites, enzymes, and antimicrobial activities were determined. A substantial enhancement was observed in the growth characteristics and leaf pigments of laser-irradiated and BAP-primed sprouts. Furthermore, the combined treatments improved the accumulation of minerals, vitamins, and amino acids, and also enhanced the N-metabolism more than LL or BAP alone. Furthermore, the combined priming boosted the antioxidant capacity by increasing the contents of fatty acids, phenols, and flavonoids. Antimicrobial activity and the highest increase in bioactive compounds were recorded in linseed sprouts simultaneously treated with LL and BAP. This work suggests that priming L. usitatissimum sprouts with laser light and BAP is a promising approach that can improve the nutritional value and health-promoting impacts of L. usitatissimum sprouts