Neurokinin 1 receptor antagonist along with dexamethasone reduces the inflammation in COVID-19 patients: a novel therapeutic approach

Background: Corona virus infection is a respiratory infection, compromising the normal breathing in critical patients by damaging the lungs. The aim of this study was to evaluate the clinical outcomes of Substance P receptor Neurokinin 1 antagonist in COVID-19 patients against the usual treatments as controls.Methods: It is a two-arm, open-label, randomized clinical trial that was carried out at Bahria International Hospital in Lahore, Pakistan. PCR-positive, hospitalized patients older than 18 years old, all sexes, and in the critical to life-threatening stage were included. 52 patients were placed in control group A and 67 patients were placed in intervention group B out of a total 119 patients who were randomly assigned to both arms. Before and after the intervention, lab tests were conducted in both groups. Aprepitant, a neurokinin-1 receptor antagonist, was additionally administered to the other arm while the other arm got standard therapy and care. Additionally, both groups received oral administration of the corticosteroid dexamethasone.Results: Patients in group A were on average 56.05 years old, compared to 58.1 years old in group B. There were 24 women in group A and 28 in group B, while there were 28 men and 39 women in group A. Group A had three critical cases, but group B had six. The reduction in C-reactive protein in the intervention group, improvement in platelet count in group B, and normalization of ferritin and LDH levels in group B all indicated decreased inflammation in the biochemical and haematological parameters in both groups. However, because of the reduced sample size, it wasn't very significant.Conclusion: The results of this recent trial provide a solid indication of Aprepitant's medicinal potential. Patients who got a combined therapy of dexamethasone and aprepitant had better clinical results, more favourable lab results, and lower levels of C-reactive protein, an inflammatory marker

Parental knowledge of RVS infection and attitude to infant immunization with monoclonal antibodies in western region, Saudi Arabia

Background: Human Respiratory Syncytial Virus (RSV) is a single-stranded (RNA) virus belongs to genus orthopneumovirus. It accounted as one of the main causes of lower respiratory tract infection in the pediatric age group and associated with their hospitalization and morbidity. Prophylactic monoclonal antibodies help in improvement and reduction of the serious complications resulting from the virus. Objective : The aim of this paper is to assess parental knowledge of RSV infection and attitudes to infant immunization with monoclonal antibodies. Method: A cross-sectional study conducted using online questionnaire from February 2023 to June 2023 in western region in the Kingdom of Saudi Arabia. A total of 606 of participants, which include any parents or caregiver who believe in childhood vaccination in western region of Saudi Arabia with exclusion of any parents who hesitate towards or refuse childhood vaccinations and outside western region. The statistical analysis done using IBM SPSS. Results: The study included 606 participants from the western province of Saudi Arabia, 218 (36%) were in the age group of 20-30 years, 383 (63.2%) had bachelor degrees And 77(12.7) works in healthcare, RSV was the least known childhood infectious agent (48.7%) of the participants never heard of it. 542 (89.4%) had a positive attitude toward childhood vaccinations in general and (51.2%) toward RSV vaccination with (75.2%) concerned about its safety.Conclusion: Despite the fact that practically all children were exposed to RSV, a sizable percentage of parents never heard of it. We propose that dependable healthcare professionals provide evidence-based information regarding RSV and its safety, effectiveness, and duration of protection against RSV for parents

Metastatic papillary thyroid carcinoma in pleural effusion: a case report and review of the literature

Abstract Introduction Papillary thyroid carcinoma accounts for the most common type of thyroid cancer of well-differentiated type. Papillary thyroid carcinoma is featured by biologically low-grade and less aggressive tumors with a survival rate of 10 years in most of the diagnosed cases. Papillary thyroid carcinoma can be presented with the involvement of cervical lymph nodes in about 50% of the patients, yet distant spread is very uncommon. Case presentation Herein, we discuss a Saudi male patient in his early 50s with a history of papillary thyroid carcinoma who presented to the emergency department complaining of shortness of breath and a radiological finding of hydrothorax. Cytologic examination together with immune-histochemical staining and molecular studies of pleural effusion aspiration concluded the definitive diagnosis of metastatic papillary thyroid carcinoma in the pleural space. Conclusions Papillary thyroid carcinoma seldom causes metastatic niches in the pleural space; this is a rare clinical presentation, nevertheless, a differential diagnosis of thyroid metastasis needs to be excluded. A definitive diagnosis of metastatic papillary thyroid carcinoma can be made using clinical presentation, cytologic examination, immunohistochemical investigation, and molecular testing. The most common mutation found in papillary thyroid carcinoma cases is the V600E mutation found in the BRAF gene, yet these patients have a relatively low probability of cancer recurrence. Patients with papillary thyroid carcinoma who have the BRAF mutation frequently experience metastases and relapses of the disease after the cancer has progressed aggressively. To help with therapy planning and the introduction of BRAF inhibitors, genetic testing for BRAF mutation may therefore prove to be a useful tool, especially in cases of aggressive subtypes of TC