Plitidepsin under Clinical Trial for COVID-19

Our team wants to draw attention to the clinical trial of drug Plitidepsin for COVID 19 treatment. SARS-CoV-2 has caused a catastrophe worldwide devastatingly of over 208 million confirmed cases and more than 4.4 million deaths reported worldwide as of early September 2021 according to WHO. Remdesivir despite being the only approved antiviral drug for the specific treatment of COVID- 19, has limited efficacy against the virus [1]. Because of very limited options for treatment of viral infection, the scientist has to work really hard to find out more treatment options so that we can protect humanity from next pandemic. SARS-CoV-2 encounters many proteins in the human body. After hijacking many of these proteins SARS-CoV-2 starts replicating inside the human cells. These proteins and their inhibition can be the target in clinical studies to exploring the therapeutically potential of any antiviral drug. One such host protein is Eukaryotic elongation factor-1A (eEF1A) whose inhibitor Plitidepsin has come under the significant interest of researchers as Plitidepsin [2]. The antiviral activity of Plitidepsin is mediated through its inhibition of Eukaryotic Elongation Factor 1A (eEF1A) [3]. It has a cytostatic impact on cell proliferation and strongly inhibits nucleocapsid protein expression, thus inhibiting the cytoplasmic replication stage [4]. Plitidepsin is a cyclic depsipeptide isolated from the marine tunicate Aplidium Albicans

Case of Severe Infantile Seborrhoeic Dermatitis (the Cradle Cap)

The term infantile seborrhoeic dermatitis is used to describe as apparently particularly eczematous or psoriasiform eruption seen in infants, having a fondness for the scalp and flexures, and can be compared with atopic dermatitis. This is a very common problem in neonates. We reported a 20th-day-old male neonate brought to us with his mother having complaints of yellowish greasy scales with thick greenish crust on them. Lesions were present on the scalp and the face

A Comprehensive Review on Treatment Modalities of Malignant Melanoma

Melanoma is an aggressive tumor that exhibits an increased occurrence and poor prognosis if metastasized. Early diagnosis and effective management are the mainstays for melanoma management. Effective management includes the selection of an effective treatment plan, supportive care, and training of patients for early diagnosis; various diagnostic options are available i.e. biopsy assessment, imaging procedures, and different biomarkers like liquid biopsy, various proteins, and polymorphism. As for the biomarkers, assessment of circulating tumor cells, microRNAs (miRNAs), and cell-free DNAs and RNAs are effectively used in the diagnosis of melanoma cases; the dysfunction of these molecules gives rise to the pathogenesis of melanoma. Many treatment modalities could be used potentially for melanoma management i.e. radiation therapy, surgery, systemic therapy, immunotherapy, and antibodies therapy. Proper care and training for melanoma patients contribute to enhance monitoring of the cases, in response to different treatment modalities. In this review, we have summarized details about malignant melanoma, keeping in view its epidemiology, classification, diagnosis, and various treatment modalities

Burden of Depression and its Correlates among Patients of Skin Diseases: a Snap-shot from Dermatology Outpatient Clinic in Karachi, Pakistan

Background: Skin problems are widespread health issues that account for a significant portion of the burden of disease worldwide and because of this der-matologists frequently face mood disorders. Objective: The present study has been planned to determine the prevalence and correlates of depression among skin diseases patients presenting in a derma-tology clinics in Karachi, Pakistan. Methods: This cross-sectional study was performed at dermatology clinic at Noor-e-Zia Consultant Clinics during April to August, 2022. Depression screening was performed using Patient Health Questionnaire of 9 items (PHQ-9). The cut-off for positive depression screening was 10 and above. Results: Total 385 patients were studied with a median age of 38 (IQR=27-48) years and majority of them were females (n=256, 66.5%). Patients presented with a median disease duration of one month with range of 1-24 months. 188 (48.8%) had the PHQ-9 score ≥10. On multivariable logistic regression, lower education, occupation of student, patients living in joint family system, current smokers, presence of comorbid, severe diseases and diagnosis of urticarial and folliculitis were associated with higher odds of depression. Conclusion: The depression burden is higher in dermatology clinic with sig-nificantly higher depression among patient of lower education, students, current smokers, patients with comorbid, severe diseases, and diagnoses of urticaria and folliculitis

Case Report of Herpes Zoster in the 17-year-old Boy

Herpes zoster has been caused because of the reactivation of latent Varicella-Zoster virus. It is a proportionally uncommon condition in the young population, as compared with adults. After taking consent from the legal guardian of the patient, we report a 17-year-old boy with a history of varicella, who came to us with the complaint of very severe painful vesicular lesions on the right side T1 and T2 dermatomal distribution of the chest, arm, and dorsal side of the trunk. Ultimately, the patient was diagnosed with herpes zoster. We focus to highlight that herpes zoster could occur in the healthy and immunocompetent young population and this may be due to the previous subclinical infection or vaccine strain reactivation

Uses of Antidepressant as Adjunct Treatment of Very Severe Atopic Dermatitis

This is a case of severe atopic dermatitis in a young married male age 37 years. This patient was very anxious and frustrated. The patient was using all the standard treatments for severe atopic dermatitis for e.g azathioprine, cyclosporine, tab deltacortril, applying emollients with clobetasol in it but he was not getting better. By chance the patient's family dragged him to visit a psychiatrist and the patient was advised to start venlafaxine and within 15 days the patient started getting better miraculously. Atopic Dermatitis is a very frustrating disease and patients face severe depression and bouts of severe itching exacerbated by exposure to dust, stress, sweating, changing and wearing clothes, etc. The use of antidepressants is not common practice in treating atopic dermatitis. Most general practitioners and dermatologists don't pay attention to how much a patient is suffering not only physically but also mentally and because of this, they don't suggest antidepressants. The role of antidepressants as an anti-inflammatory is still needed to be educated among physicians. This is a vicious cycle. The stress causes the exacerbation of this disease in which patients start itching all over the body and because of itching, lesions all over the body start getting infected as during itching staphylococcus aureus which resides under the nail enter in the lesion and cause infection and because of infection patients have a fever, lethargy, and weakness. The use of antidepressants is a game-changer in the management of atopic eczema

Severe Lice Infestation in Patient of Atopic Dermatitis

A 13-year-old female came to us with the complaint of severe itching in her scalp, low-grade fever, loss of weight, and enlarged occipital lymph node. The patient was having very severe infestations of lice in her scalp. The patient was very anxious and irritated because of her itching. We excluded all the options for sexual, mental, and physical abuse by having proper examination and history taking in the absence of any guardian after taking permission from guardians. The patient was having lice and nits only on her scalp, other parts of body hairs were spared from the lice infestations. The patient was maintaining proper hygiene and belongs to an upper socioeconomic family. Along with this patient's mother informed us about her diagnosis of atopic dermatitis. The patient has been diagnosed with atopic dermatitis since she was at the age of 3. Lice infestation is a very common problem in low socio-economic societies and generally, it is considered the person who has the lice infestations must be unhygienic, in reality, it has been seen very often in very neat and clean people. Very severe lice infestations depend on many factors not only in neglected, homeless, or non-hygienic people, it depends on sebum production, many skin diseases e.g. hyperhidrosis, etc

Clinicopathological features of craniopharyngioma: A 15-year study from a tertiary care center in Pakistan

Introduction: Craniopharyngiomas (CPs) are benign neoplasms and most common suprasellar tumors. They are more frequent in children, contributing to a significant number of intracranial tumors in the pediatric population and are thought to be arising either from the epithelial remnant cells of the craniopharyngeal duct or from the adenohypophysis epithelium. Two subtypes of CPs exist, namely, adamantinomatous craniopharyngioma (ACP) and papillary craniopharyngioma (PCP). ACP is more common in children with a relatively aggressive clinical course and more frequent relapses than PCP. The study objective was to evaluate the clinicopathological features of CP in our population.Methods: We conducted a retrospective observational study in the Department of Histopathology at Aga Khan Hospital, Karachi, Pakistan, over a period of 15 years, from January 2001 to December 2015. All CP cases were included in the study. A total of 207 cases were diagnosed during this period by histopathologists based on histologic features. All slides were retrieved, and diagnosis was confirmed after a reexamination of slides.Results: We found that the mean age of diagnosis was 25.59±14.71 years, and the median follow-up time was 7 (3-19) years. The number of male patients was 136 (65.7%) and the number of female patients was 71 (34.3%). The most common tumor site was suprasellar (71.5%) followed by the sellar and temporal lobe (12.1% and 6.8%, respectively). The most common complaints were headache (21.7%), followed by loss of vision/decreased vision (16.4%) and vomiting (5.3%). The overall survival rate was 95.2% with a recurrence rate of 5.8%. A significant association of survival was noted with tumor recurrence.Conclusion: CP is a rare brain tumor with good overall survival. We found a low recurrence rate of CP in our study. However, recurrence was found to be the most important factor determining survival in patients with CP

Metaplastic breast carcinoma: Clinicopathological parameters and prognostic profile

Introduction: Metaplastic breast carcinoma (MBC) is defined as breast cancer with a heterologous non-glandular component. MBC is considered a special type of breast cancer with a prognosis that is worse than invasive ductal carcinoma (IDC) of the breast. MBC is the most common breast cancer with a triple-negative profile. Therefore, in this study, we evaluated the clinicopathological parameters, recurrence and survival of MBC in our population.Methods: We conducted a retrospective observational study in the Department of Histopathology at Prince Faisal Oncology Centre, Buraidah, Saudi Arabia, over a period of five years. All cases diagnosed as MBC were included in the study. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu) immunohistochemistry (IHC) was performed on representative tissue blocks.Results: Total 183 cases of MBCs were included in the study, out of which 120 cases were excision specimens. The mean age of the patients was 48.84±12.99 years, and the most common age group was between 36 and 50 years of age. Most of the cases were tumor (T) stage T3 (50%), and nodal metastasis was present in 40% of cases. Most cases were grade III (78.7%). ER, PR and HER2/neu positivity was noted in 15.8%, 13.1%, and 9.8% cases, respectively. Follow-up data were available for 70 cases, with a median follow-up period of 4 (1-7) years. Tumor recurrence was noted in 31.4% cases, with a survival rate of 71.4%. Squamous, chondroid, spindle cell differentiation, and matrix production were noted in 70.5%, 7.1%, 13.7%, and 2.2% cases, respectively. A significant association of squamous differentiation was noted with HER2/neu positivity. An inverse association of spindle cell differentiation was seen with axillary metastasis. Survival analysis by Kaplan-Meier revealed a significant association of survival with tumor recurrence.Conclusion: MBC is an important subtype of breast cancer, histopathological identification of which is challenging, owing to varied histological differentiation. We found squamous differentiation to be the most common in MBC, which was associated with HER2/neu positivity. A high recurrence rate of MBC was also observed in our study that was significantly associated with survival

Burden of Depression and its Correlates among Patients of Skin Diseases: a Snap-shot from Dermatology Outpatient Clinic in Karachi, Pakistan

Background: Skin problems are widespread health issues that account for a significant portion of the burden of disease worldwide and because of this dermatologists frequently face mood disorders. Objective: The present study has been planned to determine the prevalence and correlates of depression among skin disease patients presenting in dermatology clinic in Karachi, Pakistan. Methods: This cross-sectional study was performed at the dermatology clinic at Noor-e-Zia Consultant Clinics from April to August 2022. Depression screening was performed using the Patient Health Questionnaire of 9 items (PHQ-9). The cut-off for positive depression screening was 10 and above. Results: A total of 385 patients were studied with a median age of 38 (IQR=27-48) years and the majority of them were females (n=256, 66.5%). Patients presented with a median disease duration of one month with a range of 1-24 months. 188 (48.8%) had a PHQ-9 score ≥10. On multivariable logistic regression, lower education, occupation, patients living in a joint family system, current smokers, presence of comorbid, disease severity, and diagnosis of urticaria and folliculitis were associated with higher odds of depression. Conclusion: The depression burden was higher in dermatology clinic with significantly higher depression among patients of lower education, students, current smokers, patients with comorbid, disease severity, and diagnoses with urticaria and folliculiti