scholarly journals Use of remdesivir in the treatment of coronavirus disease 2019 (COVID-19) infection among Sudanese patients: a case series

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 512
Author(s):  
Maysoun Yousif ◽  
Ghada Abd El-Raheem ◽  
Doaa Mohamed
Keyword(s):  
Side Effects ◽  
Liver Enzymes ◽  
Case Series ◽  
Supportive Therapy ◽  
First Case ◽  
Case Series Study ◽  
New Treatment ◽  
Series Study

Introduction: The coronavirus disease 2019 (COVID-19) pandemic is affecting populations worldwide. Remdesivir is an anti-retroviral agent, with a broad spectrum of usage. Remdesivir usage against COVID-19 had been studied both in vitro and in vivo but is still considered a new treatment for COVID-19 and is not available in all countries. The aim of our study was to report several cases of the use of remdesivir in Sudanese patients and report the adverse events related to the course of treatment. Methods: A case series study was conducted in Imperial Hospital, Khartoum, Sudan reporting two cases who received remdesivir for treating COVID-19 besides other treatments such as steroids and supportive therapy in December 2020. Cases were males aged over 65 years. Cases presentation: Both patients were severe cases of COVID-19 admitted to the intensive care unit (ICU), who received remdesivir for treating COVID-19 infection. Several side effects were reported: the first case had increased liver enzymes and then unexpectedly died from severe resistant hypotension; and hypoalbuminemia was noticed in the second case. Conclusions: Remdesivir use among patients in Sudan must be studied extensively in order to determine the unexpected fatal event and assess the association of this event to remdesivir use, as well as to report the frequency of the side effects.

scholarly journals Use of Remdesivir in The Treatment of COVID-19 Infection Among Sudanese Patients - Case Series

2021 ◽  
Author(s):  
Maysoun Ahmed Awad Yousif ◽  
Ghada Omer Hamad Abd El-Raheem ◽  
Doaa Salih Ibrahim Mohamed
Keyword(s):  
Side Effects ◽  
Liver Enzymes ◽  
Case Series ◽  
The Other ◽  
Elevated Liver Enzymes ◽  
Case Series Study ◽  
Profound Hypotension ◽  
Series Study

Abstract Introduction: COVID-19 infection is a viral pandemic started in 2019, all societies have the susceptibility of getting infected. Remdesivir is an anti-retroviral agent, with a broad spectrum of activity. Remdesivir activity against COVID-19 had been studied in both in vitro and in vivo, but still considered new for COVID-19 treatment and not available in all countries. The aim of our study was to report the use of remdesivir among Sudanese population and report the adverse events related to the course of treatment. Methods: case series study was conducted in Imperial Hospital reporting the three cases who received Remdesivir for treating COVID-19 infection.Cases presentation: Three cases had received remdesivir for treating COVID-19 infection, side effects reported were elevated liver enzymes, profound hypotension and hypoalbuminemia. Discussion: All three patients were severe cases of COVID-19 admitted to the ICU. Unexpectedly, severe resistant hypotension was the cause of death in 2 cases who received remdesivir. Increased liver enzymes was noticed in one case. In the other hand, hypoalbuminemia was noticed in one case as well.

scholarly journals Opioid-free anesthesia for patients with joint hypermobility syndrome undergoing craneo-cervical fixation: a case-series study focused on anti-hyperalgesic approach

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Carlos Ramírez-Paesano ◽  
Albert Juanola Galceran ◽  
Claudia Rodiera Clarens ◽  
Vicenҫ Gilete García ◽  
Bartolomé Oliver Abadal ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Hospital Discharge ◽  
Case Series ◽  
Ehlers Danlos Syndrome ◽  
Painful Condition ◽  
Discharge Data ◽  
Gastrointestinal Complications ◽  
Case Series Study ◽  
Series Study

Abstract Background Patients with Ehlers-Danlos Syndrome/Hypermobility Type (EDS-HT/JHS) and Craneo-Cervical Instability frequently suffer from severe widespread pain which is difficult to control. Chronic neuroinflammation, opioid-induced hyperalgesia, and central sensitization may explain this painful condition. The aim of this study was to determine if opioid-free anesthesia plus the postoperative administration of lidocaine, ketamine and dexmedetomidine can reduce postoperative pain and the need of methadone rescues in comparison with opioid-based management in these patients undergoing Craneo-Cervical Fixation (CCF). The secondary aim was to assess the needs of opioids at hospital-discharge, incidence of gastrointestinal complications and the requirement of anxiolytic. Methods A retrospective, consecutive case series study was designed. 42 patients with EDS-HT/JHS undergoing CCF were enrolled in two groups: an OFA-plus Group that received opioid-free anesthesia with propofol, lidocaine, ketamine and dexmedetomidine, and OP Group, opioid-based anesthesia-analgesia. The main variables: Preoperative Visual Analogue Score (VAS), postoperative VAS on the 1st, 2nd, 4th and 6th days, sufentanil or morphine requirements, need for methadone rescue, and VAS at hospital-discharge. Data was presented by mean ± SD, percentage, median or interquartile range. Chi-squared or Fisher’s test. 95% C.I and P values < 0.05. Results Nineteen patients in OFA-plus, and 23 patients in OP group. VAS was lower in OFA-plus on the postoperative days evaluated (p < 0.001).VAS at hospital-discharge was lower in OFA-plus: 4.96 (4.54–5.37) vs. OP 6.39 (6.07–6.71) (p < 0.001). Methadone requirement was lower in the OFA-plus (p < 0.001). 78% of patients in OFA-plus didn’t need methadone rescue. 95% in OP group needed methadone rescues at high doses(> 15 mg/day). No differences regarding equivalent doses of sufentanil or morphine consumption on the 2nd, 4th, and 6th postoperative days were found. OFA-plus decreased ileus, nausea and vomiting (p < 0.001). 60.9% in OFA-plus group decreased opioid requirements at hospital-discharge compared with preoperative values. A 77% reduction of anxiolytics requirements was shown. Conclusion OFA-plus management for patients undergoing CCF with EDS-HT/JHS shows significant reduction in postoperative pain and at hospital-discharge compared with opioid-based anesthesia. OFA-plus management decreases the total doses of methadone rescues, reduces anxiolytic requirements and gastrointestinal side-effects, except for constipation. OFA-plus management is a feasible option to improve postoperative pain control, reducing the opioids’ use and their postoperative side-effects in patients undergoing CCF with EDS-HT/JHS.

scholarly journals Opioid-free Anesthesia for Patients With Joint Hypermobility Syndrome Undergoing Craneo-cervical Fixation: a Case-series Study Focused on Anti-hyperalgesic Approach

2020 ◽  
Author(s):  
Carlos R Ramirez-Paesano ◽  
Albert Juanola Galcerán ◽  
Claudia Rodiera Clarens ◽  
Vicenç Gilete García ◽  
Bartolomé Oliver Abadal ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Hospital Discharge ◽  
Case Series ◽  
Joint Hypermobility Syndrome ◽  
Ehlers Danlos Syndrome ◽  
Discharge Data ◽  
Gastrointestinal Complications ◽  
Case Series Study ◽  
Series Study

Abstract Background. Patients with Ehlers-Danlos Syndrome/Hypermobility Type (EDS-HT/JHS) and Craneo-Cervical Instability frequently suffer from severe widespread pain which is difficult to control. Chronic neuroinflammation, opioid-induced hyperalgesia, and central sensitization may explain this painful condition.The aim of this study was to determine if opioid-free anesthesia plus the postoperative administration of lidocaine, ketamine and dexmedetomidine can reduce postoperative pain and the need of methadone rescues in comparison with opioid-based management in these patients undergoing Craneo-Cervical Fixation(CCF). The secondary aim was to assess the needs of opioids at hospital-discharge, incidence of gastrointestinal complications and the requirement of anxiolytic.Methods. A retrospective, consecutive case series study was designed. 42 patients with EDS-HT/JHS undergoing CCF were enrolled in two groups: an OFA-plus Group that received opioid-free anesthesia with propofol, lidocaine, ketamine and dexmedetomidine, and OP Group, opioid-based anesthesia-analgesia. The main variables: Preoperative Visual Analogue Score (VAS), postoperative VAS on the 1st, 2nd, 4th and 6th days, sufentanil or morphine requirements, need for methadone rescue, and VAS at hospital-discharge. Data was presented by mean ± SD, percentage, median or interquartile range. Chi-squared or Fisher’s test. 95% C.I and P values <0.05 . Results. Nineteen patients in OFA-plus, and 23 patients in OP group. VAS was lower in OFA-plus on the postoperative days evaluated (p<0.001).VAS at hospital-discharge was lower in OFA-plus: 4.96 (4.54-5.37) vs. OP 6.39 (6.07-6.71) (p<0.001). Methadone requirement was lower in the OFA-plus (p<0.001). 78% of patients in OFA-plus didn’t need methadone rescue. 95% in OP group needed methadone rescues at high doses(>15mg/day). No differences regarding equivalent doses of sufentanil or morphine consumption on the 2nd, 4th, and 6th postoperative days were found. OFA-plus decreased ileus, nausea and vomiting (p<0.001). 60.9% in OFA-plus group decreased opioid requirements at hospital-discharge compared with preoperative values. A 77% reduction of anxiolytics requirements was shown. Conclusion: OFA-plus management for patients undergoing CCF with EDS-HT/JHS shows significant reduction in postoperative pain and at hospital-discharge compared with opioid-based anesthesia. OFA-plus management decreases the total doses of methadone rescues, reduces anxiolytic requirements and gastrointestinal side-effects, except for constipation. OFA-plus management is a feasible option to improve postoperative pain control, reducing the opioids’ use and their postoperative side-effects in patients undergoing CCF with EDS-HT/JHS.

scholarly journals Systemic Minoxidil Accidental Exposure in a Paediatric Population: A Case Series Study of Cutaneous and Systemic Side Effects

2021 ◽  
Vol 10 (18) ◽  
pp. 4257
Author(s):  
Manuel Sánchez-Díaz ◽  
David López-Delgado ◽  
Trinidad Montero-Vílchez ◽  
Luis Salvador-Rodríguez ◽  
Alejandro Molina-Leyva ◽  
...  
Keyword(s):  
Side Effects ◽  
Treatment Time ◽  
Case Series ◽  
Paediatric Population ◽  
High Dose ◽  
Retrospective Case ◽  
Case Series Study ◽  
High Doses ◽  
Initial Zone ◽  
Series Study

Oral minoxidil is an approved treatment for high blood pressure which is also used as an off-label drug for alopecia. Knowledge about the effects of systemic minoxidil in the paediatric population is limited. A retrospective case series study of paediatric patients with history of systemic minoxidil intake due to contaminated sets of omeprazole was performed to describe side effects of high dose oral minoxidil intake in children. Twenty patients aged between 2 months and 13 years joined the study. They had received high doses of oral minoxidil (mean dose 0.90 mg/kg/day) during a mean time of 38.3 days. Hypertrichosis appeared in 65%, with a mean latency time of 24.31 days. Treatment time was associated with the appearance of hypertrichosis (p < 0.05). Most common initial zone of hypertrichosis was the face. Systemic effects developed in 15%, with no cases of severe disorders. The present study shows a novel insight into the side effects of high doses of oral minoxidil in children.

scholarly journals Recovery from Idiopathic Facial Paralysis (Bell’s Palsy) Using Photobiomodulation in Patients Non-Responsive to Standard Treatment: A Case Series Study

Photonics ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 341
Author(s):  
Claudio Pasquale ◽  
Anatoliy Utyuzh ◽  
Maria Vladimirovna Mikhailova ◽  
Esteban Colombo ◽  
Andrea Amaroli
Keyword(s):  
Standard Treatment ◽  
Continuous Wave ◽  
Case Series ◽  
Supportive Therapy ◽  
Facial Asymmetry ◽  
Spot Size ◽  
Pharmacological Therapy ◽  
Psychological Burden ◽  
Case Series Study ◽  
Series Study

Diminished facial movement and marked facial asymmetry can lead to a consistent psychological burden. Bell′s palsy (BP) is one of the most common causes of facial nerve illness, which comes with unilateral acute facial paresis. Nowadays, no clear guidelines for treating BP are available. We carried out a case series study to test the efficacy of photobiomodulation (PBM) therapy in patients with BP non-responsive to standard treatment. The study was experimentally performed at the Department of Surgical and Diagnostic Sciences, University of Genoa (Genoa, Italy), in accordance with case report guidelines. Patients were referred to our department by colleagues for evaluation to be included in the case series because no consistent improvement was observed at least 3 months from the diagnosis of BP. All the patients interrupted their pharmacological therapy before the initiation of PBM therapy. PBM therapy (808 nm, 1 W irradiated in continuous-wave for 60 s on spot-size 1 cm2; 1 W/cm2; 60 J/cm2; and 60 J) was administered every 2 days until complete resolution. Evaluation of the House-Brackmann scale was performed before and after treatments. Fourteen patients were screened as eligible for the study. Patients were Caucasians (36% females and 64% males) with a mean age ± standard deviation of 56.07 ± 15.21 years. Eleven patients out of 14, who experienced BP a maximum of 6 months, completely recovered through PBM. The three patients that did not show improvement were those who had experienced BP for years. PBM could be a supportive therapy for the management of BP in patients non-responsive to standard treatment. However, randomized controlled trials are necessary to sustain our encouraging results, exclude bias, and better explain the boundary between the time from diagnosis and the recovery of BP through PBM therapy.

scholarly journals Hybrid drug combination: A new treatment strategy for type 2 diabetes- A review

2020 ◽  
Vol 11 (2) ◽  
pp. 2008-2017
Author(s):  
Shraddha Sharma ◽  
Vengal Rao P ◽  
Seema Mehdi ◽  
Manjula S N ◽  
Aalap Das
Keyword(s):  
Diabetes Mellitus ◽  
Side Effects ◽  
Synthetic Drugs ◽  
Treatment Of Diabetes ◽  
New Treatment ◽  
Bioactive Agents ◽  
Oral Hypoglycemic Drugs

Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia arising from deregulation in insulin secretion, insulin action, or both. The current synthetic drugs have dose-dependent side effects which confined their uses. The phytochemicals are the natural compounds that have better therapeutic efficacy and interacts synergistically with oral hypoglycemic drugs. The addition of phytochemicals with OHDs may reduce the dose of synthetic drugs as well as their side effects and toxicity. A detailed outline about such combinations like Ferulic acid & THZ/Metformin, Ellagic acid & Pioglitazone (THZ), Chlorogenic acid & THZ/Metformin, Caffeic acid & THZ/Metformin, eugenol acid & THZ/Metformin, cinnamic acid & THZ/Metformin, p- coumaric acid & THZ/Metformin, Arecoline &Vanillic acid with the THZ/ Metformin have been illustrated. This review has also discussed the synergy and mechanism of phytochemical with the OHDs to combat hyperglycemia and other risk associated with it. A comprehensive review was conducted to pile up the information about polyphenols & synthetic drug combinations used for the treatment of diabetes mellitus, which has been carried out in-vitro or in-vivo and may contribute to identifying novel strategies in the treatment of T2D condition. This review shows the importance of the responsible bioactive agents present in medicinal plants in the drive to demonstrate their antidiabetic effects.

Combined in vivo reflectance confocal microscopy and digital dermoscopy for follow up of patients at high risk of malignant melanoma: A prospective case series study

2017 ◽  
Vol 44 (6) ◽  
pp. 681-689 ◽  
Author(s):  
Uxúa Floristán Muruzábal ◽  
Reyes Gamo Villegas ◽  
Ana Pampín Franco ◽  
Fernando Pinedo Moraleda ◽  
Elia Pérez Fernández ◽  
...  
Keyword(s):  
High Risk ◽  
Malignant Melanoma ◽  
Confocal Microscopy ◽  
Case Series ◽  
Case Series Study ◽  
Prospective Case Series ◽  
Series Study ◽  
Digital Dermoscopy
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