TNF-Alpha Inhibitors and Ustekinumab for the Treatment of Psoriasis: Therapeutic Utility in the Era of IL-17 and IL-23 Inhibitors

Psoriasis is a chronic inflammatory condition for which eleven FDA-approved biologic therapies are approved. Over the past decade, studies have documented the higher efficacy of IL-17 and IL-23 inhibitors for the treatment of psoriasis compared to the TNF-alpha inhibitors and ustekinumab, an IL-12/23 inhibitor. Despite this, there remains an important role for the use of TNF-alpha inhibitors and ustekinumab in the treatment of psoriasis. Here, we review how considerations of infection and malignancy risk, patient demographics, treatment resistance, and comorbidities may make certain TNF-alpha inhibitors or ustekinumab an excellent choice for therapy in particular patient subgroups.

Mesenchymal Stem Cell Therapy in Diabetic Cardiomyopathy

The incidence and prevalence of diabetes mellitus (DM) are increasing worldwide, and the resulting cardiac complications are the leading cause of death. Among these complications is diabetes-induced cardiomyopathy (DCM), which is the consequence of a pro-inflammatory condition, oxidative stress and fibrosis caused by hyperglycemia. Cardiac remodeling will lead to an imbalance in cell survival and death, which can promote cardiac dysfunction. Since the conventional treatment of DM generally does not address the prevention of cardiac remodeling, it is important to develop new alternatives for the treatment of cardiovascular complications induced by DM. Thus, therapy with mesenchymal stem cells has been shown to be a promising approach for the prevention of DCM because of their anti-apoptotic, anti-fibrotic and anti-inflammatory effects, which could improve cardiac function in patients with DM.

Salivary Exosomes: From Waste to Promising Periodontitis Treatment

Periodontitis is a chronic inflammatory condition that causes tooth loss by destroying the supporting components of the teeth. In most cases, it is difficult to diagnose early and results in severe phases of the disease. Given their endogenous origins, exosomes, which are rich in peptides, lipids, and nucleic acids, have emerged as a cell-free therapeutic approach with low immunogenicity and increased safety. Because the constituents of exosomes can be reprogrammed depending on disease states, exosomes are increasingly being evaluated to act as potential diagnostic biomarkers for dental disease, including periodontitis. Exosomes also have been demonstrated to be involved in inflammatory signal transmission and periodontitis progression in vitro, indicating that they could be used as therapeutic targets for periodontal regeneration. Nevertheless, a review on the involvement of salivary exosomes in periodontitis in impacting the successful diagnosis and treatment of periodontitis is still lacking in the literature. Thus, this review is intended to scrutinize recent advancements of salivary exosomes in periodontitis treatment. We summarize recent research reports on the emerging roles and characteristics of salivary exosomes, emphasizing the different expressions and changed biological roles of exosomes in periodontitis.

Extragenital lichen sclerosus arising in tattooed skin

Lichen sclerosus (LSc) is a chronic inflammatory condition commonly affecting the anogenital area, with extragenital involvement seen in less than 1%–20% of cases. Concomitant extragenital and genital LSc is extremely rare in male patients. The Koebner phenomenon is a recognised feature of LSc; here we present a rare case of extragenital LSc occurring in tattooed skin.

Bullous Disease of Diabetes (Bullosis Diabeticorum)

Acanthosis nigricans, acrochordrons, diabetic dermatopathy, necrobiosis lipoidica, and bullous diabeticorum are some of the cutaneous symptoms of diabetes. Bullous illness (bullosis diabeticorum) is a blistering, non-inflammatory condition of the acral skin. Diabetes bullous illness is more common in people who have had diabetes for a long time or who have many comorbidities. Although the actual cause is uncertain, it is likely to be multifactorial. Neuropathy, nephropathy, vasculopathy, and UV (ultraviolet) light are all suggested to have a role. BD is most likely caused by the various problems that come with poorly managed diabetes. The exact number of people who have BD is unknown. The majority of case studies in the literature were based on a small number of cases. Bullous diabeticorum is a restrictive diagnosis, which necessitates a histological study that includes direct immunofluorescence to rule out other vesicobullous illnesses. In terms of BD management, no strong consensus has formed. The blisters have historically been thought to be self-limiting, with bullae resolving in 2 to 6 weeks if left untreated. In some cases antibiotic may be used. In this article we’ll be looking at Bullosis Diabeticorum. Its etiology, epidemiology, diagnosis, and treatment.

Subacute Thyroiditis Post-Covid-19 Infection: A Case Report

Background: Subacute thyroiditis (SAT) or granulomatous thyroiditis is usually a self-limiting inflammatory condition. The clinical presentation varies from person to person, but is usually associated with pain and systemic symptoms. Case Report: Herein, a case of a previously healthy 40 years old male who presented with unilateral right neck pain of gradual onset and progressive course has been described. The patient had recovered from a symptomatic Covid-19 infection 5 months back. The clinical examination, imaging and histopathological examination were consistent with the clinical diagnosis of subacute thyroiditis. The patient received medication in the form of pain killer, Celebrex and paracetamol, without corticosteroids, and completely recovered. Conclusion: The possibility of subacute thyroiditis post-COVID-19 infection should be considered.

A case study of feline triaditis

Triaditis is an inflammatory condition involving three specific organs, namely the pancreas, liver, and intestines. The most common clinical signs of triaditis are vomiting, diarrhea, jaundice, and loss of appetite. Therefore, this case study was con-ducted to determine cases of triaditis in cats with these clinical signs. This case study was carried out on five cats with diar-rhea, lethargy, and loss of appetite. The fecal scores of cats with diarrhea were 2 and 3. Based on physical examination, there were two cats with hepatomegaly and three cats with jaundice on their mucosa. Treatments for five cats with diarrhea were antibiotic combination (sulfadiazine-trimetropine 50 mg/kg BW) and combination of antispasmodic, analgesic, and antipyret-ic (dipyrone-lidocaine 5 mg/kg BW). Treatments for three cats with jaundice were asering fluid therapy and oral medication (ursodeoxycholic acid 8 mg/kg BW). Anthelmintic combination (fenbendazole, praziquantel, and pyrantel pamoate 0.07 g/kg BW) was given as an additional therapy for cats with intestinal worms. The two cats with diarrhea, hepatomegaly and jaun-dice were not survive after about one week of treatment, while the other one can survive until now

Xanthogranulomatous hypophysitis: a different rare presentation in a young patient

Hypophysitis is a rare inflammatory condition that may present both clinically and radiologically as a neoplastic lesion. Xanthogranulomas are rare intracranial lesions with controversial etiology. Here, we report a clinical case of histologically confirmed xanthogranuloma in a young female with type I diabetes mellitus and hypothyroidism.

Odontogenic Maxillary Sinusitis: The Interface and Collaboration between Rhinologists and Dentists

Odontogenic maxillary sinusitis (OMS) is an inflammatory condition affecting the paranasal sinuses and is commonly encountered by both Otorhinolaryngologists and Dentists. However, there is an ongoing debate regarding the best sequence of management. Clinicians are faced with the dilemma of first addressing either the affected tooth or the affected sinus. This paper provides a review of the current literature on the aetiology, presentation, and management of OMS, as well as our experience in managing this condition. Overall, the causative pathology of the patient’s OMS, their symptoms, and the risk of surgery should drive decision making with regards to sequence of management.

MANAGEMENT OF CHRONIC SINUSITIS THROUGH ALTERNATE RECHANA AND SNEHANA NASYA - REPORT FROM A PILOT STUDY

Chronic sinusitis is the chronic inflammatory condition affecting the paranasal sinuses. It may be correlated to Dushta pratisyāya in Ayurveda, which is a Kapha predominant disease affecting jatṟuṛdhva bhāgā which needs teekshna virecana nasya for its management. Vāgbhaṭācārya opines that except for vātika rogas, nasya should be done as ekāhāntara (alternate day) i.e., with a gap of one day in between. But according to Cakṟadatta commentary, ekāhāntara nasya is to be done with virecana nasya and snehana nasya on alternate days. For virecana nasya, Tuḷasi patṟa svarasa (Ocimum sanctum Linn.) and for snehana nasya, Aṇutaila were selected. A patient aged 43 years diagnosed with adult rhinosinusitis diagnostic criteria was taken for the study and was given ekāhāntara nasya with Tuḷasi patṟa svarasa and Aṇutaila for 7 days. During follow up period Pathyākṣadhātṟyādi kaṣāya was given for 15 days. Samyak nasya lakṣaṇa and Event evaluation scales were assessed on each day of nasya and Scale for scoring of symptoms, Rhinosinusitis Disability Index and Visual Analogue Scale were assessed before trial, after trial and after follow up. After the course of treatment 100% improvement was found in the Scale for scoring of symptoms, Rhinosinusitis Disability Index and Visual Analogue Scale. Keywords: Case report, Ekāhāntara (alternate day) nasya, Tuḷasipatṟasvarasa, Aṇutaila, Chronic sinusitis