Objectives: To report changes in adult hospital admission rates for acute ENT infections following the introduction of Covid-19-related physical interventions such as hand washing, use of face mask and social distancing of 2-metres in the United Kingdom. Design: Retrospective cohort study comparing a one-year period after the introduction of Covid-related physical interventions (2020-21) with a one-year period before this (2019-20). Settings: 3 UK secondary care ENT departments Participants: Adult patients admitted with acute tonsillitis, peritonsillar abscess, epiglottitis, glandular fever, peri-orbital cellulitis, acute otitis media, acute mastoiditis, retropharyngeal abscess and parapharyngeal abscess. Main outcome measures: Number of adult hospital admissions Results: In total there were significantly fewer admissions for ENT infections (n=1073, 57.56%, p<0.001; RR 2.36, 95% CI [2.17, 2.56]) in the 2020-2021 period than in the 2019-2020 period. There were significant reductions in admissions for tonsillitis (64.4%; p<0.001), peritonsillar abscess (60.68%; p<0.001), epiglottitis (66.67%; p<0.001), glandular fever (38.79%; p=0.001), acute otitis media (26.85%; p=0.01) and retropharyngeal and/or parapharyngeal abscesses (45.45%; p=0.04) Conclusion: Our study demonstrates a sizeable reduction in adult admissions for ENT infections since the introduction of Covid-19-related physical interventions. There is evidence to support the use of physical interventions in the prevention of viral transmission of respiratory disease. Preventing ENT infections requiring admission through simple physical interventions could be of great benefit to the quality of life of patients and economical benefit to healthcare systems.

Aims: To evaluate the efficacy, effectiveness, and safety of integrase inhibitors in the treatment of HIV/AIDS in patients coinfected with tuberculosis (TB). Methods: Clinical trials or observational studies were included. The searches were performed in the MEDLINE, EMBASE, LILACS, COCHRANE, Web of Science, Scopus, and CINAHL databases using the terms “HIV”, “AIDS”, “tuberculosis”, “raltegravir potassium”, “dolutegravir”, “elvitegravir”, “bictegravir”, “integrase inhibitor”, and their respective synonyms. The methodological quality of the studies was independently assessed using the Cochrane risk of bias and Newcastle Ottawa scales. Results: Reports from three randomised clinical trials and a historical cohort were included. Patients coinfected with TB and HIV/AIDS showed a good response to TB treatment, which was above 85% in all arms of the evaluated studies. As a primary outcome, the HIV viral load suppression rates at week 48 were greater than 60% in all arms. The therapies evaluated in patients coinfected with TB and HIV/AIDS were also proven to be safe. However, there was no statistically significant difference in the efficacy outcomes between the efavirenz and integrase inhibitor arms, and regarding safety outcomes, there were few events compared with the total. Furthermore, the certainty of the evidence of the outcomes assessed was low, indicating that future research is likely to have an important impact on this estimate. Conclusion: Integrase inhibitors are effective and well tolerated, being an alternative to efavirenz in clinical protocols. However, more studies with high quality evidence are needed on the use of this treatment in health systems.

COVID-19 patients are prone to co-infections during their hospitalization. These co-infections are challenging as they involve longer hospital stays, high costs, and higher mortality risk. Here we present a case of a patient with multi-infection by resistant parasites, fungi, and bacteria during his hospitalization in a Peruvian hospital

Half and half nail or Lindsay's nail is a rare clinical finding that can be seen in many chronic diseases, such as chronic renal failure. We report 2 cases of half and half nail aspect during severe Covid-19 infection suggesting that it can be considered as a severity marker.

Diabetes mellitus is rare in infants and causes a high mortality when complicated with diabetic ketoacidosis (DKA).The concomitant of COVID-19 and DKA in four-month infant with first presentation of neonatal diabetes shows that COVID-19 can accelerate the onset of DKA, and we should consider this in the clinical context.

We are reporting a COVID-19 positive patient who developed diplopia and was found to have an isolated abducens palsy. We reviewed the available English literature of cranial mononeuropathy as a possible manifestation of COVID-19 infection.It is a rare presentation of COVID-19.

We described eleven patients positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The younger age and female gender seem to contribute to poor outcomes possibly. Furthermore, the left ventricle ejection fraction and pro-BNP improvement within the first week of treatment might indicate a good prognosis.

We report a 60-year-old lady known to have a stable MS disease. Who presented with right-hand weakness on the same day of COVID 19 vaccine administration. MRI showed a relapse, and she was treated with steroids with improvement in her symptoms. neurological side effects can occur following COVID 19 vaccines

Subacute thyroiditis (SAT) is an inflammatory thyroid disease of post-viral origin; linked with many viruses such as SARS-COVID-2. The objective of this work is to report a case of SAT associated with COVID-19 vaccination, in a healthy patient with no history of previous COVID-19 or upper respiratory tract infection.

The host pathogen interactome can be visualized as a vast continuous network in which molecular mimicry of host proteins by pathogens constitutes a strategy to hijack the host pathways. Despite extensive work in this field, there is no dedicated resource for mimicked domains and motifs in host pathogen interactome. In this work, we collated all the data regarding the experimental host pathogen (HP) and host-host (HH) protein-protein interactions (PPIs). The domains and sequence linear motifs of the proteins were annotated using CD Search and ScanProsite. Host and pathogen proteins with a shared host interactor and similar domain/motif constitute a linear pair. A linear pair that exhibits global structural domain similarity (Domain linear pair; DLP) or local sequence motif similarity (Motif Linear Pair; MLP) has a high probability of being co-expressed and co-localized. 2,06,449 DLPs and 38,45,643 MLPs were identified in 50,812 experimental HP-PPIs and organized in a web- based resource, ImitateDB, accessible at http://imitatedb.sblab-nsit.net. ImitateDB provides user-friendly access to the mimicry data. It can be queried by protein UniProt ID, pathogen, domain, motif, or interaction detection method. The results are externally integrated using hyperlinked domain PSSM ID, motif ID and protein ID. Kinase, UL36, Smc and DEXDc were frequent DLP domains whereas Protein Kinase C, Casein Kinase 2, glycosylation and myristoylation sites were frequent MLP motifs. Novel DLP domains SANT, Tudor, PhoX and MLP motifs Microbodies C-terminal targeting signal, Ubiquitin-interacting motif and Lipocalin signature were proposed. ImitateDB constitutes a resource for researchers in the field of infectious diseases and microbiology.

Breast cancer is the first cancer associated with cutaneous metastasis (CM). The clinical presentation of these metastases is very broad. We report an original case of carcinoma en cuirasse associated with zosteriform metastasis that announced the developing of contralateral breast cancer.”

A patient with late in COVID-19 pneumonia presented peripheral cystic features on chest computed tomography, which were spontaneously resolved with no antibiotic therapy or surgery. Physicians should pay attention to follow up the late phase of COVID-19 pneumonia for better understanding its etiologies and clinical course in the convalescing period.

We describe the case of a 32-year-old-woman, who developed psychomotor agitation and memory disorders.The Clinical, biological and radiological findings initially showed an infectious etiology.The presence of Anti-N-Methyl-D-aspartate receptor (NMDA) antibodies allowed the diagnosis of a dysimmune etiology of the disease

Coronavirus disease 2019 (COVID-19) is a fearsome infectious disease which cause some excessive complications along with it. the authors present a case of acute invasive rhino-orbital mucormycosis in a 62-year-old man with severe COVID-19 pneumonia, who had a history of uncontrolled diabetes mellitus along with ketoacidosis and nephropathy.

We describe a 74-year-old female who presented with thrombocytopenia 20 days after receiving her first dose of the novel mRNA vaccine. After an exhaustive workup, Immune Thrombocytopenia was diagnosed secondary to her recent mRNA vaccine administration. She was treated aggressively with high-dose steroids and IVIG, with adequate response.

COVID-19 Virus has affected the world in many ways, resulting in several challenges. COVID 19 vaccines were introduced recently, with a variable degree of immunogenicity and safety. We report a 61-year-old man who had GBS a few days after Receiving The vaccine, his condition improved after 5 days of IVIG

We experienced a case of COVID-19 with hypoxia, which was presumed to be due to the development of ventilation and blood flow imbalance by pulmonary intravascular coagulopathy or hypoxic pulmonary vasoconstriction. Early, short-term combination therapy with remdesivir, nafamostat mesilate and low-dose dexamethasone was extremely effective.

In this study, we evaluated the clinical findings, therapy, and outcomes in a patient with cutaneous anthrax who was co-infected with HSV 1&2 (Herpes Systemic Virus) and S. Pyogenes (Streptococcuspyogenes) at the time of hospitalization.

We are reporting a case of Guillain- Barré syndrome seven days after the first dose of Pfizer-BioNTech COVID-19 Vaccine. As this vaccine is still under investigation, reporting possible rare side effects is essential. In this case, the temporal relationship was suggestive of a vaccine-induced cause.

There has been an increased prevalence of Group B Streptococcal disease over the last two decades with a mortality rate of ∼25% for invasive infection. We report a patient whom we discovered Monoclonal B cell Lymphocytosis that led to disseminated GBS disease . Likely source was asymptomatic bacteriuria following TURP

Favipiravir is one of the repurposed antiviral medications for the treatment of SARS-CoV-2 infection. Since the dosing regimen is a prominent factor for the success of the antiviral therapy, this prospective observational study aimed to characterize the pharmacokinetic characteristics of favipiravir in COVID-19 patients. Adult patients (n=21) hospitalized for mild to moderate COVID-19 with a positive RT-PCR test, and assigned for favipiravir treatment were included. Favipiravir was administered for 5 days, with a loading dose of 3200 mg and a 1200 mg/day maintenance dose. Serial blood samples were collected on Day-2 and Day-4 of the therapy. Laboratory findings of the patients and in-hospital mortality were assessed. Favipiravir concentrations exhibited high variations and a significant decrease during the treatment of COVID-19. The median favipiravir trough concentration (C0-trough) on Day-2 was 21.26 µg/mL whereas it decreased significantly to 1.61 µg/mL on Day-4, the area under the concentration versus time curve decreased from 345.6 µg.h/mL to 108.6 µg.h/mL, respectively. Gender seems significant to affect favipiravir concentrations. Day-2-C0-trough of female patients was significantly higher than male patients. Of the 5 patients that died, 4 were male with a significant increase in ferritin levels from Day-0 to Day-5 compared to surviving patients. In addition, there was a significant decrease in D-dimer and CRP levels in the surviving patients. Our findings indicate that favipiravir concentrations show significant changes during the treatment of COVID-19. Therapeutic drug monitoring may best guide dose adjustments in patients that do not respond to treatment with favipiravir.

Scabies may present with unusual features like vesicles, pustules, and bullae. In the setting of an already burdened health sector, careful history taking is of utmost importance in order to avoid unnecessary and expensive investigations to reach a diagnosis.

Objectives. The aim of this systematic review is to assess the effects of community pharmacist-led interventions to optimize the use of antibiotics and identify which interventions are most effective. Methods. This review was conducted according to the PRISMA-P guidelines (PROSPERO: CRD42020188552). PubMed, EMBASE and the Cochrane Central Register of Controlled Trials were searched for (randomised) controlled trials. Included interventions were required to target antibiotic use, be set in the community pharmacy context and be pharmacist-led. Primary outcomes were quality of antibiotic supply and adverse effects while secondary outcomes included patient reported outcomes. Risk of bias was assessed using the ‘Cochrane suggested risk of bias criteria’ and narrative synthesis of primary outcomes conducted. Results. Seventeen studies were included covering in total 3,822 patients (mean age 45.6 years, 61.9% female). Most studies used educational interventions. Three studies reported on primary outcomes, twelve on secondary outcomes and two on both. Three studies reported improvements in quality of dispensing where interventions led to more intensive symptom assessment and a reduction of OTC or wrong choice antibiotic supply. Some interventions led to higher consumer satisfaction, effects on adherence were mixed. All studies had unclear or high risks of bias across at least one domain, with large heterogeneity between studies. Conclusions. Our review suggests some possible positive results from pharmacist-led interventions, but the role of the pharmacist needs to be expanded. This review should be interpreted as exploratory research, as more high-quality research is needed. Authors did not receive funding for the review.

Neurological manifestation and complications are common due to COVID-19. It affects higher functions, cranial nerves and the motor system. The authors report a case of GBS as an example of a success story in managing a complicated case of COVID-19 in an elderly male with signs of a poor prognosis.