A Very Rare Disease of Patent Urachus Cyst With Vesico-Umbilical Urinary Fistula in Adults: A Case Report and Short Review.

Rare developmental anomalies known as urachal remnants are brought on by flaws in the foetal developmental process. However, depending on the location and degree of incomplete obliteration, the urachus can undergo a variety of urachal anomalies. An umbilical fistulogram and a voiding cystourethrogram both supported the existence of the adult urachal cyst in this case. To treat the sepsis, we provided the patient with antibiotics first, then a surgical procedure. The entire vesico-umbilical tract with the urachal cyst was removed using the open approach. The excised specimen's histology revealed a foreign body giant cell reaction without any indication of malignancy. The presentation and diagnosis of vesico-umbilical urinary fistula (VUUF) in adults can occasionally be difficult. They happen very rarely. So we began putting forward this case for the same reason.

Is Daclatasvir a suitable substitute for Amphotericin B in the treatment of Mucormycosis when Amphotericin B is scarce?

BACKGROUND: Mucormycosis has been infesting the universe for a while back, often with no prompt treatments. The disease devastation is spreading at an alarming rate. Many researchers are still hoping for a good potential drug that could help the healthcare system in this tussle. Molecular docking is an in silico tool that has gained popularity over the last few decades. Knowing the mechanism of enzymatic action is aided by imitating membrane protein actions in binding ligands. AIM: The aim of this perspective is to determine whether an existing drug, daclatasvir, has antifungal activity. OBJECTIVE: The primary objective of this in silico study was to investigate the potential effects of the binding affinity of daclatasvir with the crucial protein (1XFF) of mucormycosis, as well as the binding pattern of the active site amino acids with the drug molecule. MATERIALS AND METHODS: To calculate the binding affinity of daclatasvir to the fungal protein 1XFF, Auto Dock Vina was used for molecular docking studies. The CDOCKER protocol was used to determine the receptor-ligand interaction by configuring various parameters. RESULTS: The docking energy of the ligand (daclatasvir) on the protein (1XFF) was found to be -16.7216 kcal/mol, while the interaction energy was found to be - 42.1314 kcal/mol. CONCLUSION: The binding pattern completely alters the dynamics of the protein, resulting in the breakdown of the fungal wall. The vital protein (1XFF) of Rhizopus oryzae is proposed as a possible protein target for the non-structural protein 5A inhibitor/antiviral drug daclatasvir in this study.

Pleural Effusion Induced by Systemic Consumption of Topical Minoxidil: A Rare Case Report.

INTRODUCTION: Pleural effusions can be caused by several conditions such as cancer, connective tissue disease, and infection. They are occasionally caused due to the adverse drug reaction. Most commonly, systemic minoxidil use can cause pleural effusions in patients with chronic kidney disease. CASE PRESENTATION: We present a case of a patient without chronic kidney disease who developed pleural effusion as a result of unintentional use of topical minoxidil orally. The patient's oxygen saturation was 90% on room air; there was dullness to percussion and asymmetrical chest expansion with diminished air entry on both sides. In chest x-ray there were bilateral pleural opacities. Minimal pleural effusions were shown in ultrasonography of the chest. The patient was managed with diuretics and airway management which resolved completely. CONCLUSION: Minoxidil is a commonly used drug by many people for the treatment of hair fall with or without doctor advice. We would like to stress that even though rare, physicians/pulmonologists should be aware of the rare side effects of topical minoxidil, and it should be kept in mind as a differential diagnosis for pleural effusion.

Repurposing Thalidomide, its Analogue and Apremilast for Possible Antiviral in Situation of Severe COVID Cytokine Syndrome.

BACKGROUND: COVID-19, caused by SARS-corona virus-2, is a globally expanded public health risk at a bizarre level. In this current situation, COVID-19 has become a serious emerging pandemic. Drug reusing is a crucial step in identifying the new uses of old established drugs. To achieve a significant and healthy way of treatment in COVID patients within a short duration, drug repurposing is a novel method. OBJECTIVE: The present study concentrated on the molecular docking of thalidomide and its analogues and Apremilast against Coronavirus infectious symptoms, and evaluated virus proteins (Spike Protein, 3cl Protease, Nucleocapsids). METHODS: The present study explores the possibility of repurposing thalidomide for the treatment of SARS-COV-2 infection by assessing and confirming with docking affinity scores of thalidomide and its analogues and Apremilast, with spike protein, 3cl protease, and nucleocapsids. RESULTS: From the study results, thalidomide, pomalidomide, lenalidomide, and Apremilast exhibited better binding affinity to N Protein (4KXJ), Protease (4WY3) and Spike Protein (5WRG). In comparison to targets, N Protein - 4KXJ is the best for the four ligands. It is finalized that all four ligands (Thalidomide -8.6, Pomalidomide -8.8, Lenalidomide, and -8.2,and Apremilast -8.1) have good docking scores with the target N Protein. CONCLUSION: The present study confirms that thalidomide and its analogues and apremilast are a better fit for treating high risk patients of COVID-19 viral infection, which are supposed to promote beneficial effects for both respiratory illnesses like COVID-19 symptoms as well as improve the pathological state of condition.

A Survey from a Tertiary Care Hospital in India on Pediatric Medication Re-Dosing Practices After Patient Vomiting.

OBJECTIVE: The study was started in our institution to analyze the clinical problem and identify the benefits and drawbacks of current practices associated with drug re-dosing after vomitting. Opinions and perspectives from health care professionals from various pediatric hospitals were also gathered to build an effective and systematic protocol. METHODS: Survey participants were recruited by using email distribution lists and forums catering to health care. Using this, 2 online surveys were carried out in the window period of 6 months. RESULTS: Of the 14 responses from the study hospitals that were suitable for analysis, 64.2% reported pediatric patients that vomited after being administered oral medications: 7.1% faced this daily, 35.7% weekly, and 21.4% monthly. When respondents were asked to rate the importance of 8 factors potentially affecting the decision to re-dose, more than half indicated that the patient's vitals and condition (stable, unstable, or critical) were most important (57.4%), followed by time after ingestion (50%), familiarity with medication (42.8%), and formulation of medication (42.8%). Of 43 respondents from other institutions, only 11.9% had a functioning guideline for re-dosing in their institution. CONCLUSIONS: Health care professional respondents to our surveys listed the time between ingestion and vomiting and the condition of the patient as the most important factors in their decision to re-dose the medication.

Proportion of New Onset of Anosmia and Its Diagnostic Significance in COVID-19.

OBJECTIVE: This study aimed to know the proportion of new-onset of anosmia and to find its diagnostic significance in coronavirus disease 2019 (COVID-19) patients attending the hospital. Study design and duration: The Indian smell test in COVID-19 by AIIMS Raipur (ISCA-R) was developed for evaluating olfaction in the Indian population. The olfactory function was assessed using the corona scale on anosmia AIIMS Raipur (COSANAr). RESULTS: Out of 256 patients, 171 were males and 85 were females. In the majority of the patients, 75 (29.29%), the COSANAr score "0" was higher on the day of admission compared to the score "3" on the day of discharge with 61 (23.82%) patients. There was no improvement in 134 (52.34%) patients with loss of smell at the time of discharge. CONCLUSION: This study is a step forward in identifying anosmia by ISCA-R at the early stages of the COVID phase. The COSANAr is affordable for the Indian population. It is noticed that most of the patients have mild hyposmia at the time of discharge and anosmia at the admission time.