The role of colchicine in the management of COVID-19: a Meta-analysis.

BACKGROUND: The Coronavirus disease 2019 (COVID-19) pandemic has robustly affected the global healthcare and economic systems and it was caused by coronavirus-2 (SARS-CoV-2). The clinical presentation of the disease ranges from a flu-like illness to severe pneumonia and death. Till September 2022, the cumulative number of cases exceeded 600 million worldwide and deaths were more than 6 million. Colchicine is an alkaloid drug that is used in many autoinflammatory conditions e.g., gout, familial Mediterranean fever, and Behçet's syndrome. Colchicine inhibits the production of superoxide and the release of interleukins that stimulate the inflammatory cascade. Colchicine decreases the differentiation of myofibroblast and the release of fibrotic mediators including transforming growth factor (TGF-ß1) that are related to the fibrosis. Moreover, colchicine has been used to traet viral myocarditis caused by CMV or EBV, interstitial pneumonia, and pericarditis resulting from influenza B infection. Additionally, colchicine is considered safe and affordable with wide availability. OBJECTIVE: The aim of the current study was to assess the evidence of colchicine effectiveness in COVID-19 treatment. METHODS: A comprehensive review of the literature was done till May 2022 and yielded 814 articles after ranking the articles according to authors and year of publication. Only 8 clinical trials and cohort studies fulfilling the inclusion criteria were included for further steps of data collection, analysis, and reporting. RESULTS: This meta-analysis involved 16,488 patients; 8146 patients in the treatment group and 8342 patients in the control group. The results showed that colchicine resulted in a significant reduction in the mortality rate among patients received colchicine in comparison with placebo or standard care (RR 0.35, 95%CI: 0.15-0.79). Colchicine resulted in a significant decrease in the need for O2 therapy in patients with COVID-19 (RR 0.07, 95%CI 0.02-0.27, P = 0.000024). However, colchicine had no significant effect on the following outcomes among COVID-19 patients: the need for hospitalization, ICU admission, artificial ventilation, and hospital discharge rate. Among the PCR confirmed COVID-19 patients, colchicine decreased the hospitalization rate (RR 0.75, 95%CI 0.57-0.99, P = 0.042). However, colchicine had no effect on mortality and the need for mechanical ventilation among this subgroup. CONCLUSION: Colchicine caused a significant clinical improvement among COVID-19 patients as compared with the standard care or placebo, in terms of the need for O2, and mortality. This beneficial effect could play a role in the management of COVID-19 especially severe cases to decrease need for oxygen and to decrease mortality among these patients.

Cluster-Based Multi-User Multi-Server Caching Mechanism in Beyond 5G/6G MEC.

The work on perfecting the rapid proliferation of wireless technologies resulted in the development of wireless modeling standards, protocols, and control of wireless manipulators. Several mobile communication technology applications in different fields are dramatically revolutionized to deliver more value at less cost. Multiple-access Edge Computing (MEC) offers excellent advantages for Beyond 5G (B5G) and Sixth-Generation (6G) networks, reducing latency and bandwidth usage while increasing the capability of the edge to deliver multiple services to end users in real time. We propose a Cluster-based Multi-User Multi-Server (CMUMS) caching algorithm to optimize the MEC content caching mechanism and control the distribution of high-popular tasks. As part of our work, we address the problem of integer optimization of the content that will be cached and the list of hosting servers. Therefore, a higher direct hit rate will be achieved, a lower indirect hit rate will be achieved, and the overall time delay will be reduced. As a result of the implementation of this system model, maximum utilization of resources and development of a completely new level of services and innovative approaches will be possible.

Revitalizing the local anesthetic effect of Mebeverine hydrochloride via encapsulation within ethosomal vesicular system.

Mebeverine hydrochloride (MBH) is an antispasmodic drug that holds the potential to exert a local anesthetic action via blocking voltage operated sodium channels. However, its local anesthetic activity was not yet exploited due its poor skin permeability. Nanocarriers have emerged as efficient vehicles for delivering both lipophilic and hydrophilic drugs through the stratum corneum. In this study, therefore, the efficacy of ethosomes for delivering MBH via skin for local anesthetic effect was investigated. The ethosomes were formulated, optimized and characterized for particle size, zeta potential, entrapment efficiency and in vitro permeation studies. Then, the optimized formula was incorporated into Carbopol 940® gel and evaluated for skin irritation and in vivo local anesthetic action. Ethosomes were spherical in shape with vesicle sizes varied from 308.2 ± 18.2 nm to 78.8 ± 8.6 nm and entrapment efficiencies of 18-65%. In vitro drug permeation across rabbit ear skin revealed enhanced drug permeation and higher transdermal flux with ethosomal formulations, compared to aqueous drug solution. In addition, an ethosomal gel of optimized formula showed a potent local anesthetic effect as manifested by a 2.3-fold increase in the area under the efficacy curve (AUEC) of MBH loaded ethosomal gel, compared to the MBH gel. Furthermore, skin irritation experiments demonstrated that MBH ethosomal gel induced neither erythema nor edema upon application to rabbit skin. Collectively, MBH loaded ethosomal vesicles might represent a promising delivery vehicle for safe and efficient local anesthetic effect.

Efficient wound healing composite hydrogel using Egyptian Avena sativa L. polysaccharide containing ß-glucan.

The purpose of this study was to develop an efficient wound healing PVA-biopolymer composite hydrogel using the polysaccharide derived from Egyptian Avena sativa L. The prepared polysaccharide showed high ß-glucan content which accelerates wound healing. The ß-glucan content was 13.28% and GC analysis revealed that glucose was the major sugar component (71.19%). Different PVA-polysaccharide hydrogels combined with different polymers and loaded with 0.3% bacitracin zinc were developed using the freezing-thawing method. The used polymers were; polyvinylpyrrolidone (PVP), Carbopol 940 (CP), hydroxyethylcellulose (HEC), hydroxypropyl methylcellulose (HPMC), and sodium carboxymethylcellulose (Na CMC). The prepared hydrogels were characterized by determination of gel fraction, swelling ratio, mechanical and bioadhesive properties. The results revealed that hydrogels prepared using anionic (NaCMC and CP) and more hydrophilic (HEC) polymers showed better swelling ratio, bioadhesive and mechanical characters compared with hydrogels prepared using cationic (PVP) or less hydrophilic (HPMC) polymers. For two selected formulations containing HEC (F7) and NaCMC (F9), disk diffusion method and In vitro microbial penetration were performed for microbiological assessment. In addition, In vivo evaluation of the anti-inflammatory and wound healing activity compared with conventional products were performed on rats. The results showed higher anti-inflammatory activity of F7 (21.4% edema reduction) compared with F9 (19.8% edema reduction). Similarly, F7 showed better healing (99% relative wound size reduction) than F9 (75%). The current study revealed the potential of using the prepared Egyptian Avena sativa L. polysaccharide and HEC for development of an efficient wound healing dressing with antimicrobial and anti-inflammatory activities.

Schistosomiasis and Bladder Cancer in Egypt: Truths and Myths.

BACKGROUND: The gathered archeopathological evidence has confirmed that Schistosomiasis has been endemic in Ancient Egypt for over 500 decades. The association between Schistosoma hematobium and increase bladder cancer risk is also well acknowledged. However, over the years, there is a proved changing pattern of bladder cancer that needs to be investigated. AIM: We aim to discuss the truths and myths about bladder cancer and its association with Schistosomiasis in Egypt. METHODS: A cross-sectional, case-control study was performed to collect recent data on the topic. RESULTS: Of the reported cancer cases, 79.3% were transitional cell carcinoma (TCC), an additional 6% showed associated squamous features. Squamous cell carcinoma (SCC) constituted only 13.8% of cancer cases. Schistosomiasis was histologically confirmed in 19 cancer cases, only one was SCC. The relative frequency of TCC is increasing, while SCC is decreasing. There is no evidence that this pattern is related to smoking or environmental factors, as the incidence of lung cancer, is not proportionately increasing. CONCLUSION: The old concept that Schistosomiasis is associated with SCC should be revaluated as most cases are associated with TCC. Relying on the histopathology for confirmation of Schistosomiasis in our research studies appears to be non-accurate and leads to irrelevant results.