Background: Up till now, there has been no definite treatment for severe acute respiratory syndrome coronavirus-2 (SARS-COV-2). Some studies have shown favorable effects of corticosteroids on COVID-19. This study aimed to compare the effect of dexamethasone versus methylprednisolone in COVID-19 patients, and their effects upon the neutrophil/lymphocyte ratio (NLR) in correlation to mortality.

Methods: A randomized double-blind clinical trial of 60 patients was divided into two equal groups. Group D, was delivered intravenous dexamethasone 8 mg/day for 7 days. Group M, was delivered intravenous methylprednisolone 1 mg/kg/day in 2 divided doses per day for 7 days. Inflammatory response monitoring by NLR and other markers was compared between the two groups.

Results: The NLR was significantly lower in the methylprednisolone group than the dexamethasone group on the 5th and 7th days (p-values of 0.014 and 0.019 respectively). The IL-6 was also significantly lower in the M than the D group on the 7th day (16.70 ± 5.5 versus 39.61 ± 8.19 with p-value 0.024). The mortality rate was significantly lower in the methylprednisolone group than dexamethasone group as well (5 versus 13 patients respectively with p-value = 0.024). The ROC curve for the NLR and its correlation to the mortality rate showed a higher area under the ROC curve in group M than in group D (0.968 versus 0.81 respectively). The optimal cut-off points were 13.25 in group D versus 10.65 in group M.

Conclusions: Methylprednisolone can reduce inflammatory response and mortality as reflected upon NLR and IL-6 than dexamethasone in COVID-19 patients admitted to ICU. Clinical Trials Registration Number: NCT04909918: All authors stated that the manuscript has been read and approved by all of them and that each author believes that the manuscript represents an honest work

Background: Sixty moderate diseased COVID-19 patients were divided into two equal groups and were enrolled in a randomized double-blind clinical trial. Group C was delivered standard enteral nutrition plus 100 ml/day of 0.9% normal saline. Group L was delivered fish-oil-based lipid emulsion (FOBLE) supplementation to standard enteral nutrition at a dose of 100 ml/day. Both groups infused at a rate of 12.5 ml/h over 8 h for 5 days. We aimed to compare the effect of FOBLE versus placebo in COVID-19 disease to clarify the impact on the number of patients shifted to the ICU, oxygenation, inflammatory markers, and short-term outcomes (7 days).

Results: The failed conventional care and shift to ICU was significantly lower in group L in comparison to group C (six patients (20.0%) versus 14 patients (46.7%) shifted to ICU, P-value = 0.028). The inflammatory markers were determined and evaluated. Throughout the trial, there were no significant changes with the exception of the 7th day neutrophil/lymphocyte ratio (NLR), when the ratio was lower in group L than in group C (6.10 (3.90–7.20) versus 9.65 (8.30–10.90), respectively, P-value 0.001).

Conclusions: In moderate diseased COVID-19 patients, early administration of parenteral FOBLE as an adjuvant to enteral feeding reduces shifts and so minimizes the burden on the ICU.

Introduction

The aging process is intricately linked to alterations in cellular and tissue structures, with the respiratory system being particularly susceptible to age-related changes. Therefore, this study aimed to profile the activity of proteases using activity-based probes in lung tissues of old and young rats, focusing on the expression levels of different, in particular cathepsins G and X and matrix Metalloproteinases (MMPs). Additionally, the impact on extracellular matrix (ECM) components, particularly fibronectin, in relation to age-related histological and ultrastructural changes in lung tissues was investigated.

Materials and methods

Lung tissues from old and young rats were subjected to activity-based probe profiling to assess the activity of different proteases. Expression levels of cathepsins G and X were quantified, and zymography was performed to evaluate matrix metalloproteinases activity. Furthermore, ECM components, specifically fibronectin, were examined for signs of degradation in the old lung tissues compared to the young ones. Moreover, histological, immunohistochemical and ultrastructural assessments of old and young lung tissue were also conducted.

Results

Our results showed that the expression levels of cathepsins G and X were notably higher in old rat lung tissues in contrast to those in young rat lung tissues. Zymography analysis revealed elevated MMP activity in the old lung tissues compared to the young ones. Particularly, significant degradation of fibronectin, an essential ECM component, was observed in the old lung tissues. Numerous histological and ultrastructural alterations were observed in old lung tissues …

Idiopathic ketotic hypoglycemia (IKH) is defined as bouts of hypoglycemia with increased blood or urine ketones in certain children after prolonged fasting or during illness. IKH is divided into physiological IKH, which is most frequently observed in normal children with intercurrent acute illness, and pathological IKH, which occurs in children who lack counter-regulatory hormones, have a metabolic disease, or have Silver-Russell syndrome. The typical patient is a young child between the ages of 10 months and 6 years. Episodes nearly always occur in the morning after overnight fasting. Symptoms include those of neuroglycopenia, ketosis, or both. IKH may be diagnosed after ruling out various metabolic and hormonal conditions associated with ketotic hypoglycemia. Sufficient amounts of carbohydrates and protein, avoidance of prolonged fasting, and increased frequency of food ingestion are the main modes of treating IKH. It is crucial to understand the pathogenesis of IKH and to distinguish physiological IKH from pathological IKH. In this mini-review, we present a brief summary of IKH in terms of its definition, types, clinical presentation, diagnosis, and therapeutic approach in children.

Gynecomastia (GM) is a common and continuously evolving condition that commonly occurs during adolescence. It is the source of significant embarrassment and psychological stress in adolescent males. GM is characterized by enlargement of the male breast due to the proliferation of glandular ducts and stromal components. The main cause of GM during adolescence is physiological or pubertal GM, which is primarily attributed to an imbalance between estrogen and androgen activity. Physiological GM is typically transient and resolves within several months, although it may take several years to resolve. GM may also be caused by other pathological conditions and could be indicative of an endocrine disease. It is crucial to understand the pathogenesis of GM to distinguish it from normal developmental variants due to pathological causes. The aim of this review is to highlight the significance of GM during adolescence in terms of potential etiologies, clinical and laboratory diagnoses, and current management.

Refractory hypothyroidism (RF) defined as raised serum levels of thyroid stimulating hormone (TSH) above upper limit of the reference range with or without the persistence of hypothyroid symptoms following a 6-week interval after the dosage was last increased to upper limits of dose per age. The most common cause of RH is inadequate compliance. In addition, diet, concomitant medication interactions, and gastrointestinal diseases can all result in l-thyroxine (LT4) malabsorption, which can cause RH. Moreover, weight gain, switching brands of LT4, poor storage of LT4, chronic liver disorders, cystic fibrosis, nephrotic syndrome, consumptive hypothyroidism, Addison’s disease are significant contributors to RF in children. RH in children is frequently asymptomatic, when symptoms do occur, they are typically minor and resemble those of hypothyroidism. It is essential to identify RH early and treat its underlying cause

Background: Meniere's disease is a chronic illness that produces a triad of symptoms; vertigo, hearing loss and tinnitus, each of which is known to have the potential to impact on quality of life and patients' self-care. Aim: Evaluate the effect of life style and dietary intervention on quality of life and self-care among patients with Meniere's disease. Patients and Method: A quasi-experimental (pre-posttest nonequivalent control group design) was used for a purposive sample of sixty adult patients, diagnosed with Meniere's disease in the Ear, Nose and Throat (ENT) department and outpatient clinics at Assiut University Hospital. Patients were randomly divided into two equal groups (study and control) 30 patients for each. Tools: Tool (I): Demographic and medical background information form, Tool (II): Dizziness Handicap Inventory and Tool (III): Therapeutic self-care measure. Results: The mean age of the study and control groups was (44±9.8, 42.03±10.3) years respectively. There was a statistically significant difference between study and control groups regarding the total QoL scores (60.13±14.55, 57.33±13.58), (35.33±7.62, 47.87±17.62) respectively, pre and post lifestyle and dietary intervention with p. value <0.001**. Also, there was a significant improvement in total mean scores of self –care measure among study group as it increased from 20.1±5.52 on pre-intervention to 42.13±8.52 post. Conclusion: Life style and dietary intervention had a positive effect on improving quality of life and self-care activities among study group patients at 3- month follow up compared to the control group. Recommendations: Healthy lifestyle and dietary modifications should be considered as an initial step for both the prevention and management of Meniere's disease.