Rhinorrhea Research Articles

Clinical characteristics and distinguishing factors of patients with COVID-19 complicated with active pulmonary tuberculosis.

The current study was conducted aimed at exploring the clinical characteristics and distinguishing factors of patients with the novel coronavirus pneumonia (COVID-19) complicated with active pulmonary tuberculosis. A total of 354 patients with COVID-19 in our hospital from November 2022 to February 2023 were included in the present study, of whom 87 patients were also combined with active pulmonary tuberculosis. Significant differences were found in fever, fatigue, nasal congestion, nasal discharge, sore throat, expectoration, and weight loss between the two groups (p < 0.05). There were significant differences in the levels of leukocyte, neutrophil, lymphocyte count, monocyte, hemoglobin, C-reactive protein, and CD4/CD8 between the two groups (p < 0.05). There were significant differences in pulmonary consolidation, multifocal ground-glass opacities in both lungs and infiltrating shadows, "cavity" by CT imaging between the two groups (p < 0.05). The independent variables were set as the indicators with different results of clinical characteristics and CT imaging, including fever, fatigue, nasal congestion, nasal discharge, sore throat, expectoration, weight loss, leukocytes, count neutrophils and lymphocytes, monocytes, hemoglobin, C-reactive protein, CD4/CD8, pulmonary consolidation, multifocal ground-glass opacities in both lungs and infiltration shadows. Our findings have revealed that fever, fatigue, expectoration, leukocytes, neutrophils, monocytes, hemoglobin, C-reactive protein, lymphocytes, CD4/CD8, pulmonary consolidation, multifocal ground-glass opacities in both lungs, and infiltration shadows were the risk factors responsible for the patients with COVID-19 complicated with active pulmonary tuberculosis.

Altered expression of long noncoding RNAs regulating neutrophilic inflammation in peripheral blood was associated with symptom severity in patients with house dust mite-induced allergic rhinitis

BackgroundLong noncoding RNAs (lncRNAs) have been implicated in a diverse array of human immune diseases; however, a comprehensive understanding of the expression and function of lncRNAs in the peripheral blood leukocytes of individuals suffering from house dust mite (HDM)-induced allergic rhinitis (AR) remains elusive.ObjectiveTo explore the potential roles and functions of long noncoding RNAs (lncRNAs) in the pathogenesis of AR.MethodsSequencing analysis was performed on peripheral blood leukocytes collected from patients with HDM-induced AR and healthy controls (HCs) to elucidate the expression patterns of lncRNAs. Differentially expressed (DE) lncRNAs were identified and validated, and further correlation analyses were conducted to explore their associations with visual analog scale (VAS) scores and cytokine levels in the serum and nasal secretions. Additionally, bioinformatics analyses were performed to predict the potential pathways influenced by DE lncRNAs. Finally, the diagnostic potential of these lncRNAs in AR was assessed via receiver operating characteristic (ROC) curve analysis.ResultsSignificant differences in the expression profiles of lncRNAs and mRNAs were detected between AR patients and HCs. Four lncRNAs were markedly upregulated in AR patients. AC011524.2 was positively correlated with nasal pruritus (r = 0.4492, P = 0.0411). AL133371.3 was positively correlated with runny nose (r = 0.4889, P = 0.0245). AC011524.2 was positively correlated with CXCL8 (r = 0.4504, P = 0.0035). AL133371.3 was significantly positively correlated with only IL-17 (r = 0.4028, P = 0.0100). IL-4 in the serum was positively related to IL-17 in the serum (r = 0.4163, P = 0.0002). CXCL5 in the serum was positively correlated with IFN-γ (r = 0.3336, P = 0.0354) in nasal secretions. The area under the curve (AUC) of the ROC curve resulting from the integration of the 4 lncRNAs exhibited a remarkable value of 0.940 for AR diagnosis.ConclusionsOur results identified several lncRNAs associated with AR symptoms and inflammatory cytokines. Specifically, AC011524.2 and AL133371.3 exhibited strong correlations with diverse AR manifestations and serum cytokines, suggesting their pivotal role in the pathogenesis of AR, likely via neutrophil- and Th17-related pathways. However, the precise underlying mechanisms are still elusive, necessitating further exploration.

Compare nasal endoscopy with Computed Tomography scans for chronic rhinosinusitis detection in adult Iraqi patients

Background: Chronic rhinosinusitis (CRS) is often diagnosed based on clinical features. Assurance in this context is based on the finding of inflammatory features during nasal endoscopy and computed tomography (CT) scans of the paranasal sinuses. While a CT scan is considered the most reliable method, research has shown that nasal endoscopy is also valuable and can sometimes provide additional information to supplement the CT scan in diagnosing CRS. Objective: The study goal was to demonstrate the comparative reliability of nasal endoscopy and computed tomography scans in diagnosing chronic rhinosinusitis in adult patients treated at Baqubah Teaching Hospital. Patients and Methods: The study sample consisted of consecutive adult participants clinically diagnosed with chronic rhinosinusitis. Patients who had a computed tomography scan of the paranasal sinuses and a nasal endoscopy during three months were the subjects of this investigation; the outcomes were linked. Results: Study results exhibit that the most prevalent symptoms seen in the study participants were nasal discharge and nasal obstruction, reported by 95% and 90%, respectively; the most prevailing observation during nasal endoscopy was middle meatus purulent discharge, noticed in 58% of the patients. Maxillary sinus was most often affected, seen in 65% of the patients on a CT scan, and 40% had obstruction of the osteomeatal complex on CT imaging. The nasal endoscopy had a sensitivity of 73.3%, specificity of 85.3%, positive predictive value of 92.7%, and negative predictive value of 55.8%. The research also found no significant differences in positive predictive value (PPV) between nasal endoscopy and CT scan. In contrast, the sensitivity of nasal endoscopy was significantly greater than that of CT scan. Conclusion: The study found that nasal endoscopic findings for patients with positive clinical features were purulent (cream-colored) discharge and middle meatus polyps, which is sufficient for diagnosing chronic rhinosinusitis; the study showed that Nasal endoscopy is almost as accurate as CT scans and CT scan findings are well correlates with sinus endoscopy, due to its precision, cheap cost, and radiation dosage.

Rank correlation between atopic comorbidity and laboratory parameters in allergic rhinitis

One of the current cutting-edge problems in allergy and ENT is the study of comorbidity in allergic rhinitis, which is the most common atopic disease among all other atopies. Two decades ago, a new endotype of the disease, local allergic rhinitis, was discovered. In the past, some patients with typical complaints of chronic nasal congestion, persistent runny nose, and other similar symptoms, did not display such characteristic diagnostic criteria as positive allergy skin tests and an increased value of serum total IgE and specific IgE antibodies. They were qualified by allergists and ENT specialists as individualists with non-allergic rhinitis and, accordingly, did not receive adequate treatment. However, their symptoms remained, prompting them to abuse decongestants and resulting in an increased burden on the cardiovascular system. This, along with the burden of concomitant pathology, including other atopies, can be considered a significant medical and social problem. With the purpose to study rank correlation between comorbidity and three laboratory biomarkers, 46 patients with allergic rhinitis were examined. The list of parameters included two routine items such as serum total IgE and eosinophilic cationic protein, and rarely studied IL-4 in skin exudate. Clinical analysis showed that significantly more often allergic rhinitis in patients was combined with bronchial asthma (in 39.1%, p 0.05), less often with food allergy (in 19.6%), atopic dermatitis (in 10.9%), insect allergy (in 8.7%), and allergic urticaria (in 4.5%). In one case, local perennial rhinitis was identified, accompanied by conventional seasonal rhinitis with a high content of serum total IgE and positive allergic skin tests with pollen allergens. Skin tests with household allergens, including house dust mite products, showed a negative result. This case was regarded as a manifestation of the so-called “double” allergic rhinitis. The Spearman correlation demonstrated a negative mean strength relationship between comorbidity and serum IgE and eosinophilic cationic protein (p 0.05). The seemingly paradoxical result can be interpreted quite logically, taking into account immunopathogenetic mechanisms of allergic inflammation. In particular, with an increase in the frequency of atopic comorbidity, the migration of eosinophils from the blood to sites of eosinophilic inflammation increases.

Persistent Craniopharyngeal Canal (Type 3C) with Vertebrobasilar Dolichoectasia and Bilateral Sclerochoroidal Calcification

AbstractThe persistent craniopharyngeal canal is a rare, well-corticated midline congenital bony defect through the sphenoid bone between the sellar floor and the nasopharyngeal roof. The prevalence of persistent craniopharyngeal canal is reported to be 0.42%. A 42-year-old male was evaluated for nasal discharge and progressive vision loss; and underwent computed tomography and magnetic resonance imaging, which revealed a large craniopharyngeal canal with ectopic pituitary, lipoma, encephalocele, deformed globe with sclerochoroidal calcification and vertebrobasilar dolichoectasia. The presence of orbital and optic tract malformation, craniofacial anomalies, and tumors can be associated with the craniopharyngeal canal.

Correlation between Lund-Mackay computed tomography score and subjective symptoms in Chinese patients with nasal polyps.

The association between objective imaging findings and subjective symptoms remains undefined. To investigate the correlation between objective imaging findings and symptom severity in the overall chronic rhinosinusitis with nasal polyps (CRSwNP) population as well as its subendotypes according to the eosinophilic inflammation. Patients with CRSwNP undergoing endoscopic sinus surgery were included. All participants completed the Sino-Nasal Outcome Test (SNOT-22) questionnaire. The Lund-Mackay (LM) CT scores was also obtained. Spearman correlation analysis was performed to evaluate the correlation between CT scores and SNOT-22 scores. Forty-four non-eosinophilic CRSwNP(neCRSwNP) and 93 eosinophilic CRSwNP (eCRSwNP) patients were recruited. There was significant association between LM total score and nasal subdomain of SNOT-22 in the overall CRSwNP patients. The nasal symptom of SNOT-22 was significantly associated with maxillary, frontal, sphenoid, anterior drainage, and posterior drainage in all CRSwNP patients. In eCRSwNP and neCRSwNP patients, the sense of smell/taste was associated with sphenoid and posterior drainage. Thick nasal discharge was positively correlated with maxillary, frontal, and anterior drainage only in eCRSwNP patients. The high score of sphenoid and posterior drainage may suggest the occurrence of loss of sense of smell/taste, while high score of maxillary sinus may indicate suffering from thick nasal discharge in eCRSwNP patients.

MANEJO DO HERPES-VÍRUS FELINO: MEDICINA DE ABRIGO

Infection by feline herpesvirus type 1 (FHV-1) is one of the main respiratory diseases in cats, often associated with other pathogens. The virus, which has double-stranded DNA and is sensitive to disinfectants and adverse conditions, proliferates in high-density environments, such as shelters, where stress compromises the immunity of the felines. Transmission mainly occurs through contact with secretions from infected cats, leading to inflammation and cellular necrosis. Clinical symptoms vary depending on the viral load, route of exposure, and the cat's immune status. After an incubation period of 2 to 6 days, symptoms such as depression, sneezing, fever, and loss of appetite appear, followed by nasal and ocular discharge, which may progress to secondary bacterial infection. In severe cases, especially in young or debilitated cats, viral pneumonia may occur. Diagnosis of the feline respiratory complex (FRC) involves clinical and laboratory tests, such as PCR and X-rays, and screening of new cats is fundamental for controlling the infection. Clinical management focuses on stress reduction, hydration, nebulization, and nutritional support. Treatment includes antivirals to reduce viral replication, as well as antibiotics for secondary infections. Vaccination with live attenuated virus, starting at nine weeks of age, is crucial, although it does not provide full protection. Measures such as quarantine, isolation, and disinfection are essential to control the spread of FHV-1. Collaboration between shelters, veterinarians, and animal protection organizations is vital for implementing effective measures and ensuring the welfare of cats, recognizing the importance of early detection and proper management.

Clinical, imaging and rhinoscopy findings of dogs and cats with nasal foreign bodies presenting to a UK referral hospital: 71 cases (2010-2022).

Description of clinical presentation and diagnostic findings in dogs and cats with confirmed nasal foreign bodies. This was a retrospective descriptive study. Clinical presentation, imaging and rhinoscopy findings of dogs and cats, between January 2010 and December 2022, were reviewed. A total of 63 dogs and eight cats met the criteria. Median length of clinical signs was 7 and 45 days in dogs and cats, respectively. Most common clinical signs in both groups were sneezing (46/71, 64.8%) and nasal discharge (44/71, 62%). The discharge was unilateral in the majority of cases (38/44, 86.4%). Computed tomography was the predominant form of imaging modality used in 40 cases (40/71, 56.3%). Visualisation of a foreign body using computed tomography was possible in only 14 cases (14/40, 35%). The vast majority of cases had unilateral changes (33/40, 82.5%), including fluid accumulation (33/40, 82.5%) and mucosal thickening (29/40, 72.5%). More severe changes such as turbinate destruction were evident in 26 cases (26/40, 65%). Foreign body removal was achieved through rhinoscopy or nasal flushing in 66 and four cases, respectively. Based on the findings of this study, although unilateral discharge was more common, nasal foreign bodies should remain a differential diagnosis in bilateral cases. In comparison to dogs, cats had a more chronic presentation. Computed tomography was the most common imaging modality, but visualisation of a foreign body remains difficult and was not improved with contrast study; inability to identify a foreign body does not exclude it.

Dispensing antibiotics without a prescription in Various pharmacies

Background: An important factor that leads to improper antibiotic use and an increase in antibacterial resistance is the dispensing of medicines over-the-counter. Objective: The purpose of this study is to examine the beliefs and behaviors of medical staff regarding the non-prescription dispensing of antibiotics. Methods: This is a cross-sectional study that used a questionnaire survey with 107 medical staff members from various places in Iraq between November 11, 2020, and May 8, 2021. Results: A total of 107 participants filled out the form and took part in the study. The age of participants ranged from 68% (21–25 years old) to 20% (26–35 years old), 4% (18–20 years), 4% (36–45 years old), 3% (above 55 years old), and 1% (46–55). The most prevalent condition treated with antibiotics without a doctor's prescription is urinary tract infection (21.6%), which was followed by otitis media (17.3%), sore throat (14.8%), skin infection (12.7%), fever (12%), cough (11%), runny nose (4.9%), and other conditions (5.7%). Cold and flu are the most infections that did not respond to antibiotics (30.1%) followed by runny nose (23.9%), sore throat (15.4%), bronchitis (10.4%), cough (10%), and other (10%) while the most frequently dispensed antibiotics was amoxicillin followed by azithromycin, amoxicillin plus clavulanic acid, ciprofloxacin, cephalexin, clindamycin, and meropenem. About 56.6% of patients requested or received antibiotics for obvious infections. About 29.25% requested antibiotics for family members while 14.15% requested them for no reason. The most common age of patients who request an antibiotic was young people (46.3%), elderly (38.3%) and children (15.4%). Whether consulting a doctor before dispensing antibiotics, participants answered yes (56%) and no (44%). In conclusion, the incidence of using antibiotics without prescription was high for skin infections, otitis media, sore throats, and urinary tract infection.

Comparison of clinical and laboratory characteristics of COVID-19 and influenza in hospitalized children.

COVID-19 and influenza infections have similar modes of transmission and clinical symptoms but have different prognoses and treatment methods; therefore, it is important to make a final diagnosis. Herein, we aimed to compare the demographic, clinical, and laboratory differences in hospitalized pediatric patients with COVID-19 and influenza. This retrospective study comprised patients with COVID-19 managed between March 2020 to February 2022, and patients with influenza managed between December 2017 to February 2022, at a tertiary care hospital. The clinical data and laboratory parameters were obtained from the medical records of the hospital. Pediatric intensive care unit (PICU) admission, need for oxygen support, and the mortality rates of the patients were recorded and compared statistically. Overall, 107 patients with COVID-19 and 250 patients with influenza were included. Underlying chronic disease (UCD) rates were statistically higher in patients with COVID-19 (p < 0.001). When the symptoms were compared, fever, cough, and runny nose were more common in patients with influenza, and abdominal pain and rash were more common in patients with COVID-19 (p < 0.05). In patients with influenza, white blood cell count and absolute neutrophil count values were lower (p = 0.021 and p = 0.037, respectively), and aspartate aminotransferase and creatinine kinase values were higher (p = 0.007 and p < 0.001, respectively). PICU admission rates and oxygen support needs were similar in both groups (p > 0.05). When the virus was COVID-19, it had 7.8 times higher risk of mortality compared to influenza (p = 0.002). There were statistically significant risk for mortality when the virus was COVID-19, the risk of mortality was 6.9 times higher in those with UCD, 8.5 times higher in those with admission to PICU and 3.8 times higher in those with needing mechanical ventilation (MV) compared to when the virus was influenza (p = 0.004, p = 0.006 and p = 0.049, respectively). The mortality rate was higher in patients with COVID-19 (p = 0.007). This study showed that COVID-19 might negatively affect the survival times and increase mortality rates, especially in children with an UCD, admitted to the PICU and in need of MV.

Unnoticed freshwater leech as a hidden cause for recurring epistaxis: a case series and review of literature conducted at Tertiary Care Hospital Sikkim, North East India

BackgroundWhile leeches as intranasal foreign bodies are not frequently encountered, they can be one of the causes of epistaxis. The aim of the study is to raise awareness among healthcare professionals about the possibility of patients from leech endemic regions presenting with epistaxis.Case presentationWe present a series of epistaxis cases due to intranasal leech infestation. In our series of 10 cases, there were 7 male and 3 female patients, aged between 2 and 53 years old. The duration of the complaint ranged from 1 to 5 weeks. All patients experienced with blood-stain nasal discharge or frank nasal bleeding at some point and most of them have a history of leech infestation from spring water as a local source. This article presents our approach to managing nasal leech infestation as epistaxis and outlines the precautionary measures taken for the retrieval of this living foreign body.ConclusionDetails of the history must be taken before concluding the diagnosis. Maintain a high index of suspicion of leech infestation as a hidden cause of epistaxis especially in patients coming from endemic areas.

Clinical symptoms, comorbidities and health outcomes among outpatients infected with the common cold coronaviruses versus influenza virus

BackgroundCommon cold coronaviruses (ccCoVs) and influenza virus are common infectious agents causing upper respiratory tract infections (RTIs). However, clinical symptoms, comorbidities, and health effects of ccCoV infection remain understudied.MethodsA retrospective study evaluated 3,935 outpatients with acute upper RTI at a tertiary teaching hospital. The presence of ccCoV and influenza virus was determined by multiplex molecular assay. The demographic, clinical symptoms, and health outcomes were compared between patients with ccCoV (n = 205) and influenza (n = 417) infections. Multivariable logistic regression was employed to evaluate predictors and health outcomes over a one-year follow-up.ResultsSore throat, nasal discharge, headache, and myalgia were more predominant in ccCoV infection; fever was common in influenza. Most patients reported moderate symptoms severity (49.8% ccCoV, 56.1% influenza). Subsequent primary care visits with symptoms of RTI within a year were comparable for both infections (27.3% ccCoV vs. 27.6% influenza). However, patients with influenza reported increased primary care visits for non-RTI episodes and all-cause hospital admission. Baseline comorbidities were associated with increased primary care visits with symptoms of RTI in either ccCoV (adjusted odds ratio [aOR] 2.5; 95% confidence interval [CI] 1.1–5.9; P = 0.034) or influenza (OR 1.9; 95% CI 1.1–3.1; P = 0.017) infections, due probably to the dysregulation of the host immune response following acute infections. In patients infected with influenza infection, dyslipidemia was a predictor for subsequent primary care visits with symptoms of RTI (unadjusted OR 1.8; 95% CI 1.0–3.0; P = 0.040).ConclusionsBoth influenza and ccCoV infection pose significant disease burden, especially in patients with comorbidities. The management of comorbidities should be prioritized to mitigate poor health outcomes in infected individuals.

Clinical characteristics and outcomes of COVID-19 in pediatric patients with rheumatic diseases.

This study investigates the clinical characteristics and outcomes of pediatric patients with rheumatic diseases infected with COVID-19 in China. We conducted a retrospective analysis of pediatric patients with rheumatic diseases who contracted COVID-19. Data were collected via a comprehensive questionnaire with a 14-day follow-up. Multivariable logistic regression was used to assess severe outcomes, and network analyses evaluated symptom correlations. A total of 1070 cases were collected. Fever (88.05%) and cough (62.75%) were the most common symptoms. Cough, nasal congestion, and runny nose exhibited a stronger correlation with each other. A higher incidence of fever reduced the incidence of two single symptoms (nasal congestion [r = -0.833], runny nose [r = -0.762]). Vaccinated children showed a shorter time to negative COVID-19 conversion (7.21 days vs. 7.63 days, p < 0.05) and lower hospitalization rates (p = 0.025). Prolonged symptom duration was associated with older age (OR: 1.07 [1.04-1.11]; p < 0.001) and systemic lupus erythematosus (OR: 1.47 [1.01-2.12]; p = 0.046). Pediatric patients with rheumatic diseases exhibited a wide range of clinical symptoms after COVID-19 infection. The infection generally did not lead to severe outcomes in this study. COVID-19 vaccination was associated with reduced hospitalization risk and expediting the time to negativity for virus. This manuscript demonstrates a comprehensive analysis of the clinical characteristics and outcomes of COVID-19 infection in pediatric patients with rheumatic diseases in China. It provides critical insights into the specific challenges faced by this vulnerable population and offers practical recommendations for improving patient management during periods of increased infectious risk.

Associations between clinical data, vaccination status, antibody responses, and post-COVID-19 symptoms in Thais infected with SARS-CoV-2 Delta and Omicron variants: a 1-year follow-up study

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), led to a global pandemic from 2020. In Thailand, five waves of outbreaks were recorded, with the fourth and fifth waves driven by the Delta and Omicron variants, resulting in over 20,000 new confirmed cases daily at their peaks.MethodsThis cross-sectional study investigated the associations between clinical symptoms, vaccination status, antibody responses, and post-COVID-19 sequelae in COVID-19 patients. Plasma samples and clinical data were collected from participants admitted to hospitals in Thailand between July 2021 and August 2022, with follow-ups conducted for one year. The study included 110 participants infected with either the Delta (n = 46) or Omicron (n = 64) variants. Virus genotypes were confirmed by RT-PCR of nasal swab RNA and partial nucleotide sequencing of the S gene. IgG and IgA antibody levels against the receptor-binding domain (RBD) of SARS-CoV-2 Delta and Omicron variants were measured in plasma samples using ELISA.ResultsPneumonia was found to be associated with Delta variant infections, while sore throat, congestion or runny nose, and headache were linked to Omicron infections. Vaccination with fewer than two doses and diabetes mellitus were significantly associated with higher disease severity. Specific IgG and IgA antibodies against the RBD of the Delta variant generally rose by day 14 and were maintained for up to two months, whereas the pattern of antibody response to the Omicron variant was less clear. Antibody risings were found to be positively associated with pneumonia, certain underlying conditions (obesity, hypertension, dyslipidemia, and diabetes mellitus), and age ≥ 60 years. Delta variant infections were associated with forgetfulness, hair loss, and headache during the 1-year post-infection period. Females were more likely to experience hair loss, forgetfulness, and joint pain, while older age was associated with joint pain.ConclusionsThis study enhances our understanding of SARS-CoV-2 infections in Thais, particularly concerning the Delta and Omicron variants. The findings can inform public health planning and response strategies for future outbreaks of SARS-CoV-2 or other emerging viral diseases.

Pathogenetic investigation of an outbreak of upper respiratory tract infection in a kindergarten in Baiyin City, Gansu Province

This study focuses on the cases(mainly characterized by respiratory symptoms such as cough, runny nose, fever, sore throat, and nasal congestion)of an outbreak of upper respiratory tract infections in a kindergarten in Jingyuan County, Baiyin City, Gansu Province, in May 2023. The epidemiological data were collected, and pharyngeal swab specimens were also obtained from the patients. The specimens of the research participants were subjected to respiratory multi-pathogen testing, and the positive specimens were further analyzed by sequencing the second hypervariable region (HRV2) of the G gene of respiratory syncytial virus (RSV) and constructing a phylogenetic tree. A total of 90 patients were collected, with an incidence rate of 22.84% (90/394), and the highest incidence was observed in the junior class group at 29.55%. Among the 17 pharyngeal swab specimens collected, 16 specimens were identified with the A subtype of respiratory syncytial virus. Sequencing analysis confirmed that it was the A subtype ON1 genotype. Based on the aforementioned testing results, it can be concluded that the current epidemic was primarily caused by infection with the A subtype of respiratory syncytial virus. Following the implementation of intervention measures, the epidemic has been effectively controlled.

A case study on the management of Prathishyaya (Chronic Allergic Rhinitis) using Bharangi Arka Nasal Spray

The omnipresence of Prathishyaya among school-aged groups is overlooked until the complications like kasa, swasa and rajayakshma come into being. Pratishyaya if taken heed of in the initial stage, helps to frustrate the looming effects of its complications. Bharangi Arka is cited as an effectual remedy for Prathishyaya in the Arka Prakasha of Ravana. Prescribing medications for children is usually challenging as they often resist taking them and so, Ayurveda formulations when transmuted into more palatable forms can have salutary impacts on children than classical forms. This case study was carried out on an 8 ½ years old male child with sneezing, runny nose and chronic symptoms including nasal itching and obstruction in particular. Prathishyaya was diagnosed after a proper clinical evaluation. Bharangi Arka in the form of nasal spray was opted as the sole drug in the treatment. Assessment of symptoms was done using Total Nasal Symptom score on the 7th, 14th, 21st and 28th days of the first month of the treatment and at the end of the following two months. Subsidence of all the symptoms was observed in the patient almost in the 4th week. This corroborates the stupendous action of Bharangi Arka nasal spray on Pratishyaya and it could usher in a way for further research to be carried out on the potency of nasal sprays in Ayurveda.

Xiao-Er-Kang-Du capsules regulate autophagy against the influenza B virus (Victoria strain) through the mTOR/ULK1/Beclin1/VPS34 pathway

Ethnopharmacological relevanceXiao-er-kang-du (XEKD) capsule is a Chinese herbal formula used for treatment of upper respiratory tract infection caused by various viruses in pediatric patients in China. XEKD is used clinically for the treatment of influenza-like symptoms, including fever, chills, cough, stuffy and runny nose, headache, and sore throat, with remarkable efficacy. However, the pharmacologic mechanism of XEKD against influenza B virus (IBV) infection is unclear. Aim of the studyThe main purpose of the present work is to explore the curative effect as well as possible mechanisms of XEKD against influenza B virus (IBV) (Victoria strain). Materials and methodsBoth in vivo and in vitro experiments were performed to confirm the antiviral properties of XEKD. High-performance liquid chromatography was used to analyze the active components and assess the stability of XEKD. In addition, the mechanism of action of XEKD against IBV (Victoria) was investigated by western blot, immunofluorescence, and immunohistochemical analyses, in addition to confocal fluorescence microscopy. ResultsThe findings revealed that XEKD demonstrated antiviral effects against IBV infection in both in vivo and in vitro via the mTOR/ULK1/Beclin1/VPS34 pathway and promote cellular autophagy to mitigate IBV-induced lung tissue damage. The results of this work are expected to lead to a deeper understanding of the mechanism underlying the effect of the XEKD capsule against IBV infections. ConclusionsIBV infection was found to inhibit autophagy, which exacerbated inflammatory damage. XEKD regulates autophagy through the mTOR/ULK1/Beclin1/VPS34 pathway and exerts antiviral effects, thereby laying a foundation for further development of XEKD as a potential therapeutic against IBV infection.

Comparative evaluation of the therapeutic effect of combined schemes for therapy and rehabilitation in acute respiratory infections with the inclusion of immunocorrective and sedative agents in children from 6 months to 6 years on the background of stress disorders in the conditions of war in Ukraine

Background. Acute respiratory infections (ARIs) are one of the most common groups of diseases in the practice of pediatricians. Stressful factors affect the immune system, reducing its effectiveness and leading to direct impact on the nervous system and the occurrence of its disorders: sleep changes, the development of a post-traumatic stress disorder, a decrease in the quality of life, especially during the last years in wartime conditions in Ukraine. The latter requires improving the implementation of combined therapeutic approaches to increase a short- and long-term effect on the health of the youngest children. Aim of the study: to increase the effectiveness of treatment and rehabilitation of children from the youngest age group (6 months to 6 years) with ARIs against the background of stress disorders of the war in Ukraine by using comprehensive schemes with the inclusion of immunocorrective (the drug with immunocorrective properties contained a complex of ultra-low-dose dilutions of gamma interferon antibodies, histamine antibodies, CD4 antibodies) and sedative (the drug with sedative properties contained antibodies to the brain-specific protein S100) agents. Material and methods. The study involved 119 children aged 6 months to 6 years who had ≥ 5 episodes of ARIs (55 %) during the previous year and permanently lived in almost the entire territory of Ukraine (Kyiv, Kharkiv, Lviv, Dnipro, Zaporizhzhia, Odesa, Kropyvnytskyi, Vinnytsia, Kryvyi Rih, Zhytomyr, Cherkasy, Poltava, Sumy, Berdychiv, Romny, Bila Tserkva). The study was carried out as part of the program for outpatient observation of children with various manifestations of ARIs against the background of stress damage to the nervous system who took drugs with immunocorrective properties (scheme (1)) alone and in combination with a sedative agent (scheme (1+2)). The drug with immunocorrective pro­perties contained a complex of ultra-low-dose dilutions of gamma interferon antibodies, histamine antibodies, CD4 antibodies, and the drug with sedative properties — antibodies to the brain-specific protein S100. The observation period was October-December 2023. Statistical processing of the results was carried out using GraphPad Prism 9.0 Software for Windows (USA, San Diego, CA). Results. The combined therapeutic approach of the scheme (1+2) showed a significantly better effect on fever, duration of low fever, sore throat, runny nose, bronchitis symptoms, manifestations of respiratory infection, assessed by the Wisconsin Questionnaire, as well as stress, sleep disorders, and changes in the quality of life on the 5th day of treatment and after 1 month of observation. The comparative evaluation of scheme (1) and scheme (1+2) showed a significant diffe­rence in favor of the effectiveness of the latter, which is ensured by its additional sedative and anti-anxiety action, resulting in a direct positive effect on stress-induced disturbances of the nervous system and an indirect — on the immune response, which in general increases the effectiveness of solving the problem of ARI therapy in children aged 6 months to 6 years, who for 2.5 years were constantly in psycho-traumatizing and socially oppressed conditions of the war in Ukraine. The analysis of satisfaction with the treatment effect according to the international IMOS scale during the observation period showed positive results and a high level of evaluation by both parents and doctors. Conclusions. The use of a combination of reme­dies with immunocorrective and sedative effects showed their high mutual enhancing effectiveness in the treatment and rehabilitation of children aged 6 months to 6 years, suffering from ARIs, and in the correction of stress disorders caused by the war in Ukraine.

Clinicopathological Manifestations of Contagious Bovine Pleuro-Pneumonia in a Herd of Sokoto Gudali Heifers

Contagious bovine pleuro-pneumonia (CBPP) is an endemic disease in Nigeria, mostly affecting cattle. Despite the endemic status of CBPP in Nigeria, there is a dearth of information on the clinicopathological manifestations of the disease in Sokoto Gudali breed of cattle, hence the need to highlight our findings in this report. The carcass of 11-month-old Sokoto Gudali heifer was presented for necropsy with a history of respiratory distress amongst the herd. A detailed postmortem examination was conducted, and representative tissue sections collected for histopathologic tissue processing. Swabs of the lung tissue and pleural effusion were also collected for bacteriology. A farm visit to assess and manage the disease within the herd was also carried out. Nasal swabs and blood samples were also collected for bacteriological and haematological analyses. Necropsy revealed marked fibrinous effusion in the pleural cavity, fibrinous consolidation of the left lung, and chronic pneumonia of the right lung. Clinical observations of the herd made on farm visit included emaciation, cough, nasal discharge, anorexia and fever in some of the heifers. Haematological analysis of the blood samples revealed anaemia and leukopenia due to neutropenia. Histopathological analysis of samples from the left lung revealed acute fibrinous pleuro-pneumonia whereas analysis of the right lung revealed chronic interstitial pneumonia. Microbial culture of the pleural effusion and nasal swab yielded growths of Mycoplasma mycoides subspecies mycoides (Mmm) colonies. Consequently, the sick heifers were culled while others were treated with enrofloxacin and tetracycline injections. The burden of CBPP in cattle in Nigeria is enormous and discourages investments in the livestock sector thereby thwarting efforts to meet the protein requirements of the growing population.

Nasal Extranodal NK/T Cell Lymphoma with Orbital Involvement: A Rare Entity of Common Presentations.

Nasal Extranodal NK/T Cell Lymphoma is an aggressive tumour affecting the nasal and midline structures, causing surrounding tissue destruction as the result of its progression. The initial presentations are similar to symptoms of benign nasal polyps, such as nasal obstruction, hyposmia and nasal discharge. As the disease progresses, the involvement of the palate, paranasal sinuses, orbit and skin become alarming symptoms. We report a case of a young male with Nasal ENKTL who presented with symptoms similar to acute on chronic rhinosinusitis with orbital complications. The challenges of diagnosing and getting to the correct management pathway are discussed.