Reviews in Clinical Medicine
Volume:8 Issue: 4, Autumn 2021

Tuberculosis (TB) is remains as one of the most public health concern that approximately 9.9 million individuals were fell ill with TB and 1.5 million people died from this disease (1-2). Routinely, local tuberculosis control programs follow the DOTS (directly-observed treatment, short-course) strategy that introduced by WHO since 2006 (3)In summary, tuberculosis is one of the top health challenge throughout the worldwide that HIV and emergence of drug-resistant TB confounds this problem. Implementation and evaluation of stewardship can helpful strategy to elimination of tuberculosis and curb drug-resistant TB. Development of new antimicrobial stewardship that guarantee treatment adherence and rapid case detection could be associated with decrease TB burden. According to previous literature, antimicrobial stewardship plans containing ongoing healthcare workers’ education, laboratories modification, formulary restriction as well as optimizing the drug dosage and treatment course could increase case detection and appropriate prescription that reduce drug-resistant TB burden in various geographical region.

This systematic review determined the main antimicrobial agents resulting in MOEand spectrum antimicrobial therapy covering drug resistance in the disease. All thearticles published in three electronic databases, including PubMed, Web of Science,and MEDLINE, were searched within November 15 to December 15, 2020. Eventually,27 reports were identified assessing the clinical outcomes of patients with MOE.Generally, the mean age of patients with MOE in different studies was within therange of 59–82 years, and the male/female ratio was 1.8:1. The frequency of diabetesamong patients with MOE was within the range of 40%-100%, and the frequency offacial nerve involvement was up to 60.7% in various studies. Pseudomonas aeruginosais the most commonly reported causative organism in MOE. Methicillin-resistantStaphylococcus aureus is another organism leading to MOE. The main concerningissue in antibiotic therapy is the increasing isolation of bacterial strains resistant tothis therapeutic approach. Generally, patients undergoing initial combination therapyhave better outcomes compared to those receiving single therapy. Furthermore, therisk of ciprofloxacin resistance increased, especially when used as a monotherapyagent. The early diagnosis and treatment of patients with MOE are very crucial. Inthis regard, it is necessary to consider the management of diabetes for controllingthe infection with antibiotics and debridement of necrotic tissue. Aggressive surgicalmanagement is suggested in some patients with MOE.

Tibial plateau fractures represent the fractures involving the articular surface of proximal part of the tibia bone i.e. lateral or medial condyle or both, and with varying degrees of articular depression and displacement.Fixation by locking plates has led to dramatic improvement in the treatment of tibial plateau fractures.

It was a prospective study conducted on 30 patients with tibial plateau fractures at a tertiary care hospital in New Delhi, India. Patients were operated with locking compression plates and followed up for 18 months. Union was checked with serial radiographs and functional outcome was assessed with Rasmussen Functional Knee Score.

Twentynine patients achieved union at a mean time of 13.65 weeks, one patient had infective nonunion. Overall mean Rasmussen Functional Knee Score was 27 which is graded as excellent.

Treatment of tibial plateau fractures with open reduction and plating with locking compression plates provides anatomical reduction and desirable functional outcome.  Union is earlier and functional results are better for Schatzker type 1-3 when compared to type 4-6. Return to work with greater capacity largely depends on motivation.

The use of a laryngeal mask airway is associated with complications, such as a sore throat. This study aimed to evaluate the effect of taking the licophar pill on reducing sore throat due to laryngeal mask implantation in cataract surgery candidates.

In this study, 241 patients over 18 years of age with cataract surgery and ASA Ι or ΙΙ were randomly divided into the intervention and control groups. The intervention group received one licophar pill half an hour before surgery; however, the control group received nothing. The sore throat severity was measured 1, 3, 6, 12, and 24 h after surgery using the Visual-Analogue Scale (VAS). The data were analyzed in SPSS software (version 16).

Out of 241 patients, 120 cases received licophar pills. There was no significant difference between the two groups in terms of gender; however, the mean age was lower in the control group. On the other hand, the rate of sore throat was significantly higher in the control group, compared to the intervention group. In addition, postoperative pain scores in the intervention vs. control group 1, 3, 6, 12, and 24 h were 0.466 (1.454) vs. 3.842 (3.359), 0.383 (1.298) vs. 3.280 (3.056), 0.275 (1.102) vs. 2.694 (2.580), 0.200 (0.890) vs. 2.074 (2.271), and 0.108 (0.574) vs. 1.429 (1.714), respectively. Moreover, 103 and 40 patients in the intervention and control groups reported no pain (VAS=0), respectively, 1 h after surgery.

The present study showed that the use of licophar lozenge half an hour before surgery has a significant effect on reducing postoperative sore throat.

Amyotrophic lateral sclerosis (ALS) also known as motor neuron disease is a destroying neurodegenerative disease that mainly affects the upper and lower motor neurons. It is now believed that primary diagnosis and treatment are essential and useful. Early diagnosis with newer methods prevents the progression of the disease and allows you to choose the right treatment at a more appropriate time. Earlier and more efficient treatment becomes visible to significantly improve the prognosis of this disease. In this article, we define the disease and the methods of diagnosing it, Then the mechanisms of the disease and treatment options based on these are described. ultimately the old and new methods for treatment ALS were reviewed. These methods include:  small molecule, nanotechnology, protein therapy, gene therapy, bone marrow transplantation, stem cell therapy, miRNA therapy and gene editing. The purpose of this review article is to help diagnose and select a suitable treatment and improve patients more effectively.

There is a substantial amount of data provided in preclinical research and recently made early clinical efforts to evaluate the positive MSC therapy in Limb ischemia disease impacts. The present review is primarily focused on assessing various limb ischemia-related human MSC clinical trials to select the best technique with the highest limb ischemia-related clinical trial MSC efficacy. Five studies met the criteria to be included in this review. MSCs originating from bone marrow Allogenic MSC, bone marrow autogenous MSCs, HUCB MSCs were administered. The injection was intramuscular, Intravenous, and intravenous. The mean follow-up time was between 6 to 60months after MSC therapy. All studies reported improvement from baseline in at least 1 clinical outcome measure, and no study reported major adverse events attributable to MSC therapy. In clinical assessments, the selection of the best method could improve treatment efficacy. Several factors may be involved in the MSC injection efficacy of limb ischemia patients. Both allogeneic and autologous exhibited positive results over placebo. However, it is should be mentioned that autologous MSC investigation has higher cost and toxicity. To reduce the toxicity of derived MSCs while injection, particularly in arterial and intravenous injection, different injection doses can be performed. MI injection at different doses is the best method for diminishing the side effects. To evaluate injection efficacy, different criteria can be adopted, including angiography, ABI index, ulcer healing and amputation, and pain-free walking distance follow-up for up to five years.

Anastomosis is a term which means a connection between two tubes or branched passages.Veins and arteries connect to transport blood in the body and this connection is natural anastomosis Whenever a blood vessel becomes blocked anastomosis is a backup pathway for blood flow. As the number of patients with chronic organ failure is increasing there is also a rapid increase in the demand for organ transplantation. As a result of a complicated mechanisms in different studies , activation of some factors including  FLT1 (Fms Related Receptor Tyrosine Kinase 1), macrophages, fibroblast, hypoxia, platelet drive growth factor, fibrin-based tissue ,mature vessel networks ,VEGF( Vascular endothelial growth factor) and mechanical processes are been inducing factors for vascular anastomosis. Certainly, vascular anastomosis models are necessary for in vitro vascular anastomosis formation to cover vessels with perivascular cells in a microfluidic device or discover new surgery techniques. In this study, an attempt was made to collect effective factors in inducing vascular anastomosis.

Aicardi Goutiere’s syndrome is an autosomal recessive neurodegenerative disorder. Its clinical signs usually mimic TORCH-like clinical signs; which makes the differential diagnosis difficult. Here, we report a case with one homozygous pathogenic mutation c.529G>A p.Ala177Thr on RNASEH2B gene (NM_024570) that relates to Aicardi-Goutieres syndrome type 2  that had been misdiagnosed in about 5 years.