Leveraging Nanotechnology for Addressing COVID-19: Revealing Antiviral Approaches and Hurdles

The emergence of COVID-19 has caused extensive harm and is recognized as a significant threat to human life worldwide. Currently, the application of nanomedicine techniques in pre-clinical studies related to various infections, such as respiratory viruses, herpes viruses, human papillomavirus, and HIV, has demonstrated success. Nanoparticles, due to their specific attributes, have garnered considerable attention in combating COVID-19. Strategies employing nanomaterials for COVID-19 prevention encompass the development of rapid, precise diagnostic tools, the creation of effective disinfectants, the delivery of mRNA vaccines to the biological system, and the administration of antiretroviral medications within the body. This article focuses on recent research regarding the effectiveness of nano platforms as antiviral measures against coronaviruses. It delves into the molecular characteristics of coronaviruses and the affected target systems, highlighting challenges and limitations in combating SARS-CoV-2. Additionally, it explores potential nanotechnology-based treatments to confront current and future variants of coronaviruses associated with COVID-19 infections.

Comparison of the Use of Conventional and Antibiotic-Coated Tracheal Tubes and EVAC on the Incidence of Ventilator-Associated Pneumonia (VAP)

Ventilator-associated pneumonia (VAP) is one of the most important hospital infections in hospitalized patients, which is associated with increased mortality and patient costs. The tracheal tube itself seems to be a major risk factor for VAP. Contaminated secretions pass through the endotracheal tube and reach the lungs. Also, bacteria form a bacterial biofilm on the tracheal tube and are transferred from there to the lungs. Different tracheal tube designs have been produced to overcome these cases. The purpose of this study is to investigate the effect of an Evac tracheal tube covered with antibiotics and normal on the incidence of pneumonia caused by the ventilator. Research method: 180 patients were randomly intubated in three groups of 60 people with three types of tracheal tubes, Evac and Bactiguard. Clinical examinations, endotracheal tube aspiration culture, and chest radiography were obtained from the patients and the incidence of VAP was calculated based on the CPIS standard. The relationship between the type of endotracheal tube and the incidence of VAP and the length of stay in the intensive care unit (ICU) and being discharged alive from the ICU were investigated. Findings and conclusions: The average incidence of VAP for the group of patients intubated with a conventional tracheal tube was 50%, EVAC was 45% and Bactiguard was 40%. The results showed that there is no significant relationship between the incidence of ventilator-induced pneumonia and the type of tracheal tube. The incidence of ventilator-induced pneumonia was not significantly reduced by suctioning subglottic secretions and Bactiguard tracheal tubes. It seems that using one method alone is not effective in reducing ventilator-induced pneumonia.

BMI-Adjusted Tube Current in Chest CT and Comparison of Lifetime Attributable Risk (LAR) of Breast Cancer in Two Different BMI-Based Protocols

Possible strategies to reduce radiation dose during CT scanning have been investigated over recent decades;here the optimization of the tube current and its link with patient’s cancer incidence are being evaluated. 154 consecutive trauma patients with the need for chest CT scan were included. Two different BMI-adjusted CT protocols at a fixed voltage tube and the same scan length were applied. Dose estimation parameters like CT dose index (CTDI), dose length product (DLP) and effective breast dose were calculated. Breast surface dose was obtained by using thermoluminescence dosimeters (TLDs) and eventually, the life attributable risk (LAR) of cancer incidence was estimated. The mean effective dose was 4.87 ± 2.3 mSv and 5.12 ± 2.8 mSv for patients who were scanned with tube currents of 120 mAs and 200 mAs, respectively. There was no significant difference between organ surface doses for females but in males it was notable. The risk of cancer incidence is lower for protocol 1 in comparison with protocol 2. Optimizing tube current of 120 mAs reduced breast surface dose up to 50% in comparison with the tube current of 200 mAs. In trauma patients, using lower tube current based on BMI has notable impact on the absorbed dose in the breast and can reduce the breast cancer risk by nearly 33.6% for women.

Colonoscopic evaluation of minimal rectal bleeding in average-risk patients for colorectal cancer

AIM: To assess the prevalence of clinically signifi cant lesions in patients with minimal bright red bleeding per rectum (BRBPR). METHODS: Consecutive outpatients prospectively underwent colonoscopy at Loghman Hakim Hospital, Tehran. Minimal BRBPR was defi ned as small amounts of red blood after wiping or in the toilet bowl. Patients with the following alarm signs were excluded: Positive personal history of colorectal neoplasms or inflamma-tory bowel disease (IBD), positive fi rst degree family history of colorectal neoplasms, history of altered bow- el habits, recent signifi cant weight loss, and presence of iron defi ciency anemia. Neoplastic polyps, colorectal carcinoma, and IBD were def ined as signif icant lesions. RESULTS: A total of 402 patients (183 female and 219 male, aged 43.6 ± 15.7 years) were studied. Hemorrhoids (54.2%), anal fi ssures (14.2%) and ul-cerative colitis (14.2%) were the most common lesions and colonoscopy was normal in 8.0%. Signifi cant le-sions were found in 121 (30.1%) patients, including 26 patients (6.5%) with adenocarcinoma and 30 (7.5%) with adenomatous polyps. Almost all patients with signifi cant lesions had at least one lesion in the distal colon; an adenocarcinoma and an adenomatous polyp in the proximal colon were found in 2 patients with hemorrhoids. CONCLUSION: Flexible sigmoidoscopy appears to be sufficient for the evaluation of average risk patients with minimal BRBPR. Rigid sigmoidoscopy may be used as an alternative in patients less than 40 years of age in settings where the former is not available. Thechoice of colonoscopy over flexible sigmoidoscopy in patients aged over 50 years should be individualized.

Prognostic value of cortisol and thyroid function tests in poisoned patients admitted to toxicology ICU

BACKGROUND: Prognostic value of cortisol and thyroid function tests(TFTs) has previously been evaluated in medical ICUs. We aimed to evaluate prognostic efficacy of cortisol and TFTs in critically ill poisoned patients admitted to toxicology intensive care unit(ICU).METHODS: In a prospective study of consecutively enrolled subjects admitted to the toxicology ICU, lab analyses included TFTs(total T3 and T4 as well as TSH) and cortisol levels drawn between 8 am–10 am during period of the first 24 hours post-ingestion/exposure. Simplified Acute Physiology Score Ⅱ(SAPS Ⅱ) and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) were recorded. All scores were compared to detect the best prognostic factor. Type of poisoning was also included.RESULTS: In 200 patients evaluated, 129 were male and mean age was 31 years. In general, SAPS Ⅱ, T4, and cortisol could prognosticate death. After regression analysis, only cortisol had such efficacy(P=0.04; OR=1.06; 95%CI=1.05–1.08; cut-off=42 μg/d L; sensitivity=70%; specificity=82%). Between aluminium phosphide(ALP)-and non ALP-poisoned patients, level of consciousness, mean arterial pressure, and cortisol level could prognosticate death in ALP poisoning(all Ps<0.001 in both uni and multivariate analyses). Median(interquartile range; IQR) GCS was 7(6, 10) and 15(8, 15) in non-ALP and ALP-poisoned patients(P<0.003). SAPS Ⅱ and APACHE Ⅱ could not prognosticate death at all.CONCLUSION: Cortisol best prognosticated outcomes for subjects admitted to the toxicology ICU. Its level is higher in ALP-poisoned patients probably due to the higher stress while they remain conscious till the final stages of toxicity and are aware of deterioration of their clinical condition or may be due to their significantly lower blood pressures.

Trend of blood lactate level in acute aluminum phosphide poisoning

BACKGROUND: Aluminum phosphide(Al P) poisoning is common in the developing countries. There is no specifi c antidote for the treatment of acute Al P poisoning. Early diagnosis of poisoning and outcome predictors may facilitate treatment decisions. The objective of this study was to determine the trend of blood lactate level in acute Al P poisoning to evaluate its role as a prognostic factor.METHODS: This was a prospective study on acute Al P intoxicated patients during one year. Demographic data, clinical and laboratory data on admission, and outcome were recorded in a selfmade questionnaire. Blood lactate levels were analyzed every two hours for 24 hours.RESULTS: Thirty-nine(27 male, 12 female) patients were included in the study. The mortality rate was 38.5%. The mean blood pressure, pulse rate, blood p H and serum bicarbonate level were significantly different between the survivors and non-survivors groups. Blood lactate level was signifi cantly higher in the non-survivors group during 8 to 16 hours post ingestion.CONCLUSION: Blood lactate level could be used as an index of severity of acute Al P poisoning.