This article discusses the evolving real-world practice using nitazoxanide,nonsteroidal anti-inflammatory drugs(NSAIDs)and/or azithromycin(Kelleni’s protocol)to manage the evolving manifestations of severe acute resp...This article discusses the evolving real-world practice using nitazoxanide,nonsteroidal anti-inflammatory drugs(NSAIDs)and/or azithromycin(Kelleni’s protocol)to manage the evolving manifestations of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron EG.5.1,its descendant HV.1 as well as BA.2.86 and its descendant JN.1 subvariants in Egypt in 2024.These subvariants are well-known for their highly evolved immune-evasive properties and the manifestations include some peculiar manifestations as persistent cough besides high fever in young children as well as high fever,persistent severe cough,change of voice,loss of taste and smell,epigastric pain,nausea,vomiting,diarrhea,generalized malaise and marked bone aches in adults including the high-risk groups.It’s suggested that the ongoing SARS-CoV-2 evolution is continuing to mostly affect the high-risk groups of patients,to some of whom we’ve also successfully prescribed nitazoxanide and/or NSAIDs for post-exposure prophylaxis of all household contacts.We also continue to recommend starting the immune-modulatory antiviral Kelleni’s protocol as soon as possible in the course of infection and adjusting it in a personalized manner to be more aggressive from the beginning for the high risk patients,at least until the currently encountered surge of infections subsides.展开更多
介绍了I^2C总线协议及基于FPGA芯片的I^2C总线接口结构框图．提出了复杂时序电路状态机嵌套的设计思想,并给出了基于Verilog HDL的I^2C总线接口电路的硬件描述．在ISE 6．1i平台下结合ModelSim SE 5．7进行了设计仿真,实现了XC2S100对I...介绍了I^2C总线协议及基于FPGA芯片的I^2C总线接口结构框图．提出了复杂时序电路状态机嵌套的设计思想,并给出了基于Verilog HDL的I^2C总线接口电路的硬件描述．在ISE 6．1i平台下结合ModelSim SE 5．7进行了设计仿真,实现了XC2S100对I^2C总线器件的读写操作．展开更多
The current recommendation to avoid non-steroidal anti-inflammatory drugs(NSAIDs)in the management of dengue virus disease(DVD)is scientifically considered of very low to low certainty,despite being widely adopted wor...The current recommendation to avoid non-steroidal anti-inflammatory drugs(NSAIDs)in the management of dengue virus disease(DVD)is scientifically considered of very low to low certainty,despite being widely adopted worldwide.The same recommendation,initially made during the coronavirus disease 2019(COVID-19)pandemic,was subsequently proven incorrect.In this clinical report,we present evidence,for the first time globally,from a real-life practice that NSAIDs may actually be lifesaving in the early management of DVD as they have proved to be in COVID-19.Moreover,we propose that the personalized immunemodulatory Kelleni’s protocol,which includes nitazoxanide as a key component,can be safely and effectively used to manage various separate or concomitant viral infections and co-infections,including DVD.Importantly,this article contributes to the current medical knowledge in the global pursuit of a safe and effective broad-spectrum antiviral protocol that can be used to early manage multiple highly infectious viruses.However,it’s crucial that sufficiently powered controlled randomized clinical trials be conducted to thoroughly assess and evaluate the safety of NSAIDs in the early management of DVD as well as the efficacy of nitazoxanide with or without NSAIDs in its management.展开更多
BACKGROUND Lower respiratory tract viral infections are a major cause of mortality in children under five years old,leading to hundreds of thousands of fatalities annually.The highest risk is observed in infants under...BACKGROUND Lower respiratory tract viral infections are a major cause of mortality in children under five years old,leading to hundreds of thousands of fatalities annually.The highest risk is observed in infants under one year old,underscoring the critical need for safe and effective antiviral protocols.CASE SUMMARY A 9-month-old infant suffered from severe bronchiolitis as manifested by high fever(39°C),decreased appetite,tachypnea,wheezing,and oxygen desaturation(SpO284%on room air)and was effectively managed at home using Kelleni’s protocol,which includes age-adjusted dose of nitazoxanide(60 mg twice daily),ibuprofen and azithromycin,complemented by selective antihistaminic,antitussive and mucolytic immunomodulatory treatment.The fever resolved,wheezing became more prominent but without respiratory distress,and oxygen saturation gradually increased to 92%by day 10.Nitazoxanide exerts broad antiviral and immunomodulatory effects by enhancing host interferon responses and inhibiting viral replication,potentially attenuating airway inflammation and accelerating resolution of bronchiolitis.The nitazoxanide dose(60 mg twice daily for five days)was carefully adjusted based on the developmental expression and activity of the uridine diphosphate-glucuronosyltransferase 1A1 enzyme,responsible for its metabolism,ensuring safe age-appropriate administration.The infant’s clinical status steadily improved,and by day 14 the infant achieved full recovery with normalization of oxygen saturation(96%on room air).No adverse events occurred,and follow-up at day 28 confirmed sustained recovery.CONCLUSION To the best of my knowledge,this report presents,for the first time globally,a potential of nitazoxanide within Kelleni’s protocol to early manage infants younger than one year suffering from severe lower respiratory tract viral infection at home.Selective antitussive treatment,using agents such as low dose benproperine,was employed to mitigate troublesome cough and improve patient comfort without compromising respiratory function.Additionally,alpha amylase was used to facilitate pulmonary secretion clearance.The protocol aims to reduce morbidity and mortality from viral lower respiratory tract infections in this vulnerable population.展开更多
文摘This article discusses the evolving real-world practice using nitazoxanide,nonsteroidal anti-inflammatory drugs(NSAIDs)and/or azithromycin(Kelleni’s protocol)to manage the evolving manifestations of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron EG.5.1,its descendant HV.1 as well as BA.2.86 and its descendant JN.1 subvariants in Egypt in 2024.These subvariants are well-known for their highly evolved immune-evasive properties and the manifestations include some peculiar manifestations as persistent cough besides high fever in young children as well as high fever,persistent severe cough,change of voice,loss of taste and smell,epigastric pain,nausea,vomiting,diarrhea,generalized malaise and marked bone aches in adults including the high-risk groups.It’s suggested that the ongoing SARS-CoV-2 evolution is continuing to mostly affect the high-risk groups of patients,to some of whom we’ve also successfully prescribed nitazoxanide and/or NSAIDs for post-exposure prophylaxis of all household contacts.We also continue to recommend starting the immune-modulatory antiviral Kelleni’s protocol as soon as possible in the course of infection and adjusting it in a personalized manner to be more aggressive from the beginning for the high risk patients,at least until the currently encountered surge of infections subsides.
文摘介绍了I^2C总线协议及基于FPGA芯片的I^2C总线接口结构框图．提出了复杂时序电路状态机嵌套的设计思想,并给出了基于Verilog HDL的I^2C总线接口电路的硬件描述．在ISE 6．1i平台下结合ModelSim SE 5．7进行了设计仿真,实现了XC2S100对I^2C总线器件的读写操作．
文摘The current recommendation to avoid non-steroidal anti-inflammatory drugs(NSAIDs)in the management of dengue virus disease(DVD)is scientifically considered of very low to low certainty,despite being widely adopted worldwide.The same recommendation,initially made during the coronavirus disease 2019(COVID-19)pandemic,was subsequently proven incorrect.In this clinical report,we present evidence,for the first time globally,from a real-life practice that NSAIDs may actually be lifesaving in the early management of DVD as they have proved to be in COVID-19.Moreover,we propose that the personalized immunemodulatory Kelleni’s protocol,which includes nitazoxanide as a key component,can be safely and effectively used to manage various separate or concomitant viral infections and co-infections,including DVD.Importantly,this article contributes to the current medical knowledge in the global pursuit of a safe and effective broad-spectrum antiviral protocol that can be used to early manage multiple highly infectious viruses.However,it’s crucial that sufficiently powered controlled randomized clinical trials be conducted to thoroughly assess and evaluate the safety of NSAIDs in the early management of DVD as well as the efficacy of nitazoxanide with or without NSAIDs in its management.
文摘BACKGROUND Lower respiratory tract viral infections are a major cause of mortality in children under five years old,leading to hundreds of thousands of fatalities annually.The highest risk is observed in infants under one year old,underscoring the critical need for safe and effective antiviral protocols.CASE SUMMARY A 9-month-old infant suffered from severe bronchiolitis as manifested by high fever(39°C),decreased appetite,tachypnea,wheezing,and oxygen desaturation(SpO284%on room air)and was effectively managed at home using Kelleni’s protocol,which includes age-adjusted dose of nitazoxanide(60 mg twice daily),ibuprofen and azithromycin,complemented by selective antihistaminic,antitussive and mucolytic immunomodulatory treatment.The fever resolved,wheezing became more prominent but without respiratory distress,and oxygen saturation gradually increased to 92%by day 10.Nitazoxanide exerts broad antiviral and immunomodulatory effects by enhancing host interferon responses and inhibiting viral replication,potentially attenuating airway inflammation and accelerating resolution of bronchiolitis.The nitazoxanide dose(60 mg twice daily for five days)was carefully adjusted based on the developmental expression and activity of the uridine diphosphate-glucuronosyltransferase 1A1 enzyme,responsible for its metabolism,ensuring safe age-appropriate administration.The infant’s clinical status steadily improved,and by day 14 the infant achieved full recovery with normalization of oxygen saturation(96%on room air).No adverse events occurred,and follow-up at day 28 confirmed sustained recovery.CONCLUSION To the best of my knowledge,this report presents,for the first time globally,a potential of nitazoxanide within Kelleni’s protocol to early manage infants younger than one year suffering from severe lower respiratory tract viral infection at home.Selective antitussive treatment,using agents such as low dose benproperine,was employed to mitigate troublesome cough and improve patient comfort without compromising respiratory function.Additionally,alpha amylase was used to facilitate pulmonary secretion clearance.The protocol aims to reduce morbidity and mortality from viral lower respiratory tract infections in this vulnerable population.
