Introduction Purpura fulminans (PF) is a life-threatening syndrome consisting of Disseminated Intravascular Coagulation (DIC), thrombotic occlusion of small- and medium-sized blood vessels with skin necrosis. Although there are few studies in the literature, only a minority of them discuss renal manifestations. Case Report We present a case of a 57-year-old Caucasian female with acute kidney injury (AKI) in the setting of multiorgan failure (MOF), DIC and PF. She presented with fever, exudative drainage from her port site, and skin changes concerning for bacteremia. Empiric antibiotics were started after blood, urine, and wound cultures were obtained. None of the cultures grew any organisms. Fever resolved after port removal. She exhibited thrombocytopenia, leukopenia, and neutropenia. Urinalysis showed hyaline casts and a fractional excretion of urea (FeUrea) =35% indicating a pre-renal state. Her hospital course was complicated by atrial fibrillation, acute hypoxic respiratory failure requiring mechanical ventilation, and hypovolemic shock requiring pressor support. Further, complicated by multiorgan failure including non-oliguric AKI and heart failure with reduced ejection fraction (HFrEF) of =65%. Acute skin findings included dusky, purple macules and patches involving all digits of both hands as well as gangrenous changes on the face and toes. It prompted further investigation by Hematology and Dermatology. Skin biopsy showed early leukocytoclastic vasculitis changes. Her laboratory markers were suggestive of DIC and Purpura Fulminans.

This article presents preliminary results of treatment of 51 patients with COVID 19 (Moscow Region, Russia). These patients were subjected to various schemes of immune stimulation for the prevention and treatment of this disease. Were compared-Percutaneus laser therapy (PLT), Intravenous Laser Blood Irradiation (ILBI), Drug stimulation and their combination. The results showed: 1. In the treatment of COVID-19, the use of various types of immunomodulation and anticoagulants proved to be most effective. 2. The combination of ILBI and TLT with immunomodulators proved to be the most effective in the prevention and treatment of COVID-19. 3. Immediate use of immunomodulators at the very beginning of COVID-19 reduces the severity of the disease, and facilitates its course. Background and Aims: We started to use laser therapy in 1988. When used in different categories of cancer patients, it was found that various types of laser radiation stimulate the immune system. We started to use this peculiarity of laser therapy to boost the immune status of sickly patients with weakened immune systems, as well as for prevention and treatment of respiratory viral infections (e.g. influenza, parainfluenza, acute respiratory infections). We performed various types of Immunostimulation in 51 patients from Russia and evaluated its influence both on the morbidity and the course of COVID-19. Rationale: Laser radiation (890-910 nm) stimulates cell immunity, increasing the amount of active T-lymphocytes. The wavelength of 630-640 nm is the most effective for irradiation both the blood and the vascular walls. At this wavelength photons are absorbed by oxygen, microcirculation improves, decrease blood viscosity, and direct impact on the nerve and muscle elements of the vascular wall influences the activity of the vascular and nervous systems. Conclusion: The laser therapy practice we have been exercising for over 30 years has shown that it produces good immunostimulating effects. The use of various laser therapy methods combined with immunomodulatory drugs allow to reduce the number of patients infected with COVID-19, and reduce the severity of the disease.

Objective To compare group supervised exercise (GE) and individual exercise (IE) in a hospital setting, in terms of improvement in quality of life, gait and balance and social interaction. Study Design and Setting This was a prospective cohort study in Jos (Plateau State) Participants Sixty seven patients completed the outcome data. Measures Daily activities were measured by the bartel index, tinetti scale (balance and gait), short form SF-36 health survey to compare quality of life. Results No statically significant differences were found between the two groups regarding the symptoms of PD. After exercise supervised by physiotherapist both group showed significant improvement from each measurement. These improvements were better in individual than group supervised exercise patient with all functionality scales with a smaller margin. Conclusion Individual supervised exercise is more effective than group supervised exercise in term of improvement in quality of life, activities of daily living, gait and balance and social interaction.

Ameloblastoma is a benign odontogenic tumor. It is locally invasive and unlimited growth capacity, with a propensity for recurrence if not entirely excised. The therapeutic challenge in this type of tumors is to have an adequate resection with a wide margin of normal tissue but also a functional and aesthetically acceptable reconstruction of the residual defect. The role of radiotherapy is currently demonstrated in inoperable cases. We are reporting a case of a 45 years-old male patient with large ameloblastoma of the mandible recurrent 10 years after surgical resection. The patient benefited from exclusive radiotherapy at a dose of 60 Gy.

We report a term male neonate, born to consanguineous parents through a difficult labour who needed resuscitation at birth, followed by ventilation for respiratory distress. In view of suspected Hypoxic Ischemic Injury, he was started on whole body cooling for 72 hours. He was treated as suspected sepsis with 5 days of intravenous antibiotics. On day 6, he was noted to have hard, painless skin nodules of his back and left arm which was clinically diagnosed as subcutaneous fat necrosis. His serum calcium and phosphate levels remained normal throughout hospital stay. His full blood counts and bone profile were monitored regularly. During follow-up at 6 weeks, his white cell counts continued to be high with 69% lymphocytes. To our knowledge, this is the first case of SCFN of a neonate associated with persistent leucocytosis. Haematological and metabolic complications should be closely monitored in a neonate with subcutaneous fat necrosis.