Objectives There are several types of research on the COVID-19 disease which have been conducting. It seems that prevailing over the pandemic would be achieved only by mastering over the virus pathophysiology. We tried to categorize the massive amount of available information for useful interpretation. Evidence acquisition We searched databases with different keywords and search strategies that focus on virulence and pathophysiology of COVID-19. The present review has aimed to gather and categorize all implemented drugs based on the susceptible virulence mechanisms, and the pathophysiological events in the host cells, discussing and suggesting treatments. Results As a result, the COVID-19 lifecycle were categorized as following steps: “Host Cell Attachment” which is mainly conducted with ACE 2 receptors and TMPRSS2 from the host cell and Spike (S) protein, “Endocytosis Pathway” which is performed mainly by clathrin-mediated endocytosis, and “Viral Replication” which contains translation and replication of RNA viral genome. The virus pathogenicity is continued by “Inflammatory Reactions” which mainly caused moderate to severe COVID-19 disease. Besides, the possible effective therapeutics’ mechanism and the pharmaceutical agents that had at least one experience as a preclinical or clinical study on COVID-19 were clearly defined. Conclusion The treatment protocol would be occasional based on the stage of the infection and the patient situation. The cocktail of medicines, which could affect almost all mentioned stages of COVID-19 disease, might be vital for patients with severe phenomena. Graphical abstract The classification of the possible mechanism of medicines based on COVID-19 pathogenicity

Objective Vaccination is proven to significantly reduce the risk of human papillomavirus (HPV)–related complications, especially cervical cancer. This study aimed to assess the immunogenicity and safety of the investigational bivalent HPV vaccine (16/18), named Papilloguard (Noyan Pajouhan Biopharma, Tehran, Iran), in comparison with the reference product (Cervarix, bivalent HPV vaccine (16/18) manufactured by GlaxoSmithKline, Rixensart, Belgium) in a three-dose regimen. Methods This trial was a randomized, controlled, double-blind, phase III study of two HPV vaccines in healthy female volunteers aged 15–25. The primary endpoint was to test the noninferiority of Papilloguard (Noyan Pajouhan Biopharma) to Cervarix (GlaxoSmithKline) as measured by the geometric mean titer (GMT) ratios of HPV-16 and HPV-18 7 months after the first vaccination. Secondary endpoints were the proportion of local and systemic solicited and unsolicited events, and the number of females with seroconversion against HPV-16 and HPV-18 7 months after the first vaccination. Results Out of 504 screened women, 218 were enrolled. Seven months after the first vaccination, GMT ratios of HPV-16 and HPV-18 were 0.59 and 0.93, respectively. The seroconversion rates of both Papilloguard (Noyan Pajouhan Biopharma) and Cervarix (GlaxoSmithKline) were more than 96%. Both vaccinated groups had a generally good profile of solicited and unsolicited adverse events (AEs). The most common AE was discomfort at the injection site, which was well tolerated. Conclusion The result analysis of this study supports the noninferiority of Papilloguard (Noyan Pajouhan Biopharma) to Cervarix (GlaxoSmithKline) in terms of safety and immunogenicity based on the GMT ratio. However, long-term comparative studies to evaluate the sustainability of GMT response and risk of cervical intraepithelial neoplasia grades 2–3 are needed.

Intravenous treatment exposes the neonates to extravasation due to fragile and small veins and the long period required for treatment. Extravasation is leakage of fluids, nutrition, or drugs from a peripheral intravenous which could cause tissue damage. The injured complications range from local irritation to skin necrosis and severe scar formation after the healing. Several methods have been used to control the complications of extravasation. We used an Amniotic membrane, a biological dressing, for healing the wounds. Our object in this study is to examine whether the amniotic membrane can induce healing wounds following extravasations.This prospective 13-week single-arm clinical trial study was performed on five neonates from February 2020 till May 2021 in the children's medical center of Tehran University. Neonates with any gestational age and diagnosis of the wound due to extravasation entered our study. Neonates with skin disorders and wound stages of 1 and 2 were excluded from the study. Established wounds without necrosis and infection are treated with an amniotic membrane. The amniotic membrane covers the wound, and after 48 hours, the wound is rechecked. The sequence of replacing or removing the bandages is five to seven days until healing occurs.An amniotic membrane was applied to the wounds and the average time for healing was 2.5 weeks. The average gestational age was 33.6 weeks. We did not report any adverse reaction, and healing was without scar formation.Implementing an amniotic membrane for treating wounds due to Extravasation can be a new approach. This treatment route decreases graft requirement and can be implemented by expert nurses, so in remote NICUs, its usage is easy.

Background Injection of botulinum toxin for cosmetic purposes is a well‐established practice. Objectives This study was conducted to compare the safety and efficacy of Dyston® (investigational biosimilar abobotulinumtoxinA) with Dysport® (abobotulinumtoxinA, Ipsen) in the treatment of moderate‐to‐severe glabellar lines. Methods Out of 193 screened subjects, 126 volunteers with moderate‐to‐severe glabellar lines fulfilling eligibility criteria were randomized in a 1:1 ratio to receive either an intramuscular injection of 40–60 units of Dyston® or Dysport®. The primary objective was to test the non‐inferiority of Dyston® compared with Dysport® as measured by the percentage of volunteers who achieved no or mild glabellar lines at maximum frown assessed by the physicians based on the Glabellar Line Severity Score (GLSS) at Day 30. Secondary endpoints included the improvement in the glabellar lines at maximum frown and rest states at Days 14, 60, 90, and 120 as well as the side effects of the treatment. Results Response rates at maximum frown were 75.44% (43/57) in the Dyston® group and 76.67% (46/60) in the Dysport® group on Day 30 (p value: 0.88, 95% CI: −14.24 to 16.70, diff: 1.23) as per‐protocol set, and were 75.81% (47/62) and 76.19 (48/63) (p value: 0.96, 95% CI: −14.59 to 15.35, diff: 0.3) in the Dyston® and the Dysport® groups, respectively, based on modified intention to treat population. Adverse events were similar in both groups and mostly mild and well‐tolerated. Conclusion Treatment of moderate‐to‐severe glabellar lines with Dyston® was effective, tolerable, and non‐inferior compared with Dysport®.