Objective The anxiety-related insomnia and other sleep disorders were mentioned as possible side effects of quarantine and stay-at-home conditions. The questions to be explored were: Are there discernable differences in hours of sleep and sleep habits between the normal operational environment and the stay-at-home condition? and How seriously anxiety-induced insomnia or other sleep disorders may affect individuals during the stay-at-home? Methods This international prospective study analyzed results from the sleep-wake patterns questionnaire, daily logs, and interviews. During COVID-19 pandemic, surveys were administered to the healthy volunteers with stay-at-home for 14 days or more, without previous sleep disorders; volunteers were not involved in online education/work daily timetable-related activities. Results We analyzed 14,000 subjects from 11 countries with average stay-at-home of 62 days. The most significant changes in sleep occurred during the first 14 days of stay-at-home. The difference in the sleep duration between weekdays and weekends disappeared. Most of the participants discontinued using alarm clocks. The total sleep time increased in duration up to 9:10 ± 1:16 to the end of the quarantine/stay-at-home (+1:34, p = 0.02). The age-dependent changes in napping habits occurred. Only 1.8% of participants indicated insomnia during the first 14-day period with a decline to 0.5% after two months of stay-at-home. Conclusion During the stay-at-home situation, both duration and timing of sleep significantly differ from those of daily routine and most humans sleep longer than in a schedule-dependent operational environment. An appearance of anxiety-induced insomnia is extremely rare if a healthy individual is already in the stay-at-home situation.

Introduction: Coronavirus is a group of viruses which causes diseases in mammals and birds. In humans, these family of viruses can cause the respiratory infections from mild form to fatal forms. It is preferably called as coronavirus. Formally it known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or 2019 novel coronavirus (2019- nCoV) and this disease is called as coronavirus disease 2019 (COVID-19). SARS-CoV-2 is infectious in humans and world health organization has announced that Covid-19 as a pandemic disease. Tocilizumab is a biological agent which inhibits the cytokine, interleukin 6 (IL-6 inhibitor). As SARS-CoV-2 infection leads to the development of cytokine storm syndrome, the drug tocilizumab seems to have positive effect in patients with covid-19. Purpose of the Study: To analyze and review the possible effects and efficacy of the tocilizumab (monoclonal antibody against IL-6 receptors) in SARS-CoV-2 patients. Materials and methods: The search strategy on recent research and review articles is used for the SARS-CoV-2 disease and their characteristics. Furthermore we have analyzed most recent research article on monoclonal antibody against IL-6 receptors (tocilizumab) and their possible clinical effects in Covid-19 and their clinical trials on Covid-19 patients. Results and Conclusion: Covid-19 is a disease caused by SARS-CoV-2 infection. It is a life threatening condition which can give rise to fatal outcomes if left untreated. However there are no approved treatment for covid-19 globally. Furthermore we can conclude that SARS-CoV-2 is associated with worsening of lung conditions characterized by interstitial pneumonia with acute respiratory distress syndrome as a result of cytokine storm syndrome. According to available research data tocilizumab, a recombinant humanized anti-human monoclonal antibody of IgG1τ (gamma 1, kappa) can improve patient’s condition from cytokine storm syndrome by inhibiting the IL-6 (Interleukin 6) receptors. The rational use of the tocilizumab in severe and critically ill covid-19 patients can prevent the development of irreversible lung injury and death of the patient. Three retrospective studies of Xiaoling Xu et al., Pan luo et al. and Paola Tonaiti et al. has shown the efficacy of tocilizumab in severe and critically ill covid-19 patients. However we need more randomized research studies with significant number of patients which can confirm the promising results on tocilizumab treatment in covid-19 patients and even ongoing clinical trails such as TOSCA, COVACTA results has not been published yet which are expected to give better and more significant results on tocilizumab’s effectiveness and safety.

Background: Under normal physiological conditions, endotoxin (ET) released during self-renewal of the colibacillus pool is an obligate stimulus for the formation of the immune system and homeostasis of the body. Violation of the barrier function of the intestinal wall and the mechanisms of neutralization of endotoxin leads to systemic endotoxemia of intestinal origin. It’s development is facilitated by: stress, intoxication, a decrease in nonspecific resistance of the body, as well as damage to the intestinal mucosa and dysbiosis, where the mucous membrane is more vulnerable and permeable to endotoxin. Purpose of the Research: To compare and assess the severity and nature of hepatocyte damage from endotoxin exposure and the degree of manifestation of stress due to oxidation. To determine the characteristics of structural changes in hepatocytes and to assess the oxidation stress during endotoxin intoxication in the experiment with biochemical markers. Materials and Methods: The experiments were conducted on 40 non-linear rats, divided into two groups of 20 animals. Group 1 animals received intraperitoneal injections of ET of Escherichia coli drug (Sigma USA K-235) for seven days at a rate of 0.1 mg / kg of the body weight. Animals of the second group served as control group. Character and stage of liver damage was studied using morphological methods, including electron and light microscopy. In studying oxidizing stress were used biochemical methods to define the changes, such as conjugated diens and dienketones, spontaneous oxidizing modification of proteins. Results and Conclusion: 1. The severity and depth of morphological changes in the liver during endotoxin intoxication were correlated with the dynamics of the content of lipid oxidation products (CD and DK, MDA) and proteins. There was a tendency to a more significant increase in the oxidative modification of proteins in serum. This confirms the data on the primary damage of proteins by free radicals. 2. When exposed to intestinal microflora endotoxin, pronounced dyscirculatory changes, fatty and hydropic degeneration of hepatocytes with signs of toxic damage to their nuclei were determined, but at the same time, increased hyperplastic activity of sinusoidal cells remained associated with the effects of endotoxin. These changes are associated with both the direct toxic effect of endotoxin, and the effects of oxidative stress, in which endotoxin is a potent inducer.

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Introduction: Common purulent peritonitis is one of the most formidable complications in abdominal surgery. Evidence of this is the continuing high mortality rate, which according to various authors, ranges from 11% to 83%. According to modern concepts, the leading role in the development and progression of widespread purulent peritonitis is assigned to enteric insufficiency syndrome (EIS), which occurs in 90-100% of cases. Aim: The aim of the study was to improve the treatment outcomes of patients with peritonitis complicated by the development of enteric insufficiency syndrome and also by developing and introducing into clinical practice a complex of therapeutic measures, including the combined use of enterosorption in combination with antioxidant and antihypoxant therapy. Materials and Methods: The evaluation of the effectiveness of the proposed complex therapeutic measures was carried out on the basis of a prospective examination of 83 patients (26 men and 57 women) aged 24 to 76 years with diffuse peritonitis with III-IV degree of operational risk for ASA. The comparison group included 37 healthy people aged from 20 to 54 years. All examined patients were divided into two clinical groups. The first clinical group 67 patients with EI of the first degree and second clinical group 16 patients with II degree EI. Before the operation, a suspension of enterosorbent was preliminarily prepared. Suspension of DS was injected through the inserted probe using a Janet syringe, creating an exposure for 10-15 minutes. Then restored the free outflow of the contents of the probe. After completion of the surgical intervention, in the conditions of the intensive care unit, enterosorption continued to be performed every 8 hours (3 times a day). The study was carried out before the operation and in the terms of the 1-3rd and 10-14th days in the postoperative period. Anti-endotoxin antibodies of classes A, M and G (respectively anti-LPS-IgA, anti-LPS-IgM, anti-LPS-IgG) were determined by ELISA. Results: When used in the postoperative period for the treatment of enteric insufficiency with detoxification and antihypoxic therapy according to the developed method, a favorable effect is noted, which is confirmed by an assessment of the state of antiendotoxin immunity associated with the development of bacterial translocation and enterogenic toxemia. Conclusion: The use of the proposed intestinal therapy in combination with antioxidant and antihypoxic therapy helps to prevent the progression of endogenous intoxication, through inactivation and effective clearance of toxic metabolites, reducing the effects of hypoxia, which leads to a significant decrease in membrane-destabilizing effects from the intestinal cell structures and leads to a significant decrease in the expressed specific antigen of the immune system and better clinical outcomes.