COVID 19 infected patients will receive one dose daily of Aerosolized 13 cis retinoic acid in gradual doses increases froms 0.2 mg/kg/day to 4 mg/kg/day as inhaled 13 cis retinoic acid therapy for 14 days

COVID 19 infected patients will receive one dose daily of Aerosolized All trans retinoic acid in gradual doses increases froms 0.2 mg/kg/day to 4 mg/kg/day as inhaled All trans retinoic acid therapy for 14 days

4 Placebo tablets twice daily by mouth for 2 weeks

COVID -19

The infected patients will receive Aerosolized 13 cis retinoic acid in gradual in one dose increases froms 0.2 mg/kg/day to 4 mg/kg/day as inhaled 13 cis retinoic acid therapy for 14 days

Aerosolized 13 cis retinoic acid

The infected patients will receive Aerosolized All trans retinoic acid in gradual one dose increases froms 0.2 mg/kg/day to 4 mg/kg/day as inhaled all trans retinoic acid therapy for 14 days

Aerosolized All trans retinoic acid

Placebo is a pill or tablet that does not contain any study drug.

Placebo

Combination With Inhibitor of Neutrophil Elastase (All-trans Retinoic Acid ) and Isotretinoin May Enhances Neutralizing Antibodies in COVID -19 Infected Patients Better Than COVID-19 Inactivated Vaccines

Proportion of lung injury score decreased or increased after treatment

Serum levels of CRP, ESR ,IL-1,IL-6,TNF and Type I interferon

less than 250 ng/mL, or less than 0.4 mcg/mL of blood sample

To determine the immune correlates of viral clearance (Antibody Titres sufficient for viral clearance and neutralizing ) against future exposure to SARS-CoV-2

Number of CD4 HLA-DR+ and CD38+, CD8 lymphocytes

Kidney failure, hypersensitivity with cutaneous or hemodynamic manifestations, aseptic meningitis, hemolytic anemia, leuko-neutropenia, transfusion related acute lung injury (TRALI)

serum levels of IgG and IgM against COVID-19

ACE2 expression in patients with COVID-19 infection

Mahmoud Ramadan mohamed Elkazzaz

Principal Investigator

Kafrelsheikh University

Damietta University

Control Group:Benzydamine Hydrochloride spray by mouth three times daily for 20 days.
Follow up: The patients will be recalled at one week interval for 20 days.

Intervention group: 90% solcoseryl and 10% pumpkin seed oil spray by mouth three times daily for 20 days

Mucositis Oral

Patients will rinse by mouth three times daily for 20 days

Benzydamine Hydrochloride

Patients will receive by mouth three times daily for 20 days

Solcoseryl and pumpkin seed oil

Treatment of Chemotherapy and Radiotherapy Induced Oral Mucositis

Clinical Evaluation of Solcosreyl and Pumpkin Seed Oil Versus Benzydamine Hydrochloride in Management of Patients With Chemotherapy and Radiotherapy Induced Oral Mucositis

World Health Organization (WHO)scale.It is graded from 0 to 4. If the patient has no signs and symptoms, it is graded as 0. If the patient has painless ulcers, edema, or mild soreness, it is graded as 1. If there is painful erythema, edema, or ulcers but able to eat, it is graded as 2. If there is painful erythema, edema, or ulcers but unable eat, it is graded as 3. If there a requirement for parenteral or enteral support, it is graded as 4

Patient-Reported Oral Mucositis( PROMS scale) will measure Quality of life .The PROMS scale consists of 10, 100-mm horizontal visual analogue scales addressing oral functions affected by oral mucositis. Participants will be asked to mark a point on the line that best represents their present intra-oral condition.During the baseline examination and prior to their completion of the actual PROMS scale questionnaire, participants were subjected to a few training test-visual analogue scale questions focused on simple everyday topics to familiarize them with the concept of visual analogue scale assisted measurements. The participants will complete the PROMS questionnaire thrice; baseline, after the first week, and at the end of the study after the second week.

Ghada zaki

assistant lecturer at el ahram canadian university

Treatment will be placed in identical spray containers

Concurrent chemoradiation Therapy:
Radiation therapy:2 Gy will be given daily 5 days per week for a total of 60 Gy over 6 weeks.
Temozolomide from day 1 of radiotherapy to the last day of radiation at a daily oral dose of 75 mg/m2 for a maximum of 49 days.
Bevacizumab will be administered intravenously on days 1 and 15 of each 28-day cycle,at the beginning of the 4th week of radiation. The dose will be 10 mg/kg.
Adjuvant Therapy:
Temozolomide once per day for 5 consecutive days of a cycle. The starting dose for the first cycle will be 150 mg/m2/day, with a single dose 200 mg/m2/day in subsequent cycles if no treatment-related adverse events> grade 2 are noted.
Bevacizumab will be administered intravenously on days 1 and 15 of each 28-day cycle. The dose will be 10 mg/kg.

Glioblastoma

Radiation therapy:For both intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3D-CRT) plans, one treatment of 2 Gy will be given daily 5 days per week for a total of 60 Gy over 6 weeks.
Temozolomide will be administered continuously from day 1 of radiotherapy to the last day of radiation at a daily oral dose of 75 mg/m2 for a maximum of 49 days.
Bevacizumab will be administered intravenously on days 1 and 15 of each 28-day cycle,at the beginning of the 4th week of radiation. The dose will be 10 mg/kg of actual body weight.

Chemoradiation Therapy

Temozolomide will be administered orally once per day for 5 consecutive days (days 1-5) of a 28-day cycle. The starting dose for the first cycle will be 150 mg/m2/day, with a single dose escalation to 200 mg/m2/day in subsequent cycles if no treatment-related adverse events> grade 2 are noted.
Bevacizumab will be administered intravenously on days 1 and 15 of each 28-day cycle. The dose will be 10 mg/kg of actual body weight.

Adjuvant Therapy

Shandong Cancer Hospital and Institute

A Explore Study of Bevacizumab Combined With Conventional Therapy in Glioblastoma

An Open-label, Single Arm Study to Explore Whether Potential Image Biomarkers Correlate With Efficacy of Bevacizumab Combined With Conventional Therapy in Newly Diagnosed Glioblastoma

PFS (evaluated by RANO criteria), defined as the interval from start of treatment to investigator-assessed progression or death, whichever occurs first or lost of follow-up.
At Week 10 of the study (corresponding to 7 weeks after the commencement of bevacizumab therapy).

OS is the time interval from the start of treatment to death due to any reason or lost of follow-up.

ORR is the number of responders (CR, PR) vs. the whole study population.Tumor response will be evaluated according to the Response Assessment in Neuro-Oncology (RANO) criteria.

European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30

Safety will be measured based on the NCI-Common Terminology Criteria for Adverse Events (NCI-CTCAE), v4.0

aspartic acid/ödem

Combination With Inhibitor of Neutrophil Elastase (All-trans Retinoic Acid ) and Isotretinoin May Enhances Neutralizing Antibodies in COVID -19 Infected Patients Better Than COVID-19 Inactivated Vaccines

Treatment of Chemotherapy and Radiotherapy Induced Oral Mucositis

A Explore Study of Bevacizumab Combined With Conventional Therapy in Glioblastoma

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