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

Participants will be treated with 'Acthar Gel 80 UNT/ML Injectable Solution'. Initial dose for week 1 will be 50% of 80 units, injected twice per week. Week 2 is 75% of 80 units, week 3 and throughout treatment period (6 months in total) will be 80 units/ml twice per week.

Steroid-Resistant Nephrotic Syndrome

Participant will self inject 'Acthar Gel 80 UNT/ML Injectable Solution' 2 x per week for six months.

Acthar Gel 80 UNT/ML Injectable Solution

ACTHAR Gel for Drug REsistant Nephrotic Syndrome in Children

ADRENL - ACTHAR Gel for Drug REsistant Nephrotic Syndrome in Children, Pilot Study

Partial remission: Greater than or equal to 50% reduction in proteinuria when compared to baseline.
Complete remission: Greater than or equal to 90% reduction in proteinuria when compared to baseline or Urine Protein Creatinine ratio less than 0.5.

Blood pressure during study visit as measured in mm/Hg

Weight (kgs) and height (cms) will be combined to report BMI in kg/m^2

PedsQL 3.0 will be used as the standardized survey tool

Mohammed Khurram Faizan

Rhode Island Hospital

Mallinckrodt

University of Minnesota

Medalytics

Inclusion Criteria:
Patients between the ages of 2-21 years who fail a minimum of 12 weeks of cumulative therapy with prednisone OR one other alternate immunosuppressive agent for treatment of nephrotic syndrome, will be eligible for inclusion. Nephrotic syndrome is defined as: Presence of edema, Edema, UP/C ≥2, ≥300mg/dl or 3+ protein on Albustix, and hypoalbuminemia ≤2.5 g/dL
Calculated GFR (eGFR) using modified Schwartz formula of > 50 mls/min/m2. (Modified Schwartz formula = 0.413 x height (cms) ÷ serum creatinine mg/dL)
A clinical or biopsy diagnosis of nephrotic syndrome within the last 3 years prior to enrollment in the study.
Renal biopsy (if available) consistent with a diagnosis of Minimal Change Disease, IgM nephropathy, Mesangioproliferative Glomerulonephritis, Primary Focal Segmental Glomerulosclerosis or C1q Nephropathy

Low Back Pain

Probiotic

Inactive capsules

Diagnostic Center

Probiotics for Modic Changes in Low Back Pain Patients

Probiotics for Modic Changes: a Randomised Controlled Study to Elucidate the Effect of Probiotics on Vertebral Inflammatory End-plate Changes, So-called Type 1 Modic Changes

acne vulgaris/albumin

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

ACTHAR Gel for Drug REsistant Nephrotic Syndrome in Children

Probiotics for Modic Changes in Low Back Pain Patients

Testosterone in Female Hypoactive Sexual Desire Disorder

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