Can we trust new coranavirus vaccines?

While BioNTech and Pfizer, as well as Moderna, are leading the race to develop a COVID-19 vaccine, other pharma companies — such as Sanofi, Sinovac and Johnson & Johnson — are expected to soon present candidates of their own.

According to the World Health Organization, 47 vaccines candidates are currently in clinical trials, of which 10 are in phase 3 efficacy trials. Russia has already registered two vaccines, one of which — Sputnik V — became available for public use in August. Experts, however, warn that this vaccine has been insufficiently tested.

Open questions

Many questions, however, remain unanswered. It is unclear, for instance, how effective these vaccines are, and how they affect individuals of different ages and those with pre-existing medical conditions. Little is known about whether the vaccines lead to long-term immunity, or if they can prevent severe, or indeed asymptomatic COVID-19 infections.

It is also not known how much the vaccines will cost, who will have access to them and in what quantity and at what time, and how they will be distributed around the globe.

Are the vaccines safe?

Independent monitoring groups registered no serious safety concerns with the vaccines being developed by BioNTech/Pfizer and Moderna. This does not, however, rule out the possibility of serious side effects occurring during large-scale testing, or when vaccines are given to persons with rare pre-existing health issues.

Intramuscular injections also bear to the risk of causing local reactions. Moreover, immune responses that entail the production of B cells and supportive T cells can lead to fever, chills, muscle aches or headaches.

In addition, both vaccines — BioNTech/Pfizer's BNT162b2 and Moderna's mRNA-1273 —  belong to a new family of vaccines that so far has not been approved for medical use. They contain nucleoside-modified messenger RNA which functions as a blueprint for the virus spike protein. Once administered, the vaccine stimulates the human immune system to produce antibodies against this protein and thus the virus.

What will the situation of plants, animals and people be in the future of the world?

Most plants and animals live in areas with very specific climate conditions, such as temperature and rainfall patterns, that enable them to thrive. Any change in the climate of an area can affect the plants and animals living there, as well as the makeup of the entire ecosystem. Some species are already responding to a warmer climate by moving to cooler locations. For example, some North American animals and plants are moving farther north or to higher elevations to find suitable places to live. Climate change also alters the life cycles of plants and animals. For example, as temperatures get warmer, many plants are starting to grow and bloom earlier in the spring and survive longer into the fall. Some animals are waking from hibernation sooner or migrating at different times, too.

As the Earth gets warmer, plants and animals that need to live in cold places, like on mountaintops or in the Arctic, might not have a suitable place to live. If the Earth keeps getting warmer, up to one–fourth of all the plants and animals on Earth could become extinct within 100 years. Every plant and animal plays a role in the ecosystem (for example, as a source of food, a predator, a pollinator, a source of shelter), so losing one species can affect many others.

What can people do about it? Just like people, plants and animals will have to adapt to climate change. Many types of birds in North America are already migrating further north as the temperature warms. People can help these animals adapt by protecting and preserving their habitats.

A VIEW OF PRODUCTS USED FOR WEIGHT LOSS FROM THE PERSPECTIVE OF A PHARMACIST

The tighter and non-cellulite appearance becomes more important with the introduction of the sea season with the weight taken in the winter and the thought of giving them in the following days when we entered the summer months. Serious problems can be seen regarding the products used for slimming and similar purposes, due to the lack of legal regulations and the awareness of use in our country. In this issue, we aim to open a correct window in your perspective on these products more accurately, more purposely, without reverberation and more consciously with the information we will give you.

There are many products with chemical and natural ingredients on the subject in Turkey market. Masculine, Cheerleader, L-Carnitine, Lipotropic Factor, Sinameki, Chrome, Bromelain, Pineapple, Cabbage, Q Enzyme Co10, Red Pepper, Ephedrine, OrlistatR, Sibutramine, Chitosan, Seed. b.

After explaining these products in groups with their general duties, we want to list what you need to pay attention to.

Products That More Water Remover From The Body

These products are products that often help with slimming product formations and increase water excretion from the body (kidneys) such as Bromelain, Parsley, Cherry Stalk, which can also be used alone.

Fat Burning Products

L-Carnitine, which can be used individually as it usually enters slimming product formulations, are products that can increase the amount of fat burning in the body with or without sports, such as CLA. In response to the detection of high doses of fat-shredding and appetite-reducing effects of cinephrine active substance, there is also a blood pressure booster effect. Some oral combined products also have regional (abdomen, hips, bass) fat burning properties.

Products That Prevent Fat Absorption and Easily Purify Through Stool

Some products perform the retention of the oils taken into our body in the digestive system, allowing them to be excreted from the body through the faeces without being digested. OrlistatR, LitramineR are examples of these active ingredients.

Products That Feel Slap

The vast majority are products that create a feeling of satiety by swelling with water or fluids in the stomach. Containing natural fibers (Physillum v. b) all products, RedusureR is used for this purpose.

Intestinal Runner Products

These products, on the other hand, provide relief of the bloating problem that develops due to intestinal problems and constipation problems. Sinameki drog and herbal teas, Natural vegetable fibers can be exemplified by these products.

Metabolism Accelerator (Thermogenic) Products

Products used to reduce the working speed of our metabolism for various reasons can be counted in this group. Its main features are; they contribute to the burning of carbohydrates and fats by increasing the amount of energy burned or released in the body. It has recently been combined with other slimming active ingredients in combination. Natural herbal products containing Green Tea, Caffeine, Q Enzyme Co10, Pepper Extracts, Rosemary, Thyme, Cocoa, Iodine and iodine are examples.

Blood-Sugar Balancing Products

They are used to suppress the constant snack and dessert desire due to the disorder or irregularity of the blood sugar balance. Mulberry extract, Cinnamon products and best known can be counted as Chrome (Chrome Picolinate).

Products That Make Feeling Full in the Brain

Unnaturally, they act by creating an artificial sense of saturation by affecting the system of saturation in the brain. The most commonly used is Sibutramine. As of January 21, 2010, slimming products carrying sibutramine are prohibited from being used due to the high risk they carry. In general, it is a great danger to participate without permission and license due to the high effectiveness it shows in most slimming formulations.

Micronutrient Products

While these products keep the body fit during the diet period with the high vitamins, minerals and aminoacids they contain, they reduce the need of the body to meet these deficiencies from the outside, causing an indirect reduction in the desire to eat. Moss products, Microweeds can be given as an example.

Products That Reduce Carbohydrate Absorption

Products in this guru act by reducing the digestive enzyme activity during carbohydrate digestion, reducing the calorie value absorbed from nutrients. PhaseliteR is an example of such active ingredients.

Products with Medical Device Status

These products are products that do not interact with the body herhangibir and are gourmet as medical devices. According to the Medical Device Directive AB93/42/EEC, they are approved products that do not interact with the activities and body. Patented active ingredients such as Ommec19R, RedusureR, LitramineR, PhaseliteR have become more preferable lately as a medical device (Class IIA) by mechanical means, without interacting with the body. Their inability to interact with the body minimized the incidence of side effects and harmful effects on the body.

Products Used Outside the Body

These products are driven from outside, without mouth cream, gel v. b are products. They may contain some of the mouth slimming active ingredients, as well as natural vegetable oils, natural plant extracts. Often Thyme, Rosemary, Lemon, Orange, Lavender v. b may contain oils. Side effects of products taken from the mouth recently and cellulite, heir v. b The importance of outsourced products to improve weight-related conditions is increasing.

Natural Food Products

These products are products that we can easily take during our nutrition and contribute to our weakening. Grapefruit, Green Tea, Yogurt, Almond, Coffee, Apple, Spinach, Bean, Pepper, Broccoli, Curry, Cabbage, Cucumber, Cinnamon, Curry, Broccoli, Egg, Walnut, Garlic, Oatmeal, Soy Milk.

Other Natural Food Supplements and Natural Teas Used as Auxiliary

In addition to the products used internally and externally, described above, some natural food supplements that are used or do not fall under these classifications are found in herbal teas and excipients. Slimming Teas, Apple Vinegar, Egyptian Tassel v. b products can be counted in this gurupta.

What You Need to Pay Attention Regarding Slimming Product Selection and Use?

1- It should be noted that the lack of products fully approved by the competent authorities in terms of serious legal regulation and registration of ingredients related to products placed in the slimming products market is a very serious problem.

2- Do not choose products without professional help from your doctor, pharmacist, dietician or healthcare professional in the provision of these products. This situation can harm you instead of benefit.

3- Especially sold on the internet channel, quality and product reliability are not approved by health orthorities (Ministry of Agriculture approval in Turkey, although many herbal products are considered sufficient, this should be done by a separate and autonomous competent institution. no product should be respected.

4- Rather than advertising on products, product content, scientific results in this regard, and the advice of the healthcare professional should be the basic decision-making method.

5- Not only with single product use of slimming, diet, exercise v. It should be noted that it will be healthy with the support of b. If possible, the slimming process should be managed using all of them together.

6- It should not be forgotten that no herbal product will be able to give 8-10 kg in a month, it should be known that losing weight quickly and in a very short time is not healthy.

7- The prospect of many products on the market in Turkey or the content written on the box should not be forgotten that there may be differences in what actually happened, professional in product reviews, more scientific and healthy methods should be the reason for the choice of products selling products. It should also be noted that with bad products available on the market, it may be subject to the same negative comments on good and professional products.

8- The cause of your weight problem should be determined after the necessary control, examination, inquiry by a healthcare worker and your use of the products selected in this direction should be ensured.

9- Some products used to lose weight are more effective with sports. For example, using L-Karnitin some time before sports will provide significant support in your fat burning during sports.

10- You should definitely add foods that help you lose weight in your weight loss program to your diet.

11- You will choose slimming products; You should be careful that it is more scientifically supported, without synthetic material, with more naturally approved ingredients.

12- Rather than comments on those who use the products, the opinions of health professionals who sell or have knowledge of these products should be consulted.

13- It should be noted that losing weight is a process that needs to be managed well and this process varies from person to person.

14- It should be noted that the effectiveness and results of all products you will use in a way related to weight loss may vary from person to person.

15- It should also be noted that the product you use to weaken does not mean that it is herbal, harmless.

16- The slimming product should be realized by adding it in a more natural, side-inactive, if possible, several functional combinations, if possible, in an externally applicable product.

"Vitamin D and COVID-19"

There have recently been advances in the treatment of COVID-19. Clinical trials support intervention with steroids and antiviral drugs to shorten both the length and severity of illness. Vitamin D has also been suggested as both a prevention and treatment but as yet all positive evidence is indirect. However, the strength of the evidence has prompted several authorities to recommend Vitamin D supplementation on a population level. Vitamin D deficiency is easily treatable by supplements, which are very safe^[1].

Vitamin D is known as the sunshine vitamin being made by the action of sunlight on our skin. People living in higher latitudes tend to have lower levels of Vitamin D and increased mortality from COVID-19. In addition Vitamin D deficiency is more common in obese individuals, people with type 2 diabetes, hypertension, and most strikingly amongst ethnic minorities in Europe and North America, all of whom have higher mortality rates from COVID-19

According to the Royal Society, Vitamin D deficiency is associated with an increased risk of both respiratory viral infections and inflammatory conditions. Vitamin D has an important regulatory role in the human immune system, so a deficiency of Vitamin D is likely to cause immune dysregulation, which may reduce the first line of our defence against COVID-19^[2].

Charles Bangham, professor of immunology at Imperial College London and co-author of the Royal Society paper, said: “I started from quite a sceptical position, doubting whether vitamin D was going to play an important role in COVID-19, but I am now convinced that there is strong evidence that people who are deficient in vitamin D are more susceptible to acute respiratory tract infections^[3].”

Many countries have recommendations for use of vitamin D supplements. UK Government advice during the COVID-19 pandemic is that everyone should consider taking 10 micrograms (400iu) of vitamin D a day because they might not be getting enough from sunlight if they're indoors most of the day. Six medical societies from across the globe are also emphasizing the importance of individuals obtaining the daily recommended dose of vitamin D, especially given the impact of the COVID-19 pandemic on outdoor time. They felt the need to clarify the recommendations for clinicians. Central to the guidance is the recommendation to directly expose the skin to sunlight for 15 - 30 minutes per day, while taking care to avoid sunburn.

In Hong Kong with social distancing measures in place, particularly the closure of pools and beaches, it may be hard to achieve adequate daily sun exposure. This being the case individuals and families may wish to supplement with Vitamin D. According to Public Health England there are many brands, and formulations of vitamin D supplements that may have different recommended doses^[4]. This can make deciding which supplement to take difficult without health professional advice. If in doubt a blood test for Vitamin D status is readily available in Hong Kong and can allow your Doctor to guide your supplementation with Vitamin D.

References

1. Rhodes, J., Subramanian, S., Laird, E., Griffin, G., Kenny, R. (2020) Perspective: Vitamin D deficiency and COVID-19 severity –plausibly linked by latitude, ethnicity, impacts on cytokines,ACE2 and thrombosis. Journal of Internal Medicine. doi.org/10.1111/joim.13149

2. The Royal Society (2020) Vitamin D and COVID-19.Retrieved July 27, 2020, from https://royalsociety.org/-/media/policy/projects/set-c/set-c-vitamin-d-and-covid-19.pdf

3. Cookson, C. (2020). Vitamin D promoted as potential defence against coronavirus. Retrieved July 27, 2020, from https://www.ft.com/content/932920f9-f9ae-414a-940f-602169ee620f

4. McCall, B. (2020). Medical Societies Advise on Vitamin D in Midst of COVID-19. Medscape. Retrieved July 27, 2020 from https://www.medscape.com/viewarticle/933715

5. NICE (2020). COVID-19 rapid evidence summary: Vitamin D for COVID-19 Retrieved July 27, 2020 from https://www.nice.org.uk/advice/es28/chapter/Key-messages

"The First Clinical Trial to Support Vitamin D Therapy For Covid-19"

[Updated 27 Sept] Oral calcifediol reduced ICU admission for Covid-19 from 50% to 2%. And key questions about the trial answered.

Astudy from Spain finally presents the first clinical evidence for the use of vitamin D to treat Covid-19. The study, “Effect of Calcifediol Treatment and best Available Therapy versus best Available Therapy on Intensive Care Unit Admission and Mortality Among Patients Hospitalized for COVID-19: A Pilot Randomized Clinical study,” was published in The Journal of Steroid Biochemistry and Molecular Biology on 29 August. It is called a pilot because the sample size is small, but its randomization and prospective design still make it a robust research.

 

What the study did and found

Researchers randomly allocated 76 cases of Covid-19 into oral calcifediol (50 patients) or no-calcifediol control (26 patients) groups on the day of the hospital admission. Oral calcifediol was given at high doses at 0.532 mg on the first day and then at 0.266 mg on the third and seventh day, and then weekly until discharge or admission to the intensive care unit (ICU).

Calcifediol, also called 25-hydroxyvitamin D3 (vitamin D3), is the main metabolite (effector) of vitamin D. All patients also received the best available standard care at that time, which was hydroxychloroquine plus azithromycin.

Results revealed that 13 out of 26 patients (50%) in the control group were admitted to ICU, and two died in the end. In the calcifediol group, only one out of 50 (2%) required ICU admission, and none died.

Both calcifediol and control groups had similar baseline characteristics in terms of age, sex, comorbidities (lung, cardiovascular, and kidney diseases, type 2 diabetes, and immunosuppression), and clinical biomarkers of disease severity (oxygen levels, C-reactive protein, interleukin-6, ferritin, D-dimer, lactate dehydrogenase, and lymphocyte count). The only difference is that the control group had a higher prevalence of hypertension than the calcifediol group (57.69% vs. 24.19%).

Results revealed that 13 out of 26 patients (50%) in the control group were admitted to ICU, and two died in the end. In the calcifediol group, only one out of 50 (2%) required ICU admission, and none died. These results were statistically significant, equating to a 93% reduction in odds of ICU admission after adjusting for possible confounders (e.g., hypertension).

“Although this was a small trial, the ICU results are so dramatic that they are statistically highly significant,” stated a featured letter in The BMJ, a top-tier medical journal, in response to this clinical trial.

A few more questions about the study

1. What does the study not tell us?

All patients received standard care. Thus, it is not known if calcifediol would be effective on its own. And calcifediol is a medical drug used to treat parathyroid problems, so it is unclear if normal vitamin D supplementation would achieve the same effect.

Calcifediol is also 3.2-fold more effective than native vitamin D3 supplements in restoring low blood levels of vitamin D3.

The researchers also did not measure the vitamin D3 levels of the patients, but they were probably deficient based on prior population data. Still, it remains uncertain if vitamin D3 levels would affect the efficacy of calcifediol treatment for Covid-19. And other possible confounders in this study that the researchers did not measure are obesity, ethnicity, and socioeconomic status.

2. Why calcifediol over native vitamin D3?

Calcifediol is the actual hormonal effector of vitamin D3. Upon contact with sun rays (UV-B spectrum), the skin makes vitamin D3, which can also be taken as a supplement. The liver then converts vitamin D3 into 25-hydroxyvitamin D3, also called calcifediol or calcidiol that has wide-ranging effects on the immune system and other physiological systems. In this sense, calcifediol is a better biomarker for the body’s stores of vitamin D3.

Calcifediol is also 3.2-fold more effective than native vitamin D3 supplements in restoring low blood levels of vitamin D3. Because normal vitamin D3 needs to undergo liver processing first, which is not required for calcifediol. Another perk of calcifediol is its higher intestinal absorption rate.

Source (CC BY): Šimoliūnas et al. (2019). Bioavailability of Different Vitamin D Oral Supplements in Laboratory Animal Model.

Healthy vitamin D status associates with a regulated immune system — characterized by increased B-cells and T-cells but decreased systemic inflammation, disease severity, and mortality…

3. Is the study in line with prior clinical evidence?

The clinical trial from Spain provided the strongest evidence to date that vitamin D3 therapy could work for Covid-19. These results support prior cohort and observational studies that found low vitamin D3 levels (calcifediol) in the blood as an independent risk factor for severe Covid-19, as discussed further here:

Low Vitamin D Levels as a Risk Factor for Greater Covid-19 Severity

Evidence from cohort studies, an observational study, meta-analyses, and reviews.

medium.com

Low vitamin D3 status not only increases the risk of greater Covid-19 severity but of positive diagnosis as well. In a September paper in JAMA involving 489 Covid-19 patients, those likely deficient in vitamin D3 had a 1.77-times increased risk of testing positive for Covid-19 than those with likely sufficient levels. The term ‘likely’ is used because vitamin D3 levels were measured one year before Covid-19 testing.

This result agrees with a previously published study paper where researchers found that, in a sample of 107 Covid-19 cases in Switzerland, those tested positive had significantly lower vitamin D3 levels (median 11.1 ng/ml) than those tested negative (22.0 ng/ml) for SARS-CoV-2. And this time, vitamin D levels were measured three days after the testing.

A more recent study of 235 Covid-19 patients discovered that healthy vitamin D status associates with a regulated immune system — characterized by increased B-cells and T-cells but decreased systemic inflammation, disease severity, and mortality — even after adjusting for confounders such as age, sex, BMI, smoking, and comorbidities.

4. How does vitamin D3 help fight Covid-19?

From a mechanistic standpoint, vitamin D3 and Covid-19 both target similar physiological systems — namely the renin-angiotensin system (RAS) and immune system.

A recent breakthrough has uncovered that Covid-19 kills by bradykinin storm, in addition to the cytokine storm. The RAS regulates blood pressure and fluid volume and breaks down bradykinin. According to the bradykinin hypothesis, SARS-CoV-2 dysregulates the RAS via its interaction with the angiotensin-converting enzyme 2 (ACE2) receptor. This leads to the accumulation of bradykinin, which makes blood vessels leaky. This poses multiorgan consequences; for example, it causes leakage of fluid and immune cells into the lungs and breakdown of the blood-brain-barrier.

From a mechanistic standpoint, vitamin D3 and Covid-19 both target similar physiological systems — namely the renin-angiotensin system (RAS) and immune system.

The research team that formulated the bradykinin hypothesis then proposes vitamin D as a potential treatment for Covid-19. This is because vitamin D is one of the very few hormones that regulates the RAS and prevents bradykinin accumulation. Vitamin D also acts as an immunomodulator that keeps inflammation at bay while supporting functions of B-cells and T-cells, which are essential in fighting infections and generating immunological memory. For instance, T-cells must have their vitamin D receptor (VDR) activated to ‘wake up’ form their inactive state.

Short abstract

Finally, there is a pilot randomized controlled trial that supports vitamin D3 therapy for Covid-19. Oral calcifediol reduced the risk of ICU admission by 93% compared to no calcifediol in Covid-19 patients. Specifically, 50% of patients in the control group were admitted to the ICU, and two died in the end. But only 2% of patients receiving calcifediol required ICU admission, and none died.

This trial supports prior evidence that low vitamin D3 status increases the risk of Covid-19 positive diagnosis, greater severity, and mortality. Further, mechanistically speaking, there is no reason why vitamin D3 could not be helpful. Vitamin D3 regulates the RAS and immune system, both of which are critical determinants of how one responds to Covid-19.

Microbial Instincts

Decoding the microbial angle to health and the microbial world.

WHAT IS DERMOCOSMETIC?

What is dermocosmetics? What is not?

WHAT IS DERMOCOSMETIC?

    While we've all heard a lot of things like Dermocosmetics lately, I'm sure we can't clarify many things. As a healthcare worker engaged in this job, I wanted to shed some light on the subject.

    Before explaining the term dermocosmetics, let's explain a little word meaning and where it consists of. Cosmetics appear as the general name given to all products used over time to care for human skin, body and look better for many years. Dermocosmetics taboo; The drug used for the treatment of some dermatologically encountered conditions in humans as a result of the development of the cosmetics industry, cosmetics v. b emerged as a result of insufficient products and the need for more advanced products. For example; vaseline, glycerin v. in a body moisturizer used to moisturize the skin. Drugs or commercial products (cosmetics) obtained as a result of the use of substances that give moisture to the skin require frequent and repetitive use, while urea, hyaluronic acid v. Although it is used less with the addition of b substances, products that provide more skin moisture (dermocosmetics) can be reached. This is the main purpose of dermocosmetics. Taking the condition better, treating it, solving problems that may be encountered with patient sleepers or products related to other used products.

What content should we use??

What are the right known mistakes in this regard?

What should we pay attention to in cosmetic products??

• While dermocosmetics solve these problems, to prove that they are smoother and more effective, more natural; they have the following features.

• They may contain more specific and different properties of active substances.

• It has been dermatological tests and some features have been tested.

• They are produced in a more natural nature, especially with the principle that products to be produced for more sensitive skin and babies should be more natural. It carries special certificates on this subject and its natural ingredients are expressed in %.

• They may contain patented active ingredients and ingredients and Patented systems.

• Manufacturers specify their content in full and with quantities or %.

• One and a few active ingredients, standard plant extract and drogs, vitamins, minerals, patented ingredients, proven special products (such as thermal water), microbiological, bioactive ingredients, peptide-protein structures and all products they may contain are unlimited.

• They can be designed for some special cases, they can show some special conditions such as pH adjusted (such as incline washing gels), hygienic, sterile, chemical-free, apirogen.

• They can be used in the diagnosis and treatment of many diseases, ailments and special conditions that can also be encountered in the skin or systemically.

• Many drugs or active substance carriers such as liposome, niosis, microcure, nanocure, transdermal systems are applicable to the new system and thus the desired feature of the product is recoverable (by ensuring that the protector from a sun with a liposome formulation descends to the lower layers of the skin, the length of action and the result of providing controlled release.

• They can be presented in very different packaging and active/ active substance carrier-protective special containers (with elevator pump system, double helix active-auxiliary substance mixer.

• Treatment of one or more conditions can respond to the condition of correction (such as wrinkle, detention bag, bruising eye cream.

• While their prices should be more expensive due to their intense content, their prices are in a downward trend with dermocosmetics production and increased brands.

• It does not contain many of the chemical or natural products that have proven odor, coloring matter, harms or possible harms (Parabens, oil derivatives.

• They undergo some tests as sensitive as drugs in terms of efficacy, side effects, shelf life, stability, toxicity, they are developed and tested under clinical conditions.

• Almost all dermocosmetics are sold in pharmacies. There are also products sold in both pharmacies and other sales channels.

• Common aspect of all dermocosmetics products; they are necessarily recommended by a dermatologist physician, a pharmacist or a skin specialist, according to different skin types, with separate solutions for different problems.

What health problems can be caused by not using dermocosmetics?

    We can divide the negative effects of not using dermocosmetics or using more other products into two gurus as short and long-term effects. Some of them do not use their product or occur as soon as they follow after use; some of them can occur longer months, years later. With all the scientific studies done today; more naturally based, close to nature, prepared in accordance with human nature (appropriate pH v. b) While showing that the products give better results, the treatment feature has shown that the products that are prepared for special treatment and prevention purposes, which are high and have more chemical properties, or that we have been dermocosmetically tabulated, have high patient sleepiness and treatment effectiveness. 

    For this reason, with the use of cosmetic products, we are more likely to encounter undesirable short and long-term conditions such as chemical reactions, skin reactions, side effects, product ineffectiveness. If we explain the situation with a simple example; when we moisten one hand of a patient complaining of dryness with a petroleum-derived vaseline-based cosmetic moisturizer and moisten the other hand with a dermocosmetics moisturizer with a high natural content containing natural avacoda extract; The results we will get from two hands, humidification effect times, product toxicity, damage to tissues and of course patient satisfaction results will be undoubtedly different.