Thailand has expressed interest in joining the Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP), an 11-country plurilateral trade agreement whose original incarnation included the United States of America (USA). When the USA withdrew from this agreement, key intellectual property clauses relevant to pharmaceuticals were suspended. These could be reinstated should the USA decide to re-join. This study aimed to measure the impact of these suspended clauses by costing Thailand’s 2020 hepatitis C treatment program under four scenarios: 1) existing treatment regime, which does not use the currently recommended treatment regime and does not source the lowest price medicines, 2) treatment regime if Thailand joined the CPTPP and suspended clauses were reinstated, 3) treatment regime if Thailand utilised flexibilities in international law enabling access to the cheapest direct acting antivirals on the global market and 4) lowest-cost generic pan-genotypic regime on the global market. Joining the CPTPP would increase the cost of Thailand’s hepatitis C treatment program more than tenfold if suspended CPTPP clauses were reinstated and TRIPS flexibilities not fully utilised. Within the existing budget, the price and regime for scenario 4 would enable an additional 7,571 people to access hepatitis C treatment and avoid the need for genotype testing. Signing trade agreements such as the CPTPP that require stronger intellectual property protections could compromise Thailand’s hepatitis C program and other national treatment programs reliant on affordable generic medicines and prevent it from relying on its own pharmaceutical capabilities to manufacture medicines needed to sustain its treatment programs.

In Electric Vehicle (EV) application, the voltage conversion is significant to obtain the desired operating voltage from the source voltage. A conventional boost converter can handle such applications, but it may add losses throughout the conversion process. This work focuses on the design and implementation of a multi device Interleaved DC-DC converter with greater voltage gain, lower voltage stress across the switch, and improved efficiency when compared to the standard Boost converter and conventional Interleaved Converter. The suggested converter has three times the voltage gain of a standard Boost DC-DC converter. These converters are used in applications that demand a constant DC voltage, such as electric vehicles. The proposed converter’s mathematical modelling and modes of operation are discussed. The proposed DC-DC converter’s feasibility is validated using real-time simulation (OPAL-RT), and the results are presented in detail.

Quantum dot Cellular Automata (QCA) may be viewed as the potential digital logic design alternative to supplant the current CMOS Technology. The logical design is based on the polarization of electrons to transfer information which results in a huge improved performance metric in terms of speed, power & area. This paper focuses on the design of a Reversible Arithmetic Processor (RAP) with Reversible Multiplexer (RM) and Reversible Functional Gate (RFG) in QCA. The QCA Designer-E simulation tool has been used to design and verify all the proposed architecture and the energy dissipation has been simulated using a coherent vector energy engine setup. The total and average energy dissipation per cycle of our proposed RAP using QCA are 3 . 9 1 × 1 0 − 1 ev and 3 . 5 6 × 1 0 − 2 ev respectively. Regarding cell count, area, latency, and energy dissipation, the proposed architecture beats out the existing architecture.

Ultrasound images often get distorted by impulse noise during data acquisition and processing in the Back-end of the system, which overlay the finer details of the scanned body parts. Generally, a portable low-cost USG system doesn’t have an impulse noise-cleaning module which hinders detections of smaller details in the images. A Depth Invariant Impulse Noise Removal (DIINoR) algorithm and its hardware architecture for real-time impulse noise removal from the corrupt USG image are proposed in this paper. In this decision-based algorithm, the corrupt pixel is first detected depending on the homogeneity of the processing window and is restored with the median of the window or previous pixel value. Testing of the DIINoR algorithm on different USG images establishes that the denoised images have superior quantitative performance compared to those of existing schemes. Implementation of this architecture in VIRTEX-7 FPGA gives a maximum clock frequency of 357.96 MHz. Synthesis of this architecture using UMC 90nm technology gives 103 mW power consumption at a clock frequency of 100 MHz with a gate count of 63K (NAND2) including two memory buffers which proves its suitability for the real-time fixed and random valued impulse noise cleaning in the Back-end of the portable USG system.

Nodular melanoma (NM) is the third most common subtype of melanoma among African Americans (AA) behind acral lentiginous melanoma (ALM) and superficial spreading melanoma (SSM) (1, 2). This case of NM in an African American Japanese male was selected due the rare occurrence of NM in skin of color patients.

We present a case of a 13-day-old neonate with shock who was diagnosed with persistent fifth aortic with critical coarctation by cardiac point-of-care ultrasound and surgery confirmed the anomalies. This case demonstrates the value of cardiac point-of-care ultrasound in detecting congenital anomalies of great vessels in neonates and may be beneficial in clinical management.

Background Most patients undergoing left atrial appendage closure (LAAC) are elderly individuals with atrial fibrillation (AF) and many comorbidities, which may elevate the risk for complications associated with contrast agents with fluoroscopic image-guided procedure. . Objectives This retrospective study of patients with AF at high risk for use of contrast agents evaluated the feasibility and safety of LAAC using Percutaneous and Non-fluoroscopic procedure with transesophageal echocardiography (TEE) as the only image guidance relative to those under fluoroscopic image guidance. Methods From September 2017 to December 2020, a cohort of 126 consecutive eligible patients with AF undergoing LAAC at our center were retrospectively recruited and divided into 2 groups according to image guidance modality, namely, a TEE group (n = 32; mean age, 75.4 ± 7.9 years; 25 (78.1%) with stage III chronic kidney disease [preoperative eGFR, 52.7 ± 8.8 mL/min/1.73m 2] and 7 (21.9%) allergic to contrast agent) and a fluoroscopic group (n = 94; mean age, 65.7 ± 10.0 years). Propensity score matching was used to adjust for baseline differences. Results Propensity-score matching yielded 25 pairs of patients with similarly distributed age (72.9 ± 6.9 vs. 73.1 ± 4.9 years, p = .925), gender (10:15 vs 11:14, p = 1), weight (68.3 ± 11.2 vs. 68.1 ± 12.3 kg, p = .948) and ALT level (20.0 ± 9.8 vs. 22.5 ± 14.2 U/L, p = .482). The LAA was successfully occluded in all patients with statistically similar success rate (100% vs. 100%, p = 1), hospitalization duration (5.0 [3.0, 7.0] vs. 5.0 [3.0, 6.0] days, p = .498), and rates of complications: 1 (4.2%) pericardial effusion and 1 (4.2%) residual shunt in the TEE group, and 5 (20%) residual shunts, 1 (4.2%) pericardial effusion, 1 (4.2%) myocardial infarction and 1 (4.2%) access-related complications in the fluoroscopic group. There were no deaths. The overall incidence rate of all procedure-related complications (6.2% vs . 18.1%, p = .153) at mean 22.2±4.5 months follow-up was statistically similar. Conclusion In patients with AF of high risk for use of contrast agents, LAAC under non-fluoroscopic guidance appears feasible and safe with similar outcomes to that under fluoroscopic guidance.

Ultrasound has emerged as an efficient green technology for intensification of lipase-catalyzed processes. These processes are of high significance in the context of renewable fuels synthesis. In this paper, we have attempted to reveal the molecular mechanism of sonication-induced enhancement of lipase-catalysed reactions. Using hybrid quantum mechanics/ molecular mechanics computations, we have initially determined the structure and amino acid composition of the binding pockets of two common lipase enzyme, viz. CALB and TLL. Next, these binding pockets were visualized using softwares PyMOL and VMD to deduce their location in different motifs of the secondary structure of lipases. Finally, the docking analysis of different ligands was performed to reveal the amino acid residues involved for each ligand and the nature of their interactions. Our results revealed that most of the binding pockets are located in the α-helix and random coil motifs of enzyme and binding interactions are of the type hydrogen bond and hydrophobic interactions. Previous literature reports significant rise in α-helix and random coil contents of lipases with sonication. This observation concurs with our analysis, and suggests rise in enzyme activity with sonication due to widening of catalytic cavity and easier accessibility to binding pockets. Thus, our analysis provides molecular-level insight into the sonication-induced enhancement in kinetics and yield of lipase-catalyzed reactions.

Our ability to understand population spread dynamics is complicated by rapid evolution, which renders simple ecological models insufficient. If dispersal ability evolves, more highly-dispersive individuals may arrive at the population edge than less-dispersive individuals (spatial sorting), accelerating spread. If individuals at the low-density population edge benefit (escape competition), high dispersers have a selective advantage (spatial selection). These two processes are often described as forming a positive feedback loop; they reinforce each other, leading to faster spread. Although spatial sorting is close to universal, this form of spatial selection is not: low densities can be detrimental for organisms with Allee effects. Here, we present two conceptual models to explore the feedback loops that form between spatial sorting and spatial selection. We show that the presence of an Allee effect can reverse the positive feedback loop between spatial sorting and spatial selection, creating a negative feedback loop that slows population spread.

A document by Jorge Herrera de la Cruz. Click on the document to view its contents.

Fcγ receptors (FcγRs) is an important family of receptors involved in the recognition of IgG- coated particles and complexes. Engagement of activating FcγRs initiates phagocytosis, antibody- dependent cellular cytotoxicity, and the release of inflammatory mediators. Many systemic autoimmune diseases are under FcγR control. Immune thrombocytopenic purpura (ITP) is the most common cause of thrombocytopenia in children. Multiple pathophysiologic mechanisms contribute to thrombocytopenia in ITP, including phagocytosis and destruction of autoantibody-coated platelets. Aim To study the impact of FcγRIIIa polymorphism on development of ITP in Egyptian children, and its impact on bleeding severity, response to treatment and disease chronicity. Subjects and methods: This is a case-control study including 40 patients with ITP (25 newly diagnosed, 15 chronic ITP) and 20 normal controls. Medical history and physical examination were performed. Laboratory investigations included CBC, Coombs test, serum complement and antinuclear antibody, platelet- associated IgG, ELISA test for H. pylori antigen in stools, and FcγRIIIa genotyping by PCR. Patients were followed up for one year to assess severity of the disease and response to treatment. Results: The high affinity FcγRIIIa genotype (158 V/V) and the heterozygous genotype (V/F) were significantly overrepresented in ITP patients compared to the control group. There was no significant difference among ITP patients carrying different FcγRIIIa genotypes regarding response to therapy with corticosteroids or IVIg, and FcγRIIIa genotypes were similar in acute and chronic ITP. Conclusion: FcγRIIIa polymorphism might confer susceptibility to ITP, however, different FcγRIIIa genotypes did not affect response to therapy or development of chronic ITP.

Holoprosencephaly (HPE) is a complex brain malformation resulting from incomplete cleavage of the prosencephalon, occurring between the 18th and 28th day of gestation. Endocrinologic dysfunctions such as diabetes insipidus (DI), hypothyroidism, and growth hormone deficiency are common in HPE and correlated with the degree of hypothalamic non-separation.

Aim: Thyroidectomy is frequently associated with substantial postoperative pain. Esketamine, an N-methyl-D-aspartate receptor antagonist, has been demonstrated to be effective in multiple analgesia. We hypothesized that intraoperative administration of esketamine may reduce perioperative opioid consumption and postoperative pain in patients undergoing thyroidectomy. Methods: Sixty patients undergoing thyroidectomy were randomly assigned to two groups. Patients in the saline group received a pre-incisional intravenous bolus of 0.9% NaCl followed by an intraoperative infusion of 0.9% NaCl; patients in the esketamine group received a pre-incisional intravenous bolus of esketamine (0.5 mg kg-1) followed by an intraoperative infusion of esketamine (0.24 mg kg-1 h-1). The primary outcome was perioperative sufentanil consumption. The postoperative pain, sleep quality, and adverse events during the first postoperative 24 h were also evaluated. Results: Patients in the esketamine group consumed significantly less sufentanil than those in the saline group (24.6 ± 3.1 μg vs. 33.7 ± 5.1 μg, mean difference, 9.1; 95% confidence interval, 6.9–11.3, P <0.001). Postoperative pain scores were significantly lower in the esketamine group than those in the saline group during the first 24 h postoperatively (P <0.05). Patients receiving esketamine experienced higher sleep quality than those in the saline group during surgical night (P = 0.043). There were no significant differences in adverse events between the two groups. Conclusion: Intraoperative administration of esketamine reduces perioperative sufentanil consumption and postoperative pain without increasing adverse events in patients undergoing thyroidectomy. The development of combined anesthesia regimens, including esketamine, may foster strategies for pain management during thyroidectomy.

BACKGROUND Preoperative evaluation of Image Defined Risk Factors (IDRFs) in neuroblastoma (NB) is crucial for determining suitability for upfront resection or tumor biopsy. IDRFs are linked with a higher potential morbidity at operation and lessen the chance of complete tumor resection. The IDRFs do not all carry the same weight in predicting tumor complexity and surgical risk. In this study we aimed to assess and categorize the degrees of surgical complexity (Surgical Complexity Index, SCI) in NB resection.  PROCEDURE A panel of 15 surgeons was involved in an electronic Delphi consensus survey to identify and score a set of shared items predictive and/or indicative of surgical complexity, including the number of preoperative IDRFs. Risk categories included - (a) Standard risk; (b) Moderate risk; (c) High risk; (d) Very high risk. A shared agreement included the achievement of at least 75% consensus focused on a single category or, alternatively, on the sum between the prevailing category and an immediately closest one. RESULTS After 3 Delphi rounds, agreement was established on 25/27 items (92.6%). A severity score was established for each item ranging from 0 to 3 with an overall SCI range varying from a minimum score of zero to a maximum score of 29 points for any given patient.  CONCLUSIONS A consensus on a SCI to stratify the risks related to tumor resection was established by the panel experts. This index will now be deployed to critically assign a better severity score to IDRFs involved in NB surgery.

Introduction There is ongoing controversy regarding the prognostic value of PR prolongation among individuals free of cardiovascular diseases. It is necessary to risk-stratify this population according to other electrocardiographic parameters. Methods and Results This study based on the Third National Health and Nutrition Examination Survey. A total of 6188 participants (58.1±13.1 years; 55% women) were included. The median frontal QRS axis of the entire study population was 37° (IQR: 11–60°). PR prolongation was present in 7.6% of the participants, of whom 61.2% had QRS axis ≤37°. In a multivariable-adjusted model, mortality risk was highest in the group with concomitant prolonged PR interval and QRS axis ≤37° (HR: 1.20, 95% CI: 1.04-1.39). In models with similar adjustment where population were reclassified depending on PR prolongation and QRS axis, prolonged PR interval and QRS axis ≤37° was still associated with increased risk of mortality (HR: 1.18, 95% CI: 1.03-1.36) compared with normal PR interval. Conclusion QRS axis is an important factor for risk stratification in population with PR prolongation. The extent to which this population with PR prolongation and QRS axis ≤37° is at higher risk of death compared with the population without PR prolongation.

Aim: This study was conducted to evaluate the impact of genetic polymorphisms on lipid profiles of statin users. Methods: This retrospective cross-sectional study involved 229 hyperlipidaemic statin users in east coast region of Peninsular Malaysia. DNA was extracted from patients’ blood (3mL) and SNP genotyping was performed using PCR-RFLP. Lipid profiles were evaluated before and after statin administration. Multi-factorial impact on the attainment of LDL goal of <2.6mmol/L was assessed by multivariate binary regression. Results: The participants were mostly females (53.3%), Malays (96.1%) and treated with atorvastatin (64.2%). Minor allele frequency (MAF) of the studied SNPs as follow; ABCG2 rs2231142 = 0.12, ABCC2 rs717620= 0.58, APOE rs429358 and rs7412 = 0.35, GATM rs9806699 = 0.63, COQ2 rs4693075= 0.96, and APOA5 rs662799= 0.45. Before statin treatment, ABCG2 rs2231142 (P=0.035) and APOA5 rs662799 (P=0.007) carriers had greater HDL-c levels while ABCC2 rs717620 carriers had higher TC (P=0.040) and LDL-c values (P=0.022). After statin treatment, the following SNPs have affected the lipid profiles; ABCC2 rs717620 (lower TG, P=0.009), APOA5 rs662799 (higher HDL, P=0.031; lower TG, P=0.037) and ABCG2 rs2231142 (higher TC, P=0.038). Furthermore, males were affected lipid profiles significantly than females in APOA5 rs662799 (lower TG, P= 0.038; higher HDL, P= 0.006). Of all independent variables tested, only pravastatin users were predicted patient’s achieving LDL-target of <2.6 mmol/L (P=0.040, OR=0.110, 95% CI=0.013-0.902). Conclusion: ABCC2 rs717620, APOA5 rs662799 and ABCG2 rs2231142, as well patient gender, determined different lipid profiles either with or without statin treatment in a subset of Malaysian population.

Autonomous cars have become increasingly popular in the last decade because of their numerous benefits, such as lower travel time, increased safety, and improved fuel economy. Many car manufacturing companies and tech giants are working on this technology to make fully autonomous automobiles or strengthen their existing driver-less cars. These cars use very complex, advanced, and sophisticated hardware technologies. However, the software is an equally important feature because it must operate all functions seamlessly while working in sync with other vehicle components. The software must analyze a large amount of data to make quick real-time decisions, so any vulnerabilities or bugs can be a severe problem to the vehicle and the passengers riding in it. Many researchers have proposed various software defect prediction schemes for different projects and applications, but most of them have focused on specific software issues and excluded others. Thus, their methods cannot be applied to the software of autonomous cars. In this paper, we propose an improved Artificial Neural Network (ANN) model, called Dropout-Artificial Neural Network (D-ANN), to solve this problem of defect prediction in autonomous cars. This inclusive model can consider all the parameters simultaneously for effective bugs prediction. The proposed model can be used for the software of any autonomous cars, and it is trained and evaluated using standard methods. The results obtained show that the proposed model predicts software defects with higher accuracy than other models.

Current evidence and guidelines suggest a time-based approach to the perioperative administration of direct oral anticoagulants (DOAC). Quantifying haematological concentrations of DOACs is possible however, the evidence suggests a large inter-individual variation and unlike INR is to warfarin, it does no correlation with anticoagulant effect. There are multiple confounding factors that affect DOAC metabolism and may result in a cohort of patients who satisfy one guideline (time based) but are ruled out using an objective, serum quantity-based guideline. The unsubstantiated use of DOAC level testing to inform surgical triage and use of reversal agents preoperatively may increase harm to patients.

Introduction: During the early phase of the coronavirus disease 2019 (COVID-19), remdesivir was only approved for hospitalized patients. Our institution developed hospital-based, outpatient infusion centers for selected hospitalized patients with COVID-19 who had clinical improvement to allow for early dismissal. The outcomes of patients who transitioned to complete remdesivir in the outpatient setting were examined. Methods: Retrospective study of all hospitalized adult patients with COVID-19 who received at least one dose of remdesivir from 11/6/2020 to 11/5/2021 at one of the Mayo Clinic hospitals. Results: Among 3,029 hospitalized patients who received treatment with remdesivir for COVID-19, the majority (89.5%) completed the recommended the five-day course. Among them, 2,169 (80%) completed treatment during hospitalization, while 542 (20.0%) patients were dismissed to complete remdesivir in outpatient infusion centers. Patients who completed the treatment in the outpatient setting had lower odds of death within 28 days (aOR 0.14, 95% CI 0.06-0.32, p<0.001). However, their rate of subsequent hospital encounters within 30 days was higher (aHR 1.88, 95% CI 1.27-2.79, p=0.002). Among patients treated with remdesivir only in the inpatient setting, the adjusted odds of death within 28 days were significantly higher among those who did not complete the 5-day course of remdesivir (aOR 2.07, 95% CI 1.45-2.95, p<0.001). Conclusions: This study describes the clinical outcomes of a strategy of transitioning remdesivir therapy from inpatient to outpatient among selected patients. Mortality was lower among patients who completed the 5-day course of remdesivir.

In this study, Syzygium aromaticum extract as a stabilizing and reducing agent was utilized to synthesize copper nanoparticles in the aqueous medium. Various techniques containing UV-Vis. spectroscopy, FT-IR spectroscopy, X-ray diffraction (XRD), scanning electron microscopy (SEM), and Energy Dispersive X-ray Spectrometry (EDS) were used to characterize the synthesized nanoparticles (CuNPs). On the other hand, the MTT assay was run to evaluate anti lung cancer activity of CuNPs. The crystal size of CuNPs, according to the XRD analysis, was 30.73 nm. Moreover, the uniform spherical morphology ranging from 19.55 to 69.70 nm was detected in the SEM images for the biosynthesized nanoparticles. In the cellular and molecular part of the recent study, the treated cells with CuNPs@Syzygium aromaticum were assessed by MTT assay for 48 h about the cytotoxicity and anti-human lung adenocarcinoma properties on normal (HUVEC) and lung adenocarcinoma cell lines i.e. HLC-1, LC-2/ad, and PC-14. In the antioxidant test, the IC50 of CuNPs@Syzygium aromaticum and BHT against DPPH free radicals were 119 and 69 µg/mL, respectively. The viability of malignant lung cell line reduced dose-dependently in the presence of CuNPs@Syzygium aromaticum. The IC50 of CuNPs@Syzygium aromaticum were 443, 500, and 377 µg/mL against LC-2/ad, HLC-1, and PC-14 cell lines, respectively.

Runoff prediction has a pivotal role in the flood warning system. For small-sized watersheds, establishing a reliable and efficient model to forecast flood is multifarious and disorderly work. The ensemble framework for flash flood forecasting(EF5) provides a new opportunity for runoff prediction in small basins to model simply and practically. This paper used the framework to structure a flood forecast model for a small watershed in Hubei Province, China, where flash floods occur frequently. Four flood events with unique characteristics were selected to verify the accuracy and usability of the EF5 model. Evaluation using real data indicated that the EF5 model performs well in these four flood cases, with over 0.9 Pearson’s linear correlation coefficient(PCC) values and over 0.85 Nash-Sutcliffe coefficient of efficiency(NSE) values during the validation. In addition, the study verify the influence of the rainfall sources from four distinct interpolation methods on the model and evaluate the reasons for the significant differences. Finally, we detected the flood prediction performance of the EF5 model under various forecast lead time, and further statistical tests revealed that the EF5 model can maintain PCC of more than 0.9, NSE of more than 0.7, and flood peak bias(FPB) of more than -0.2 when the forecast lead time exceeds 3h. Numerous indicators and plots prove the excellent effect of the model forecast. Considering the convenience and validity of this framework, the research and verification of the EF5 model in the small-sized basin are of significance to flood prediction.

In the present study, tin nanoparticles were green-synthesized using the aqueous extract of Foeniculum vulgare leaf aqueous extract. The synthesized SnNPs were characterized by analytical techniques including EDX, FE-SEM, XRD, UV-Vis., and FT-IR. The anti-human gastric cancer activity of SnNPs was evaluated using MTT assay. The nanoparticles were formed in a spherical shape in the range size of 26.45 to 38.53 nm. In the antioxidant test, the IC50 of F. vulgare, SnNPs@FV, and BHT against DPPH free radicals were 384, 119, and 71 µg/mL, respectively. In the cellular and molecular part of the recent study, the treated cells with SnNPs@FV were assessed by MTT assay for 48h about the cytotoxicity and anti-human lung cancer properties on normal (HUVEC) and lung cancer cell lines i.e., NCI-H2126, NCI-H1299, and NCI-H1437. The IC50 of SnNPs@FV were 108, 168, and 122 µg/mL against NCI-H2126, NCI-H1299, and NCI-H1437 cell lines, respectively. The viability of malignant lung cell line reduced dose-dependently in the presence of SnNPs@FV.

Human health is burdened by diverse range diseases, particularly chronic diseases. Free radicals and other oxidants are implicated in development of those diseases as free radicals induced oxidative stress. The antioxidants are salient substances that involve maintaining a normal long life by scavenging the free radicals in the body. Phycocyanin is free radicals’ scavenger with ability to find and tackle the side effects of free radicals; the phycocyanin also possesses other physiological and pharmaceutical properties. This research aimed at evaluating the effectiveness of TiO2 nanoparticles, and reduced graphene oxide titanium dioxide nanoparticles (herein after referred to rGO-TiO2 nanoparticles) under visible light conditions to boost the accumulation of phycocyanin in Arthrospira (Spirulina) platensis (FACHB-314) cells. The experimental results indicated that the both nanoparticles exhibited high phycocyanin content accumulation compared to the control group. Under optimized visible light conditions of 165 μmol/m2/s wavelength and continuous lighting with white lights, the phycocyanin content of 80.3 mg/g and maximum yield of phycocyanin production were 97.16 mg/L in the rGO-TiO2 nanoparticles culture; 55.7 mg/g and 81.88 mg/L in the TiO2 nanoparticles culture, compared to 75.5 mg/g and 81.86 in the control culture. The maximum dry weight biomass cells were observed under the control group compared the experimental conditions. These research results indicate that rGO-TiO2 nanoparticles have potential commercial applications due to the excellent properties, and can be used in A. platensis and other microalgae cultivation to optimize productivity.

Oral Lichen Planus (OLP) and chronic hepatitis C association have been widely discussed. Here, we presented a case of extensive, erosive OLP in a hepatitis C virus-positive patient for whom clinical management was challenging. Full remission was obtained after topical corticosteroid application and several sessions of oral cavity sanitation.