Recent advances in anti-infective drug discovery最新文献

Recently, natural products have been became the center of attraction for the scientific society and exploration of their biologically abilities is proceeding continuously. In search for novel antiparasitic agents with an objective of protecting humans from parasitic infections, the present work was focused on naphthoquinones possessing antiparasitic activity. Among naphthoquinones, plumbagin is one of the secondary metabolites exhibiting diverse biological properties such as antibacterial, antimalarial, antiinflammatory, insecticidal and antiparasitic. Plumbagin is reported to have antischistosomiasis, anti-haemonchosis, anti-fascioliasis, antiotoacariasis, anti-leishmaniasis, antimalaria, antiallergic and anthelmintic activities. Besides, various methods of extraction of plumbagin from different methods, their effectiveness against different parasites, and the structure-activity relationship reported by different researchers. This work highlight on recent advancements in the phytochemistry of plumbagin, studies associated with various biological activities. The structure-activity relationship studies have also been summarized. To conclude, present review could be beneficial for the scientific community to get better insight into medicinal research of plumbagin and may provide a new horizon for the rational design of plumbagin based compounds.

Background: Plants and their derived products have been used in history as food and medicine. Plant materials are rich sources of fiber, minerals, vitamins, and bioactive phytochemicals, which are useful for human beings. Strictinin is an important phytoconstituent of green tea.

Methods: Present work mainly focuses on the biological importance, therapeutic potential, and pharmacological activities of strictinin in medicine. Numerous scientific data have been collected from various literature databases such as Google Scholar, Science Direct, PubMed, and Scopus database in order to realize the health beneficial potential of strictinin. Pharmacological data has been collected and analyzed in the present work to find the effectiveness of strictinin against human disorders and complications. Analytical data of strictinin has been also collected and analyzed in the present work.

Results: Scientific data analysis revealed the biological importance of strictinin in medicine. Scientific data analysis signified the therapeutic benefit of strictinin mainly due to its anticancer, antimicrobial, antibacterial, antiviral, and antioxidant activity. However, enzymatic activities, cytotoxicity, effectiveness on skin disorders, and osteogenic potential of strictinin have also been discussed. Analytical data revealed the importance of modern analytical techniques in medicine for the separation, identification, and isolation of strictinin.

Conclusion: Present work signified the biological importance and therapeutic benefits of strictinin in medicine and other allied health sectors.

Background: The COVID-19 pandemic has resurfaced in India as a hardhitting second wave. This study aims to compare the clinical profile of the first wave (April-June 2020) and the second wave (March-May 2021) of the severe acute respiratory syndrome coronavirus-2 pandemic (SARS-CoV-2) in a single tertiary care center in India.

Methods: In this retrospective observational study, we examined the demographic profile, symptoms at presentation, severity of illness, baseline investigations, treatments received, underlying comorbidities, and outcomes of the COVID-19 patients belonging to the first (W1) and the second wave (W2) of the pandemic in India.

Results: The age group affected most in the W2 is 50.5 (17.7) versus 37·1 (16·9) years for W1. The baseline oxygen saturation is lower in W2, being 84·0 (13·4) % compared with 91·9 (7·4) % in W1 [SpO2 < 90% OR 14.3 (6.1-33), P < 0.0001]. 70.2 % of the cases belonged to the severe category in W2 compared to 37.5% in W1. W2 has worse outcomes. Incidence of acute respiratory distress syndrome (ARDS) [48.7% v/s 6.45%; OR 15.4 (6.5-35.7), P<0.0001], Acute Kidney Injury (AKI) [18% v/s 2.4%; OR 6 (1.7- 22.2), P = 0.005], Acute Liver Injury (transaminitis) [12.8% v/s 6.4%, OR 7.3 (3.7- 14.3), P < 0.0001], and deaths (29% v/s 9.6%, standardized mortality ratio 3.5) is higher in W2. Similarly, the CT severity score for W2 [29.5 (6.7)] was higher than W1 [23·2 (11·5), P < 0.05]. The proportion of patients requiring oxygen [81.8% v/s 11.2%; OR 125 (40-333.3), P < 0.0001], high flow nasal cannula (HFNC) (11.4% v/s 5.6%), Non- Invasive Ventilation (NIV) (41.2% v/s 1.5%), invasive ventilation [24.5% v/s 0.9%; OR 22.72 (2.94-166.6), P = 0.003], as well as ICU/HDU admissions [56.4% v/s 12.0%; OR 10.5 (5.3-21.2), P < 0.0001] was higher for W2 as compared with W1. Cough, invasive ventilation, inotrope requirement, and ARDS are significantly related to higher mortality in the W2 than W1.

Conclusion: Higher age, oxygen requirement, ventilator requirement, ICU admission, and organ failure are more prevalent in the admitted COVID-19 cases during the second wave that hit India than in the first wave and are associated with more fatalities. Strategy for another wave should be planned accordingly.

Background: Statins are first-line lipid-lowering agents with tolerable adverse reactions, low cost, and high availability worldwide. The potent anti-inflammatory, antioxidant, anti-thrombotic and immunomodulatory effects of statins propose them as an option against COVID-19 infection.

Objective: In this randomized triple-blind placebo-controlled clinical trial, we have investigated the atorvastatin efficacy in the management of mild to moderate hospitalized COVID-19 patients.

Methods: In this study, 52 mild to moderate hospitalized COVID-19 patients who fulfilled the inclusion criteria were allocated to the treatment group to receive 40 mg atorvastatin orally once daily for two weeks (n=26) or the placebo group (n=26). Patients' symptoms and laboratory investigations were assessed at baseline and during the follow-up period. We also evaluated the duration of hospitalization and supplemental oxygen therapy as endpoints.

Results: After 14-day of follow-up, the oxygen saturation (SaO2) was significantly higher, and the serum high sensitivity C-reactive protein (hs-CRP) level was lower in the treatment group compared to the placebo group. Moreover, at the end of the followup in the treatment group, the lymphocyte count was higher, and the duration of symptom resolution was shorter but not significant. Additionally, in the treatment group, the length of supplemental oxygen therapy and hospitalization duration were meaningfully shorter. Our results revealed that the mortality rate was almost twice higher in the placebo group compared to the treatment group, without any significant adverse drug reaction.

Conclusion: Atorvastatin significantly reduces supplemental oxygen need, hospitalization duration, and serum hs-CRP level in mild to moderate hospitalized COVID-19 patients.

Background and aims: COVID-19 vaccines are now accessible to all Indian citizens. Infection with COVID-19, on the other hand, continues to spread constantly. Our study aimed to determine the number of persons who had COVID-19 infections despite receiving the recommended number of doses of the COVID-19 vaccination at AIIMS Rishikesh, a tertiary care facility in Uttarakhand, India.

Methods: We analysed meticulously preserved data regarding COVID-19 vaccination, COVID-19 infection, clinical symptoms, and RT-PCR testing among all HCWs in our healthcare institution from 16 January 2021 to 30th June 2021.

Results: During this period, 5273 (90.3%) HCWs received two doses of the COVID-19 vaccine, while 566 (9.7%) received only one dose. 628 HCWs (10.8%) were BBV152 recipients and 5211 (89.2%) were AZD1222 (ChAdOx1-S) recipients. 423 HCWs (7.2%, confidence interval of 95% - 13.8, 22.0) reported COVID-19 infections. 274 (5.19% of total vaccinated HCWs) breakthrough infections and 149 non-breakthrough COVID-19 infections were reported in HCWs who had previously received a single dose of the COVID-19 vaccination.

Conclusion: Viral infections, especially breakthrough infections, following adequate vaccination, are a cause for concern, but there is a lack of data on these infections in the actual world. Therefore, the primary focus of research should be on the emergence of illness in India following the completion of a full vaccine course.

Background: Leprosy is a highly stigmatized disease that can range from a minor skin lesion to life-threatening conditions such as deformities and disability. The World Health Organization (WHO) has developed a tool called "Access, Watch, and Reserve" (AWaRe) to reduce antibiotic misuse and abuse.

Aim: The purpose of this review is to determine whether the drugs used in the leprosy treatment regimen are complied with the AWaRe programme, in order to improve the quality of hospital antibiotic use and reduce the incidence of antimicrobial resistance (AMR).

Methods: We started by looking for antibiotics that are used in the treatment and chemoprophylaxis of leprosy, as defined by the WHO's AWaRe classification. Furthermore, we look for studies on antibiotics that showed sensitivity or less resistance after antimicrobial sensitivity testing (AST) on isolates from infected leprosy ulcers, as well as their AWaRe category.

Results: There were 32 studies found, but only 5 of them met the inclusion criteria. They consisted of four cross-sectional studies and one descriptive retrospective study. A total of 19 antibiotics were identified in 5 studies, with 9 (47.4%) antibiotics in the access category, 8 (42.1%) antibiotics in the watch group, and 2 (10.5%) antibiotics in the reserve group.

Conclusion: As per our knowledge, this is the first study to explore antibiotics in leprosy treatment, chemoprophylaxis, and complications such as ulcer compliance with the AWaRe programme. Antimicrobial resistance is on the rise, which is a global issue that continues to pose challenges to clinical practices. This review may provide physicians with an overview of the current state of drug prescribing trends in leprosy, whether in accordance with the AWaRe classification in selecting the right drug when the use of antimicrobials is indicated and may also aid in rational drug prescribing.