Publications by authors named "Rahul Singh"

310 Publications

Generalizability of Homeopathic Prognostic Factor Research Outcome in COVID-19 Treatment: Comparison of Data.

Homeopathy 2021 Oct 19. Epub 2021 Oct 19.

Directorate of AYUSH, Health and Family Welfare Department AYUSH, Government of NCT of Delhi, New Delhi, India.

Background/objective:  During the coronavirus disease 2019 (COVID-19) pandemic, several homeopathic prognostic factor research (PFR) projects have been undertaken. We found two projects with comparable outcomes to assess consistency and possible flaws.

Methods:  Two comparisons were made. (1) Outcome of a PFR data collection from the Liga Medicorum Homoeopathica Internationalis (LMHI) by about 100 doctors with 541 cases was compared with a previous analysis of 161 cases in the same database. (2) The updated LMHI database was also compared with a data collection carried out in India by four doctors with a total of 1,445 cases. Differences that resulted in conflicting outcomes (indication in one, contraindication in the other) were examined for possible causes.

Results:  There was only a single outcome in the updated LMHI database that conflicted with the previous dataset, and this could have been due to statistical variation. The Indian data contained many cases, from few doctors, while the LMHI database had few cases per doctor, but many doctors. The overlap between the projects (individual cases entered in both) was between zero and 22%. In 72 comparisons we found six (8.3%) conflicting outcomes. Possible causes were statistical error due to small numbers of cases and/or observers, confirmation bias, and keynote prescribing if this resulted in symptoms being inadequately checked.

Conclusion:  There was little conflict between the outcomes of the two versions of one project and between the two different PFR projects. Differences could mostly be explained by causes that can be managed. This consistency should primarily be interpreted as showing a strong overall consensus between homeopathic practitioners worldwide, but with variation of consensus between small groups of practitioners.
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http://dx.doi.org/10.1055/s-0041-1732307DOI Listing
October 2021

Clinical and Outcome Analysis in Head Injury Patients with Fahr's Disease.

Asian J Neurosurg 2021 Jul-Sep;16(3):549-553. Epub 2021 Sep 14.

Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Context: Fahr's disease (FD) is a rare neurodegenerative disorder. Head injury in patients with FD is an uncommon occurrence.

Aim: The aim is to evaluate clinical and outcome characteristics in traumatic head injury patients with FD.

Settings And Design: Retrospective cohort study.

Materials And Methods: This retrospective cohort study includes 13 patients of FD presenting as head injury in neurosurgical emergency between September 2018 and February 2021. Each patient was evaluated in terms of demographic profile, Glasgow coma scale (GCS) at admission, severity of head injury, type of head injury, preexisting clinical features of FD, radiological findings, Glasgow outcome score (GOS), family history of FD, and biochemical abnormalities. Patients were also evaluated for dichotomized outcome (Good recovery: GOS 5-4 versus Poor recovery: GOS 1-3) and gender differences in FD presentation.

Statistical Analysis Used: Fisher's exact test and unpaired -test were used. < 0.05 was considered statistically significant.

Results: Neurological symptoms (69.2%), neuropsychiatric manifestations (46.1%) and extrapyramidal features (38.5%) were preexisting in these patients. Seizure (61.5%) was the most common neurological manifestation. Depression (23.1%) and anxiety disorder (15.4%) were common psychiatric disorders seen. Akathisia (23.1%) followed by tremor (15.4%) were predominant extrapyramidal presentations. On dichotomized outcome analysis, preexisting neurological, neuropsychiatric, and extrapyramidal manifestations due to FD were not associated significantly with outcome following head injury. GCS at admission, severity of head injury and pupillary changes were significantly associated with outcome ( < 0.05). Neuropsychiatric features ( = 0.0210) were significantly more in females suffering from FD.

Conclusions: Neurological features in FD predominate over neuropsychiatric and extrapyramidal symptoms. FD does not affect outcome following head injury.
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http://dx.doi.org/10.4103/ajns.AJNS_92_21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477836PMC
September 2021

Exploitation of E. coli for the production of penicillin G amidase: a tool for the synthesis of semisynthetic β-lactam antibiotics.

J Genet Eng Biotechnol 2021 Oct 15;19(1):156. Epub 2021 Oct 15.

Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.

Background: Penicillin G amidase/acylases from microbial sources is a unique enzyme that belongs to the N-terminal nucleophilic hydrolase structural superfamily. It catalyzes the selective hydrolysis of side chain amide/acyl bond of penicillins and cephalosporins whereas the labile amide/acyl bond in the β-lactam ring remains intact. This review summarizes the production aspects of PGA from various microbial sources at optimized conditions. The minimal yield from wild strains has been extensively improved using varying strain improvement techniques like recombination and mutagenesis; further applied for the subsequent synthesis of 6-aminopenicillanic acid, which is an intermediate molecule for synthesis of a wide range of novel β-lactam antibiotics. Immobilization of PGA has also been attempted to enhance the durability of enzyme for the industrial purposes.

Short Conclusion: The present review provides an emphasis on exploitation of E. coli to enhance the microbial production of PGA. The latest achievements in the production of recombinant enzymes have also been discussed. Besides E. coli, other potent microbial strains with PGA activity must be explored to enhance the yields.
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http://dx.doi.org/10.1186/s43141-021-00263-7DOI Listing
October 2021

Exploring biological efficacy of novel benzothiazole linked 2,5-disubstituted-1,3,4-oxadiazole hybrids as efficient α-amylase inhibitors: Synthesis, characterization, inhibition, molecular docking, molecular dynamics and Monte Carlo based QSAR studies.

Comput Biol Med 2021 Sep 17;138:104876. Epub 2021 Sep 17.

Department of Chemistry, Kurukshetra University Kurukshetra, Haryana, -136119, India.

In an effort to explore a class of novel antidiabetic agents, we have made an effort to synergize the α-amylase inhibitory potential of 1,3-benzothiazole and 1,3,4-oxadiazole scaffolds by combining the two into a single structure via an ether linkage. The structure of synthesized benzothiazole clubbed oxadiazole derivatives are established by different spectral techniques. The synthesized hybrids are evaluated for their in vitro inhibitory potential against α-amylase. Compound 8f is found to be the most potent with a significant inhibition (87.5 ± 0.74% at 50 μg/mL, 82.27 ± 1.85% at 25 μg/mL and 79.94 ± 1.88% at 12.5 μg/mL) when compared to positive control acarbose (77.96 ± 2.06%, 71.17 ± 0.60%, 67.24 ± 1.16% at 50 μg/mL, 25 μg/mL and 12.5 μg/mL concentration). Molecular docking of the most potent enzyme inhibitor, 8f, shows promising interaction with the binding site of biological macromolecule Aspergillus oryzae α-amylase (PDB ID: 7TAA) and human pancreatic α-amylase (PDB ID: 3BAJ). To a step further, in-depth QSAR studies show a significant correlation between the experimental and the predicted inhibitory activities with the best R= 0.8701. The developed QSAR model can provide ample information about the structural features responsible for the increase and decrease of inhibitory activity. The mechanistic interpretation of the structure-activity relationship (SAR) is done with the help of combined computational calculations i.e. molecular docking and QSAR. Finally, molecular dynamic simulations are performed to get an insight into the binding mode of the most potent derivative with α-amylase from A. oryzae (PDB ID: 7TAA) and human pancreas (PDB ID: 3BAJ).
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http://dx.doi.org/10.1016/j.compbiomed.2021.104876DOI Listing
September 2021

Anomalous Diffusion and Lévy Walks Distinguish Active from Inertial Turbulence.

Phys Rev Lett 2021 Sep;127(11):118001

International Centre for Theoretical Sciences, Tata Institute of Fundamental Research, Bangalore 560089, India.

Bacterial swarms display intriguing dynamical states like active turbulence. Now, using a hydrodynamic model, we show that such dense active suspensions manifest superdiffusion, via Lévy walks, which masquerades as a crossover from ballistic to diffusive scaling in measurements of mean-squared displacements, and is tied to the emergence of hitherto undetected oscillatory streaks in the flow. Thus, while laying the theoretical framework of an emergent advantageous strategy in the collective behavior of microorganisms, our Letter underlines the essential differences between active and inertial turbulence.
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http://dx.doi.org/10.1103/PhysRevLett.127.118001DOI Listing
September 2021

Impact of COVID-19 pandemic on bariatric surgery in India: An obesity and metabolic surgery society of India survey of 1307 patients.

J Minim Access Surg 2021 Oct-Dec;17(4):542-547

Wockhardt Hospital, Mumbai, Maharashtra, India.

Background: Although safe practice guidelines were issued by the Obesity and Metabolic Surgery Society of India (OSSI) in the end of May 2020, surgeons have been in a dilemma about risk of subjecting patients to hospitalisation and bariatric surgery. This survey was conducted with the objective to evaluate the risk of coronavirus disease-19 (COVID-19) infection in peri- and post-operative period after bariatric and metabolic surgery (BMS).

Methods: A survey with OSSI members was conducted from 20 July 2020 to 31 August 2020 in accordance with EQUATOR guidelines. Google Form was circulated to all surgeon members through E-mail and WhatsApp. In the second phase, clinical details were captured from surgeons who reported positive cases.

Results: One thousand three hundred and seven BMS were reported from 1 January 2020 to 15 July 2020. Seventy-eight per cent were performed prior to 31 March 2020 and 276 were performed after 1 April 2020. Of these, 13 (0.99%) patients were reported positive for COVID-19 in the post-operative period. All suffered from a mild disease and there was no mortality. Eighty-seven positive cases were reported from patients who underwent BMS prior to 31 December 2019. Of these, 82.7% of patients had mild disease, 13.7% of patients had moderate symptoms and four patients succumbed to COVID-19.

Conclusion: BMS may be considered as a safe treatment option for patients suffering from clinically severe obesity during the COVID-19 pandemic. Due care must be taken to protect patients and healthcare workers and all procedures must be conducted in line with the safe practice guidelines.
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http://dx.doi.org/10.4103/jmas.JMAS_2_21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486048PMC
September 2021

Cancer and diabetes: the interlinking metabolic pathways and repurposing actions of antidiabetic drugs.

Cancer Cell Int 2021 Sep 17;21(1):499. Epub 2021 Sep 17.

Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Cancers are regarded as one of the main causes of death and result in high health burden worldwide. The management of cancer include chemotherapy, surgery and radiotherapy. The chemotherapy, which involves the use of chemical agents with cytotoxic actions is utilised as a single treatment or combined treatment. However, these managements of cancer such as chemotherapy poses some setbacks such as cytotoxicity on normal cells and the problem of anticancer drug resistance. Therefore, the use of other therapeutic agents such as antidiabetic drugs is one of the alternative interventions used in addressing some of the limitations in the use of anticancer agents. Antidiabetic drugs such as sulfonylureas, biguanides and thiazolidinediones showed beneficial and repurposing actions in the management of cancer, thus, the activities of these drugs against cancer is attributed to some of the metabolic links between the two disorders and these includes hyperglycaemia, hyperinsulinemia, inflammation, and oxidative stress as well as obesity. Furthermore, some studies showed that the use of antidiabetic drugs could serve as risk factors for the development of cancerous cells particularly pancreatic cancer. However, the beneficial role of these chemical agents overweighs their detrimental actions in cancer management. Hence, the present review indicates the metabolic links between cancer and diabetes and the mechanistic actions of antidiabetic drugs in the management of cancers.
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http://dx.doi.org/10.1186/s12935-021-02202-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8447515PMC
September 2021

Impact of Bias in Data Collection of COVID-19 Cases.

Homeopathy 2021 Sep 9. Epub 2021 Sep 9.

Independent Researcher, Breda, The Netherlands.

Background/objective:  Prognostic factor research (PFR), prevalence of symptoms and likelihood ratio (LR) play an important role in identifying prescribing indications of useful homeopathic remedies. It involves meticulous unbiased collection and analysis of data collected during clinical practice. This paper is an attempt to identify causes of bias and suggests ways to mitigate them for improving the accuracy in prescribing for better clinical outcomes and execution of randomized controlled studies.

Methods:  A prospective, open label, observational study was performed from April 2020 to December 2020 at two COVID Health Centers. A custom-made Excel spreadsheet containing 71 fields covering a spectrum of COVID-19 symptoms was shared with doctors for regular reporting. Cases suitable for PFR were selected. LR was calculated for commonly occurring symptoms. Outlier values with LR ≥5 were identified and variance of LRs was calculated.

Results:  Out of 1,889 treated cases of confirmed COVID-19, 1,445 cases were selected for pre-specified reasons. Nine medicines, and , were most frequently prescribed. Outlier values and large variance for and were noticed as indication of bias. Confirmation bias leading to lowering of symptom threshold, keynote prescribing, and deficiency in checking of all symptoms in each case were identified as the most important sources of bias.

Conclusion:  Careful identification of biases and remedial steps such as training of doctors, regular monitoring of data, checking of all pre-defined symptoms, and multicenter data collection are important steps to mitigate biases.
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http://dx.doi.org/10.1055/s-0041-1731314DOI Listing
September 2021

Effectiveness of nudges as a tool to promote adherence to guidelines in healthcare and their organizational implications: A systematic review.

Soc Sci Med 2021 Oct 18;286:114321. Epub 2021 Aug 18.

Cone Health, Greensboro, NC, USA. Electronic address:

The shift in the United States in recent years toward value-based healthcare delivery models has brought renewed pressure on healthcare organizations to improve adherence to clinical and administrative guidelines designed to deliver high quality care at lower costs. However, getting clinicians to adhere to these guidelines remains a persistent problem for many organizations. The use of nudges has emerged as a popular intervention in healthcare settings to promote adherence to both sets of guidelines. This systematic review aims to assess the empirical evidence base on the use of various types of nudges and their effectiveness as a tool to promote this adherence and to identify the boundary conditions under which they are effective. In our assessment of 83 empirical studies, we found compelling evidence that nudges are an effective tool for promoting adherence to guidelines. However, much of this evidence relies heavily on studies focused on three types of nudges (increasing salience, providing feedback, and default). Other types of nudges (anticipated error reduction, structuring of complex problems, and understanding mapping) received far less attention. We also found that this literature is primarily focused on whether nudge interventions work, with little consideration for organizational issues such as cost effectiveness, impact on healthcare workers, and disruptions of established workflows and routines. We offer observations and recommendations on how research at the intersection of organizational studies and health services can improve our understanding of nudge interventions.
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http://dx.doi.org/10.1016/j.socscimed.2021.114321DOI Listing
October 2021

Crystal structure of aspartyl dipeptidase from Xenopus laevis revealed ligand binding induced loop ordering and catalytic triad assembly.

Proteins 2021 Aug 25. Epub 2021 Aug 25.

Beamline Development and Application Section, Bhabha Atomic Research Centre, Mumbai, India.

Gene encoding aspartyl dipeptidase from Xenopus levies (PepExl) is upregulated by thyroid hormone and is proposed to play a significant role in resorption of tadpole tail during metamorphosis. However, the importance of peptidase activity for the resorption of the tail remain elusive. Here we report the crystal structures of first eukaryotic S51 peptidase, PepExl, in its ligand-free and Asp-bound states at 1.4 and 1.8 Å resolutions, respectively. The active site is located at dimeric interface and the catalytic triad is found to be dissembled in ligand-free and assembled in Asp-bound state. Structural comparison and molecular dynamic simulations of ligand-free and Asp-bound states shows that distinct loop (loop-A) plays an important role in active site shielding, substrate binding and enzyme activation. This study illuminates the Asp-X dipeptide binding in PepExl is associated with ordering of the loop-A and assembly of residues of catalytic triad in active conformation for enzymatic activity.
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http://dx.doi.org/10.1002/prot.26220DOI Listing
August 2021

Ion-Exchange Membranes for the Fabrication of Reverse Electrodialysis Device.

J Vis Exp 2021 07 20(173). Epub 2021 Jul 20.

Department of Mechanical Engineering, Energy Engineering Lab, Sogang University;

Reverse electrodialysis (RED) is an effective way to generate power by mixing two different salt concentrations in water using cation-exchange membranes (CEM) and anion-exchange membranes (AEM). The RED stack is composed of an alternating arrangement of the cation-exchange membrane and anion-exchange membrane. The RED device acts as a potential candidate for fulfilling the universal demand for future energy crises. Here, in this article, we demonstrate a procedure to fabricate a reverse electrodialysis device using laboratory-scale CEM and AEM for power production. The active area of the ion-exchange membrane is 49 cm. In this article, we provide a step-by-step procedure for synthesizing the membrane, followed by the stack's assembly and power measurement. The measurement conditions and net power output calculation have also been explained. Furthermore, we describe the fundamental parameters that are taken into consideration for obtaining a reliable outcome. We also provide a theoretical parameter that affects the overall cell performance relating to the membrane and the feed solution. In short, this experiment describes how to assemble and measure RED cells on the same platform. It also contains the working principle and calculation used for estimating the net power output of the RED stack using CEM and AEM membranes.
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http://dx.doi.org/10.3791/62309DOI Listing
July 2021

Valproic acid and Propionic acid modulated mechanical pathways associated with Autism Spectrum Disorder at prenatal and neonatal exposure.

CNS Neurol Disord Drug Targets 2021 Aug 6. Epub 2021 Aug 6.

Department of Pharmacology, Post Graduate Institute for Medical Education and Research (PGIMER), Chandigarh. India.

Autism Spectrum Disorder (ASD) is a composite disorder of brain development with uncertain etiology and pathophysiology. Genetic factors are important in ASD causation, although environmental factors are also involved in ASD pathophysiology. Environmental factors might affect the genetic processes of brain development through the modulation of molecular pathways that might be involved with ASD. Valproic acid and Propionic acid are the major environmental factors that serve as medicine and food preservative. VPA is used as an anti-epileptic medicine, but it has adverse effects on pregnant women and alters the developmental patterns of the embryo. It is a multi-targeting agent and affects through the 5-HT, GABA, etc. PPA is a secondary metabolite of gut microbiota that is commonly used as a food preservative. PPA plays a significant role in ASD causation by altering the several developmental molecular pathways like PTEN/Akt, mTOR/Gskβ, Cytokines activated pathways, etc., at the prenatal and neonatal stage. Moreover, ASD complexity might be increased by some other important factors like vitamin A deficiency and Vitamin A is important for cortical brain development and neuronal cell differentiation. Additionally, several important genes such as RELN, Lhx2, CREB, IL-6, NMDA, BDNF, etc. also altered in ASD that involved in brain development, Central Nervous System, Enteric Nervous System. These genes affect the neuronal differentiation, hyperactivity, oxidative stress, oxytocin, and GABA imbalance that lead the improper behavior in autistic individuals. These genes are also studied in VPA and PPA ASD-like animal models. In this review, we explored the mechanical pathways that might be altered with VPA and PPA exposures at the embryonic developmental stage or neonatal developmental stage.
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http://dx.doi.org/10.2174/1871527320666210806165430DOI Listing
August 2021

Radiographic Evaluation of Mastoid Parameters for Sexual Differentiation in North Indian Population.

Cureus 2021 Jun 29;13(6):e16011. Epub 2021 Jun 29.

Orthopaedics, Hamdard Institute of Medical Sciences, New Delhi, IND.

Introduction: Morphometric differences of several bones form the basis of sexual differentiation. The mastoid triangle has been widely used as a predictor of sexual differentiation. However, the radiographic measurements of the mastoid triangle, which form the clinical alternative of this parameter, have not been studied in the North Indian population. Therefore, we analyzed skull radiographs of live subjects to investigate the effectiveness of the radiographic mastoid triangle in sex determination.

Methods: One hundred skull lateral radiographs (55 male and 45 female) from the digital archives of a tertiary care teaching institute in Northern India were retrospectively analyzed. The following parameters: porion-mastoidale length, mastoidale-asterion length, asterion-porion length, and area of the mastoid triangle were measured. Gender-based differences for these parameters were then calculated for any statistical significance. Further, the low value of Wilks' lambda, high values of Eigenvalues, and percentage of correct prediction accuracy denoted higher predictive value. Finally, discriminant function analysis was used to predict the relative validity of each measured parameter.

Result: All measured parameters were significantly higher in the male group. The porion-mastoidale length was 32.21±2.15 mm in males and 31.66±3.21 mm in females. The mastoidale-asterion length was 50.00±9.75 mm in males and 49.84±6.97 in females. The asterion-porion length was 44.11±6.82 mm in males and 39.72±5.77 mm in females. The area of the mastoid triangle was 690.74±123.35 mm in males and 570.57±130.0 mm in females. The area of the mastoid triangle has the highest relative validity (78%).

Conclusion: Considerable ethnic and racial differences have been observed in the radiographic morphology of the mastoid. The radiographic dimensions of the mastoid are potential predictors of sexual dimorphism. With the use of discriminant function analysis, the current study predicts the effectiveness of the area of the mastoid triangle as a reliable parameter for sexual differentiation in the Northern Indian population.
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http://dx.doi.org/10.7759/cureus.16011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8319872PMC
June 2021

A Rare Location of a Repeat Ectopic Pregnancy: A Case Report.

Cureus 2021 Jun 28;13(6):e15982. Epub 2021 Jun 28.

Obstetrics and Gynecology, Dr. Balwant Singh's Hospital, Georgetown, GUY.

Ectopic pregnancies often recur in the same patients as its etiology is tubal damage, which is rarely unilateral. In the setting of a well-documented history of ectopic pregnancy in the past where a salpingectomy was performed, and the clinical picture now suggests another ectopic, it can be reasonably concluded that the ectopic is in the remaining tube. In the case we present here, the ultrasound findings also suggested a tubal pregnancy in the remaining tube. Therefore, it was a surprise to find a profusely bleeding ectopic gestation in the stump of the same tube (where salpingectomy was performed earlier) on laparoscopy.
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http://dx.doi.org/10.7759/cureus.15982DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317251PMC
June 2021

Determinants of Influenza Vaccine Uptake in Patients With Cardiovascular Disease and Strategies for Improvement.

J Am Heart Assoc 2021 08 28;10(15):e019671. Epub 2021 Jul 28.

Division Health Equity & Disparities Research Center for Outcomes Research Houston Methodist Hospital Houston TX.

Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Influenza infection is associated with an increased risk of cardiovascular events (myocardial infarction, stroke, and heart failure exacerbation) and mortality, and all-cause mortality in patients with CVD. Infection with influenza leads to a systemic inflammatory and thrombogenic response in the host body, which further causes destabilization of atherosclerotic plaques. Influenza vaccination has been shown to be protective against cardiovascular and cerebrovascular events in several observational and prospective studies of at-risk populations. Hence, many international guidelines recommend influenza vaccination for adults of all ages, especially for individuals with high-risk conditions such as CVD. Despite these long-standing recommendations, influenza vaccine uptake among US adults with CVD remains suboptimal. Specifically, vaccination uptake is strikingly low among patients aged <65 years, non-Hispanic Black individuals, those without health insurance, and those with diminished access to healthcare services. Behavioral factors such as perceived vaccine efficacy, vaccine safety, and attitudes towards vaccination play an important role in vaccine acceptance at the individual and community levels. With the ongoing COVID-19 pandemic, there is a potential threat of a concurrent epidemic with influenza. This would be devastating for vulnerable populations such as adults with CVD, further stressing the need for ensuring adequate influenza vaccination coverage. In this review, we describe a variety of strategies to improve the uptake of influenza vaccination in patients with CVD through improved understanding of key sociodemographic determinants and behaviors that are associated with vaccination, or the lack thereof. We further discuss the potential use of relevant strategies for COVID-19 vaccine uptake among those with CVD.
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http://dx.doi.org/10.1161/JAHA.120.019671DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475658PMC
August 2021

A data-driven performance dashboard for surgical dissection.

Sci Rep 2021 07 22;11(1):15013. Epub 2021 Jul 22.

Project neuroArm, Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.

Surgical error and resulting complication have significant patient and economic consequences. Inappropriate exertion of tool-tissue force is a common variable for such error, that can be objectively monitored by sensorized tools. The rich digital output establishes a powerful skill assessment and sharing platform for surgical performance and training. Here we present SmartForceps data app incorporating an Expert Room environment for tracking and analysing the objective performance and surgical finesse through multiple interfaces specific for surgeons and data scientists. The app is enriched by incoming geospatial information, data distribution for engineered features, performance dashboard compared to expert surgeon, and interactive skill prediction and task recognition tools to develop artificial intelligence models. The study launches the concept of democratizing surgical data through a connectivity interface between surgeons with a broad and deep capability of geographic reach through mobile devices with highly interactive infographics and tools for performance monitoring, comparison, and improvement.
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http://dx.doi.org/10.1038/s41598-021-94487-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298519PMC
July 2021

Identification of potential plant bioactive as SARS-CoV-2 Spike protein and human ACE2 fusion inhibitors.

Comput Biol Med 2021 09 8;136:104631. Epub 2021 Jul 8.

Structural Bioinformatics Lab, CSIR-Institute of Himalayan Bioresource Technology (CSIR-IHBT), Palampur, HP, 176061, India; Biotechnology Division, CSIR-IHBT, Palampur, HP, 176061, India; Academy of Scientific & Innovative Research (AcSIR), Ghaziabad, 201002, India. Electronic address:

The Spike receptor binding domain (S-RBD) from SARS-CoV-2, a crucial protein for the entrance of the virus into target cells is known to cause infection by binding to a cell surface protein. Hence, reckoning therapeutics for the S-RBD of SARS-CoV-2 may address a significant way to target viral entry into the host cells. Herein, through in-silico approaches (Molecular docking, molecular dynamics (MD) simulations, and end-state thermodynamics), we aimed to screen natural molecules from different plants for their ability to inhibit S-RBD of SARS-CoV-2. We prioritized the best interacting molecules (Diacetylcurcumin and Dicaffeoylquinic acid) by analysis of protein-ligand interactions and subjected them for long-term MD simulations. We found that Dicaffeoylquinic acid interacted prominently with essential residues (Lys417, Gln493, Tyr489, Phe456, Tyr473, and Glu484) of S-RBD. These residues are involved in interactions between S-RBD and ACE2 and could inhibit the viral entry into the host cells. The in-silico analyses indicated that Dicaffeoylquinic acid and Diacetylcurcumin might have the potential to act as inhibitors of SARS-CoV-2 S-RBD. The present study warrants further in-vitro and in-vivo studies of Dicaffeoylquinic acid and Diacetylcurcumin for validation and acceptance of their inhibitory potential against S-RBD of SARS-CoV-2.
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http://dx.doi.org/10.1016/j.compbiomed.2021.104631DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264305PMC
September 2021

Dietary Polyunsaturated Fatty Acids (PUFAs): Uses and Potential Health Benefits.

Curr Nutr Rep 2021 Sep 13;10(3):232-242. Epub 2021 Jul 13.

Department of Botany, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab, 144411, India.

Purpose Of Review: Polyunsaturated fatty acids (PUFAs) are obtained from various sources, which can be incorporated in the routine diet to maintain the health. They provide protection from several diseases like osteoarthritis, cancer, and autoimmune disorders. Major focus is given to the PUFAs omega-3 (ω-3) and omega-6 (ω-6) fatty acids which are available in both terrestrial and in the marine environment. The main concern of this article is to review the key scientific reports in context with the human health consequences and advantages of the food sources of ω-3 and ω-6 fatty acids.

Recent Findings: ω-3 and ω-6 fatty acids are consumed by the population globally in the form of foods that are rich in fatty acids. Their nutritional effects have the capability to improve the physical functioning and metabolic rate of the body. These PUFAs contribute in various cellular activities like cell signaling, structural integrity and fluidity of cell membrane, the regulation of blood pressure, glucose level, the nervous system, inflammatory reactions, and hematic clotting. Animal and cell-based models represent that ω-3 and ω-6 PUFAs can regulate the skeletal muscle metabolism. The main concern of this article is to review the key scientific reports in context with the human health consequences and advantages of the food sources of ω-3 and ω-6 fatty acids.
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http://dx.doi.org/10.1007/s13668-021-00363-3DOI Listing
September 2021

High-Temperature Proton Conduction in Covalent Organic Frameworks Interconnected with Nanochannels for Reverse Electrodialysis.

ACS Appl Mater Interfaces 2021 Jul 12;13(28):33437-33448. Epub 2021 Jul 12.

Department of Mechanical Engineering, Energy-Water Nexus Lab, Sogang University, 35Baekbeom-Ro, Mapo-Gu, Seoul 121-742, Republic of Korea.

The crystalline porous organic framework offers a highly ordered and stable structure under hydrated conditions at high temperatures. Here, we demonstrated a method for preparing high-performance membrane buildup using "heterogeneous networks" and "polymer phase-separated nanochannels". A well-interconnected "nanochannel" with a "crystalline organic framework" forms a highly stable hybrid membrane above 80 °C under 100% hydration under acidic and basic conditions. The prepared structure provides a self-standing membrane that easily overcomes the problem faced by conventional high ion-exchange capacity (IEC)-based membranes such as swelling, gelling, fragility, and dissolving at elevated temperatures. Apart from structural stability, it also shows better chemical stability with enhanced proton conduction at elevated temperatures. This proton conduction with better structural stability in the high IEC sample confirms from thermal analysis, whereas it also offers relatively low in-plane membrane swelling as compared to the conventional membranes. These hybrid membranes were further combined with the FAA-3 membrane to manufacture a reverse electrodialysis system for generating a power output. We also evaluated the maximum power density () of the stack theoretically and experimentally. The determined net power density () is reported to be 0.45 W m at a flow rate of 40 mL min. These results confirm that the developed membrane can withstand robustly under realistic ambient conditions maintaining stable cell performance.
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http://dx.doi.org/10.1021/acsami.1c06285DOI Listing
July 2021

Knowledge, Awareness, and Practice Among Caregivers of Children With Vernal Keratoconjunctivitis in a Tertiary Care Pediatric Hospital.

J Pediatr Ophthalmol Strabismus 2021 Jun 1:1-6. Epub 2021 Jun 1.

Purpose: To determine the knowledge and awareness about vernal keratoconjunctivitis (VKC) and factors affecting the practice and compliance with treatment in caregivers of children with VKC.

Methods: The study was conducted in a tertiary care pediatric hospital in northern India. It was a hospital-based cross-sectional study in which 65 caregivers (parents or guardians) were interviewed regarding their knowledge about the disease and attitude of caregivers.

Results: Of 268 children with VKC visiting the ophthalmology department during the study period, 65 children met the inclusion criteria; 53 (81.54%) were boys and 12 (18.46%) were girls. A total of 69.2% of caregivers were not aware of the symptoms of the disease and 83% of caregivers were unaware of the side effects of eye drops used. A total of 24.61% of caregivers considered VKC affected school hours and other recreational activities of children ( < .001). Compliance with treatment decreases with more episodes of VKC and longer duration of symptoms.

Conclusions: The chronic course of the disease affects compliance with treatment and follow-up with an eye specialist. Proper education of caregivers of children with VKC can influence the compliance with treatment. .
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http://dx.doi.org/10.3928/01913913-20210426-02DOI Listing
June 2021

Anti-enterococcal and anti-oxidative potential of a thermophilic cyanobacterium, sp. HNBGU 003.

Saudi J Biol Sci 2021 Jul 20;28(7):4022-4028. Epub 2021 Apr 20.

Department of Microbiology, VBS Purvanchal University, Jaunpur 222003, Uttar Pradesh, India.

Enterococci, the opportunistic pathogens, pose several serious and life-threatening infections such as urinary tract infections, sepsis, and endocarditis. The situation is worsening due to the development of drug resistance in these pathogens against several antibiotics. The addition of anti-enterococcal compounds with antioxidant activity in fermented and packaged food may help prevent the transmission of food-borne enterococcal infections. Scientists are in continuous search of such compounds from various sources. Hence, the present study has tested the diethyl ether extracts of thermophilic cyanobacteria, selected based on a previous study, against the multidrug-resistant and -sensitive strains of . Out of the eleven tested extracts, 72% have shown anti-enterococcal activity against both strains. Among the extracts with anti-enterococcal activity, the diethyl ether extract of sp (DEEL-3) inhibited the growth of VRE in a dose-dependent manner with a minimum inhibitory concentration of 2.0 mg mL. The DEEL-3 has also shown its antioxidant potential in terms of DPPH scavenging with an IC of 3.16 mg mL. The organism was named sp. HNBGU 003 based on 16SrRNA sequence homology analysis and morphological features. Further, the GC-MS analysis of the DEEL-3 has revealed the predominance of two phenolic compounds, phenol, 2,4-bis(1,1-dimethylethyl)-, phosphite (3:1) and tris(2,4-di--butylphenyl) phosphate, in it. Thus, the anti-enterococcal and antioxidant activity of DEEL-3 may be attributed to these phenolics, which may be isolated and developed as food additives.
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http://dx.doi.org/10.1016/j.sjbs.2021.04.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8241890PMC
July 2021

Functional and Radiological Improvement in a COVID-19 Pneumonia Patient Treated With Steroids.

Cureus 2021 May 26;13(5):e15257. Epub 2021 May 26.

Family Medicine, Amita Health, Chicago, USA.

Like its predecessors, coronavirus disease 2019 (COVID-19) can lead to long-term health-related consequences in a significant segment of the afflicted population. Although the medical community has developed multiple vaccines by now, COVID-19 has affected over 100 million individuals worldwide and will infect millions more before vaccines can be effectively distributed on a global scale. Additionally, it seems probable that another outbreak caused by a coronavirus may occur in the future, given that this is the third outbreak caused by a coronavirus in recent history. In light of this, the medical community must develop reliable methods of curtailing long-term sequelae of coronaviruses, and the use of corticosteroids in affected patients may be vital for this purpose. In this report, we present a case of progressive dyspnea caused by COVID-19 pneumonia; the patient was treated with a short course of oral corticosteroids, and subsequently showed marked improvement of the dyspnea with corresponding improvements on chest CT.
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http://dx.doi.org/10.7759/cureus.15257DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8231732PMC
May 2021

A novel G-quadruplex aptamer-based spike trimeric antigen test for the detection of SARS-CoV-2.

Mol Ther Nucleic Acids 2021 Dec 24;26:321-332. Epub 2021 Jun 24.

Aptamer Technology and Diagnostics Laboratory, Multidisciplinary Clinical and Translational Research, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India.

The recent SARS-CoV-2 outbreak has been declared a global health emergency. It will take years to vaccinate the whole population to protect them from this deadly virus, hence the management of SARS-CoV-2 largely depends on the widespread availability of an accurate diagnostic test. Toward addressing the unmet need of a reliable diagnostic test in the current work by utilizing the power of Systematic Evolution of Ligands by EXponential enrichment, a 44-mer G-quadruplex-forming DNA aptamer against spike trimer antigen of SARS-CoV-2 was identified. The lead aptamer candidate (S14) was characterized thoroughly for its binding, selectivity, affinity, structure, and batch-to-batch variability by utilizing various biochemical, biophysical, and techniques. S14 has demonstrated a low nanomolar K, confirming its tight binding to a spike antigen of SARS-CoV-2. S14 can detect as low as 2 nM of antigen. The clinical evaluation of S14 aptamer on nasopharyngeal swab specimens (n = 232) has displayed a highly discriminatory response between SARS-CoV-2 infected individuals from the non-infected one with a sensitivity and specificity of ∼91% and 98%, respectively. Importantly, S14 aptamer-based test has evinced a comparable performance with that of RT-PCR-based assay. Altogether, this study established the utility of aptamer technology for the detection of SARS-CoV-2.
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http://dx.doi.org/10.1016/j.omtn.2021.06.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223116PMC
December 2021

Contributions of the international plant science community to the fight against human infectious diseases - part 1: epidemic and pandemic diseases.

Plant Biotechnol J 2021 10 19;19(10):1901-1920. Epub 2021 Jul 19.

Department of Chemical Engineering, University of California, Davis, Davis, CA, USA.

Infectious diseases, also known as transmissible or communicable diseases, are caused by pathogens or parasites that spread in communities by direct contact with infected individuals or contaminated materials, through droplets and aerosols, or via vectors such as insects. Such diseases cause ˜17% of all human deaths and their management and control places an immense burden on healthcare systems worldwide. Traditional approaches for the prevention and control of infectious diseases include vaccination programmes, hygiene measures and drugs that suppress the pathogen, treat the disease symptoms or attenuate aggressive reactions of the host immune system. The provision of vaccines and biologic drugs such as antibodies is hampered by the high cost and limited scalability of traditional manufacturing platforms based on microbial and animal cells, particularly in developing countries where infectious diseases are prevalent and poorly controlled. Molecular farming, which uses plants for protein expression, is a promising strategy to address the drawbacks of current manufacturing platforms. In this review article, we consider the potential of molecular farming to address healthcare demands for the most prevalent and important epidemic and pandemic diseases, focussing on recent outbreaks of high-mortality coronavirus infections and diseases that disproportionately affect the developing world.
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http://dx.doi.org/10.1111/pbi.13657DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486245PMC
October 2021

Contributions of the international plant science community to the fight against infectious diseases in humans-part 2: Affordable drugs in edible plants for endemic and re-emerging diseases.

Plant Biotechnol J 2021 10 19;19(10):1921-1936. Epub 2021 Jul 19.

Department of Chemical Engineering, University of California, Davis, Davis, CA, USA.

The fight against infectious diseases often focuses on epidemics and pandemics, which demand urgent resources and command attention from the health authorities and media. However, the vast majority of deaths caused by infectious diseases occur in endemic zones, particularly in developing countries, placing a disproportionate burden on underfunded health systems and often requiring international interventions. The provision of vaccines and other biologics is hampered not only by the high cost and limited scalability of traditional manufacturing platforms based on microbial and animal cells, but also by challenges caused by distribution and storage, particularly in regions without a complete cold chain. In this review article, we consider the potential of molecular farming to address the challenges of endemic and re-emerging diseases, focusing on edible plants for the development of oral drugs. Key recent developments in this field include successful clinical trials based on orally delivered dried leaves of Artemisia annua against malarial parasite strains resistant to artemisinin combination therapy, the ability to produce clinical-grade protein drugs in leaves to treat infectious diseases and the long-term storage of protein drugs in dried leaves at ambient temperatures. Recent FDA approval of the first orally delivered protein drug encapsulated in plant cells to treat peanut allergy has opened the door for the development of affordable oral drugs that can be manufactured and distributed in remote areas without cold storage infrastructure and that eliminate the need for expensive purification steps and sterile delivery by injection.
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http://dx.doi.org/10.1111/pbi.13658DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486237PMC
October 2021

DUI: the drug use insights web server.

Bioinformatics 2021 Jun 23. Epub 2021 Jun 23.

Department of Computer Science, San Francisco State University, San Francisco, CA, USA.

Motivation: Substance abuse constitutes one of the major contemporary health epidemics. Recently, the use of social media platforms has garnered interest as a novel source of data for drug addiction epidemiology. Often however, the language used in such forums comprises slang and jargon. Currently, there are no publicly available resources to automatically analyse the esoteric language-use in the social media drug-use sub-culture. This lacunae introduces critical challenges for interpreting, sensemaking and modeling of addiction epidemiology using social media.

Results: Drug-Use Insights (DUI) is a public and open-source web application to address the aforementioned deficiency. DUI is underlined by a hierarchical taxonomy encompassing 108 different addiction related categories consisting of over 9,000 terms, where each category encompasses a set of semantically related terms. These categories and terms were established by utilizing thematic analysis in conjunction with term embeddings generated from 7,472,545 Reddit posts made by 1,402,017 redditors. Given post(s) from social media forums such as Reddit and Twitter, DUI can be used foremost to identify constituent terms related to drug use. Furthermore, the DUI categories and integrated visualization tools can be leveraged for semantic- and exploratory analysis. To the best of our knowledge, DUI utilizes the largest number of substance use and recovery social media posts used in a study and represents the first significant online taxonomy of drug abuse terminology.

Availability: The DUI web server and source code are available at: http://haddock9.sfsu.edu/insight/.

Supplementary Information: Supplementary data are available at Bioinformatics online.
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http://dx.doi.org/10.1093/bioinformatics/btab461DOI Listing
June 2021

Role of toll-like receptor 7/8 pathways in regulation of interferon response and inflammatory mediators during SARS-CoV2 infection and potential therapeutic options.

Biomed Pharmacother 2021 Sep 10;141:111794. Epub 2021 Jun 10.

Department of Chemistry and Centre of Advanced Studies in Chemistry, Panjab University, Chandigarh 160014, India; National Interdisciplinary Centre of Vaccine, Immunotherapeutics and Antimicrobials, Panjab University, Chandigarh, 160014, India. Electronic address:

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) is the causative agent of Corona Virus Disease 2019 (COVID-19). Lower production of type I and III interferons and higher levels of inflammatory mediators upon SARS-CoV2 infection contribute to COVID-19 pathogenesis. Optimal interferon production and controlled inflammation are essential to limit COVID-19 pathogenesis. However, the aggravated inflammatory response observed in COVID-19 patients causes severe damage to the host and frequently advances to acute respiratory distress syndrome (ARDS). Toll-like receptor 7 and 8 (TLR7/8) signaling pathways play a central role in regulating induction of interferons (IFNs) and inflammatory mediators in dendritic cells. Controlled inflammation is possible through regulation of TLR mediated response without influencing interferon production to reduce COVID-19 pathogenesis. This review focuses on inflammatory mediators that contribute to pathogenic effects and the role of TLR pathways in the induction of interferon and inflammatory mediators and their contribution to COVID-19 pathogenesis. We conclude that potential TLR7/8 agonists inducing antiviral interferon response and controlling inflammation are important therapeutic options to effectively eliminate SARS-CoV2 induced pathogenesis. Ongoing and future studies may provide additional evidence on their safety and efficacy to treat COVID-19 pathogenesis.
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http://dx.doi.org/10.1016/j.biopha.2021.111794DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8189763PMC
September 2021

A computational approach for rational discovery of inhibitors for non-structural protein 1 of SARS-CoV-2.

Comput Biol Med 2021 08 8;135:104555. Epub 2021 Jun 8.

Structural Bioinformatics Lab, CSIR-Institute of Himalayan Bioresource Technology (CSIR-IHBT), Palampur, HP, 176061, India; Biotechnology Division, CSIR-IHBT, Palampur, HP, 176061, India; Academy of Scientific & Innovative Research (AcSIR), Ghaziabad, 201002, India. Electronic address:

Background: Non-structural protein 1 (Nsp1), a virulence agent of SARS-CoV-2, has emerged as an important target for drug discovery. Nsp1 shuts down the host gene function by associating with the 40S ribosomal subunit.

Methods: Molecular interactions, drug-likeness, physiochemical property predictions, and robust molecular dynamics (MD) simulations were employed to discover novel Nsp1 inhibitors. In this study, we evaluated a series of molecules based on the plant (Cedrus deodara) derived α,β,γ-Himachalenes scaffolds.

Results: The results obtained from estimated affinity and ligand efficiency suggested that BCH10, BCH15, BCH16, and BCH17 could act as potential inhibitors of Nsp1. Moreover, MD simulations comprising various MD driven time-dependent analyses and thermodynamic free energy calculations also suggested stable protein-ligand complexes and strong interactions with the binding site. Furthermore, the selected molecules passed drug likeliness parameters and the physiochemical property analysis showed acceptable bioactivity scores.

Conclusion: The structural parameters of dynamic simulations revealed that the reported molecules could act as lead compounds against SARS-CoV-2 Nsp1 protein.
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http://dx.doi.org/10.1016/j.compbiomed.2021.104555DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184359PMC
August 2021

Bioactive Molecules of Tea as Potential Inhibitors for RNA-Dependent RNA Polymerase of SARS-CoV-2.

Front Med (Lausanne) 2021 31;8:684020. Epub 2021 May 31.

Biotechnology Division, CSIR-IHBT, Palampur, India.

The coronavirus disease (COVID-19), a worldwide pandemic, is caused by the severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2). At this moment in time, there are no specific therapeutics available to combat COVID-19. Drug repurposing and identification of naturally available bioactive molecules to target SARS-CoV-2 are among the key strategies to tackle the notorious virus. The enzyme RNA-dependent RNA polymerase (RdRp) performs a pivotal role in replicating the virus. RdRp is a prime target for Remdesivir and other nucleotides analog-based antiviral drugs. In this study, we showed three bioactive molecules from tea (epicatechin-3,5-di-O-gallate, epigallocatechin-3,5-di-O-gallate, and epigallocatechin-3,4-di-O-gallate) that showed better interaction with critical residues present at the catalytic center and the NTP entry channel of RdRp than antiviral drugs Remdesivir and Favipiravir. Our computational approach to identify these molecules included molecular docking studies, followed by robust molecular dynamics simulations. All the three molecules are readily available in tea and could be made accessible along with other medications to treat COVID-19 patients. However, these results require validation by further and studies.
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http://dx.doi.org/10.3389/fmed.2021.684020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8200525PMC
May 2021

Promising traditional Indian medicinal plants for the management of novel Coronavirus disease: A systematic review.

Phytother Res 2021 Aug 16;35(8):4456-4484. Epub 2021 Jun 16.

Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Traditional Indian medical practices (Ayurveda, Siddha, Unani, and homeopathy) are a vast reservoir of knowledge about medicinal plants. The promising pharmacological properties of these plants have paved the way for developing therapy against novel Coronavirus (CoV) infection. The current review will summarize published works of literature on the effects of traditional Indian medicinal plants against acute respiratory infection (COVID-19, SARS, Influenza, and Respiratory syncytial virus infection) and registered clinical trials of traditional Indian herbal medicines in COVID-19. The current study aims to comprehensively evaluate the data of traditional Indian medicinal plants to warrant their use in COVID-19 management. PubMed, Embase, and Cochrane databases were searched along with different clinical trial databases. A total of 22 relevant traditional Indian medicinal plants (35 relevant studies) were included in the current study having potential antiviral properties against virus-induced respiratory illness along with promising immunomodulatory and thrombolytic properties. Further, 36 randomized and nonrandomized registered clinical trials were also included that were aimed at evaluating the efficacy of herbal plants or their formulations in COVID-19 management. The antiviral, immunomodulatory, and thrombolytic activities of the traditional Indian medicinal plants laid down a strong rationale for their use in developing therapies against SARS-CoV-2 infection. The study identified some important potential traditional Indian medicinal herbs such as Ocimum tenuiflorum, Tinospora cordifolia, Achyranthes bidentata, Cinnamomum cassia, Cydonia oblonga, Embelin ribes, Justicia adhatoda, Momordica charantia, Withania somnifera, Zingiber officinale, Camphor, and Kabusura kudineer, which could be used in therapeutic strategies against SARS-CoV-2 infection.
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http://dx.doi.org/10.1002/ptr.7150DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8441711PMC
August 2021
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