Neurological manifestations of SARS-CoV-2: complexity, mechanism and associated disorders.

BACKGROUND: Coronaviruses such as Severe Acute Respiratory Syndrome coronavirus (SARS), Middle Eastern Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) are associated with critical illnesses, including severe respiratory disorders. SARS-CoV-2 is the causative agent of the deadly COVID-19 illness, which has spread globally as a pandemic. SARS-CoV-2 may enter the human body through olfactory lobes and interact with the angiotensin-converting enzyme2 (ACE2) receptor, further facilitating cell binding and entry into the cells. Reports have shown that the virus can pass through the blood-brain barrier (BBB) and enter the central nervous system (CNS), resulting in various disorders. Cell entry by SARS-CoV-2 largely relies on TMPRSS2 and cathepsin L, which activate S protein. TMPRSS2 is found on the cell surface of respiratory, gastrointestinal and urogenital epithelium, while cathepsin-L is a part of endosomes. AIM: The current review aims to provide information on how SARS-CoV-2 infection affects brain function.. Furthermore, CNS disorders associated with SARS-CoV-2 infection, including ischemic stroke, cerebral venous thrombosis, Guillain-Barré syndrome, multiple sclerosis, meningitis, and encephalitis, are discussed. The many probable mechanisms and paths involved in developing cerebrovascular problems in COVID patients are thoroughly detailed. MAIN BODY: There have been reports that the SARS-CoV-2 virus can cross the blood-brain barrier (BBB) and enter the central nervous system (CNS), where it could cause a various illnesses. Patients suffering from COVID-19 experience a range of neurological complications, including sleep disorders, viral encephalitis, headaches, dysgeusia, and cognitive impairment. The presence of SARS-CoV-2 in the cerebrospinal fluid (CSF) of COVID-19 patients has been reported. Health experts also reported its presence in cortical neurons and human brain organoids. The possible mechanism of virus infiltration into the brain can be neurotropic, direct infiltration and cytokine storm-based pathways. The olfactory lobes could also be the primary pathway for the entrance of SARS-CoV-2 into the brain. CONCLUSIONS: SARS-CoV-2 can lead to neurological complications, such as cerebrovascular manifestations, motor movement complications, and cognitive decline. COVID-19 infection can result in cerebrovascular symptoms and diseases, such as strokes and thrombosis. The virus can affect the neural system, disrupt cognitive function and cause neurological disorders. To combat the epidemic, it is crucial to repurpose drugs currently in use quickly and develop novel therapeutics.

Effect of Celiac Plexus Neurolysis for Pain Relief in Patients with Upper Abdominal Malignancy: A Retrospective Observational Study and Review of Literature.

BACKGROUND: Abdominal pain from primary cancer or metastatic disease is a significant cause of pain for patients undergoing treatment for the disease. Patient's pain may be resistant or non-responsive to the pharmacological management, hence minimal invasive pain intervention like celiac plexus neurolysis or splanchnic nerve rhizolysis may be required to relieve pain of such patients. OBJECTIVE: The aim of this retrospective study is to assess the effect of celiac plexus neurolysis for pain relief in patients with upper gastro-intestinal malignancies. STUDY DESIGN: This is a retrospective, observational study with short review. METHODS: This retrospective observational study was done in the Pain Medicine unit from 2016 and November 2018. Ninety-four patients with upper abdominal malignancy and unrelenting pain, non-responsive or poorly responsive to pharmacological treatment as per WHO ladder of analgesics, received fluoroscopy-guided celiac plexus neurolysis (CPN). All the patients underwent celiac plexus neurolysis through Trans-Aortic approach and the primary outcome measure was pain as assessed with Visual Analogue Scale (VAS) ranging from 0 to 10; the secondary outcome measures were morphine consumption per day (M), quality of life (QOL) as assessed by comparing the percent of positive responses and complications, if any. These were noted and analyzed prior to intervention and then on day 1, and months 1, 2, 3, 4, 5, 6 following CPN. RESULTS: Follow up was completed 6 months after the procedure. VAS score, daily morphine consumption, and the quality of life showed improvement for the duration of the study. There was some relapse in pain and deterioration in QOL during the fourth to sixth month of pain intervention due to disease progression. Some transient known side effects also occurred. CONCLUSION: Trans-Aortic celiac plexus neurolysis with low volume of alcohol is a safe procedure providing up to 6 months of pain relief and is an effective, well established, minimally invasive procedure for abdominal pain due to primary malignancy or metastatic spread.

Topical Nano-emulgel for Skin Disorders: Formulation Approach and Characterization.

BACKGROUNDS: Acne vulgaris is a common chronic skin disease that affects around 9.4% (approx. 650 million people) of the global population. Growing research in the field of nanomedicine over the years has now been exploited in management of various human disorders. The nanomedicine concept has an immense opportunity for the effective management and control of acne disease by designing a novel, low-dose topical delivery system. Topical nanoemulsion-based gel preparations are said to have various benefits over the conventional formulations. The recent patents on topical anti-acne formulation (US 7241456B2; US 6897238B2; US 6284234B1) provided the concept to design thymol loaded nano-emulgel for topical application in acne. METHODS: The objective of the current investigation was to design a thymol loaded nanoemulgel preparation by exploiting low-energy emulsification method for topical application in acne. Furthermore, developed formulation was characterized for thermodynamic stability, mean droplet size, zeta potential, drug content and in-vitro drug diffusion study. RESULTS: The optimized thymol loaded nanoemulsion was found to be 13.60±0.117 nm with PdI 0.197±0.008. Nanoemulsions will provide an enormous surface area for better penetration of therapeutic agent into the pilosebaceous region, resulting better efficacy. CONCLUSIONS: From the above studies, it concluded that aqueous-based gel vehicle of the developed formulation system exploited for topical delivery has moisturising properties which can improve local tolerability also.

Effect of modified atmospheric packaging on the shelf life of Kalakand and its influence on microbial, textural, sensory and physico-chemical properties.

Kalakand, a popular traditional milk sweet of Indian sub-continent, was packaged under air and modified atmospheric packaging (MAP) conditions (98 % N2, 98 % CO2 and 50 % N2: 50 % CO2). The samples were stored at 10, 25 and 37 °C and evaluated for various physico-chemical, microbial, textural and sensory changes, in order to establish the applicability of MAP for storage of Kalakand. It could be established that the MAP conditions of 50 % N2: 50 % CO2and storage at 10 °C, were the most suitable conditions for preserving the Kalakand for upto 60 days.

Optimization of a process for high fibre and high protein biscuit.

Biscuits are popular and convenient food products due to their ready to eat nature. Biscuits were prepared from sorghum and whole wheat flour with the addition of spirulina (Spirulina platensis) powder to produce high fibre and high protein biscuit. Levels of ingredients in biscuits such as spirulina powder, sorghum flour and guar gum were optimized using response surface methodology (RSM) for its sensory, textural and antioxidant attributes. Sensory attributes as colour intensity (R2 = 0.89, P < 0.0001), flavor (R2 = 0.98, P < 0.0001), sweetness (R2 = 0.97, P < 0.0001), graininess (R2 = 0.99, P < 0.0001), and crispiness (R2 = 0.94, P < 0.0001), textural attributes as hardness (R2 = 0.95, P < 0.0001) and fracturability (R2 = 0.96, P < 0.0001), antioxidant activity as DPPH inhibition (R2 = 0.87, P < 0.0001) and antioxidant activity as ABTS inhibition (R2 = 0.98, P < 0.0001) were significantly related to processing parameters of biscuit. Rheological characteristics (TPA and extensograph) of biscuit dough were measured. Studies indicated that amongst all the processing parameters, the composition of spirulina powder and sorghum flour was found to have significant effect on the responses.

Effect of modified atmospheric packaging on chemical and microbial changes in dietetic rabri during storage.

Rabri is a dairy based sweet popular in the Indian subcontinent. The high sugar and fat content impose restrictions on its consumption due to health reasons. Dietetic rabri was prepared by the replacement of sugar with aspartame. Inulin was added to partially replace the milk fat and to improve the consistency of rabri. The rabri samples were packed in the polyethylene bags filled with different gaseous compositions (Air, 50 % CO2:50 % N2 and 100 % N2) and stored at 10 °C. The shelf life was evaluated on the basis of changes in the chemical quality parameters such as HMF, TBA and FFA and microbial content such as total plate count, yeast and molds and coliform counts. The chemical parameters and microbial spoilage increased in all the samples with the progression of storage period. The samples packed with air showed significantly higher chemical deterioration and microbial spoilage as compared to the other two combinations. The samples packed with 100 % N2 were more shelf stable than with air and 50 % CO2:50 % N2 combinations.

Effect of modified atmosphere packaging on the shelf life of lal peda.

Lal peda is a traditional dairy-based sweet, popular in the Indian subcontinent, but it has a poor shelf life. The lal peda samples were packed in polyethylene bags filled with 3 different gaseous compositions (Air, 70 % N2: 30 % CO2 and 98 % N2) and stored at 10 °C. The shelf life was evaluated on the basis of changes in the microbial status of the product such as total plate count, yeast and molds and coliform counts and also the physico-chemical changes such as hydroxy methyl furfural (HMF), thiobarbituric acid (TBA) and free fatty acid (FFA). The microbial spoilage and the indices of chemical changes increased in all the samples with the progression of storage period. The samples packed with air showed significantly higher chemical deterioration and microbial spoilage as compared to the other two combinations. The results showed that samples packed with 70 % N2: 30 % CO2 combination had better shelf stability as compared to the samples packed under air and 98 % N2.

Detection and quantification of soymilk in cow-buffalo milk using Attenuated Total Reflectance Fourier Transform Infrared spectroscopy (ATR-FTIR).

Milk consumption is steadily increasing, especially in India and China, due to rising income. To bridge the gap between supply and demand, unscrupulous milk vendors add milk-like products from vegetable sources (soymilk) to milk without declaration. A rapid detection technique is required to enforce the safety norms of food regulatory authorities. Fourier Transform Infrared (FTIR) spectroscopy has demonstrated potential as a rapid quality monitoring method and was therefore explored for detection of soymilk in milk. In the present work, spectra of milk, soymilk (SM), and milk adulterated with known quantity of SM were acquired in the wave number range of 4000-500cm(-1) using Attenuated Total Reflectance (ATR)-FTIR. The acquired spectra revealed differences amongst milk, SM and adulterated milk (AM) samples in the wave number range of 1680-1058cm(-1). This region encompasses the absorption frequency of amide-I, amide-II, amide-III, beta-sheet protein, α-tocopherol and Soybean Kunitz Trypsin Inhibitor. Principal component analysis (PCA) showed clustering of samples based on SM concentration at 5% level of significance and thus SM could be detected in milk using ATR-FTIR. The SM was best predicted in the range of 1472-1241cm(-1) using multiple linear regression with coefficient of determination (R(2)) of 0.99 and 0.92 for calibration and validation, respectively.