Opinion and Beliefs of Physicians about Integrating Families into the Care System of Preterm Hospitalized Neonates- A Qualitative Experience.

OBJECTIVES: To explore the opinions and beliefs of physicians about integrating families into the care system of hospitalized preterm neonates. METHODS: The setting was Neonatal Intensive Care Unit (NICU) of a tertiary care center in North India. Focus group discussions (FGDs) were conducted with the physicians using a pre-validated FGD topic guide. The FGDs were audio-recorded and transcribed. The meanings were drawn, and dependability was ensured. Themes and sub-themes were generated and finalized with a common consensus. RESULTS: Five FGDs were conducted involving 28 physicians. The physicians opined that making families a part of the care system has several benefits, though they brought out some concerns. They opined that involving parents gives them confidence and satisfaction as they get empowered about neonatal care at the hospital and home after discharge. They reported difficulties in communication due to perceived inadequacy in counseling skills, language barriers and literacy levels of families, and lack of adequate time due to clinical overload. They identified nurses and public health nurses as an important bridge between physicians and families, and peer support as a useful facilitator. They suggested that role assignments to team members, training in counseling and communication, improving the comfort of parents and organizing information in easy-to-understand audio- visual content can help improve the family integration. CONCLUSIONS: The physicians highlighted practical barriers, facilitators, and remedial measures to effectively integrate the families into the care system of preterm hospitalized neonates. There is a need to address the concerns of all stakeholders including the physicians for successful implementation of family integration.

Phytochemical rich Himalayan Rhododendron arboreum petals inhibit SARS-CoV-2 infection in vitro.

Phytochemicals with potential to competitively bind to the host receptors or inhibit SARS-CoV-2 replication, may prove to be useful as adjunct therapeutics for COVID-19. We profiled and investigated the phytochemicals of Rhododendron arboreum petals sourced from Himalayan flora, undertook in vitro studies and found it as a promising candidate against SARS-CoV-2. The phytochemicals were reported in various scientific investigations to act against a range of virus in vitro and in vivo, which prompted us to test against SARS-CoV-2. In vitro assays of R. arboreum petals hot aqueous extract confirmed dose dependent reduction in SARS-CoV-2 viral load in infected Vero E6 cells (80% inhibition at 1 mg/ml; IC50 = 173 µg/ml) and phytochemicals profiled were subjected to molecular docking studies against SARS CoV-2 target proteins. The molecules 5-O-Feruloyl-quinic acid, 3-Caffeoyl-quinic acid, 5-O-Coumaroyl-D-quinic acid, Epicatechin and Catechin showed promising binding affinity with SARS-CoV-2 Main protease (MPro; PDB ID: 6LU7; responsible for viral replication) and Human Angiotensin Converting Enzyme-2 (ACE2; PDB ID: 1R4L; mediate viral entry in the host). Molecular dynamics (MD) simulation of 5-O-Feruloyl-quinic acid, an abundant molecule in the extract complexed with the target proteins showed stable interactions. Taken together, the phytochemical profiling, in silico analysis and in vitro anti-viral assay revealed that the petals extract act upon MPro and may be inhibiting SARS-CoV-2 replication. This is the first report highlighting R. arboreum petals as a reservoir of antiviral phytochemicals with potential anti-SARS-CoV-2 activity using an in vitro system.