Pneumococcal vaccine uptake in patients with inflammatory arthritis: a single centre cohort study.

INTRODUCTION: Current guidelines recommend pneumococcal vaccination in individuals who are over the age of 65 or are immunosuppressed due to a disease or treatment. The objective of this study was to assess vaccine uptake rates in people with inflammatory arthritis for the pneumococcal, influenza and Covid-19 vaccines and factors determining uptake. METHODS: We conducted a retrospective single centre cohort study in the UK of individuals with rheumatoid arthritis, psoriatic arthritis and axial spondylarthritis between October and December 2023. Data were collected for age, gender, co-morbidities, immunosuppressive therapies, and dates of vaccines. Logistic regression was used to evaluate predictors of vaccine uptake, with adjustments for demographic and clinical factors. RESULTS: 906 individuals were identified. 46% were receiving treatment with csDMARD, 26% on biologic monotherapy, and 23% were on both biologic and csDMARDs. 316 individuals (35%) received a pneumococcal vaccine, lower than uptake for influenza (63%) and Covid-19 (87%) vaccines. Predictors of pneumococcal vaccine uptake included age, with older patients more likely to be vaccinated (odds ratio [OR] for age ≥ 65 years: 1.67, 95% CI 1.21-2.29). Those on biological therapy demonstrated higher likelihood of vaccination (OR for biologic therapy: 1.81, 95% CI 1.33-2.47). Additional Joint committee for immunisation and vaccination (JCVI) Green Book indicators also positively influenced vaccine uptake (OR: 1.67, 95% CI 1.19-2.33). CONCLUSION: Pneumococcal vaccine uptake in inflammatory rheumatic diseases is low, especially in younger patients and those not on biological therapy. The study highlights the need for a focused approach, distinct from strategies for other vaccines, to address this public health challenge.

Enhancing Water Purification by Integrating Titanium Dioxide Nanotubes into Polyethersulfone Membranes for Improved Hydrophilicity and Anti-Fouling Performance.

Water pollution remains a critical concern, one necessitated by rapidly increasing industrialization and urbanization. Among the various strategies for water purification, membrane technology stands out, with polyethersulfone (PES) often being the material of choice due to its robust mechanical properties, thermal stability, and chemical resistance. However, PES-based membranes tend to exhibit low hydrophilicity, leading to reduced flux and poor anti-fouling performance. This study addresses these limitations by incorporating titanium dioxide nanotubes (TiO2NTs) into PES nanofiltration membranes to enhance their hydrophilic properties. The TiO2NTs, characterized through FTIR, XRD, BET, and SEM, were embedded in PES at varying concentrations using a non-solvent induced phase inversion (NIPS) method. The fabricated mixed matrix membranes (MMMs) were subjected to testing for water permeability and solute rejection capabilities. Remarkably, membranes with a 1 wt% TiO2NT loading displayed a significant increase in pure water flux, from 36 to 72 L m2 h-1 bar-1, a 300-fold increase in selectivity compared to the pristine sample, and a dye rejection of 99%. Furthermore, long-term stability tests showed only a slight reduction in permeate flux over a time of 36 h, while dye removal efficiency was maintained, thus confirming the membrane's stability. Anti-fouling tests revealed a 93% flux recovery ratio, indicating excellent resistance to fouling. These results suggest that the inclusion of TiO2 NTs offers a promising avenue for the development of efficient and stable anti-fouling PES-based membranes for water purification.

The Role of Teleconsultations in Remote Oral Radiology Interpretation.

Background: Teleconsultations have gained prominence as a viable method for delivering medical services remotely. In oral radiology, the ability to interpret radiographic images accurately is crucial for diagnosing and treating various dental conditions. The use of teleconsultations in this domain holds promise for extending specialized care to patients who are geographically distant from dental healthcare facilities. Materials and Methods: A total of 50 patients' oral radiographic images were collected for analysis in this study. These images were obtained from diverse geographical locations, showcasing the applicability of teleconsultations. Two groups of dental professionals, one conducting in-person evaluations and the other performing remote interpretations through teleconsultations, participated in the study. The radiographic findings were assessed for concurrence between the two groups. Statistical analysis included the calculation of P values to determine the level of agreement between the in-person and teleconsultation interpretations. Results: The results of this study revealed a substantial level of agreement between in-person and teleconsultation interpretations of oral radiographic images. The calculated P values indicated a statistically significant concordance between the two evaluation methods (P < .05). This suggests that teleconsultations can be a reliable approach for oral radiology interpretation, offering comparable results to traditional in-person evaluations. Conclusion: In conclusion, teleconsultations have demonstrated their potential as an effective means of interpreting oral radiographic images remotely.

Explorative laparotomy of cecal volvulus in a pediatric patient. A case report and review of literature.

INTRODUCTION AND IMPORTANCE: Cecal volvulus is a rare intestinal pathology that occurs due to abnormal cecum mobility associated with spectrum of complications. It is usually manifested in adults. However, on extremely rare occasions, it occurs in pediatrics. We presented a case of cecal volvulus demonstrating the significance of early diagnosis and treatment to reach successful outcomes. CASE PRESENTATION: A 12 year old boy who presented to the emergency department for clinical evaluation for acute abdomen. History and clinical examination was suggestive of acute bowel obstruction. Abdominal x-ray showed a large, distended gas filled viscus with base pointed towards the right lower quadrant. On the bases of radiological investigations, diagnosis of cecal volvolus made. Accordingly, the patient underwent emergency exploratory laparotomy. The post operative course was uneventful and was discharged in stable condition. CLINICAL DISCUSSION: Cecal volvulus is an extremely rare manifestation of intestinal obstruction and malrotation. The clinical presentation of cecal volvulus depending on the duration and extent of the involvement of cecal malrotation The exact pathogenesis of cecal volvulus is unclear. However the association of the embryological development of the colon, affects the attachment to the posterior parietal peritoneum after ordinary anatomical rotation of 270°. The core-stone management of cecal volvulus is surgical approach. CONCLUSION: Cecal volvulus requires a high index of suspicion and delicate care by the pediatric surgeon as it is considered an extremely rare entity in this age group. We highlighted the significance of early diagnosis, surgical treatment and the possibility of developing postoperative complications if left untreated.

Multivessel Coronary Artery Disease Presenting as a False-Negative Nuclear Stress Test: A Case of Balanced Ischemia.

Myocardial perfusion imaging (MPI) is fundamental to comparing coronary vessel perfusion levels and guides in identifying ischemic areas. However, false negatives, such as balanced ischemia, are important considerations in interpreting these results. In this case report, we describe a 77-year-old female who presented with cardiac chest pain with normal laboratory results, electrocardiogram, and imaging. However, given her history and risk factors, left heart catheterization was performed, which showed triple vessel coronary artery disease.

Evaluating the Impact of Teledentistry on Patient Outcomes, Diagnostic Accuracy, and Satisfaction in a Prospective Observational Analysis.

Background Teledentistry, defined as the use of telecommunication technologies for dental care, has emerged as a transformative approach to oral health services. This prospective observational analysis aims to comprehensively assess the impact of teledentistry on patient outcomes and satisfaction, addressing key aspects such as diagnostic accuracy, longitudinal treatment outcomes, and economic and logistical considerations. Methods The study involved 242 participants selected from diverse dental clinics offering teledentistry services. Participants could choose between traditional in-person visits and teledentistry consultations. The teledentistry interventions included remote consultations, diagnostic evaluations, and treatment planning facilitated through virtual communication tools. Baseline assessments captured initial dental conditions, and follow-up assessments were conducted at three, six, and 12 months. Outcome measures included diagnostic accuracy, patient satisfaction, changes in dental conditions over time, and economic and logistical feedback. Results Descriptive statistics revealed baseline characteristics, with participants evenly distributed between in-person and teledentistry groups. However, the overall satisfaction with diagnoses was significantly lower in the teledentistry group as compared to the in-person group (p < 0.001). Longitudinal assessments demonstrated comparable changes in dental conditions between the two groups. Economic feedback highlighted a cost-saving advantage for teledentistry users, with 80% reporting reduced expenses. Conclusion This study highlights the transformative potential of teledentistry in expanding access to oral health services, reducing costs, and providing comparable treatment outcomes to traditional in-person care. Future efforts should focus on enhancing the teledentistry experience, addressing patient satisfaction concerns, and refining the delivery of remote dental care to maximize its benefits for both patients and healthcare systems.

An experimental census of retrons for DNA production and genome editing.

Retrons are bacterial immune systems that use reverse transcribed DNA as a detector of phage infection. They are also increasingly deployed as a component of biotechnology. For genome editing, for instance, retrons are modified so that the reverse transcribed DNA (RT-DNA) encodes an editing donor. Retrons are commonly found in bacterial genomes; thousands of unique retrons have now been predicted bioinformatically. However, only a small number have been characterized experimentally. Here, we add substantially to the corpus of experimentally studied retrons. We synthesized >100 previously untested retrons to identify the natural sequence of RT-DNA they produce, quantify their RT-DNA production, and test the relative efficacy of editing using retron-derived donors to edit bacterial genomes, phage genomes, and human genomes. We add 62 new empirically determined, natural RT-DNAs, which are not predictable from the retron sequence alone. We report a large diversity in RT-DNA production and editing rates across retrons, finding that top performing editors outperform those used in previous studies, and are drawn from a subset of the retron phylogeny.

Evaluation of the efficacy of hydro-alcoholic extract of Evolvulus alsinoides L. for the treatment of primary hypertension - A randomized controlled trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Evolvulus alsinoides L. (Sankhaholi) has been traditionally used in Unani (Greco-Arabic) medicine to treat diverse cardiovascular disorders. Notably, preclinical and clinical investigations have substantiated its remarkable potential as an antihypertensive agent. AIM OF THE STUDY: The aim of this study was to compare the efficacy of hydroalcoholic extract of Evolvulus alsinoides L. and ramipril in treating hypertension using a higher dose of the test drug within the recommended limit. MATERIALS AND METHODS: In this open-label randomized controlled trial, 57 participants (29 in the test group, 28 in the control group) completed the 42-day study. The test group received 630 mg of dried hydro-alcoholic extract of Evolvulus alsinoides L. in capsule form orally once daily, while the control group received 5 mg of Ramipril orally once daily. Participants in both groups were advised to adhere to the Dietary Approaches to Stop Hypertension (DASH) eating plan in terms of diet and lifestyle adjustments recommended by JNC-8. The primary outcome measures were changes in systolic and diastolic blood pressure as well as changes in plasma levels of hsCRP and IL6. Secondary outcome measures included changes in symptoms such as palpitations, giddiness, headaches, fatigue and shortness of breath. Headaches, palpitations, and giddiness were assessed using a customized Visual Analog Scale (VAS) graded as "none," "mild," "moderate," and "severe". Fatigue was assessed on a binary scale as either absent or present, and dyspnea was assessed using the modified Medical Research Council (mMRC) scale for breathlessness. Both primary and secondary outcomes were assessed at baseline and each follow-up visit (2nd week, 4th week, and 6th week) until the completion of the trial. RESULTS: At the end of the trial, the mean differences for the primary outcomes were as follows:SBP:-1.8895%CI:-4.82,1.05,p=0.203,d=0.33, DBP: -2.8395%CI:-4.67,-0.10,p=0.003,d=0.8, hsCRP: -1.4095%CI:-2.80,-0.003,p=0.49,d=0.53, and IL6: -88.6795%CI:-148.90,-28.43,p=0.005,d=0.78. No statistically significant differences were observed between the two groups for any of the secondary outcomes. CONCLUSIONS: Based on the preliminary results, it can be inferred that the hydro-alcoholic extract of Evolvulus alsinoides L. exhibits significant antihypertensive potential, comparable to that of ramipril. Furthermore, it appears that Evolvulus alsinoides L. may be more effective than ramipril in reducing the biochemical markers of inflammation associated with primary hypertension. However, additional research is required to validate these findings.

Proprotein convertase subtilisn/kexin type 9 inhibitors and small interfering RNA therapy for cardiovascular risk reduction: A systematic review and meta-analysis.

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality worldwide. Atherosclerosis occurs due to accumulation of low-density lipoprotein cholesterol (LDL-c) in the arterial system. Thus, lipid lowering therapy is essential for both primary and secondary prevention. Proprotein convertase subtilisn/kexin type 9 (PCSK9) inhibitors (Evolocumab, Alirocumab) and small interfering RNA (siRNA) therapy (Inclisiran) have been demonstrated to lower LDL-c and ASCVD events in conjunction with maximally tolerated statin therapy. However, the degree of LDL-c reduction and the impact on reducing major adverse cardiac events, including their impact on mortality, remains unclear. OBJECTIVE: The purpose of this study is to examine the effects of PCSK9 inhibitors and small interfering RNA (siRNA) therapy on LDL-c reduction and major adverse cardiac events (MACE) and mortality by conducting a meta-analysis of randomized controlled trials. METHODS: Using Pubmed, Embase, Cochrane Library and clinicaltrials.gov until April 2023, we extracted randomized controlled trials (RCTs) of PCSK9 inhibitors (Evolocumab, Alirocumab) and siRNA therapy (Inclisiran) for lipid lowering and risk of MACE. Using random-effects models, we pooled the relative risks and 95% CIs and weighted least-squares mean difference in LDL-c levels. We estimated odds ratios with 95% CIs among MACE subtypes and all-cause mortality. Fixed-effect model was used, and heterogeneity was assessed using the I2 statistic. RESULTS: In all, 54 studies with 87,669 participants (142,262 person-years) met criteria for inclusion. LDL-c percent change was reported in 47 studies (n = 62,634) evaluating two PCSK9 inhibitors and siRNA therapy. Of those, 21 studies (n = 41,361) included treatment with Evolocumab (140mg), 22 (n = 11,751) included Alirocumab (75mg), and 4 studies (n = 9,522) included Inclisiran (284mg and 300mg). Compared with placebo, after a median of 24 weeks (IQR 12-52), Evolocumab reduced LDL-c by -61.09% (95% CI: -64.81, -57.38, p<0.01) and Alirocumab reduced LDL-c by -46.35% (95% CI: -51.75, -41.13, p<0.01). Inclisiran 284mg reduced LDL-c by -54.83% (95% CI: -59.04, -50.62, p = 0.05) and Inclisiran 300mg reduced LDL-c by -43.11% (95% CI: -52.42, -33.80, p = 0.01). After a median of 8 months (IQR 6-15), Evolocumab reduced the risk of myocardial infarction (MI), OR 0.72 (95% CI: 0.64, 0.81, p<0.01), coronary revascularization, 0.77 (95% CI: 0.70, 0.84, p<0.01), stroke, 0.79 (95% CI: 0.66, 0.94, p = 0.01) and overall MACE 0.85 (95% CI: 0.80, 0.89, p<0.01). Alirocumab reduced MI, 0.57 (0.38, 0.86, p = 0.01), cardiovascular mortality 0.35 (95% CI: 0.16, 0.77, p = 0.01), all-cause mortality 0.60 (95% CI: 0.43, 0.84, p<0.01), and overall MACE 0.35 (0.16, 0.77, p = 0.01). CONCLUSION: PCSK9 inhibitors (Evolocumab, Alirocumab) and siRNA therapy (Inclisiran) significantly reduced LDL-c by >40% in high-risk individuals. Additionally, both Alirocumab and Evolocumab reduced the risk of MACE, and Alirocumab reduced cardiovascular and all-cause mortality.

Tomato maturity recognition with convolutional transformers.

Tomatoes are a major crop worldwide, and accurately classifying their maturity is important for many agricultural applications, such as harvesting, grading, and quality control. In this paper, the authors propose a novel method for tomato maturity classification using a convolutional transformer. The convolutional transformer is a hybrid architecture that combines the strengths of convolutional neural networks (CNNs) and transformers. Additionally, this study introduces a new tomato dataset named KUTomaData, explicitly designed to train deep-learning models for tomato segmentation and classification. KUTomaData is a compilation of images sourced from a greenhouse in the UAE, with approximately 700 images available for training and testing. The dataset is prepared under various lighting conditions and viewing perspectives and employs different mobile camera sensors, distinguishing it from existing datasets. The contributions of this paper are threefold: firstly, the authors propose a novel method for tomato maturity classification using a modular convolutional transformer. Secondly, the authors introduce a new tomato image dataset that contains images of tomatoes at different maturity levels. Lastly, the authors show that the convolutional transformer outperforms state-of-the-art methods for tomato maturity classification. The effectiveness of the proposed framework in handling cluttered and occluded tomato instances was evaluated using two additional public datasets, Laboro Tomato and Rob2Pheno Annotated Tomato, as benchmarks. The evaluation results across these three datasets demonstrate the exceptional performance of our proposed framework, surpassing the state-of-the-art by 58.14%, 65.42%, and 66.39% in terms of mean average precision scores for KUTomaData, Laboro Tomato, and Rob2Pheno Annotated Tomato, respectively. This work can potentially improve the efficiency and accuracy of tomato harvesting, grading, and quality control processes.

Enhancing CO2 separation from N2 mixtures using hydrophobic porous supports immobilized with tributyl-tetradecyl-phosphonium chloride [P44414][Cl].

The main obstacles in adopting solvent-based CO2 capture technology from power plant flue gases at the industrial scale are the energy requirements for solvent regeneration and their toxicity. These challenges can be overcome using new green and more stable ionic liquids (ILs) as solvents for post-combustion CO2 capture. In the current study, tributyl-tetradecyl-phosphonium chloride [P44414][Cl] as an IL, was immobilized on hydrophobic porous supports of polypropylene (PP), polyvinylidene fluoride (PVDF), and polytetrafluoroethylene (PTFE) at 298 ± 3 K and pressures up to 2 bar. The surface morphology indicated homogenous immobilization of the IL on the membrane support. Supported ionic liquid membranes (SILMs) were tested for CO2 permeability and CO2/N2 selectivity. None of the SILMs exhibited IL leaching up to 2 bar. The PTFE-based SILM performed better than other supports with minimum loss in water contact angle (WCA) and achieved good antiwetting with a maximum CO2 permeability and selectivity over N2 of 2300 ± 139 Barrer and 31.60 ± 2.4, respectively. This work achieves CO2 permeability about two-fold more than other works having CO2/N2 selectivity range of 25-35 in similar SILMs. The diffusivity of CO2 and N2 in [P44414][Cl] was measured as 3.64 ± 0.18 and 2.01 ± 0.09 [10-8 cm2 s-1] and CO2 and N2 solubility values were 9.79 ± 0.47 and 0.19 ± 0.001 [10-2 cm3(STP) cm-3 cmHg-1], respectively. The high values of Young's modulus and tensile strength of the PTFE support-based SILM (234 ± 12 MPa and 6.07 ± 0.31 MPa, respectively) indicated the long-term application of SILM in flue gas separation. The results indicated phosphonium chloride-based ILs could be better solvent candidates for CO2 removal from large volumes of flue gases than amine-based ILs.

A Comparative Evaluation of the Effect of Different Beverages on Colour Stability and Surface Micromorphology of Nanocomposite Restorative Material.

AIM: This investigation was carried out to evaluate the color stability of a nanocomposite restorative material and the erosive potential of carbonated soft drinks (Coca-Cola; The Coca-Cola Company, Atlanta, Georgia, United States) and packaged orange juice (Real Fruit Power Orange; Dabur Ltd, Ghaziabad, Uttar Pradesh, India) on its surface micromorphology. MATERIALS AND METHODS: Sixty discs (2mm thick and 10mm diameter) of nanocomposite material (Herculite Précis; KaVo Kerr, Brea, California, United States) were prepared using a silicon cylindrical mold. Initially, all the specimens were stored in artificial saliva in five Petri dishes; 12 specimens in each dish. In the Petri dishes, the specimens were immersed in the respective beverages once or twice a day. Before and after each immersion, the specimens were stored in artificial saliva at room temperature. Artificial saliva was changed each day, i.e., every 24 hours. The whole procedure was carried out for three months and then evaluated for color stability using a spectrophotometer and surface micromorphology using a scanning electron microscope. Now, the exposure of specimens to aerated drinks (Coca-Cola) and packaged orange juice (Real Orange) was put to a halt, and specimens were kept continuously in artificial saliva. This procedure was carried out for one month and then evaluated for color stability. The information was analyzed using PASW Statistics for Windows, Version 18.0 (Released 2009; SPSS Inc., Chicago, United States). A p-value of 0.05 was considered significant. RESULTS: The p-value after three months, which is < 0.001 (p<0.05) indicates that the mean color difference values for groups I, II, III, IV, and V show a statistically significant change between the five groups, and similarly, the p-value after one month, which is < 0.001 (p<0.05) indicates that the mean color difference values for groups I, II, III, IV, and V show a statistically significant change between the five groups. Specimens immersed in the carbonated drink twice a day showed clinically more color change than packaged orange juice and artificial saliva on the composite restorative material. Coca-Cola, an aerated drink, was shown to have a higher erosive potential on the composite restorative material than Real Fruit Power Orange and fake saliva. CONCLUSION: The findings are consistent with the hypothesis that repeated exposure to carbonated beverages (such as Coca-Cola and packaged juice) degrades the surface qualities of dental restorations.

Novel biogenic silver nanoconjugates of Abrus precatorius seed extracts and their antiproliferative and antiangiogenic efficacies.

Biogenic silver nanoconjugates (AgNCs), derived from medicinal plants, have been widely explored in the field of biomedicines. AgNCs for the first-time were synthesized using ethyl acetate seed extracts of Abrus precatorius and their antiproliferative and antiangiogenic efficacies were evaluated against cervical and oral carcinoma. Ultraviolet-Visible spectrophotometry, dynamic light Scattering (DLS), and scanning electron microscopy (SEM) were used for characterization of AgNCs. Antiproliferative activity was investigated using MTT, DNA fragmentation and in-vitro antioxidant enzyme activity assays. In-vivo chick chorioallantoic membrane (CAM) model was used to evaluate antiangiogenic activity. A total of 11 compounds were identified in both the extracts in GCMS analysis. The synthesized AgNCs were spherical shaped with an average size of 97.4 nm for AgAPE (Sox) and 64.3 nm for AgAPE (Mac). AgNCs possessed effective inhibition against Hep2C and KB cells. In Hep2C cells, AgAPE (Mac) revealed the highest SOD, catalase, GST activity and lower MDA content, whereas AgAPE (Sox) showed the highest GSH content. On the other hand, in KB cells, AgAPE (Sox) exhibited the higher SOD, GST activity, GSH content, and least MDA content, while AgAPE (Mac) displayed the highest levels of catalase activity. Docking analysis revealed maximum binding affinity of safrole and linoleic acid with selected targets. AgAPE (Sox), AgAPE (Mac) treatment profoundly reduced the thickness, branching, and sprouting of blood vessels in the chick embryos. This study indicates that A. precatorius-derived AgNCs have enhanced efficacies against cervical and oral carcinoma as well as against angiogenesis, potentially limiting tumour growth.

Photoswitchable nonlinear optical properties of azobenzene-based supramolecular complexes: insights from density functional theory.

Density functional theory (DFT) calculations were performed for a series of supramolecular assemblies containing azobenzene (Azo-X where X = I, Br and H) and alkoxystilbazole subunits to evaluate their electronic, linear and nonlinear optical properties. These assemblies are derivatives of azobenzene, obtained by the substitution of electron-withdrawing and electron-donating groups onto the molecular skeleton. The interaction energies (Eint) of all the designed supramolecular complexes (IA-IF, IIA-IIF and IIIA-IIIF) range from -1.0 kcal mol-1 to -7.7 kcal mol-1. The electronic properties of these hydrogen/halogen bond driven supramolecular assemblies such as vertical ionization energies (VIE), HOMO-LUMO energy gap (GH-L), excitation energies, density of states (DOS) and natural population (NPA) analyses were also computed. The non-covalent interaction index (NCI) and quantum theory of atoms in molecules (QTAIM) analyses were also performed to validate the nature of inter- and intra-molecular interactions in these complexes. A substantial enhancement in the first hyperpolarizability (ß0) values of the designed supramolecular complexes was observed, which is driven by the charge transfer from the pyridyl moiety of alkoxystilbazole to Azo-X. The highest ß0 value of 1.3 × 104 au was observed for the supramolecular complex of p-nitro substituted azobenzene with alkoxystilbazole (ID complex). Moreover, the results show that the substitution of electron-withdrawing groups on Azo-X can also bring larger ß0 values for such complexes. It was confirmed on a purely theoretical basis that both the types of noncovalent interactions present and the substituent group incorporated influence the nonlinear optical (NLO) response of the systems. Furthermore, the ß0 values of the E (trans) and Z (cis) forms were compared to demonstrate the two-way photoinduced switching mechanism.

Efficacy of the Unani Regimen as an Add-On to Standard Treatment in Hospitalised RT-PCR-Confirmed Mild to Moderate COVID-19 Patients: An Open-Label Randomized Controlled Trial.

Background The coronavirus disease 2019 (COVID-19) pandemic resulted in mortality and morbidity worldwide. Many treatment modalities have been experimented with limited success. Therefore, the traditional system of medicine needs to be explored. Objective To evaluate the benefits of Unani regimensTiryaq-e-Arba and Unani Joshanda, as adjuvant therapy, were compared to standard treatment alone among reverse transcription polymerase chain reaction (RT-PCR)-confirmed mild to moderate COVID-19 cases. Materials and methods An open-label, double-arm, randomized, controlled interventional clinical study was conducted among 90 RT-PCR-confirmed mild to moderate COVID-19 inpatients admitted to a tertiary care hospital in New Delhi, India. Participants who fulfilled the criteria for inclusion were randomly assigned to two arms, with 43 subjects allocated to the Unani add-on arm and 47 subjects to the control arm receiving standard treatment alone. Results Clinical recovery was achieved in all patients of the Unani arm, while in the control arm, three (6.4%) patients deteriorated and had to be shifted to ICU following admission. In the intervention arm, a shorter duration of hospitalization was observed (mean 5.95 days {SD = 1.99}) than in the control arm (mean 7.62 days {SD, 4.06}); which was a statistically significant difference (p-value 0.017). The majority of the patients recovered within 10 days in the Unani add-on arm. The number of days taken for the reduction of symptoms was significantly less in the intervention arm (mean 5.14 days {SD, 2.39}) as compared with standard treatment (mean 6.53 days {SD, 3.06}) (p < 0.02). Renal and liver safety parameters were within the normal limits in both arms and no serious adverse event was reported. Conclusion Adding Unani formulations to standard treatment significantly reduced the duration of hospital stay and showed early recovery in COVID-19 patients compared with the control arm. It may be concluded that the synergistic effect of the Unani add-on with standard treatment gave more promising results in mild to moderate COVID-19 patients.

Licorice as a herbal extract in periodontal therapy.

Periodontal disease is caused by specific pathogens which results in inflammation of the tooth-supporting structures and subsequently causes the continued breakdown of alveolar bone and periodontal ligament. Licorice (Glycyrrhiza glabra) is a perennial herb with substantial medicinal value. Licorice extract is derived from dried, unpeeled stolons and roots of Glycyrrhiza uralensis and G. glabra. The bioactive ingredients in licorice extract such as glycyrrhizin, licoricidin, glabridin, licochalcone A, and licorisoflavan A have anti-inflammatory, antimicrobial, and anti-adherence effects that are beneficial against periodontal disease. Since periodontal disease has a complex etiology that includes the host response and microorganisms, licorice phytochemicals offer a therapeutic advantage due to their dual functionality. The aim of this review was to enumerate the bioactive compounds present in herbal licorice extract and to elucidate the beneficial effects of licorice and its derivatives in periodontal therapy. Literature review and clinical trials evaluating the effect of licorice on periodontopathogens and periodontal disease are included in this article.

An overview of topical lipid-based and polymer-based nanocarriers for treatment of psoriasis.

Psoriasis is a consistently recurring, inflammatory skin disease, affecting about 2-5 % of the world population. Different types of psoriasis can be observed such as guttate psoriasis, pustular psoriasis, psoriatic arthritis, scalp psoriasis, flexural psoriasis etc. Several therapeutic approaches are available for the treatment of psoriasis. However, none of them are entirely safe and effective to treat the disease without compromising patient compliance. The traditional treatment plan is associated with harmful side effects such asimmune system suppression and damage of essential organs at high doses, which poses a challenge to treat psoriasis. Novel drug delivery systems are being developed to replace traditional therapy in order to address these shortcomings. Currently, nanoformulations have gained widespread application for treatment of psoriasis. Researchers have developed different types of lipid-based nanoparticles like liposomes, niosomes, ethosomes, transethosomes, nanostructured lipid carriers and solid lipid nanoparticles. These innovative formulations provide advantages in terms of reduction in dose, dosing frequency, dose-dependency with enhanced efficacy, improved encapsulation efficiency, controlled release, increased surface area, high bioavailability and greater stratum corneum permeability. This review highlights detailed and comparative discussion of lipid-based and polymer-based nanoparticles for psoriasis along with the pathophysiology and other treatments of psoriasis.

Knowledge, Opinion, and Practices Towards Screening of Oral Cancer Among Homeopathy and Ayurveda Students in Indore, Madhya Pradesh, India.

INTRODUCTION: Oral cancer is one of the most common cancers in the world. Early recognition leads to higher cure rates and better quality of life. Homeopathy and Ayurveda can help improve the general well-being and vitality of patients without inducing any side effects. AIM: To assess knowledge, opinion, and practices towards oral cancer among homeopathy and ayurvedic students. OBJECTIVES: To find the correlation between knowledge and practices followed by homeopathy and ayurvedic students. METHOD: A descriptive cross-sectional study was conducted among 157 homeopathy and 153 ayurvedic students in Indore city, Central India. The subjects were selected using a convenient sampling technique, and the data was collected using a pre-tested close-ended self-administered questionnaire with 24 questions. The data were analyzed by IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. using descriptive and analytical (Chi-square and independent sample t-tests) statistics. Correlation analysis was performed to assess the relation between knowledge and preventive practices score. RESULTS: Homeopathy students showed a significantly higher mean knowledge (4.74+0.96) and practice score (4.82+1.54) as compared to ayurvedic students (knowledge score 4.49+1.11) (practice score 4.09+1.98). No significant differences were observed in the mean knowledge and practice scores of the homeopathy students. There was a statistically significant difference between the mean knowledge score and practice score of third-, fourth-, and fifth-year ayurvedic students at p-value <0.05. A positive (p-value <0.0001) correlation was observed between the knowledge and practice scores for ayurvedic students. As the year of professional studies increased, the overall practice of the students regarding oral cancer also increased, with fifth-year students showing significantly better practice (OR- 1, p-value = <0.05) than the other year students.  Conclusion: Homeopathy students showed better knowledge, whereas ayurvedic students showed better opinions and practices towards oral cancer.

Analytical review of Tiryaq-i-Wabai - A Unani panacea for the control of COVID-19.

Introduction: COVID-19 has affected the whole world drastically and led to a substantial loss of human life. Relentless research is underway to identify effective treatment to control the disease. Traditional systems are also being explored to search for a potent drug. Unani formulation 'Tiryaq-i-Wabai' has long been used in cholera, plague and other epidemic diseases. This review is aimed at analysing the possible role of Tiryaq-i-Wabai in the prevention and control of COVID-19. Methodology: Unani classical texts and Pharmacopoeias available in the library of Regional Research Institute of Unani Medicine, Chennai were reviewed to collect information related to epidemics, commonly prescribed drugs during epidemics, and therapeutic uses of Tiryaq-i-Wabai ingredients. ScienceDirect, Springer, PubMed and Google Scholar were searched to collect information regarding current pandemic and pharmacological activities of ingredients and phytoconstituents present in the formulation. The collected data was analyzed and interpreted. Results: Tiryaq-i-Wabai was found to be the most recommended prophylactic and curative drug during epidemics. The formulation ingredients, Sibr (Aloe vera (L.) Burm.f.), Murr Makki (Commiphora myrrha (T.Nees) Engl.) and Zafran (Crocus sativus L.) are categorized under Tiryaqi Advia (literally - antidote drugs) and are considered to be very effective in SARS related conditions. These ingredients have been reported to exhibit immunomodulatory, antioxidant, antiviral, antibacterial, antitussive, smooth muscle relaxant, antipyretic and anti-inflammatory activities corroborating the traditional use of Tiryaq-i-Wabai. Conclusion: Scientific data imply great potential and utility of the formulation which could be a possible alternative approach for the prevention and control of current and future pandemics.