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Drug repurposing is a strategy for ascertaining new implications for already approved drugs. Historically, this field started with the serendipitous and inadvertent findings of a drug that was found to have an effect other than its original indication that was previously unrecognized and that had potential application in an entirely different disease. The fact that the rate of failure associated with the development of new drugs is high and the funds needed are enormous, it has compelled the scientific fraternity to look for alternatives and thus the drug repurposing approach has gained traction in the scientific community. The havoc that COVID-19 wreaked is unprecedented and till date it has led to the death of around 5.7 million people worldwide. The scientific fraternity, the world over, has embarked on the journey of getting a sure shot treatment for this deadly disease and till date many studies have been published discussing the role of various repurposed drug candidates in COVID-19 treatment. A majority of these studies have been carried out using structural bioinformatics and have not been validated by in vitro experiments. There is a pressing need for the treatment of COVID-19 disease using repurposed drugs by experimental validation and clinical testing, and augmented by the modern Machine Learning (ML)-and Artificial Intelligence (AI)-based approaches. A number of drug candidates have been investigated for their potential applications in cancer therapy, however the conundrum about the utility of either repurposed drug candidates or only active anti-cancer drugs for cancer therapy is to be pursued thoroughly so that mankind gets the most out of whatever potential the drug candidates, whether old or new, have in store for us. This chapter discusses the utility of drug repurposing approach as an alternative strategy for drug discovery that is intended to find treatment for new and emerging infectious diseases, viz. COVID-19 and cancer. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.
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Halliburton uses the term "local content" to describe programs to develop and use local resources in providing our services in that host country. Local content requirements vary by country, but commonly include providing employment opportunities to local citizens, procurement of goods and services from within the country, manufacturing and value addition through partnerships with and development of local entities, training programs to develop the technical skills of local individuals and businesses, and carry out research and development for finding indigenous alternates of imported materials. In almost all cases, local content requirements are mandated by the laws of the countries where we operate. Adhering to and improving local content is an important part of Halliburton's commitment to support the countries in which it operates and it also brings benefits for both Halliburton and local communities. In this paper, we share a case study of how Halliburton carried out the process of localizing chemical manufacturing in Saudi Arabia, the steps taken, and support extended in developing the local suppliers. Meeting local content requirements requires precise collaboration and communication between regional and country management teams, compliance with host country laws and regulations, adherence to Halliburton company policies, and meeting the quality standards the National Operating Company which is the end user in most cases. The methodology for achieving effective localization results started with setting the right strategy and putting challenging but achievable targets. This localization initiative exemplifies company efforts to create value in every aspect of the company's business through the In-Kingdom Total Value Add (iktva) program mandated by the national operating company in the country. Having a local source of manufacturing and supply chain mitigates any disruptions like the one we saw during COVID 19 whereby the movement across borders was partially closed and supply chain globally was disrupted. Any local souring effectively diminishes the impact of any such disruptions. This initiative considered more than 50 Halliburton commercial chemical products and resulted in more than 10 successful replacements. Halliburton was able to export three products to company's operations outside Saudi Arabia. Partnering with Saudi Aramco, chamber of commerce and local manufacturers and suppliers in this program will drive additional domestic value creation to support a rapidly changing economic environment and foster future prosperity. Copyright © 2022, International Petroleum Technology Conference.
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INTRODUCTION: Cryptogenic organizing pneumonia (COP) accounts for 5% of all ILD cases. Due to a low incidence rate of 1 case per 100,000 persons per annum, it is often misdiagnosed as bacterial pneumonia, but when timely managed, it has an excellent prognosis. We discuss Methamphetamine, a commonly abused stimulant that has unfortunately not yet garnered enough notoriety as a respiratory toxidrome for causing inhalation injury, potentially leading to fulminant COP. DESCRIPTION: A 44-year-old male presented to ED with fevers, cough, and dyspnea gradually worsening over the past two weeks. Of note, he smoked ten cigarettes/day and relapsed to methamphetamines inhalation, the latest use being two weeks prior. On physical exam, oxygen saturation was 70% on RA and had significant bilateral inspiratory crackles. The respiratory Viral Panel, including COVID-19, was negative. Drug screens were negative. Chest X-Ray and CTA showed bilateral ground glass opacities concerning multifocal pneumonia but no pulmonary embolism. Broadspectrum antibiotics were started. For worsening Acute Hypoxemic Respiratory failure (AHRF) on Day 3, he underwent intubation and mechanical ventilation. Further workup for infectious etiologies like S. pneumoniae and Legionella, HIV-1, and sputum and blood cultures were all negative. Initial autoimmune and connective tissue disease workup was within normal limits. Bronchoalveolar lavage (BAL) analysis did not yield an infectious, inflammatory, or neoplastic source. On day 7, he underwent an open lung biopsy which confirmed COP, with histological features of toxic injury. IV glucocorticoids were started, with gradual improvement noticed in AHRF. DISCUSSION: Respiratory failure within 30 days of hospitalization is the most common cause of mortality in fulminant COP.If a patient's history suggests exposure to inhaled amphetamine and have no response to antibiotics for supposed pneumonia, physicians should consider COP to make a timely diagnosis and initiate glucocorticoid treatment to warrant rapid clinical improvement, often seen as early as 72 hours, and prevent future relapses.With Substance use continuing to be a major healthcare problem, now more than ever, healthcare providers must be familiar with respiratory toxidrome to provide timely diagnosis and treatment.
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Objective: Diabetes is one of the major risk factor responsible for poor outcomes of corona virus disease (COVID-19). Association between pre infection HbA1c level in diabetic individuals and severity of COVID-19 based on the requirement for hospitalization, will be helpful in controlling and defeating COVID-19. Methods: This was cross sectional study carried out in Khalifa Gul Nawaz, (KGN) hospital, Bannu, Pakistan. 160 diabetic individuals with COVID-19 were registered in this study. All the registered subjects were divided into Hospitalized COVID-19 Daibetic, (HCD group) and Non Hospitalized COVID-19 Daibetic (NHCD groups). In HCD group 32 diabetic individual with a deadly disease and severe complications of COVID-19 were considered while in NHCD group 128 diabetic individuals with mild complications of COVID-19 were present. Data analysis was performed by using IBM SPSS version 26. Results: Mean age of HCD group was significantly higher (p< 0.05) as compared to NHCD group. Among the different co-morbidities hypertension and chronic kidney diseases were significantly associated with hospitalization of COVID-19 individuals. But, after adjusting for several preexisting clinical factors, HbA1c ≥9% was the only predictor linked with a substantially higher risk of hospitalization in a multivariate analysis. Conclusion: Higher pre infection levels of HbA1c are clear markers for the hospitalization of COVID-19. Using HbA1c levels ≥ 9, we can highlight the high risk population and can successfully control and defeat COVID-19.
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Background: Coronavirus Disease-2019 (COVID-19) has appeared as a deadly pandemic affecting most of the countries across the world. The disease has caught humanity unprepared;therefore, there has been a lack of awareness about the causes, and transmission and mortality rates. It has also affected the overall socioeconomics from individual to worldwide levels. COVID-19 is an unprecedented and first-time challenge for Pakistan and a lockdown imposed by the Government of Pakistan has further devastated the economy of the country. This online survey was conducted to know the effects of the Covid-19 pandemic on the social life and economic status of the people of Pakistan. In this article, we mainly focused on teachers and students from different Universities of Pakistan for data generation because they can provide better information due to the use of modern technologies as a source of information. Methods: An online questionnaire survey covering 11 parameters including age, gender, employment status, mortality rate, education, marital status and, information about the pathogen responsible for the disease was filled by 1260 individuals from Pakistan. Results: The results obtained show that 56.6% of the responders were males,43.4% were females, 59.9% were unmarried, 37.7% were graduate students and, 48.7% unemployed. Most of the responders (55.6%) said that COVID-19 negatively affected the jobs of the people. We found (93%) of the responders with good knowledge about COVID-19. Conclusion: We conclude from the results that most of the responders were males, educated and they knew the pathogenic effect of the COVID-19 virus on humans. These results also show that the disease has drastically affected the economy and social life of the people of Pakistan.
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Black pepper (Piper nigrum L.) is a popular spice that is grown as tropical and subtropical plant throughout the world. The leaf, flower, fruit, and root are the most important elements of the plant. Asexual or vegetative propagation is becoming highly popular, although the sexual approach is still used for pepper vine cultivation. For mass production of the pepper plant, in vitro culture is also used. The bioactive components contained in them are extremely important because of their therapeutic potential against a number of diseases. They are usually classed as functional foods because, in addition to providing basic nutrition, provide physiological benefits and help to avoid chronic illness. The main component of black pepper is piperine. It has a complex phyto-chemistry includes: Volatile oil, alkaloids, and oleoresins. Because of its free-radical scavenging properties, black pepper and its active components can be prevention and control of tumor growth. Piperine, which can bind and inhibit the SARS-CoV-2 virus that causes the sickness, is present in black pepper and has antibacterial and antiviral effects. Piperine, a key alkaloid component of black pepper, it also helps to cognitive brain function, nutritional absorption, and gastrointestinal health. Black pepper is known as the “King of Spices” as well as the “King of Medicinal Agents,” since it includes a wide variety of bioactive compounds with nutraceutical and pharmacological applications. An overview of the most common applications for black pepper, along with a strong evidence is present in this review. © 2021 Ahasan Ullah Khan, Mohammad Samiul Ahsan Talucder, Mitali Das, Sana Noreen, Yunita Sari Pane.
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Background: The impacts of lockdown on air pollution have been examined in various parts of the world. The concentration of main air pollutants has been decreased owing to a decline in anthropogenic activities like fossil fuel burning, etc. The main aim of this research was to assess the impacts of lockdown on air pollution of the main urban areas of Pakistan. Methods: The present study was conducted to assess the air quality index (AQI) of the main urban areas of Pakistan based on the pre- and post-lockdown effects and mortality rate due to coronavirus disease 2019 (COVID-19). Hotspot analysis was conducted to assess the most vulnerable spots at the country level. Results: The AQI greatly improved in all the main cities of Pakistan which ranges from 51 to 87. The pre- and post-lockdown AQI were categorized from unhealthy for sensitive groups to hazardous and moderate, respectively. There are noticeable hotspots in the vicinity of Lahore and Karachi. The level of nitrogen dioxide (NO2) dropped 45%, 49%, 20%, 35%, and 56% in Peshawar, Lahore, Multan, Karachi, Islamabad, and Rawalpindi, respectively. Conclusion: Nature healed due to lockdown, which is the only good face of the COVID-19 pandemic. The temporary lockdown greatly improved air quality which may stimulate the policymakers, researchers, and governments for the smart use of resources to minimize emissions to heal the nature. The present study also suggests the application of hotspot analysis in different contexts fur the evidence-based care services decisions during the COVID-19 pandemic.
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Introduction: Delirium is a common neuropsychiatric syndrome in patients over the age of 65 presenting to medical admissions units yet remains under-diagnosed despite significant associated mortality and morbidity. Our trust's delirium screening tool incorporates a fourstep approach, with completion of validated 4AT test warranted in all those over 65 years of age admitted with increased confusion or social withdrawal. Our aim was to measure current uptake of this delirium screening and introduce measures to improve practice. Method: We retrospectively collected data from medical records of patients on two Geriatric inpatient wards (42 patients) at the Leicester Royal Infirmary, to determine whether appropriate delirium screening was taking place for at-risk patients on admission. We then introduced two PDSA (plan, do, study, act) cycles: 1. teaching at departmental weekly educational meetings with sending electronic communications to all doctors in medicine highlighting importance of delirium screening;and 2. displaying posters on all admissions wards. A third cycle was planned involving visiting wards to raise awareness, however this was interrupted by the COVID pandemic. Results: Initial baseline results showed only 5% (1 of 18) of at-risk patients were fully screened for delirium. Following our first intervention, this increased to 13% (3 of 23). Second intervention involving display of posters led to an increase to 44% (8 of 18) of atrisk patients being screened. Proportions of dementia were comparable across PDSA cycles. Conclusions: Education, raising awareness, and display of reminder posters can improve delirium screening uptake of at-risk patients on admission to medical admission units, despite growing pressures associated with the COVID pandemic. Further interventions are planned to improve and maintain awareness and uptake of delirium screening.
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The coronavirus disease 2019 (COVID-19) is a highly contagious pneumonia that has spread throughout the world. It is caused by a novel, single stranded RNA virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Genetic analysis revealed that, phylogenetically, the SARS-CoV-2 is related to severe acute respiratory syndrome-like viruses seen in bats. Because of this, bats are considered as a possible primary reservoir. The World Health Organization has declared the COVID-19 outbreak as a pandemic. As of May 27, 2020, more than 5,406,282 confirmed cases, and 343,562 confirmed deaths have been reported worldwide. Currently, there are no approved vaccines or antiviral drugs available against COVID-19. Newly developed vaccines are in the first stage of clinical trials, and it may take a few months to a few years for their commercialization. At present, remdesivir and chloroquine are the promising drugs for treating COVID-19 patients. In this review, we summarize the diversity, genetic variations, primary reservoirs, epidemiology, clinical manifestations, pathogenesis, diagnosis, treatment strategies, and future prospects with respect to controlling the spread of COVID-19.