Fulminant varicella infection complicated by disseminated intravascular coagulation following influenza-A case report

Objectives: Varicella is common infectious disease mainly in childhood, usually is a mild, self-limited illness and complications are usually rare. The incubation period for this disease is generally 14- 16 days but may vary from 7 to 21 days. Varicella in the adults with comorbidities or immunosuppressed children may be severe and prolonged with complications. Method(s): A case report of a 6-year-old girl hospitalized for new-onset manifestations of disseminated vesicular exanthema, the manifestations of which occurred mainly on the chest, back, capillitium, oral cavity, and genital area. The child was suffering from abdominal, knee and lumbosacral pain at that time. The patient's history revealed that 10 days prior to the cutaneous manifestations, she had influenza with bronchopneumonia requiring oxygen therapy, steroids and antibiotics. Result(s): The condition progressed within 48 h, complicated by the development of multi-organ failure, coagulopathy with the development of disseminated intravascular coagulopathy over the course of antiviral, antibiotic and antifungal therapy. Laboratory parameters included high elevation of C-reactive protein, il-6, leukocytosis, neutrophilia and highly elevated liver enzymes. Varicella infection was confirmed by detection of herpes zoster virus - polymerase chain reaction (PCR) from vesicles. The patient received intravenous immunoglobulin therapy at a dose of 2 g/L and fresh frozen plasma, thrombocyte concentrate. The girl was intubated with analogization. Laboratory parameters subsequently revealed high anti CoV-2 positivity, high CoV-2 IgG positivity and negative CoV-2 IgM. The patient's condition did not preclude the course of multisystem inflammatory syndrome in children (MIS-C) corticosteroids were added to the treatment at a dose of 1 mg/kg weight. Patient's condition stabilized after 1 month. Discussion(s): Our case report presents an example of fulminant complicated life-threatening course of varicella. Even in common respiratory infections, we must think about the risk and consequences of coinfections and post-infectious complications such as in our case especially influenza and COVID-19.

Repurposing Methylene Blue for the Management of COVID-19: Prospects, Paradox, and Perspective

COVID-19 onslaught has led to widespread morbidity and mortality globally. Another major concern, especially in developing countries like India, has been the development of fungal superinfection and colonization of other pathogens in hospitalized COVID-19 patients. Even though an armamentarium of repurposed, antiviral, anticytokine, and antifungal drugs is available to manage the disease progression, no single drug and/or therapy has provided positive clinical outcomes with efficacy and affordability. Therefore, it is imperative to explore innovative approaches for standalone treatment and/or adjunct therapeutic regimes based on our current understanding of disease prognosis. Low-income and emerging economies have less resources to protect themselves against the COVID-19-induced health and economic crisis. With the continuously evolving nature of coronavirus, a cost-effective strain independent mechanism that could be delivered easily even in a nonhealthcare setting is an urgent need of the hour. Methylene blue appears an apt candidate as it is an FDA-approved safe drug that is economically viable and easily available. Since MB has a long-standing history of being used in clinical setup for diverse medical applications and possesses intrinsic anti-inflammatory, anticytokine, and antifungal properties, this study analyzes prospects of its use in the management of COVID-19. Paradox and prospects of MB applications for the management of COVID-19, with or without fungal superinfections, are also discussed. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.

A comprehensive overview on COVID-associated mucormycosis

In recent times, numerous reports of systemic fungal infections have been a major concern. The angioinvasive fungal infection, mucormycosis has surged in patients with COVID-19 due to various factors, mainly uncontrolled diabetes and inappropriate corticosteroid use. The prevalence of this acute and fatal fungal infection caused by Mucorales-related fungal species has been highest in the Indian population. COVID-associated mucormycosis (CAM) has a propensity for contiguous spread, and exhibits high morbidity as well as mortality. Unless promptly detected and treated, it is associated with a poor prognosis. A high index of suspicion, aggressive surgical debridement and use of systemic antifungal agents continue to be the standard of care for CAM. Moreover, there is an imperative need to address this public health issue by increasing public awareness and education. This article provides a comprehensive overview on the emergence of CAM during the pandemic, the current burden, pathophysiology, diagnostic interventions and management of CAM in Indian clinical practice.

Nanoparticles as an exotic antibacterial, antifungal, and antiviral agents

Globally, concerns regarding the COVID-19 pandemic its prevention have become important. Because of COVID-19 and other microbial diseases, enhance research work has emerged revealing new antimicrobial and antiviral materials and techniques. Tremendous growth in nanotechnology has opened up the door to fabricating numerous nanomaterials. These nanomaterials are employed as antimicrobial and antiviral agents for various applications with 99.99% effectiveness compared with conventional techniques. Nanoparticles possess unique physicochemical characteristics for multiple applications. This chapter details the use of nanoparticles for antifungal, antimicrobial, and antiviral applications. It describes various kinds of nanoparticles, such as nanometals, metal oxides, polymeric nanomaterials, and carbon-based nanomaterials. © 2023 Elsevier Inc. All rights reserved.

Disseminated Mucormycosis in a patient on long term immunosuppression: Severe fungal infections as multi-system disorders

Introduction: Mucormycosis is a rare, severe fungal infection with an incidence of 0.005 to 0.17 per million.1 but incidence has risen recently, particularly in the Asian subcontinent, due to use of immunosuppression for Covid19.2 Presentations can vary and are classified into: rhino-orbito-cerebral, pulmonary, cutaneous, disseminated, renal and gastrointestinal. Risk factors include diabetes, immunosuppression, iron overload, malnutrition, and prematurity.1,3 Although mucormycosis has an extremely high mortality rate and disseminated infection is usually fatal, treatment options exist if diagnosed early and surgical debridement may be curative. Objective(s): We present a case of mucormycois in a female patient in her 40s who was immunosuppressed with methotrexate for rheumatoid disease. This case is discussed to increase awareness of critical illness caused by opportunistic invasive fungal infections in immunosuppressed patients and promote timely identification and management. Method(s): We detail the clinical context and management of a patient with mucormycosis and discuss relevant literature. Result(s): A female patient in her 40s who had been experiencing upper respiratory tract symptoms for several weeks, including cough and brown sputum, was admitted with a presumptive diagnosis of methotrexate toxicity after a full blood count performed by the general practitioner demonstrated pancytopenia. Initially, National Early Warning System 2 score (NEWS2) was 2 but became intensely hypertensive during blood transfusion and then profoundly shocked with an escalating NEWS2. Broad-spectrum antibiotics and fluconazole were commenced for neutropenic sepsis and the patient was referred to critical care in multiple organ failure. Computerised tomography (CT) scan of the chest, abdomen and pelvis showed "left upper lobe consolidation, which with neutropenia might represent an angioinvasive aspergillosis". She had multiple areas of skin discolouration and desquamation. Haematology and Infectious Diseases opinions were sought, and a bone marrow biopsy was performed which showed severe toxic effects consistent with sepsis/life threatening infection. Progressive proptosis was noted, and CT scan of her head was requested. Sadly, she was never stable enough for CT transfer. Beta D Glucan and aspergillus antigen serology was negative. Broncho-alveolar lavage demonstrated Candida albicans and then, later, Rhizopus arrhizus was isolated and anti-fungal treatment changed to voriconazole and then amphotericin B. Upon reviewing the notes in light of the positive culture for Rhizopus, the patient had likely been exhibiting symptomatic Mucormycosis sinus infection for some time prior to this admission with disseminated infection. The patient's condition continued to deteriorate and she sadly died. Conclusion(s): * The Early Warning Score significantly underestimated how unwell the patient was upon arrival in ED, a systems-based assessment would have demonstrated that the patient had multiple system dysfunction and significant potential to deteriorate suddenly despite having stable observations * The methotrexate level has no clinical value in diagnosing or refuting a diagnosis of methotrexate toxicity * A full examination of the immunosuppressed patient including ENT is a necessity when searching for a source of infection * Invasive fungal infections can cause multi-system symptoms and atypical presentations * As a greater proportion of patients have received systemic immunosuppression for Covid-19, vigilance for more unusual pathogens, including Mucormycosis by clinicians is advised.

Maxillary osteomyelitis secondary to mucormycosis, a sequel of COVID-19: a clinical case report

Introduction: One of the consequences of COVID-19 is the incidence of mucormycosis in the jaws and subsequent osteomyelitis in patients with undiagnosed or uncontrolled comorbidities, such as diabetes mellitus and associated immunosuppression. Case Report: A 52-year-old male patient with a history of COVID-19 two months ago presented a painful ulcerative lesion of insidious onset in the palatal raphe measuring approximately 2 mm. He referred to numbness of the palatal region of one month of evolution. During the physical examination, purulent content, multiple pustules in the anterior maxillary buccal mucosa, and mobility of upper anterior teeth were observed. The CT revealed isodense bilateral images in maxillary and ethmoidal sinuses, bone sequestrations, and partial loss of anterior vestibular cortical bone. Laboratory tests revealed no abnormality, except for HbH1c: 10.2gr/dl. The patient was hospitalized for control of newly diagnosed diabetes mellitus. Maxillary incisional biopsy was performed, and microscopic analysis showed a mixed inflammatory infiltrate, fibrin deposits with eosinophilic and birefringent ribbon-like hyphae, branched at right angles, compatible with maxillary osteomyelitis secondary to mucormycosis. The treatment started with antifungal and intravenous antibiotics, followed by surgical cleaning under general anesthesia. The patient progressed favorably. Conclusion(s): Immunosuppression resulting from COVID-19 and/or uncontrolled systemic diseases can condition the appearance of rare opportunistic microorganisms causing infections such as mucormycosis. Early diagnosis and treatment make a difference in the morbidity and mortality of patients.

Medication Update

The article offers medical briefs. Topics include the authorization of a new drug called Gohibic for critically ill patients with COVID-19;the approval of an over-the-counter naloxone nasal spray for opioid overdose treatment;and the Food and Drug Administration approval of a long-acting antifungal called Rezzayo for the treatment of candidemia and invasive candidiasis for hypertension medications.

A case of COVID-19-associated rhino-orbito-cerebral mucormycosis caused by Apophysomyces variabilis with a review of the literature.

A fatal case of COVID-19-associated mucormycosis (CAM) affected a 40-year-old woman who was initially admitted to our hospital due to a SARS-CoV-2 infection. Her clinical condition worsened, and she finally died because of respiratory failure, hemodynamic instability, and mucormycosis with invasion into the orbit and probably the brain. According to DNA sequence analysis of the fungus isolated from the patient, Apophysomyces variabilis was involved. This is the first published case of CAM and the third case of mucormycosis due to this mold.

COVID-19-associated pulmonary aspergillosis (CAPA): identification of Aspergillus species and determination of antifungal susceptibility profiles.

Among the co-infectious agents in COVID-19 patients, Aspergillus species cause invasive pulmonary aspergillosis (IPA). IPA is difficult to diagnose and is associated with high morbidity and mortality. This study is aimed at identifying Aspergillus spp. from sputum and tracheal aspirate (TA) samples of COVID-19 patients and at determining their antifungal susceptibility profiles. A total of 50 patients with COVID-19 hospitalized in their intensive care units (ICU) were included in the study. Identification of Aspergillus isolates was performed by phenotypic and molecular methods. ECMM/ISHAM consensus criteria were used for IPA case definitions. The antifungal susceptibility profiles of isolates were determined by the microdilution method. Aspergillus spp. was detected in 35 (70%) of the clinical samples. Among the Aspergillus spp., 20 (57.1%) A. fumigatus, six (17.1%) A. flavus, four (11.4%) A. niger, three (8.6%) A. terreus, and two (5.7%) A. welwitschiae were identified. In general, Aspergillus isolates were susceptible to the tested antifungal agents. In the study, nine patients were diagnosed with possible IPA, 11 patients were diagnosed with probable IPA, and 15 patients were diagnosed with Aspergillus colonization according to the used algorithms. Serum galactomannan antigen positivity was found in 11 of the patients diagnosed with IPA. Our results provide data on the incidence of IPA, identification of Aspergillus spp., and its susceptibility profiles in critically ill COVID-19 patients. Prospective studies are needed for a faster diagnosis or antifungal prophylaxis to manage the poor prognosis of IPA and reduce the risk of mortality.

A Case Series of Kodamaea Ohmeri Infection: The Hidden Threat Unleashed

Intro: Kodamaea ohmeri, previously known as Pichia ohmeri, is an ascomycetous yeast that has emerged as an important cause of fungemia in immunocompromised patients. During the anamorphic stage this organism is also known as Candida guillermondii var. membranaefaciens. Method(s): We report five cases of Kodamaea ohmeri encountered from multicenter in Malaysia. Antifungal agent of choice will be discussed based on literature review. Finding(s): The cases were: (1) a contaminated peritoneal fluid in an adult patient on peritoneal dialysis;(2) a 60-year-old man with infected diabetic foot isolated K. ohmeri from a bone sample. Both cases discharged well without active antifungal fungal therapy. We observed fatality cases involving (3) an old man with underlying gastric adenocarcinoma who complicated with catheter- related bloodstream infection caused by K. ohmeri;(4) a patient with ventilator- associated pneumonia and septicaemic shock secondary to perforated terminal ileum;(5) and a severely ill COVID-19 stage 5b patient who passed away due to systemic fungaemia caused by K. ohmeri. Discussion(s): All three fatal cases received either amphotericin B or caspofungin as active antifungal agent. Literature evidence has shown that 40% of patient met demise despite on active antifungal agent, suggesting that currently no definitive antifungal agent proven to be a superior treatment option for K. ohmeri infection. Removal of indwelling medical device combined with antifungal therapy has favorable clinical outcome. Conclusion(s): Therefore, K. ohmeri infection in severely ill patients should be considered as a critical condition. Potential of alternative antifungal combinations need to be explored for an effective treatment option.Copyright © 2023

Beyond silver sulfadiazine: A dive into more than 50 years of research and development on metal complexes of sulfonamides in medicinal inorganic chemistry

Sulfonamides revolutionized the treatment and management of bacterial infections. Prontosil was the very first synthetic antibacterial agent ever used in the clinics and its metabolite, sulfanilamide, led to the development of a diverse range of sulfonamides with a diverse spectrum of action. Although being developed as antibacterial agents, sulfonamides have also shown to present antitumor, antifungal, and antiviral activities. While for antibacterial applications the focus is on the dihydropteroate synthase enzyme, for antitumor compounds a lot of attention has been given to carbonic anhydrases. For antiviral applications some studies focus on inhibiting HIV replication, and with the COVID-19 pandemic in the last years, attention has been given to inhibit SARS-CoV-2 replication as well. For antifungal applications it seems there is a lack of target focus, but with some compounds presenting relevant activities. Silver sulfadiazine was the first metal complex of a sulfonamide to be used in the clinics as a topical agent for prevention and treatment of infections in burn patients and is vastly used to this day. Here, we covered the history of silver sulfadiazine development, its chemical properties, antibacterial activity and clinical data. Controversial results on the true efficacy of silver sulfadiazine as a topical treatment for burn wounds gave rise to ongoing debate on the advantages of using this compound when compared to other dressings loaded or not with silver-containing agents. Nonetheless, the 50-year history of silver sulfadiazine's successful use in the clinics has motivated the development of other metal complexes of sulfonamides, which are reviewed here. The biological endpoints for these novel metal complexes were not limited to antibacterial use, but expanded to antitumor, antifungal, and antiviral applications as well. Altogether, this review presents the developments in the applications of metal complexes of sulfonamides in medicinal inorganic chemistry in the past years.

Rhino-Orbito-Cerebral Mucormycosis—The Bane of the ‘Black Fungus'

Rhino-orbito-cerebral mucormycosis (ROCM) is an infection of the nasal passages and orbit caused by ubiquitous fungi of the order Mucorales. These fungi are known to affect patients with phagocyte and neutrophil dysfunction. Patients with uncontrolled diabetes, solid-organ, haematological malignancies and organ transplant recipients on immunosuppressive therapy are especially susceptible. The disease is being seen with alarming frequency in patients with COVID-19 infection or those who have recently recovered from it. Poor glycaemic control due to the indiscriminate use of steroids has been strongly implicated. Patients present with periocular pain, oedema, numbness or skin discoloration along with symptoms of the nasal blockade. Direct microscopy of a deep nasal swab taken from the involved mucosa reveals broad aseptate or pauci-septate fungal hyphae, clinching the diagnosis. CT scan of the paranasal sinuses and orbit would reveal a hyperdense lesion involving the nasal turbinates and sinuses with extension into the orbit. Lack of contrast enhancement indicates necrosis of the tissues. The treatment involves administration of systemic antifungals (Amphotericin B, Posaconazole and isavuconazole) and aggressive surgical debridement of involved tissues. In spite of all measures, the mortality rate is about 46% in these patients. Strict diabetic control and judicious prescription and monitoring of systemic steroids in the setting of COVID-19 infection, keeping a high index of suspicion with early detection of the disease can go a long way in improving the prognosis. © The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd. 2021.

Novel role of 18F- FDG PET/CT in rhinosinonasal mucormycosis in the era of covid-19 infection

Objectives: In the Covid-19 era, there was a surge in the cases of a life-threatening infection of rhinosinonasal mucormycosis. Mucormycosis, popularly known as black fungus, is an infection caused by mycetes mucorales, an aseptate hyphae. Presently, computed tomography (CT) and magnetic resonance imaging (MRI) are commonly used imaging modalities for the management of patients with rhinosinonasal mucormycosis. The present study was aimed to evaluate the role of 18F- FDG PET/CT in the detection of recurrent or residual disease in post-surgical or post antifungal therapy in these patients for further management. Method(s): A total of 10 patients were included in this pilot study of Covid-19 positive patients and histologically proven mucormycosis (by KOH mount). 18F- FDG PET/CT was performed to assess the disease status in 6 postoperative/ post debridement patients and response to antifungal therapy in 4 patients, at an interval of 40 (range = 27-66) days post intervention. Result(s): The mean age of the patients was 45.0 +/- 11.65 years. The male: female ratio was 9:1. The common clinical presentation was ipsilateral facial or orbital pain and swelling. Covid-19 infection was positive in all the patients except one who had CT finding with HRCT score of 10/25 and hence was considered as post Covid-19 infection. Six out of 10 patients were diabetic on oral hypoglycaemic agents or insulin. All patients had a baseline CT/MRI for staging the initial extent of the disease. Surgical debridement was done in 6 out of the 10 patients followed by antifungal therapy (Liposomal Amphotericin B and Pozaconazole). Remaining four patients were treated with antifungal therapy. PET/CTwas performed after an average of 40 days of surgical/medical intervention, in whom clinical symptoms persisted or worsened even on antifungal therapy. 18F-FDG PET/CT showed metabolically active residual disease in all the patients with a mean SUVmax of 9.78 +/- 4.03. Conclusion(s): In the era of ongoing Covid-19 infection, black fungus has been a debilitating disease with high mortality and morbidity. Present study demonstrated that 18F-FDG PET/CT can be an efficient imaging tool for an early surgical/ medical treatment response assessment and restaging.

Esophageal Squamous Cell Carcinoma: An Unfavorable Complication of Achalasia

Introduction: Achalasia is a motility disorder of the esophagus characterized by impaired relaxation of the lower esophageal sphincter and loss of peristalsis in the distal esophagus. It is a rare condition with an annual incidence of 0.5-1.2 per 100,000 individuals. The etiology of primary achalasia is unknown, however secondary achalasia can be attributed to malignancy, infections or systemic diseases such as amyloidosis. An infrequent complication of achalasia is esophageal squamous cell carcinoma which has a prevalence of 26 in every 1,000 cases. We present a case of interval locoregionally advanced esophageal squamous cell carcinoma only 2 years after a normal upper endoscopy. Case Description/Methods: A 67-year-old female with known achalasia and previous pneumatic dilation in her 30s presented to our outpatient clinic in 2019 with complaints of worsening chronic dysphagia. EGD was performed which revealed a significantly dilated esophagus with candida esophagitis. Despite completing antifungal therapy, she continued to experience dysphagia to solids and liquids. Barium swallow demonstrated absent peristalsis with pooling of contrast within the esophagus. High-Resolution Manometry testing demonstrated absent peristalsis. She opted for surgical myotomy, however due to COVID restrictions, the procedure was delayed. Repeat EGD was performed in 2022 for pre-surgical evaluation and showed a large obstructing friable esophageal mass in the lower third of the esophagus. Pathology was consistent with invasive poorly differentiated squamous cell carcinoma. PET scan showed locoregional disease with FDG-avid esophageal and gastrohepatic node lesions. She was started on chemoradiation with Paclitaxel and Carboplatin (Figure). Discussion(s): The risk of esophageal squamous cell carcinoma in achalasia has significantly increased with incidence of approximately 1 in 300 patients. The presumed mechanism of malignancy in achalasia is poor emptying resulting in food stasis, bacterial overgrowth and inflammation leading to dysplasia and development of carcinoma. Given the relatively low incidence, there are currently no guidelines on routine endoscopic screening to assess for malignancy in patients with achalasia. Survival rates are poor as patients are often diagnosed at advanced stages. This case aims to illustrate the importance and need for interval screening in individuals with long standing achalasia to improve outcomes.

Phytochemical Characterization and Screening of the Anti-Pneumonia (Anti-COVID-19, Anti-Fungal, and Anti-Bacterial) Activities of Cuscuta Campestris Extract

Introduction: Although, several vaccines are being approved, no effective antiviral drug has been developed for COVID-19 infectious. The present investigation was aimed to increase the essential oils of Cuscuta campestris using far-red light treatment and examine the potential of crude extracts of C. campestris against selected pneumonia pathogens and COVID-19.Methods: Anti-COVID-19 activity was determined in human lung cell lines and COVID-19 positive patients.Results: Results demonstrated that the aqueous extract had the highest amount of anti-COVID-19, antibiotic and antioxidant activity. The far-red light treatment increased Scoparone, cineole, Benzofuran, 2, 3- dihydro, Cinnamic acid, and Benzo[h]quinoline, 2, 4-dimethyl, which are mainly effective components against COVID-19 inflammation and pneumonia microbes. CT scan and clinical laboratory tests in a clinical case study, a 30-year-old woman who presented with severe 2019-nCoV, demonstrated that inhalation of 30 mg extract nebulized/day for seven days resulted in significant improvement in consolidation and ground-glass opacity in lungs on the seventh day of treatment.Conclusion: It is hoped that this study leads to the introduction of some compounds that could be used to formulate new and more potent anti-COVID-19 antibiotics, or other drugs of natural origin in medicine.

Antimicrobial Activity: Different Mechanistic Elucidation of Antibacterial, Antiviral, Antifungal & Antialgae Agents

In recent days, the increasing number of microbes and their increasing resistance power against conventional drugs have led to enormous worldwide mortalities, hence they pose a great threat to human health. The modern era is already going through the threat of COVID-19, also caused by one of those microbes called the virus. In order to get a clear understanding, all the microbes have been classified in certain types. Nowadays, to develop new alternative antimicrobial medicines, scientists must acquire clarity about the responsible functional groups of different conventional drugs with proper mechanistic elucidation on different types of microbes. This information not only clarifies the functionalities and properties responsible for exhibiting antimicrobial effects, but also facilitates the idea of new drug development through proper functional group incorporation or modification. These modifications increase the efficacy of antimicrobial drugs as well as their activity and water solubility. In this review, my focus will majorly be on the four main types of microbes and their possible mechanistic elucidation of commonly used antibiotics and alternative antimicrobial medicines discovered till now. I thank the Science and Engineering Research Board (SERB), Council of Scientific and Industrial Research (CSIR), and Government of India for my fellowship and research grants during my Ph.D in Indian Institute of Science Education and Research, Kolkata and Postdoctoral journey in the University of Burdwan. I acknowledge Prof. Bimalendu Ray (Chemistry department, The University of Burdwan), Prof. Priyadarsi De, (Polymer Research Centre, Department of Chemical Sciences, Indian Institute of Science Education and Research Kolkata), Prof. Punyasloke Bhadury (Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata), Dr. Anwesha Ghosh (Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata) for many helpful discussions and laboratory use.Copyright © 2023 are reserved by International Journal of Pharmaceutical Sciences and Research.

Silver nanoparticle-modified melt-blown polypropylene: Antibacterial and antifungal properties and antiviral activity against SARS-CoV-2.

Melt-blown polymer fiber materials are frequently used in the face mask manufacturing. In the present work, a melt-blown polypropylene tape was modified by silver nanoparticles using chemical metallization. The silver coatings on the fiber surface consisted of crystallites 4-14 nm in size. For the first time, these materials were comprehensively tested for antibacterial, antifungal and antiviral activity. The silver-modified materials showed antibacterial and antifungal activities, especially at high concentrations of silver, and were found to be efficient against the SARS-CoV-2 virus. The silver-modified fiber tape can be used in the face mask manufacturing and as an antimicrobial and antiviral component in filters of liquid and gaseous media.

Synthesis and evaluation of imidazole-bearing chalcones as a potential treatment for pulmonary aspergillosis

Pulmonary aspergillosis (PA) is a category of respiratory illnesses that significantly impacts the lives of immunocompromised individuals. However, new classifications of secondary infections like influenza associated aspergillosis (IAA) and COVID-19 associated pulmonary aspergillosis (CAPA) only exacerbate matters by expanding the demographic beyond the immunocompromised. Meanwhile anti-fungal resistant strains of Aspergillus are causing current treatments to act less effectively. Symptoms can range from mild (difficulty breathing, and expectoration of blood) to severe (multi organ failure, and neurological disease). Millions are affected yearly, and mortality rates range from 20-90% making it imperative to develop novel medicines to curtail this evolving group of diseases. Chalcones and imidazoles are current antifungal pharmacophores used to treat PA. Chalcones are a group of plant-derived flavonoids that have a variety of pharmacological effects, such as, antibacterial, anticancer, antimicrobial, and anti-inflammatory activities. Imidazoles are another class of drug that possess antibacterial, antiprotozoal, and anthelmintic activities. The increase in antifungal resistant Aspergillus and Candida species make it imperative for us to synthesize novel pharmacophores for therapeutic use. Our objective was to synthesize a chalcone and imidazole into a single pharmacophore and to evaluate its effectiveness against three different fungi from the Aspergillus or Candida species. The chalcones were synthesized via the Claisen-Schmidt aldol condensation of 4-(1H-Imizadol-1-yl) benzaldehyde with various substituted acetophenones using aqueous sodium hydroxide in methanol. The anti-fungal activity of the synthesized chalcones were evaluated via a welldiffusion assay against Aspergillus fumigatus, Aspergillus niger, and Candida albicans. The data obtained suggests that chalcone derivatives with electron-withdrawing substituents are moderately effective against Aspergillus and has the potential for further optimization as a treatment for pulmonary aspergillosis. This project was supported by grants from the National Institutes of Health (NIH), National Institute of General Medicine Sciences (NIGMS), IDeA Networks of Biomedical Research Excellence (INBRE), Award number: P20GM103466. The content is solely the responsibility of the authors and do not necessarily represent the official views of the NIH.Copyright © 2023 The American Society for Biochemistry and Molecular Biology, Inc.

A Clinical Analysis of COVID Associated Mucormycosis in a Tertiary Care Hospital

Background: With an increase in the spread of the pandemic, ailments related to the COVID illness started to appear. Patients with COVID - 19 infection experienced a worse outcome with an increase in the prevalence of opportunistic infections in the infected person especially Mucormycosis. It was recognized that people with diabetes, cancer, patients undergoing chemotherapy and other immune-compromised conditions can develop Mucormycosis. Systemic steroids and other immune-modulating agents which are the mainstay of treatment for COVID-19 predisposes to the chance of developing invasive fungal infections. Methodology: Here we provide a retrospective analysis in which out of 212 patients who were subjected to screening 13 individuals were KOH mount positive with unique clinical characteristics as well as demographic and therapeutic profile. The information was gathered retrospectively at a single facility that serves a sizable group of patients with varying severity of the Corona virus infection. Results: Of the total in-patients taken into consideration 13 were diagnosed with mucormycosis post COVID-19 infection. The median age was greater among individuals who survived the infections (49.5 years) and those with severe COVID had high chance of dying (23.8), with an overall mortality rate of 64.3 percent. Additionally 61.5 percent of patients had diabetes mellitus and 75% of them died. 11 patients (84.6%) had previously been on steroids for COVID-19. Both the individuals who survived and succumbed to the disease had same level of hyperglycemia. Conclusion: The prevalence of mucormycosis among COVID-19 patients appears to be rising, which may be attributed to increasing usage of steroid, a potential immunocompromised state brought about by the virus per se and the co-morbid conditions. A high index of suspicion and early diagnosis is necessary to bring down the mortality rate This is in addition to the preventive measures and sensible use of immunemodulators. [ FROM AUTHOR] Copyright of Journal of Pharmaceutical Negative Results is the property of ResearchTrentz and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)