Intermittent preventive treatment with Sulfadoxine pyrimethamine for malaria: a global overview and challenges affecting optimal drug uptake in pregnant women.

Malaria in Pregnancy (MiP) leading to morbidity and mortality is a major public health problem that poses significant risk to pregnant women and their fetus. To cope with this alarming situation, administration of Sulfadoxine-pyrimethamine (SP) drugs to pregnant women as an intermittent preventive treatment (IPT) from 16 weeks of gestation is recommended by the World Health Organization (WHO) guidelines. We conducted a comprehensive search of published articles related to MiP in last 10 years with predefined keywords or their synonyms. The mapping of malaria in pregnant women showed a prevalence rate up to 35% in many countries. Although IPTp-SP has been implemented in endemic regions since several years but the IPTp-SP coverage percentage vary from country to country and continue to remain below the target of 80%. Major reasons for low IPTp-SP involve gestational age at first prenatal visit, level of education, place of residence, knowledge of IPTp-SP benefits, and use of antenatal services. Several challenges including the emergence of septuple and octuple SP-resistant parasites is reported from many countries which make the prophylactic use of IPTp-SP currently debatable. This narrative review addresses the barriers for optimal use of IPTp-SP and discusses alternative approaches to increase the use and effectiveness of SP intervention for preventing MiP. The COVID pandemic has drastically affected the public health disrupting the management of diseases worldwide. In view of this, a brief summary of COVID impact on MiP situation is also included.

COVID-19 and the Urgency of the Interdisciplines in the Corporate University

As US universities and colleges increasingly identify with neoliberal discourses of students as human capital and higher education as a direct investment in earning potential, the liberal arts and humanistic fields of study are valued only for their capacity to train students in "multicultural communication." The minimization of their intellectual project marks these fields as susceptible to terminal budget cuts, a long-standing trend intensified by the COVID-19 pandemic. Some humanists have responded to this devaluation by defending the humanities as sites that produce knowledge for knowledge's sake. Such reflections defend the older venerable humanistic traditions often at the expense of newer and lesser humanities, namely, Black studies and feminist studies. In a recent Forbes article, the president of the American Council of Trustees and Alumni argues that core language and humanities courses (e.g. writing, US history) should be protected, but "expensive fluff" courses should be eliminated as a cost-cutting measure. This "fluff" in fact represents the only significant epistemic challenge to the unreflective valuation of the Enlightenment project that birthed both scientific and humanistic traditions of study. This article analyzes recent COVID-related medical research to demonstrate how Black and feminist studies reject the assumptions of the Western canon in both humanities and STEM courses. Investing in these fields does not merely invest in students' communication skills, but in their ability to critically engage their home disciplines, fields of work, and political systems. Rather than defunding the interdisciplines, we urge institutions to model undergraduate studies more broadly in line with these fields.

The spectrum of clinical biomarkers in severe malaria and new avenues for exploration.

Globally, malaria is a public health concern, with severe malaria (SM) contributing a major share of the disease burden in malaria endemic countries. In this context, identification and validation of SM biomarkers are essential in clinical practice. Some biomarkers (C-reactive protein, angiopoietin 2, angiopoietin-2/1 ratio, platelet count, histidine-rich protein 2) have yielded interesting results in the prognosis of Plasmodium falciparum severe malaria, but for severe P. vivax and P. knowlesi malaria, similar evidence is missing. The validation of these biomarkers is hindered by several factors such as low sample size, paucity of evidence-evaluating studies, suboptimal values of sensitivity/specificity, poor clinical practicality of measurement methods, mixed Plasmodium infections, and good clinical value of the biomarkers for concurrent infections (pneumonia and current COVID-19 pandemic). Most of these biomarkers are non-specific to pathogens as they are related to host response and hence should be regarded as prognostic/predictive biomarkers that complement but do not replace pathogen biomarkers for clinical evaluation of SM patients. This review highlights the importance of research on diagnostic/predictive/therapeutic biomarkers, neglected malaria species, and clinical practicality of measurement methods in future studies. Finally, the importance of omics technologies for faster identification/validation of SM biomarkers is also included.

Dutch-beta thalassemia: A rare mutation from India

Introduction COVID-19 pandemic imposed challenges towards management of transfusion-dependent thalassemia patients (TDT). The need for regular blood transfusions and iron chelation therapy in these patients added further uncertainty about managing COVID-19 in this subset of patients. Aims To describe the clinical manifestations of SARS-CoV2 infection in patients with TDT and to evaluate feasibility of home management for patients with mild disease. Materials and methods The study involved TDT patients registered with thalassemia day care center, DMCH, who tested positive for COVID-19 by RTPCR. The demographics, clinical characteristics and baseline investigations were recorded. Patients with mild disease were managed at home and others were hospitalized. The daily home monitoring and the hospital course were noted and analyzed. Results The study involved 14 TDT patients who were infected with SARS-CoV2 with a mean age of 18.9 ± 6.7 years and a male to female ratio of 6:1. Five patients each were in low and high-risk groups and 4 patients were in highest risk group. The symptoms reported by these patients were fever, fatigue, sore throat etc. Two patients were hospitalized with one patient requiring oxygen therapy. He was discharged after 48 hours. The other patient had severe cardiac iron overload and diabetes mellitus. His iron chelation therapy was with held during hospitalization. He presented with a cardiac arrhythmia later and was cardioverted. Thus, all other patients were continued on iron chelation with deferasirox. Twelve patients were successfully managed at home with regular telephonic monitoring. Conclusion Patients with thalassemia do not necessarily need hospitalization for management of COVID-19. Home management can be offered to patients with mild disease in a resource limited setting. Iron chelation with deferasirox can be continued safely.

Comprehensive study on clinical responses and socioeconomic characteristics of COVID-19 patients during outbreak.

The severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) causes coronavirus disease 2019 (COVID-19) and emerged as a new public health crisis. This RNA virus, which has an origin in bats, is phenotypically and genotypically diverse. The source of transmission is by direct inhalation or contact with infected droplets or indirect through fomites. The disease shows an average incubation period of 2 to 14 days. The general symptoms include fever, cough, sore throat, breathlessness, fatigue, and malaise, although in a few it is found to be asymptomatic. The immune response shows variation from individual to individual, which varies from pneumonia, chest pain, acute respiratory distress syndrome, and multiorgan failure leading to death. The cytokine and chemokine responses play a major role in the severity of the infection. Laboratory diagnosis is done by molecular investigations. The socioeconomic conditions of individuals also play a role in disease manifestation. Treatment is supportive with symptomatic management. Preventive measures include social distancing, use of face masks, and contact tracing. This review will present a general overview of coronavirus and describe the clinical and socioeconomic features of the COVID-19 patients. It will also introduce comprehensive data of symptomatic and asymptomatic patients among different Asian and Western countries during the current pandemic. Furthermore, it also focuses on the most up-to-date information on effective management and prevention of COVID-19.

Silybin B and Cianidanol Inhibit Mpro and Spike Protein of SARS-CoV-2: Evidence from in silico Molecular Docking Studies.

BACKGROUND: The main proteases (Mpro) and Spike Proteins (SP) of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) play a major role in viral infection development by producing several non-structural proteins (nsPs) and penetrating the host cells, respectively. In this study, the potential of in silico molecular docking-based drug repositioning approach was exploited for identifying the inhibitors of Mpro and SP of SARS-CoV-2. METHODS: A total of 196 compounds, including various US-FDA-approved drugs, vitamins, and their analogs, were docked with Mpro (PDB IDs: 6YB7 and 6Y84), and the top six ligands were further tested for ADME properties, followed by docking with SP (PDB IDs: 6LXT and 6W41). RESULTS: Out of 196 compounds, binding energy (DE) of Silybin B (6YB7: DE: -11.20 kcal/mol; 6Y84: DE: - 10.18 kcal/mol; 6LXT: DE: -10.47 kcal/mol; 6W41: DE: -10.96 kcal/mol) and Cianidanol (6YB7: DE: -8.85 kcal/mol; 6LXT: DE: -9.36 kcal/mol; 6Y84: DE: -10.02 kcal/mol; 6W41: DE: -9.52 kcal/mol) demonstrated better binding and ADME properties compared with the currently endeavored drugs like Hydroxychloroquine and Lopinavir. Additionally, Elliptinone, Diospyirin, SCHEMBL94263, and Fiboflavin have shown encouraging results. Fiboflavin, an immunity booster, was found to inhibit both the Mpro and spike protein of SARSCoV- 2. It was observed that amino acid residues MET6, ALA7, PHE8, PRO9, ASP295, GLY302, VAL303, and THR304 play significant roles in protein-ligand interactions through hydrogen bonds and Vander Waals forces. CONCLUSION: Silybin B and Cianidanol showed excellent binding and ADME properties compared with the currently endeavored drugs and can be exploited as therapeutic options against SARS-CoV-2 infection after experimental validation and clinical trials.

Saponins: Extraction, bio-medicinal properties and way forward to anti-viral representatives.

Medicinal or herbal plants are widely used for their many favourable properties and are generally safe without any side effects. Saponins are sugar conjugated natural compounds which possess a multitude of biological activities such as medicinal properties, antimicrobial activity, antiviral activity, etc. Saponin production is a part of the normal growth and development process in a lot of plants and plant extracts such as liquorice and ginseng which are exploited as potential drug sources. Herbal compounds have shown a great potential against a wide variety of infectious agents, including viruses such as the SARS-CoV; these are all-natural products and do not show any adverse side effects. This article reviews the various aspects of saponin biosynthesis and extraction, the need for their integration into more mainstream medicinal therapies and how they could be potentially useful in treating viral diseases such as COVID-19, HIV, HSV, rotavirus etc. The literature presents a close review on the saponin efficacy in targeting mentioned viral diseases that occupy a high mortality rate worldwide. This manuscript indicates the role of saponins as a source of dynamic plant based anti-viral remedies and their various methods for extraction from different sources.

In Silico Studies Reveal Antiviral Effects of Traditional Indian Spices on COVID-19.

BACKGROUND: The global health emergency due to SARS-CoV-2 causing the COVID-19 pandemic emphasized the scientific community to intensify their research work for its therapeutic solution. In this study, Indian traditional spices owing to various medicinal properties were tested in silico for their inhibitory activity against SARS-CoV-2 proteins. SARS-CoV-2 spike proteins (SP) and main proteases (Mpro) play a significant role in infection development were considered as potential drug targets. METHODS: A total of 75 phytochemicals present in traditional Indian spices retrieved from the published literature and Dr. Duke's Phytochemical and Ethnobotanical Database, were docked with Mpro (PDB IDs: 6YNQ), and the SP (PDB IDs: 6LXT and 6YOR). RESULTS: Through the screening process, 75 retrieved phytochemicals were docked with spike protein (PDB IDs: 6LXT and 6YOR) and main protease (PDB ID: 6YNQ) of SARS-CoV-2. Among them, myricetin, a flavonoid (rank score: 6LXT: -11.72383; 6YOR: -9.87943; 6YNQ: -11.68164) from Allium sativum L and Isovitexin, an example of flavone (rank score: 6LXT: -12.14922; 6YOR: -10.19443; 6YNQ: -12.60603) from Pimpinella anisumL were the most potent ligands against SP and Mpro of SARS-CoV-2. Whereas, Astragalin from Crocus sativus L.; Rutin from Illicium verum, Oxyguttiferone from Garcinia cambogia; Scopolin from Apium graveolens L, Luteolin from Salvia officinalis, Emodin, Aloe-emodin from Cinnamomum zeylanicium and Apigenin from Allium sativum L showed better inhibition against Mpro than SP of SARS-CoV-2. The amino acid residues like SER, LYS, ASP and TYR were found playing important role in protein-ligand interactions via hydrogen bonding and Vander Waals forces. CONCLUSION: Optimal use of traditional spices in our daily meals may help fight against COVID-19. This study also paves the path for herbal drug formulation against SARS-CoV-2 after wet lab validation.

A Review on Emerging Infectious Diseases Prioritized Under the 2018 WHO Research and Development Blueprint: Lessons from the Indian Context.

Objective: This review describes the current scenario of a priority group of emerging infectious diseases (EIDs) listed by World Health Organization (WHO), and their main determinants and drivers for the emergence/spread of the diseases. The gaps and strategies developed by India to meet the WHO guidelines on the effective control of epidemic-prone diseases and outbreaks are also presented in the review. Methods: Epidemiologic information of EIDs, namely Crimean-Congo hemorrhagic fever (CCHF), Ebola and Marburg viruses (EboV and MarV), Zika virus (ZIKAV), Rift Valley fever (RVF), Middle East respiratory syndrome, severe acute respiratory syndrome (SARS), Nipah and Hendra virus (NiV and HeV), and Lassa fever virus (LASV), was drawn from international and national electronic databases to assess the situation. A brief view on the novel coronavirus disease 2019 (COVID-19) in India is also included. Results: There are no reports for human infection of EboV, MarV, RVF, and LASV in India. CCHF, SARS, ZIKAV, and NiV have been involved in outbreaks in eight states of India, while COVID-19 is currently reported from majority of states. India has deeply strengthened its surveillance and response system of outbreaks and epidemic-prone diseases. Conclusions: Despite its enormous improvements made in the anticipation of such threats, still more efforts are needed in sensitization of populations as well as hospital management in the context to EIDs, as addressed in the review. Furthermore, there is still a need for more research and development activities to efficiently control EIDs.