SAR based Review on Diverse Heterocyclic Compounds with Various Potential Molecular Targets in the Fight against COVID-19: A Medicinal Chemist Perspective.

Coronavirus disease (COVID-19) was reported to be transmitted from bats to humans and, became a pandemic in 2020. COVID-19 is responsible for millions of deaths worldwide and still, the numbers are increasing. Further, despite the availability of vaccines, mutation in the virus continuously poses a threat of re-emergence of the more lethal form of the virus. So far, the repurposing of drugs has been exercised heavily for the identification of therapeutic agents against COVID-19, which led FDA to approve many drugs for the same e.g., remdesivir, favipiravir, ribavirin, etc. The anti-COVID drugs explored via other approaches include nirmatrelvir (used in combination with ritonavir as Paxlovid), tixagevimab and cilgavimab (both used in combination with each other) and others. However, these approved drugs failed to achieve a significant clinical outcome. Globally, natural bioactive have also been explored for anti-COVID-19 effects, based on their traditional medicinal values. Although the clinical findings suggest that FDA-approved drugs and natural bioactives can help reducing the overall mortality rate but the significant clinical outcome was not achieved. Therefore, the focus has been shifted towards new drug development. In line with that, a lot of work has been done and still going on to explore heterocyclic compounds as potent anti- COVID-19 drugs. Several heterocyclic scaffolds have been previously reported with potent antiinflammatory, anticancer, anti-viral, antimicrobial and anti-tubercular effects. Few of them are under consideration for clinical trials whereas others are under preclinical investigation. Hence, this review discusses the evidence of rationally designed and tested heterocyclic compounds acting on different targets against COVID-19. The present article will help the researches and will serve as a pivotal resource in the design and development of novel anti-COVID-19 drugs.

Intestinal ascariasis: the commonest cause of bowel obstruction in children at a tertiary care center in Kashmir.

BACKGROUND: Ascariasis is the commonest intestinal nematodal infestation in man. Ascariasis commonly inhabits small bowel although it can migrate to biliary tree and other orifices. The aim of this study is to analyze the presentation, diagnosis, management of bowel obstruction caused by Ascaris lumbricoides and to study various surgical complications. MATERIALS AND METHODS: All patients, 3-14 years of age, who attended the emergency department with diagnosis of intestinal obstruction were screened. Out of these patients with diagnosis of ascariasis based on history of passage of worms per mouth or rectum, X-ray or ultrasonography were followed for a minimum of 6 months. Data regarding the type of management, operative findings, operative procedure and post-operative complications were noted. RESULT: Out of 207 patients who were admitted with the diagnosis of intestinal obstruction, 131 were diagnosed as having obstruction due to ascariasis. Most of the patients were 3-5 years of age. Males and females were equally affected. 64 patients needed an operative intervention. Enterotomy was the commonest procedure followed by milking of worms and resection anastomosis. Appendicular perforation was seen in four and worm in gall bladder in one patient. Surgical complications were wound infection in 17, burst abdomen in four and fecal fistula in three patients. CONCLUSION: Round worm obstruction should be considered as the first differential diagnosis in any patient of intestinal obstruction in an endemic area like ours. Although most cases are managed conservatively, many patients still need surgical intervention. Efforts should be made toward eradication of this disease by proper sanitation, hygiene and the use of antihelminthics.