Clinical characteristics of malaria in COVID-19: A systematic review of case reports.

Aims: Severe acute respiratory syndrome-coronavirus-2 is a viral infection that was first discovered in Wuhan, Hubei province, China, in December 2019. Effects of COVID-19 infection could drastically influence other concomitant diseases like Malaria. Malaria and COVID-19 may mimic each other and share look-alike symptoms. The aim of this systematic review was to analyze the clinical and biochemical characteristics of malaria and COVID-19 synergism that was based on the published case reports. Subjects and Methods: An extensive literature search was carried out between May 2020 and February 2022 in PubMed, Google Scholar, and EMBASE. Our study was devised according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results: We have evaluated 16 case reports and one case series of coinfection of malaria with COVID-19. It has been observed that all the patients showed lymphopenia, fever, headache (52%), vomiting (47%), cough (38%), chills (38%), body ache (38%), myalgia (28%), and sweating (14%). Despite unprecedented times, whenever there is a suspicion, we recommend that medical practitioners should be alert to presenting plethora features of COVID-19 and confirm with polymerase chain reaction test. Conclusion: We conclude that screening for COVID-19 should also be performed to mitigate missed diagnoses due to the long incubation period of novel coronavirus. Especially in vulnerable population, we should suspect other concurrent diseases and diagnoses in patients presenting with the symptoms of COVID-19 infection.

Formulation of Intranasal Mucoadhesive Thermotriggered In Situ Gel Containing Mirtazapine as an Antidepressant Drug.

The purpose of the present work was to develop nanoemulsion-based formulations of mirtazapine for intranasal delivery using a spray actuator to target the brain for treating depression. Research on the solubility of medications in different oils, surfactants, co-surfactants, and solvents has been done. Using pseudo-ternary phase diagrams, the various ratios of the surfactant and co-surfactant mix were computed. Thermotriggered nanoemulsion was formulated using different concentrations of poloxamer 407 (i.e., 15%, 15.5%, 16%, 16.5% up to 22%). Similarly, mucoadhesive nanoemulsion using 0.1% Carbopol and water-based plain nanoemulsions were also prepared for comparative assessment. The developed nanoemulsions were analyzed for physicochemical properties, i.e., physical appearance, pH, viscosity, and drug content. Drug-excipient incompatibility was determined by Fourier transform infrared spectral (FTIR) analysis and differential scanning calorimetry (DSC). In vitro drug diffusion studies were conducted for optimized formulations. Among the three formulations, RD1 showed the highest percentage of drug release. Ex vivo drug diffusion studies were conducted on freshly excised sheep nasal mucosa with Franz diffusion cell simulated nasal fluid (SNF) for all three formulations up to 6 h, and the thermotriggered nanoemulsion (RD1) showed 71.42% drug release with 42.64 nm particle size and a poly dispersity index of 0.354. The zeta potential was found to be -6.58. Based on the above data, it was concluded that thermotriggered nanoemulsion (RD1) has great potential to be used as an intranasal gel for treating depression in patients. It can offer great benefits by reducing dosing frequency and improving bioavailability of mirtazapine by direct nose-to-brain delivery.

Impact of vitamin B6 deficiency on the severity of diabetic peripheral neuropathy - A cross sectional study.

Background: Diabetic Peripheral Neuropathy is one of the most important and significantly prevalent microvascular complications of Diabetes Mellitus. Pyridoxine is a key nutrient for protecting nerve health. The objective of this research is to study the prevalence rate of pyridoxine deficiency in Diabetic neuropathy patients, to understand the correlation between various biochemical and markers of diabetic neuropathy and pyridoxine deficiency. Results: 249 patients were selected for the study based on the selection criteria participants. 51.8% prevalence of pyridoxine deficiency in Diabetic neuropathy patients. The nerve conduction velocity significantly reduced in pyridoxine deficiency cases (p < 0.05). A strong inverse relationship is observed with fasting blood sugar levels and glycated hemoglobin pyridoxine deficiency might contribute to impaired glucose tolerance. Conclusion: There also exists a strong inverse relationship with glycemic markers. Significant direct correlation is observed with nerve conduction velocity. Pyridoxine also has properties of antioxidant which may be utilized for the management of Diabetic Neuropathy.

Development and In Vitro Characterization of Antibiotic-Loaded Nanocarriers for Dental Delivery.

The aim of this research work was to formulate and evaluate ciprofloxacin hydrochloride-loaded nanocarriers for treating dental infections and bone regeneration. Periodontal infection is associated with inflammation, soft tissue destruction, and bone loss. The objective of the study was to extract ß tricalcium phosphate (ß-TCP) from coral beach sand using the hydrothermal conversion method and load these nanocarriers with ciprofloxacin hydrochloride. The developed drug-loaded nanocarriers were evaluated for various parameters. In vitro drug-loading studies showed the highest drug loading of 71% for F1 with a drug: carrier ratio compared to plain ciprofloxacin hydrochloride gel. ß-TCP and nanocarriers were evaluated for powder characteristics and the results were found to have excellent and fair flowability. In vitro drug release studies conducted over a period of 5 days confirmed the percentage drug release of 96% at the end of 120 h. Nanocarriers were found to be effective against S. aureus and E. coli showing statistically significant antibacterial activity at (* p < 0.05) significant level as compared to plain ciprofloxacin hydrochloride gel. The particle size of ß-TCP and nanocarriers was found to be 2 µm. Fourier transform infra-red studies showed good compatibility between the drug and the excipients. Differential scanning calorimetry studies revealed the amorphous nature of the nanocarriers as evident from the peak shift. It is obvious from the XRD studies that the phase intensity was reduced, which demonstrates a decrease in crystallinity. Nanocarriers released the drug in a controlled manner, hence may prove to be a better option to treat dental caries as compared to conventional treatments.

A retrospective study on evaluation of anti-hypertensive drugs used in gestational hypertension.

To evaluate the anti-hypertensive drugs used in pregnancy induced hypertension and to determine the safety of the anti-hypertensive drugs administered in gestational hypertensive patients. Pregnancy induced hypertension are very common in women and if unnoticed may lead to severe complications. The appropriate therapy is very much essential for the welfare of both the mother and the child. Hence this study was undertaken to identify the commonly used and safe drugs in pregnancy induced hypertension. This retrospective study was carried out in the Medical Records Department of a specialized gynecological hospital. Patient details - Name, Age, Sex, Occupation, Body Mass Index (BMI), Social History (SH), Past Medical History (PMH), Diagnosis, mother weight and BP, baby weight, specific anti-hypertensives given, outcome, complication in both mother and baby if any, duration of anti-hypertensive drug use, duration of hospital stay were all recorded in a proforma. Adverse Drug Reactions for anti-hypertensive drugs given were also noted. Nifedipine was the most common drug prescribed both in monotherapy and dual therapy. Adverse drug reaction was seen only in 2% of patients. Pregnancy induced hypertension is one of the riskiest conditions to occur during pregnancy. Dietary modification and lifestyle modification might help in controlling pre-eclampsia.