Efficacy of a multiple-indication antiviral herbal drug (Saliravira®) for COVID-19 outpatients: A pre-clinical and randomized clinical trial study.

BACKGROUND: The scientific researches on COVID-19 pandemic topics are headed to an explosion of scientific literature. Despite these global efforts, the efficient treatment of patients is an in-progress challenge. Based on a meta-study of published shreds of evidence about compounds and their botanic sources in the last six decades, a novel multiple-indication herbal compound (Saliravira®) has been developed. Based on the antiviral, anti-inflammatory, and immune-enhancing properties of its ingredients, we hypothesized that Saliravira® has the potential to act as an antiviral agent, accelerate treatment, and reduce undesirable effects of COVID-19. METHODS: In this randomized, controlled, open-label clinical trial, COVID-19 outpatients were included by RT-PCR test or diagnosis of physicians according to the symptoms. Participants were randomly divided into intervention and control groups to receive Saliravira® package plus routine treatments of COVID-19 or routine treatments of COVID-19 alone, respectively. Saliravira® package includes tablets, nasal-sinuses spray, oral-pharynx spray, and inhaler drops. The treatment was for 10 days and followed up till 23 days after admission. RESULTS: On the 8th day, the "mean reduction rates" of viral load of the patients in the intervention group was 50% lower compared to the control group with a p-value < 0.05. The improvement of 10 out of 14 COVID-19 symptoms in the intervention group was significantly accelerated. The mean treatment duration of patients in the intervention group was 4.9 days less than the control group. In addition, no patients in the intervention group were hospitalized compared to 28% of the control group needed to be hospitalized.

A new electrochemical sensing platform based on HgS/graphene composite deposited on the glassy carbon electrode for selective and sensitive determination of propranolol.

Fabrication of selective, sensitive and reliable sensing platform for detection of propranolol (PRO) is still a great challenge. In this study, a new sensitive and selective electrochemical sensor was fabricated for the electrochemical determination of PRO using HgS/graphene composite. The incorporation of HgS microstructures on graphene sheets was done via a facile one-step method, where the simultaneous reduction of GO and the in-situ generation of HgS happened. Owing to the large surface area, excellent electronic conductivity and more electro-active sites provided by graphene, the HgS/graphene composite exhibited better electrochemical ability through the detection of PRO compared to the bare HgS. The HgS/graphene sensor revealed superb selectivity, good repeatability and superior stability of about 96.0 % of its original response after five weeks. Moreover, the sensor displayed excellent analytical parameters such as linear range of 0.5-50.0 µM with low detection limit of 0.05 µM (S/N = 3) and good sensitivity (0.1851 µA/µM). Furthermore, the constructed sensor was applied for detection of PRO in real and pharmaceutical samples, with good recoveries, ranging from 96.0 to 102.0%. The HgS/graphene composite provided here displayed satisfactory electrochemical features may hold great potential to the improvement of electrochemical sensors and electronic devices.

A biocompatible nanoplatform formed by MgAl-layered double hydroxide modified Mn3O4/N-graphene quantum dot conjugated-polyaniline for pH-triggered release of doxorubicin.

In this work, for the first time, a novel pH-sensitive biocompatible multifunctional nanocarrier was fabricated by the combination of MgAl-layered double hydroxide, Mn3O4 nanoparticles, N-graphene quantum dot and polyaniline (PANI/N-GQD/MO/LDH) for doxorubicin (DOX) delivery in breast cancer cells. Electrochemical techniques, including cyclic voltammetry (CV) and differential pulse voltammetry (DPV), were employed for proving the surface modification process. The integration of polyaniline on the surface of the nanocarrier provides ultrahigh DOX encapsulation up to 90% and possesses a slow-release behavior (4% after 72 h) under normal physiological conditions. However, releasing ~80% of the drug in a low-pH environment as a model of the extracellular tumor environment happened, presenting a pH-triggered release. The cell viability using MTT assay reveals that the DOX/PANI/N-GQD/MO/LDH had no apparent adverse effect on the viability of human L929 normal cells. Furthermore, a significant inhibition ratio against human breast cancer cell lines (MCF-7) was observed when the cells were treated with the DOX-loaded PANI/N-GQD/MO/LDH nanocarrier, suggesting that this nanocarrier could increase the therapeutic efficacy of DOX. The hemolysis rates (HRs) of human fresh blood, coagulation prothrombin time (PT), activated partial thromboplastin time (APTT), and complement activation (C3 and C4 levels) revealed the excellent blood compatibility of the nanocarrier. Thus, the nano-vehicle designed in this study could be used as a novel multifunctional and synergistic, pH-triggered platform for delivering various anti-cancer drugs and other biomedical applications.

A novel selective ternary platform fabricated with MgAl-layered double hydroxide/NiMn2O4 functionalized polyaniline nanocomposite deposited on a glassy carbon electrode for electrochemical sensing of levodopa.

In this study, a novel selective electrochemical sensor was fabricated for determination of levodopa (LD) using a glassy carbon electrode modified with MgAl-layered double hydroxide/NiMn2O4 functionalized polyaniline nanocomposite (LDH/NMO/PANI) and its successful formation was confirmed by various techniques. Owing to the high surface area and outstanding conductivity features provided by the combination of MgAl-LDH, NiMn2O4 and PANI nanoparticles, this ternary nanocomposite exhibited excellent electrochemical activity towards the detection of LD compared with the electrode modified by the pristine MgAl-LDH and MgAl-LDH/NiMn2O4 binary nanocomposite. In addition, enormous quantities of amine and imine functional groups on the surface of PANI lead to a strong affinity for attachment to organic molecules such as LD. The ternary nanocomposite modified electrode exhibited excellent analytical parameters such as wide linear response from 0.1 to 100 µM with very low detection limit of 0.005 µM, good reproducibility and long-term stability which are superior among the LD electrochemical sensors. Besides, the constructive sensor possessed acceptable selectivity for recognition of LD in the presence of a variety of potentially interfering species and can also effectively avoid the interference of dopamine (DA) and ascorbic acid (AA). Consequently, the LDH/NMO/PANI/GC electrode was effectively applied to detect LD in human plasma and urine samples with good recoveries, ranging from 98.0-100.1% and it shows potential usage in clinical researches.

A Peritoneal Dialysis Access Quality Improvement Initiative: A Single-Center Experience.

Background:Little evidence exists regarding optimal peritoneal dialysis (PD) access insertion pathways, benchmarking for patency targets, and definitions of access dysfunction.Methods:This quality improvement (QI) project evaluated patients with PD catheters inserted at a single center in Toronto, Canada, following: establishment of PD catheter insertion protocols, a PD access coordinator, PD access operator training, and outcomes reporting. We define primary vs secondary PD catheter dysfunction by presentation before/after initial home PD treatment. We report catheter dysfunction rates, interventions restoring PD catheter patency (interventional radiology [IR] vs advanced laparoscopic [AL]) (embedded vs non-embedded) between 2012 and 2017.Results:A total of 297 first PD catheters were inserted between January 2012 and December 2017. Interventional radiology PD catheters (n = 94) were placed in older patients with greater comorbidities and less prior abdominal surgery than AL-placed catheters. Indications for IR insertion included need for urgent dialysis given resource availability (36.2% [n = 34]) and prohibitive surgical risk (26.6% [n = 25]). Interventional radiology-inserted catheters had overall (primary and secondary) dysfunction rates of 17%. Non-embedded AL catheters had 16.1% overall dysfunction. Embedded AL-inserted PD catheters had a 24.6% overall dysfunction rate. Among all dysfunctional catheters, IR manipulation was successful in 31% (n = 11), and surgical revision was necessary in all unsuccessful cases with either lysis of adhesions or omentopexy to establish patency.Conclusion:Our PD catheter QI initiative involved tracking, outcome reporting, defining PD catheter dysfunction and PD access insertion pathway development, yielding important insights into opportunities for program improvement. Multicenter research initiatives are needed to further improve PD access dysfunction definitions and to establish the best benchmarks for these metrics.

Use of the BioHole™ device for the creation of tunnel tracks for buttonhole cannulation of fistula for hemodialysis.

Buttonhole cannulation is a method of cannulation of native arteriovenous fistulae traditionally practiced by self-cannulators. At St Michael's Hospital, this method has been modified to allow its use in problematic fistulae by multiple cannulators. In a busy dialysis unit, the need for a few specific cannulators to establish the tunnel tracks in combination with the variable dialysis schedules creates logistical challenges. A new method of creating tunnel tracks with the use of the BioHole™ device was evaluated. Buttonhole tracks were created in 12 patients using a peg of polycarbonated material with a holder (BioHole™ kit). The peg was inserted into the path left by the hemodialysis sharp needle following the index cannulation. Four of the 12 patients had an alternate access. Buttonhole tracks were successfully created in all the patients, albeit in 2 patients, the initial attempt to establish buttonhole tracks was aborted due to complications and the procedure was rescheduled. Compared with the modified buttonhole technique, pain on cannulation following track creation was significantly less in the BioHole™ group (P < 0.001). Ease of cannulation was significantly improved in the BioHole™ group (P<0.05) when compared with that in thrice-weekly patients using the modified buttonhole technique. Hemostasis postdialysis did not differ between the study groups. The use of the BioHole™ device is effective in the creation of tunnel tracks for buttonhole cannulation, is associated with less pain, and simplifies the logistics of arranging patient and nurses' schedules.

A simple method to create buttonhole cannulation tracks in a busy hemodialysis unit.

The preference for fistulae as the hemodialysis access of choice has led to a significant number of accesses that are less than ideal for cannulation. Buttonhole cannulation is ideal for such accesses, but the technique for creation provides major challenges. In 12 patients, buttonhole tunnel tracks were created by leaving the polyurethane catheter of a Clampcath hemodialysis needle indwelling for 10 days after the initial cannulation. After each dialysis the catheter was flushed, and dressed with an antibacterial ointment and gauze. Dialysis was carried out via the catheter during that time. After day 10, the catheter was removed, the tunnel track covered with an antibacterial dressing and the tunnel track was cannulated with a dull buttonhole needle at the next dialysis. Successful buttonhole accesses were created in 11 patients after 10 days, the 12th patient required a single sharp needle cannulation before using dull needles. During the first 2 weeks of dull needle cannulation both pain experienced on cannulation and the difficulty cannulating the access were significantly less than in the classical buttonhole technique (P<0.01). Complications during the follow-up period (6 months-1.5 years) included difficulty cannulating with a dull needle (22) and antibacterial agent induced contact dermatitis (4). There was no episode of sepsis or tunnel track infection. Initial cannulation of the fistula using a Clampcath hemodialysis needle, leaving the polyurethane catheter indwelling for 10 days, is a simple, safe, and effective technique for the creation of buttonhole tunnel tracks.