PHYSIO-CHEMICAL EVALUATION AND BIOLOGICAL ACTIVITY OF AJUGA BRACTEOSA WALL. AND VIOLA ODOROTO LINN

Background: Ajuga bracteosa and Viola odorata are frequently used by the native people of Swat-Pakistan for the curing of fever, malaria, cough, urinary and stomach disorders with slightly different practice of usage like raw powdered, extracts, decoction etc. Methods and Materials: Disc Diffusion Method was used for determination of antimicrobial activities of both plants. Nutrient Agar Media was used for the culturing and growth of all microbial strains. Vitamin C and minerals contents were determined by standard method of AOAC. Na and K were analyzed by using flame photometric technique. Micro minerals i.e. “Ni, Cr, Fe, Cu, Zn, Mn, Ca, Pb, and Mg” were determined by Atomic Absorption Spectrophotometer (AAS). Total Soluble Solid (TSS) was determined by using abbe refractometer and pH was determined by using pH meter. Results: The present study demonstrates that both plants exhibited antibacterial activities against P. aeruginos, E. coli, S. typhi, B. subtilis and S. aureus. The examined plants showed zone of inhibition for aqueous fraction (50.90, 45.90 %) against P. aeruginosa; for EtOAc fraction (41.37, 57.62%) against C. Albicans and for hexane fraction (25.86, 40.57%) against K. pneumoniae, respectively. Total of 14 different minerals (Na, K, P, Ca, Mg, Fe, Zn, Mn, Co, Cr, Ni, Cu, Pb, Cd) were determined and it was also observed that both the examined plants contained significant level of these analyzed minerals. The subject plants contained highest level of magnesium (295.75, 145.85 mg 100-1g) and calcium (212.49, 44.00 mg 100-1g) and potassium (152.6, 437.45 mg 100-1g) while moderate level P, Zn, Na and lower amount of Cd, Ni, Mn and Cu using Atomic Absorption, Flame Photometry and spectrophotometric techniques. V. odorata was found to contain a higher amount of vitamin C (64.05±12.37mg 100-1g) as compared to A. bracteosa (45.45 ± 7.29 mg 100-1 g). Conclusion: Findings of this study can persuade researchers for future comprehensive phytochemical study of these plants using state of art techniques and instruments, which include not only isolation of secondary metabolites from these plants but biological evaluation of isolated compounds both in vivo and in vitr

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Effectiveness of Gabapentin in Reducing Cravings and Withdrawal in Alcohol Use Disorder: A Meta-Analytic Review

Objective: The current meta-analysis synthesizes previous findings on the effect of gabapentin on alcohol withdrawal and craving. Data Sources: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, a search for relevant English-language literature published between January 1999 and February 2019 was conducted using PubMed and Google Scholar with the keywords alcohol use disorder, alcohol dependence, alcohol withdrawals, alcohol craving, “gabapentin in alcohol use, consumption,” and “gabapentin in alcohol withdrawals.” Study Selection and Data Extraction: Studies were included wherein gabapentin was used as an adjunctive or primary treatment of alcohol dependence/withdrawal. Studies included participants diagnosed with alcohol use disorder using DSM-IV, DSM-IV–TR, DSM-5, or the International Classification of Diseases, Tenth Revision (ICD-10). The search, as well as data extraction, was carried out by 3 blinded authors to preserve precision, using a template in Microsoft Excel to extract the needed data. Following the review of the initial 65 returns, 2 authors independently judged each trial by applying the inclusionary and exclusionary criteria, and any remaining disagreements were resolved by involving a third independent author. A total of 10 studies met the inclusion criteria and were selected for analysis. Subjects in these 10 studies were pooled using standard techniques of meta-analysis. Data Synthesis: Three sets of meta-analyses examined outcomes from (1) single-group pretest-posttest changes, (2) posttest differences between independent groups, and (3) differences in pretest-posttest change scores between independent groups. Statistically significant effect sizes were found for craving (P \u3c .01) and withdrawal (P \u3c .01, P \u3c .001) in the meta-analysis of single-group pretest-posttest outcome changes and were associated with a high level of heterogeneity. In contrast, the meta-analyses of posttest differences between independent groups—that of differences in pretest-posttest change scores between independent groups—did not yield significant effect sizes. Conclusions: Our analysis of pooled data provides evidence that the use of gabapentin to manage alcohol withdrawal symptomatology and related cravings is at least moderately effective. However, given the limited number of available well-designed studies, these findings require further support through more rigorously designed studies

Patients reasons for seeking mental health care according to standardized guidelines¹ in Timurgara district hospital, Pakistan (2012).

<p>Patients reasons for seeking mental health care according to standardized guidelines^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0097939#nt101" target="_blank">1</a>} in Timurgara district hospital, Pakistan (2012).</p

Mental health morbidity among new mental health consultations stratified by gender, Timurgara district hospital, Pakistan (2012).

<p>Mental health morbidity among new mental health consultations stratified by gender, Timurgara district hospital, Pakistan (2012).</p

Socio-demographic characteristics, source of referral and history of psychotropic medication use stratified by gender, Timurgara district hospital, Pakistan (2012).

<p>Socio-demographic characteristics, source of referral and history of psychotropic medication use stratified by gender, Timurgara district hospital, Pakistan (2012).</p

The main presenting complaints while seeking mental health care according to standardized guidelines³ stratified by gender, Timurgara district hospital, Pakistan (2012).

<p>The main presenting complaints while seeking mental health care according to standardized guidelines^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0097939#nt103" target="_blank">3</a>} stratified by gender, Timurgara district hospital, Pakistan (2012).</p

Associations between referral source and failure to return for a first follow up consultation among female patients attending mental health services, Timurgara district hospital, Pakistan (2012).

<p>Associations between referral source and failure to return for a first follow up consultation among female patients attending mental health services, Timurgara district hospital, Pakistan (2012).</p