Pharmacological therapy for COVID-19: Where are we now and where are we going?

Background: Up to the point of writing this review, there is no scientific evidence of any effective medical therapy for coronavirus disease 2019 (COVID-19). In this review, we attempted to discuss the current summary of evidence of some medication, currently in trial for the treatment of COVID-19. Material and Methods: We have done an electronic literature search using the following database: PubMed, Medline, Scopus and Google scholar. These databases were searched using the keywords COVID-19 and pharmacological therapy. Results: At present, there are no well randomized controlled studies which can give evidence for most of the therapy used for COVID-19. Several medications are in trials for COVID-19, among them: 1/ chloroquine and hydroxychloroquine;  2/anti-virals oseltamivir, remdesivir, lopinavir/ritonavir and other protease inhibitors; 3/antibiotics macrolide (Azithromycin); 4/cytokine therapy interferon; 5/ humanized monoclonal antibody tocilizumab; 6/adjunct therapies vitamins C, D, and herbal medicine; 7/ COVID-19 convalescent plasma; 8/systemic steroids; 9/expected COVID-19 vaccine. We have also included some of the herbal medicines that are commonly and widely used in the Middle East, Asia as well in Sudan, (black seeds, honey and Acacia Nilotica). It is worth mentioning that these herbal medicines have shown benefits in treating other diseases, but the evidence of their benefit in COVID-19 still needs to be established. Conclusion: Currently there is no pharmacological therapy for the COVID-19. More research and randomized clinical trials are needed to find effective therapy or vaccine against COVID-19. Keywords: COVID-19, Pharmacotherapy, herbal medicine, Suda

Progress in biomimetic leverages for marine antifouling using nanocomposite coatings

Because of the environmental and economic casualties of biofouling on maritime navigation, modern studies have been devoted toward formulating advanced nanoscale composites in the controlled development of effective marine antifouling self-cleaning surfaces. Natural biomimetic surfaces have the advantages of micro-/nanoroughness and minimized free energy characteristics that can motivate the dynamic fabrication of superhydrophobic antifouling surfaces. This review provides an architectural panorama of the biomimetic antifouling designs and their key leverages to broaden horizons in the controlled fabrication of nanocomposite building blocks as force-driven marine antifouling models. As primary antifouling designs, understanding the key functions of surface geometry, heterogeneity, superhydrophobicity, and complexity of polymer/nanofiller composite building blocks on fouling-resistant systems is crucial. This review also discusses a wide range of fouling release coating systems that satisfy the growing demand in a sustainable future environment. For instance, the integration of block, segmented copolymer-based coatings and inorganic–organic hybrid nanofillers enhanced the model's antifouling properties with mechanical, superhydrophobic, chemically inert, and robust surfaces. These nanoscale antifouling systems offered surfaces with minimized free energy, micro-/nanoroughness, anisotropic heterogeneity, superior hydrophobicity, tunable non-wettability, antibacterial efficiency, and mechanical robustness. The confined fabrication of nanoscale orientation, configuration, arrangement, and direction along the architectural composite building blocks would yield excellent air-entrapping ability along the interfacial surface grooves and interfaces, which optimized the antifouling coating surfaces for long-term durability. This review provides systematic evidence of the effect of structurally folded nanocomposites, nanofiller tectonics, and building blocks on the creation of outstanding superhydrophobicity, self-cleaning surfaces, and potential antifouling coatings. The development of modern research gateways is a candidate for the sustainable future of antifouling coatings

Non-invasive diagnostic tests for Helicobacter pylori infection

BACKGROUND: Helicobacter pylori (H pylori) infection has been implicated in a number of malignancies and non-malignant conditions including peptic ulcers, non-ulcer dyspepsia, recurrent peptic ulcer bleeding, unexplained iron deficiency anaemia, idiopathic thrombocytopaenia purpura, and colorectal adenomas. The confirmatory diagnosis of H pylori is by endoscopic biopsy, followed by histopathological examination using haemotoxylin and eosin (H & E) stain or special stains such as Giemsa stain and Warthin-Starry stain. Special stains are more accurate than H & E stain. There is significant uncertainty about the diagnostic accuracy of non-invasive tests for diagnosis of H pylori. OBJECTIVES: To compare the diagnostic accuracy of urea breath test, serology, and stool antigen test, used alone or in combination, for diagnosis of H pylori infection in symptomatic and asymptomatic people, so that eradication therapy for H pylori can be started. SEARCH METHODS: We searched MEDLINE, Embase, the Science Citation Index and the National Institute for Health Research Health Technology Assessment Database on 4 March 2016. We screened references in the included studies to identify additional studies. We also conducted citation searches of relevant studies, most recently on 4 December 2016. We did not restrict studies by language or publication status, or whether data were collected prospectively or retrospectively. SELECTION CRITERIA: We included diagnostic accuracy studies that evaluated at least one of the index tests (urea breath test using isotopes such as13C or14C, serology and stool antigen test) against the reference standard (histopathological examination using H & E stain, special stains or immunohistochemical stain) in people suspected of having H pylori infection. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the references to identify relevant studies and independently extracted data. We assessed the methodological quality of studies using the QUADAS-2 tool. We performed meta-analysis by using the hierarchical summary receiver operating characteristic (HSROC) model to estimate and compare SROC curves. Where appropriate, we used bivariate or univariate logistic regression models to estimate summary sensitivities and specificities. MAIN RESULTS: We included 101 studies involving 11,003 participants, of which 5839 participants (53.1%) had H pylori infection. The prevalence of H pylori infection in the studies ranged from 15.2% to 94.7%, with a median prevalence of 53.7% (interquartile range 42.0% to 66.5%). Most of the studies (57%) included participants with dyspepsia and 53 studies excluded participants who recently had proton pump inhibitors or antibiotics.There was at least an unclear risk of bias or unclear applicability concern for each study.Of the 101 studies, 15 compared the accuracy of two index tests and two studies compared the accuracy of three index tests. Thirty-four studies (4242 participants) evaluated serology; 29 studies (2988 participants) evaluated stool antigen test; 34 studies (3139 participants) evaluated urea breath test-13C; 21 studies (1810 participants) evaluated urea breath test-14C; and two studies (127 participants) evaluated urea breath test but did not report the isotope used. The thresholds used to define test positivity and the staining techniques used for histopathological examination (reference standard) varied between studies. Due to sparse data for each threshold reported, it was not possible to identify the best threshold for each test.Using data from 99 studies in an indirect test comparison, there was statistical evidence of a difference in diagnostic accuracy between urea breath test-13C, urea breath test-14C, serology and stool antigen test (P = 0.024). The diagnostic odds ratios for urea breath test-13C, urea breath test-14C, serology, and stool antigen test were 153 (95% confidence interval (CI) 73.7 to 316), 105 (95% CI 74.0 to 150), 47.4 (95% CI 25.5 to 88.1) and 45.1 (95% CI 24.2 to 84.1). The sensitivity (95% CI) estimated at a fixed specificity of 0.90 (median from studies across the four tests), was 0.94 (95% CI 0.89 to 0.97) for urea breath test-13C, 0.92 (95% CI 0.89 to 0.94) for urea breath test-14C, 0.84 (95% CI 0.74 to 0.91) for serology, and 0.83 (95% CI 0.73 to 0.90) for stool antigen test. This implies that on average, given a specificity of 0.90 and prevalence of 53.7% (median specificity and prevalence in the studies), out of 1000 people tested for H pylori infection, there will be 46 false positives (people without H pylori infection who will be diagnosed as having H pylori infection). In this hypothetical cohort, urea breath test-13C, urea breath test-14C, serology, and stool antigen test will give 30 (95% CI 15 to 58), 42 (95% CI 30 to 58), 86 (95% CI 50 to 140), and 89 (95% CI 52 to 146) false negatives respectively (people with H pylori infection for whom the diagnosis of H pylori will be missed).Direct comparisons were based on few head-to-head studies. The ratios of diagnostic odds ratios (DORs) were 0.68 (95% CI 0.12 to 3.70; P = 0.56) for urea breath test-13C versus serology (seven studies), and 0.88 (95% CI 0.14 to 5.56; P = 0.84) for urea breath test-13C versus stool antigen test (seven studies). The 95% CIs of these estimates overlap with those of the ratios of DORs from the indirect comparison. Data were limited or unavailable for meta-analysis of other direct comparisons. AUTHORS' CONCLUSIONS: In people without a history of gastrectomy and those who have not recently had antibiotics or proton ,pump inhibitors, urea breath tests had high diagnostic accuracy while serology and stool antigen tests were less accurate for diagnosis of Helicobacter pylori infection.This is based on an indirect test comparison (with potential for bias due to confounding), as evidence from direct comparisons was limited or unavailable. The thresholds used for these tests were highly variable and we were unable to identify specific thresholds that might be useful in clinical practice.We need further comparative studies of high methodological quality to obtain more reliable evidence of relative accuracy between the tests. Such studies should be conducted prospectively in a representative spectrum of participants and clearly reported to ensure low risk of bias. Most importantly, studies should prespecify and clearly report thresholds used, and should avoid inappropriate exclusions

Holmium: YAG Versus Cold Knife Internal Urethrotomy in the Management of Short Urethral Strictures: A Randomized Controlled Trial: Holmium Versus Cold Knife VIU

Introduction: our study aimed to assess the safety and efficacy of Holmium: YAG laser internal urethrotomy compared to the cold knife internal urethrotomy.Methods: Eighty adult male patients presented with a urethral stricture less than 1.5 cm were included in our study; they were randomly allocated into 2 groups representing Holmium and cold knife internal urethrotomy. A careful evaluation with ascending cystourethrogram and uroflowmetry were done on all patients, and they were followed up for 1 year with uroflowmetry.Results: Each group included 40 patients sharing the same demographic data. The most common cause of a urethral stricture in both groups was iatrogenic injury. The mean operative time of the cold knife urethrotomy procedure was 10.98 ± 2.40 minutes compared to 15.43 ± 2.48 minutes in the holmium laser urethrotomy group with a highly significant difference. The results showed success rates of 90% and 80% for the holmium laser and cold knife internal urethrotomy groups respectively. The perioperative complication according to the Clavien-Dindo classification, showed no statistically significant difference in grade 1 and 2 complications. A recurrence rate with the need for redo surgery representing grade 3B complication was seen in 4 cases in the Holmium group compared to 8 cases in the cold knife group with a statistically significant difference.Conclusion: Both Holmium Laser and cold knife internal urethrotomy are effective surgical options for the treatment of a urethral stricture less than 1.5 cm with a promising outcome after 1-year follow-up with a better success rate using the Holmium laser. Doi:10.34172/jlms.2021.3

Dual Penta-Compound Combination Anti-Synchronization with Analysis and Application to a Novel Fractional Chaotic System

This paper studies a fractional-order chaotic system with sine non-linearities and highlights its dynamics using the Lyapunov spectrum, bifurcation analysis, stagnation points, the solution of the system, the impact of the fractional order on the system, etc. The system considering uncertainties and disturbances was synchronized using dual penta-compound combination anti-synchronization among four master systems and twenty slave systems by non-linear control and the adaptive sliding mode technique. The estimates of the disturbances and uncertainties were also obtained using the sliding mode technique. The application of the achieved synchronization in secure communication is illustrated with the help of an example

Recent progress in marine foul-release polymeric nanocomposite coatings

Progress in materials science is associated with the development of nanomaterials in terms of energy-saving, environmentally friendly, and low-cost methods. Since the use of tributyltin compounds in antifouling coatings was banned in 2003, the search for ecofriendly alternatives has been promoted. Foul-release (FR) nanocoatings have been extensively investigated because of their non-stick, ecological, and economic advantages. Such nanocomposite systems are dynamic non-stick surfaces that deter any fouling attachment through physical anti-adhesion terminology. Instead of biocidal solutions, several functional FR nanocomposite coatings have been developed to counter biofouling and biocorrosion with ecological and ecofriendly effects. Selected inorganic nanofillers have been incorporated because of their enhanced interaction at the filler‐polymer interface for nanocomposites. Metallic nanoparticles and their oxides have also been widely explored because of their unique morphological characteristics and size-dependent, self-cleaning properties. In modeling a novel series of FR nanocoatings, two modes of prevention are combined: chemical inertness and physical microfouling repulsion for maritime navigation applications. Long-term durability and self-cleaning performance are among the advantages of developing effective, stable, and ecofriendly modeling alternatives. This review provides a holistic overview of nano-FR research achievements and describes recent advancements in non-stick marine nanocoatings for ship hulls. This review highlights the key issues of nanocomposite structures and their features in improving the biological activity and surface self-cleaning performance of ship hulls. This review may also open new horizons toward futuristic developments in FR nanocomposites for maritime navigations

Novel delivery system with a dual–trigger release of savory essential oil by mesoporous silica nanospheres and its possible targets in leukemia cancer cells: in vitro study

Abstract Introduction Essential oils (EOs) are complex structures and possess several pharmacological effects. Nanomedicine offers a solution for their major limitations, including poor solubility, volatility, and non–controlled release, preventing their clinical use. Methods Here, we developed a novel delivery system by nanoformulations that were prepared by impregnating savory essential oil (SA) into mesoporous silica nanoparticles (MSNs). The nanoformulations were characterized and examined for their anticancer activities on cancer cells (HepG2 liver and HL60 leukemia cells) and MRC5 normal cells. We further tested the mechanisms of action and possible molecular targets against HL60 cells. Results The results demonstrated that SA was governed by nanoformulations under the dual–trigger release of pH/glutathione, and it typically fit the Korsmeyer–Peppas kinetic model. The nanoformulations enhanced the anticancer effect against HepG2 cells and HL60 cells compared to SA but were less cytotoxic to MRC5 normal cells and regulated various molecular pathways of apoptosis. Most importantly, new results were obtained on the genetic regulation principle through the high inhibition of long noncoding RNAs (HOTAIR, HULC, CCAT1, and H19) and matrix metalloproteinases (MMP–2 and MMP–9), providing a novel leukemia target. Conclusions These results suggest potential impacts for nanoformulations composed of SA with a sustained release pattern controlled by dual–trigger release of pH/GSH that enhanced anticancer cells. This approach may offer a new route for using EOs as new targets for cancers and open the door for deep preclinical investigations