Convalescent Plasma Therapy in Coronavirus Disease 2019 (COVID-19) Patients: A Brief Review

The recent outbreak of the COVID-19 pandemic has reevaluated effectiveness of the convalescent plasma therapy (CPT). This review was carried out to assess the usefulness of CPT in critically COVID-19 patients, based on the published data to date. To the best of our knowledge, this is the second review of the usefulness of CPT in COVID-19 patients. PubMed, Google Scholar, Medline and EMBASE databases were searched for the relevant reports up to June 21, 2020. All the records of the published data were analyzed according to eligibility criteria protocols. Five different studies on CPT for COVID-19 critically ill patients were included in this review. The significant findings from the records are: (a) the CPT may help to reduce mortality in the seriously ill patients (b) administration of CPT increased antibodies titer and reduced the level of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA beyond detection limit (c) transfusion of convalescent plasma (CP) subsided clinical symptoms. Based on the currently available data, the CPT in the COVID-19 patients seems effective, safe and reduces mortality. There is urgent need of performing well-designed, multicenter clinical trials for establishing efficacy of the CPT in COVID-19 patients

AN EFFECTIVENESS SCAN OF THE PUBLIC HEALTH INSURANCE PROGRAM OF KHYBER PAKHTUNKHWA

This study target Health Insurance Program by government of KP, its budget allocation and utilization, level of awareness, and patient demographic profiles. The study also covers disease coverage and the minimum and maximum cost of the diseases. The study's population is the three major Medical Teaching Institutions (MTIs) of Peshawar. Sample of the study comprises 9,000 patients selected using purposive sampling approach from 2018 to 2020. The findings show that a lower average budget utilization ratio accounts for a lower level of public awareness. The study found that males dominate females by 55% in availing the Sehat Sahulat facility. The cardiac issue is the most common disease treated by the program. These findings are expected to assist policymakers in developing strategies for utilizing the program's resources. MTIs and insurance firms' managers may emphasize diseases cured and higher budget utilization ratios. Furthermore, policymakers may address less-covered areas and patient characteristics through awareness seminars to ensure the program's effectiveness. Finally, the study adds to the current literature by including imperial evidence from Khyber Pakhtunkhwa; Pakistan in the program. Future studies may address comparative analysis of the said program with the other insurance coverage programs

Pharmacodynamic evaluation of Terminalia bellerica for its antihypertensive effect.

Terminalia bellerica has been used as a folk medicine in a variety of ailments including hypertension. Our aim was to investigate the possible mechanism of its blood pressure (BP)-lowering effect. The crude extract of Terminalia bellerica fruit (Tb.Cr) which tested positive for flavonoids, sterols and tannins induced a dose-dependent (10-100 mg/kg) fall in the arterial BP of rats under anaesthesia. In isolated guinea-pig atria, Tb.Cr inhibited the force and rate of atrial contractions. In rabbit thoracic aorta, Tb.Cr relaxed the phenylephrine (PE, 1 μM) and K+ (80 mM)-induced contractions as well as suppressed the PE (1 μM) control peaks in the Ca++-free medium, similar to that caused by verapamil. The vasodilator effect of Tb.Cr was endothelium-independent as it was not opposed by Nω-nitro-L-arginine methyl ester in endothelium-intact rat aortic preparations and it occurred at the similar concentration in the endothelium-denuded tissues. These results indicate that Terminalia bellerica lowers BP through Ca++ antagonist mechanism and thus provides a sound mechanistic background for its medicinal use in hypertensio

Airways and cardiovascular inhibitory effects of Olea europea and Terminalia bellerica aqueous fractions

This study describes the bronchodilatory, vaso-relaxant and cardiac inhibitory effects of aqueous fractions of Olea europea (Oe.Aq) and Terminalia bellerica (Tb.Aq) fruits. In guinea-pig tracheal preparations, Oe.Aq and Tb.Aq caused concentrationdependent (0.03-5 mg/mL) relaxation of carbachol (CCh, 1 μM) and high potassium (80 mM)-induced contractions. When tested on rabbit aortic rings, against phenylephrine (PE, 1 μM) and potassium (K+)-induced contractions, Oe.Aq and Tb.Aq caused non-specific inhibition of the induced contractions. In isolated guinea-pig atria, Oe.Aq and Tb.Aq exhibited a suppressive effect on the atrial force and the rate of contractions. These data indicate that Olea europea and Terminalia bellerica aqueous fractions possess airways and cardiovascular inhibitory activities, via calcium antagonism like verapamil

Antisecretory and analgesic activities of Terminalia bellerica

This study describes the antisecretory and analgesic activities of the crude extract of Terminalia bellerica (Tb.Cr). T. bellerica extract inhibited the castor oil-induced intestinal fluid secretion in mice at the dose range of 300 - 1000 mg/kg. The extract also dose-dependently (50 - 100 mg/kg) reduced the numbers of acetic acid-mediated writhes in mice. These results indicate that T. bellerica exhibit antisecretory and anti-nociceptive effects, hence justifying its medicinal use in diarrhea and pain

Antispasmodic, Bronchodilator and Blood Pressure Lowering Properties of Hypericum oblongifolium - Possible Mechanism of Action

The crude extract of Hypericum oblongifolium (Ho.Cr), which tested positive for flavonoids, saponins and tannins caused concentration-dependent (0.1-1.0 mg/mL) relaxation of spontaneous and high K(+) (80 mM)-induced contractions in isolated rabbit jejunum preparations, suggesting a Ca(++) antagonistic effect, which was confirmed when pretreatment of the tissue with Ho.Cr produced a rightward shift in the Ca(++) concentration-response curves, like that caused by verapamil. Ho.Cr relaxed carbachol (1 mu M) and high K(+)-induced contractions in guinea pig tracheal preparations. It caused a dose-dependent (3-100 mg/kg) fall in arterial blood pressure of rats under anesthesia. In isolated guinea pig atria, Ho.Cr caused inhibition of both atrial force and rate of spontaneous contractions. When tested in rabbit aortic rings, Ho.Cr exhibited a vasodilator effect against phenylephrine (1 mu M) and high K(+)-induced contractions. These results indicate that Ho.Cr possesses gastrointestinal, respiratory and cardiovascular inhibitory effects, mediated via a Ca(++) antagonist mechanism

Studies on Buddleja asiatica antibacterial, antifungal, antispasmodic and Ca++ antagonist activities

Crude extract of Buddleja asiatica Lour and its fractions, chloroform (F1), ethyl acetate (F2) and nbutanol (F3) were evaluated for antibacterial, antifungal, antispasmodic and Ca++ antagonist activities. The antibacterial activity was performed against 11 types of bacteria. The crude extract and fractions F2 and F3 exhibited significant activity, while F1 showed low activity in killing the Shigella flexenari, Sternostoma boydi and Escherichia coli. In the rest bacteria, the crude extract and all the fractions (F1 to F3) revealed minimum to nil inhibitory effect. The fungicidal activity of the crude extract and all the fractions (F1 to F3) was also performed against six different fungi. The crude extract and fractions F1 and F3 displayed significant activity, while fraction F2 showed moderate activity against Fusarium solani. In the case of Microsporum canis, the crude extract and fraction F3 showed high activity but in the other four fungi, the inhibition area exhibited optimum to nil activity in crude extract and all the fractions (F1 to F3). In isolated rabbit jejunum preparations, B. asiatica crude extract caused concentration-dependent (0.03 to 1.0 mg/ml) relaxation of spontaneous and high K+ (80 mM)-induced contractions. The results indicate the antibacterial, antifungal, antispasmodic and Ca++ antagonist potential of B. asiatica Lour