Respiratory Failure in COVID-19 Condition

Respiratory failure, characterized as the unsuccessful maintenance of adequate gas exchange, is associated with abnormalities of arterial blood gas tensions. The coronavirus disease-2019 (COVID-19) is majorly a respiratory disease capable of causing infection caused by the newly discovered coronavirus (SARS-CoV-2) with a consequential effect on respiratory failure. Simply put, respiratory failure is the major clinical demonstration of COVID-19 and the frontline cause of the associated mortality. Respiratory failure instigated by COVID-19 has some clinical features in affected patients. Disorders of the respiratory neuromuscular, airway, pulmonary vesicles, and lung parenchyma all manifest in COVID-19. These features are heterogeneous and categorized into progressive respiratory distress and unique “silent hypoxemia” as two phenotypes. Knowing the exact phenotype in patients with COVID-19 has been of important clinical significance in seeking the right treatment strategies for treating respiratory failure. The chapter will, therefore, provide more insights into the pathophysiology, clinical attributes, pathogenesis, and treatment approach of respiratory failure in COVID-19 conditions, as well as evaluate any similarities and differences that may exist

Ocimum gratissimumLinn. Leaves reducethe key enzymes activities relevant toerectile dysfunction in isolated penile andtesticular tissues of rats

Background:Ocimum gratissimumL. is a medicinal plant widely grown in tropical and subtropical regions with theleafdecoctionusuallytakeninfolkmedicinetoenhanceerectileperformanceinmenalthoughtheprobablemechanism of actions remains undetermined. This study examined the inhibitory potentials ofOcimum gratissimumleaves on some key enzymes associated with erectile dysfunction in penile and testicular tissues of the rat.Methods:Inhibitory effect of aqueous extract (1:10w/v)ofO. gratissimumleaves on the activities of phosphodiesterase-5(PDE-5), arginase, angiotensin I–converting enzyme (ACE), and acetylcholinesterase (AChE) in penile and testicular tissueswere assessed. Also, the extract was investigated for ferric reducing antioxidant property(FRAP) and 1,1-diphenyl-2-picryl-hydrazil (DPPH) radical scavenging abilities.Results:The extract showed higher PDE-5 (IC50=43.19μg/mL), ACE (IC50= 44.23μg/mL), AChE (IC50= 55.51μg/mL) andarginase (IC50= 46.12μg/mL) inhibitory activity in thepeniletissuethanPDE-5(IC50= 44.67μg/mL), ACE (IC50= 53.99μg/mL), AChE (IC50= 60.03μg/mL) and arginase (IC50=49.12μg/mL) inhibitory activity in the testicular tissue homogenate.Furthermore, the extract scavenged free radicals and in a dose-dependent manner.Conclusion:Theenzymeactivitiesdisplayedmightbeassociatedwiththebioactivecompoundspresentintheextractwhich could possibly explain its use in the management of erectile dysfunction (ED)

Ocimum gratissimum Linn. Leaves reduce the key enzymes activities relevant to erectile dysfunction in isolated penile and testicular tissues of rats

Abstract Background Ocimum gratissimum L. is a medicinal plant widely grown in tropical and subtropical regions with the leaf decoction usually taken in folk medicine to enhance erectile performance in men although the probable mechanism of actions remains undetermined. This study examined the inhibitory potentials of Ocimum gratissimum leaves on some key enzymes associated with erectile dysfunction in penile and testicular tissues of the rat. Methods Inhibitory effect of aqueous extract (1:10 w/v) of O. gratissimum leaves on the activities of phosphodiesterase-5 (PDE-5), arginase, angiotensin I –converting enzyme (ACE), and acetylcholinesterase (AChE) in penile and testicular tissues were assessed. Also, the extract was investigated for ferric reducing antioxidant property(FRAP) and 1,1-diphenyl-2-picryl-hydrazil (DPPH) radical scavenging abilities. Results The extract showed higher PDE-5 (IC50 = 43.19 μg/mL), ACE (IC50 = 44.23 μg/mL), AChE (IC50 = 55.51 μg/mL) and arginase (IC50 = 46.12 μg/mL) inhibitory activity in the penile tissue than PDE-5 (IC50 = 44.67 μg/mL), ACE (IC50 = 53.99 μg/mL), AChE (IC50 = 60.03 μg/mL) and arginase (IC50 = 49.12 μg/mL) inhibitory activity in the testicular tissue homogenate. Furthermore, the extract scavenged free radicals and in a dose-dependent manner. Conclusion The enzyme activities displayed might be associated with the bioactive compounds present in the extract which could possibly explain its use in the management of erectile dysfunction (ED)

Antioxidant evaluation and computational prediction of prospective drug-like compounds from polyphenolic-rich extract of Hibiscus cannabinus L. seed as antidiabetic and neuroprotective targets: assessment through in vitro and in silico studies

Abstract Background Reports have implicated diabetes mellitus (DM) and Alzheimer’s disease (AD) as some of the global persistent health challenges with no lasting solutions, despite of significant inputs of modern-day pharmaceutical firms. This study therefore, aimed to appraise the in vitro antioxidant potential, enzymes inhibitory activities, and as well carry out in silico study on bioactive compounds from polyphenolic-rich extract of Hibiscus cannabinus seed (PEHc). Methods In vitro antioxidant assays were performed on PEHc using standard methods while the identification of phytoconstituents was carried out with high performance liquid chromatography (HPLC). For the in silico molecular docking using Schrodinger’s Grid-based ligand docking with energetics software, seven target proteins were retrieved from the database ( https://www.rcsb.org/ ). Results HPLC technique identified twelve chemical compounds in PEHc, while antioxidant quantification revealed higher total phenolic contents (243.5 ± 0.71 mg GAE/g) than total flavonoid contents (54.06 ± 0.09 mg QE/g) with a significant (p < 0.05) inhibition of ABTS (IC50 = 218.30 ± 0.87 µg/ml) and 1, 1-diphenyl-2-picrylhydrazyl free radicals (IC50 = 227.79 ± 0.74 µg/ml). In a similar manner, the extract demonstrated a significant (p < 0.05) inhibitory activity against α-amylase (IC50 = 256.88 ± 6.15 µg/ml) and α-glucosidase (IC50 = 183.19 ± 0.23 µg/ml) as well as acetylcholinesterase (IC50 = 262.95 ± 1.47 µg/ml) and butyrylcholinesterase (IC50 = 189.97 ± 0.82 µg/ml), respectively. Furthermore, In silico study showed that hibiscetin (a lead) revealed a very strong binding affinity energies for DPP-4, (PDB ID: 1RWQ) and α-amylase (PDB ID: 1SMD), gamma-tocopherol ( for peptide-1 receptor; PDB ID: 3C59, AChE; PDB ID: 4EY7 and BChE; PDB ID: 7B04), cianidanol for α-glucosidase; PDB ID: 7KBJ and kaempferol for Poly [ADP-ribose] polymerase 1 (PARP-1); PDB ID: 6BHV, respectively. More so, ADMET scores revealed drug-like potentials of the lead compounds identified in PEHc. Conclusion As a result, the findings of this study point to potential drug-able compounds in PEHc that could be useful for the management of DM and AD

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways