Global Disease Research Articles

QSAR Modeling, Molecular Docking and ADMET Study of Aryl Fluorosulfate Derivatives as Potential Anti-TB Agents

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb) infection, stands as a global infectious disease presenting substantial public health challenges due to its high incidence and mortality rates. The prolonged use of conventional anti-TB therapies has led to the emergence of severe drug resistance in Mtb, resulting in extended treatment durations, increased costs, poor patient compliance, and reduced cure rates. This phenomenon has posed a significant burden on global TB prevention and control efforts, necessitating a shift in research focus toward the exploration of novel anti-TB drugs. In this context, utilizing QSAR modeling methods, our study systematically investigated the relationship between the chemical structures of 36 aryl fluorosulfate derivatives and their inhibitory activity against Mtb. Robust and predictive Topomer CoMFA and HQSAR models were developed, featuring Topomer CoMFA model parameters: q 2 = 0.659, r 2 = 0.969, F = 102.877, N = 6, SEE = 0.138; HQSAR model parameters: q 2 = 0.705, r 2 = 0.873, SEE = 0.264, HL = 199, N = 4. Leveraging these models, structural modifications were applied to the compounds using the ZINC15 database, leading to the successful design and screening of three novel compounds with desirable inhibitory activity. Molecular docking and ADMET performance prediction results indicated that these three new compounds exhibit strong binding capabilities and promising pharmaceutical potential. This study provides valuable insights and research directions for the development of aryl fluorosulfate derivatives as potential agents for tuberculosis treatment and as novel drugs.

The global burden of cardiovascular disease attributable to diet low in fiber among people aged 60 years and older, 1990–2019: an age–period–cohort analysis of the global burden of disease study

ObjectivesThis study aimed to quantify the global cardiovascular disease (CVD) burden attributable to diet low in fiber among adults aged 60 years and older using data from the Global Burden of Disease (GBD) Study 2019.MethodsWe extracted data on CVD mortality, disability-adjusted life-years (DALYs), and risk-factor exposures from the GBD 2019 study for people aged 60 and older. Age-period-cohort models were used to estimate the overall annual percentage change in mortality and DALY rate (net drift, % per year), mortality and DALY rate for each age group from 1990 to 2019 (local drift, % per year), longitudinal age-specific rate corrected for period bias (age effect), and mortality and Daly rate for each age group from 1990 to 2019 (local drift, % per year). And period/cohort relative risk (period/cohort effect).ResultsFrom 1990 to 2019, global age-standardized cardiovascular disease (CVD) mortality rates attributable to low dietary fiber intake decreased by 2.37% per year, while disability-adjusted life years (DALYs) fell by 2.48% annually. Decreases were observed across all sociodemographic index regions, with fastest declines in high and high-middle SDI areas. CVD mortality and DALY rates attributable to low fiber increased exponentially with age, peaking at 85–89 years, and were higher in men than women. Regarding period effects, mortality and DALY rates declined since 2000, reaching nadirs in 2015–2019. For birth cohort patterns, risks attributable to low fiber intake peaked among early 1900s births and subsequently fell, with more pronounced reductions over time in women.ConclusionsLow dietary fiber intake is a leading contributor to the global cardiovascular disease burden, accounting for substantial mortality and disability specifically among older adults over recent decades.

Contribution of extracellular vesicles to steatosis-related liver disease and their therapeutic potential.

Extracellular vesicles (EVs) are small particles released by many cell types in different tissues, including the liver, and transfer specific cargo molecules from originating cells to receptor cells. This process generally culminates in activation of distant cells and inflammation and progression of certain diseases. The global chronic liver disease (CLD) epidemic is estimated at 1.5 billion patients worldwide. Cirrhosis and liver cancer are the most common risk factors for CLD. However, hepatitis C and B virus infection and obesity are also highly associated with CLD. Nonetheless, the etiology of many CLD pathophysiological, cellular, and molecular events are unclear. Changes in hepatic lipid metabolism can lead to lipotoxicity events that induce EV release. Here, we aimed to present an overview of EV features, from definition to types and biogenesis, with particular focus on the molecules related to steatosis-related liver disease, diagnosis, and therapy.

What Can Frogs Teach Us about Resilience? Adaptive Renewal in Amphibian and Academic Ecosystems.

Examples of resilience in nature give us hope amid a growing biodiversity crisis. While resilience has many definitions across disciplines, here I discuss resilience as the ability to continue to adapt and persist. Naturally, as biologists, we seek to uncover the underlying mechanisms that can help us explain the secrets of resilience across scales, from individuals to species to ecosystems and beyond. Perhaps we also ponder what the secrets to resilience are in our own lives, in our own research practices, and academic communities. In this paper, I highlight insights gained through studies of amphibian resilience following a global disease outbreak to uncover shared patterns and processes linked to resilience across amphibian communities. I also reflect on how classical resilience heuristics could be more broadly applied to these processes and to our own academic communities. Focusing on the amphibian systems that I have worked in-the Golden Frogs of Panama (Atelopus zeteki/varius) and the Mountain Yellow-Legged Frogs of California (Rana muscosa/sierrae)-I highlight shared and unique characteristics of resilience across scales and systems and discuss how these relate to adaptive renewal cycles. Reflecting on this work and previous resilience scholarship, I also offer my own thoughts about academia and consider what lessons we could take from mapping our own adaptive trajectories and addressing threats to our own community resilience.

Disparities in the Representation of Sex, Race and Ethnicity in Tension-Type Headache Clinical Trials.

While tension-type headache (TTH) is the most common primary headache disorder, its effect according to sex, race and ethnicity remains unclear. We investigated disparities in sex, racial and ethnic representation in TTH clinical trials with comparison to global disease burdens. In this cross-sectional analysis, TTH clinical trials had female overrepresentation and racial and ethnic minority underrepresentation, which may affect understanding of the impact of TTH on different populations and personalized treatment development. Trial enrollment that is diverse and reflective of global disease burdens is crucial for improving study generalizability, understanding of diverse clinical presentations, and ensuring healthcare equity.

Burden of disease attributable to high body mass index: an analysis of data from the Global Burden of Disease Study 2021

Obesity represents a major global health challenge with important clinical implications. Despite its recognized importance, the global disease burden attributable to high body mass index (BMI) remains less well understood. We systematically analyzed global deaths and disability-adjusted life years (DALYs) attributable to high BMI using the methodology and analytical approaches of the Global Burden of Disease Study (GBD) 2021. High BMI was defined as a BMI over 25kg/m2 for individuals aged ≥20 years. The Socio-Demographic Index (SDI) was used as a composite measure to assess the level of socio-economic development across different regions. Subgroup analyses considered age, sex, year, geographical location, and SDI. From 1990 to 2021, the global deaths and DALYs attributable to high BMI increased more than 2.5-fold for females and males. However, the age-standardized death rates remained stable for females and increased by 15.0% for males. Similarly, the age-standardized DALY rates increased by 21.7% for females and 31.2% for males. In 2021, the six leading causes of high BMI-attributable DALYs were diabetes mellitus, ischemic heart disease, hypertensive heart disease, chronic kidney disease, low back pain and stroke. From 1990 to 2021, low-middle SDI countries exhibited the highest annual percentage changes in age-standardized DALY rates, whereas high SDI countries showed the lowest. The worldwide health burden attributable to high BMI has grown significantly between 1990 and 2021. The increasing global rates of high BMI and the associated disease burden highlight the urgent need for regular surveillance and monitoring of BMI. National Natural Science Foundation of China and National Key R&D Program of China.

Silybin: A Review of Its Targeted and Novel Agents for Treating Liver Diseases Based on Pathogenesis

ABSTRACTLiver disease represents a significant global public health concern. Silybin, derived from Silybum marianum, has been demonstrated to exhibit a range of beneficial properties, including anti‐inflammatory, antioxidative, antifibrotic, antiviral, and cytoprotective effects. These attributes render it a promising candidate for the treatment of liver fibrosis, cirrhosis, liver cancer, viral hepatitis, non‐alcoholic fatty liver disease, and other liver conditions. Nevertheless, its low solubility and low bioavailability have emerged as significant limitations in its clinical application. To address these limitations, researchers have developed a number of silybin formulations. This study presents a comprehensive review of the results of research on silybin for the treatment of liver diseases in recent decades, with a particular focus on novel formulations based on the pathogenesis of the disease. These include approaches targeting the liver via the CD44 receptor, folic acid, vitamin A, and others. Furthermore, the study presents the findings of studies that have employed nanotechnology to enhance the low bioavailability and low solubility of silybin. This includes the use of nanoparticles, liposomes, and nanosuspensions. This study reviews the application of silybin preparations in the treatment of global liver diseases. However, further high‐quality and more complete experimental studies are still required to gain a more comprehensive understanding of the efficacy and safety of these preparations. Finally, the study considers the issues that arise during the research of silybin formulations.

Positron emission tomography combined with serum biomarkers detects fibrotic MASH

Metabolic dysfunction-associated steatohepatitis (MASH) is a rising global disease signaling the urgent need for non-invasive tests (NITs). Recent work demonstrated that dynamic 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) imaging can identify MASH by measuring liver glucose transport rate, K1, and liver CT attenuation. By combining dynamic PET/CT with the serum-based fibrosis-4 (FIB-4) test, we were able to better distinguish clinical MASH from fibrotic subtypes, enabling determination of the core tenets of MASH: steatosis, inflammation, and fibrosis. Future studies using FDG-PET technology can further enable concomitant prediction of MASH severity and extrahepatic comorbidities such as cardiovascular disease.

Platelet-to-neutrophil ratio predicts hemorrhagic transformation and unfavorable outcomes in acute ischemic stroke with intravenous thrombolysis.

Acute ischemic stroke (AIS) retains a notable stance in global disease burden, with thrombolysis via recombinant tissue plasminogen activator (rtPA) serving as a viable management approach, albeit with variable outcomes and the potential for complications like hemorrhagic transformation (HT). The platelet-to-neutrophil ratio (P/NR) has been considered for its potential prognostic value in AIS, yet its capacity to predict outcomes following rtPA administration demands further exploration. To elucidate the prognostic utility of P/NR in predicting HT and clinical outcomes following intravenous rtPA administration in AIS patients. Data from 418 AIS patients treated with intravenous rtPA at Thammasat University Hospital from January 2018 to June 2021 were retrospectively analyzed. The relationship between P/NR and clinical outcomes [early neurological deterioration (E-ND), HT, delayed ND (D-ND), and 3-mo outcomes] was scrutinized. Notable variables, such as age, diabetes, and stroke history, exhibited statistical disparities when comparing patients with and without E-ND, HT, D-ND, and 3-mo outcomes. P/NR prognostication revealed an optimal cutoff of 43.4 with a 60.3% sensitivity and a 52.5% specificity for 90-d outcomes. P/NR prognostic accuracy was statistically significant for 90-d outcomes [area under the curve (AUC) = 0.562], D-ND (AUC = 0.584), and HT (AUC = 0.607). P/NR demonstrated an association with adverse 3-mo clinical outcomes, HT, and D-ND in AIS patients post-rtPA administration, indicating its potential as a predictive tool for complications and prognoses. This infers that a diminished P/NR may serve as a novel prognostic indicator, assisting clinicians in identifying AIS patients at elevated risk for unfavorable outcomes following rtPA therapy.

Pulmonary and extra-pulmonary effects of lung transplantation in an Italian cohort of patients with systemic sclerosis

Abstract Objectives Lung transplantation (LuTx) is a life-saving intervention for SSc patients with end-stage lung disease. The aim of this study was to evaluate patients’ survival and LuTx outcomes on systemic disease manifestations. Methods A retrospective evaluation was conducted on SSc patients who underwent LuTx between 2010 and 2021. Outcomes assessed at baseline, 6, 12 and 24 months post-LuTx included skin involvement by modified Rodnan skin score (mRSS), and global disease activity using a modified EUSTAR index (0–9 scale). Lung function rescue was evaluated by forced vital capacity (FVC). Patient survival was assessed by Kaplan–Meier analysis. Results Thirteen SSc patients were included, with a male/female ratio 9/4 and a median age of 48.7 years. Nine patients were affected by diffuse cutaneous scleroderma (dcSSc) and four by limited cutaneous scleroderma (lcSSc). FVC significantly increased from 56% of the predicted value at baseline to 78% at 2 years (P = 0.003). mRSS decreased from 7.4 ± 3.8 to 3.3 ± 2.5 in patients with dcSSc (P = 0.02). The modified EUSTAR index score decreased from 2.54 ± 1.8 at baseline to 0.49 ± 0.5 at 2 years (P = 0.02). Survival rate was 92.3% at 2 years, and 76.9% at 5 years. No unexpected adverse events were observed. Conclusions In SSc patients undergoing LuTx, an excellent 2-year survival was observed, without any disease-related adverse events. Our study supports LuTx as a viable option in SSc patients with end-stage lung disease. Apart from expected recovery of lung function, LuTx was associated with improvement of mRSS and global systemic disease activity.

A Study on Serum Hepatic Enzymes in Smokers and Nonsmoker’s Adult Male

Background: Cigarette smoking is one of the greatest indirect causes of global death and disease. Cigarette smoke consists of many chemicals, including cytotoxic, carcinogenic and free radicals, therefore it affects many organs including liver either directly or indirectly. Objective: The aim of this study was to find out level of serum hepatic enzymes in smokers and non-smokers adult male. Method: This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh, from January 2019 to December 2019. Total study subjects were one hundred and twenty with age ranging from 20 to 50 years of male gender, selected from attendance of admitted patients and third & forth class employees of Dhaka Medical College Hospital, Dhaka. Study subjects were grouped smokers as Group A and age and gender matched, nonsmokers as Group B. Group A smokers again divided into three groups. Group A1- heavy smokers (who consume 20 cigarette sticks or more per day) consist of thirty study subjects, Group A2- moderate smokers (who consume 11-19 cigarette sticks per day) consist of thirty study subjects and Group A3- light smokers (who consume 1-10 cigarette sticks per day) consist of thirty study subjects. Serum Alanine Transaminase (ALT), Aspartate transaminase (AST) and Alkaline phosphatase (ALP) level of all study subjects were estimated and recorded. Results: Mean age of the study subjects in group A1, A2, A3 & B were 33.88 years, 34.60 years, 34.60 years and 29.80 years. There was a significant increase in serum ALT, AST and ALP level in heavy, moderate and light smokers when compared to nonsmokers, but the increase was more significant in heavy smokers when compared to moderate smokers, also moderate smokers when compared to light smokers. Conclusion: This study revealed that significantly higher level of serum hepatic enzymes with smokers when compared to that of non smokers. This significantly higher level was also seen in heavy smokers in comparison to moderate smokers, moderate smokers in comparison to light smokers.

Efficacy of late-onset antiviral treatment in immunocompromised hosts with persistent SARS-CoV-2 infection.

Four years after the onset of the global coronavirus disease 2019 (COVID-19) pandemic, the immunocompromised are at greatest risk of developing life-threatening severe disease. However, specific treatment plans for this most vulnerable patient group have not yet been developed. Employing a CD4+ and CD8+ T cell-depleted immunocompromised mouse model of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we explored therapeutic options of persistent infections with standard-of-care paxlovid, molnupiravir, and the experimental therapeutic 4'-fluorouridine (4'-FlU). Late-onset treatment initiated 14 days after infection was efficacious, but only 4'-FlU was rapidly sterilizing. No treatment-experienced viral variants with reduced susceptibility to the drugs emerged, albeit virus replication rebounded in animals of the paxlovid group after treatment end. This study supports the use of direct-acting antivirals (DAAs) for late-onset management of persistent SARS-CoV-2 infection in immunocompromised hosts. However, treatment courses likely require to be extended for maximal therapeutic benefit, calling for appropriately powered clinical trials to meet the specific needs of this patient group.

Advances in Diagnostic Modalities for Helicobacter pylori Infection.

Helicobacter pylori (H. pylori) infection is a widespread global health issue with a varying prevalence influenced by geography, socioeconomic status, and demographics. In the U.S., the prevalence is lower, though certain groups, such as older adults and immigrants from high-prevalence regions, show higher rates. The decrease in infection rates in developed countries is due to improved sanitation, antibiotics, and healthcare, whereas developing countries continue to experience high rates due to poor living conditions. H. pylori infection can be asymptomatic or cause symptoms like dyspepsia, abdominal pain, bloating, nausea, and loss of appetite. Pathophysiologically, H. pylori contribute to conditions such as gastritis, peptic ulcers, and gastric cancer through mechanisms including urease production and the release of virulence factors, leading to chronic inflammation and an increased cancer risk. Diagnostic methods for H. pylori have progressed significantly. Non-invasive techniques, such as serological assays, stool antigen tests, and urea breath tests, are practical and sensitive. Invasive methods, including endoscopic biopsy and molecular diagnostics, are more definitive but resource intensive. Recent advancements in diagnostic technology, including matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), biosensor technology, and next-generation sequencing (NGS), promise improved speed, accuracy, and accessibility. These innovations are expected to enhance the detection and management of H. pylori, potentially reducing the global disease burden. This review aims to discuss these diagnostic modalities with a focus on further advances under investigation.

The socio-environmental determinants of diabetes and their consequences.

The intricate connections between health and the environment are often overlooked globally, yet they play a pivotal role in shaping our well-being. Astonishingly, environmental risk factors contribute to nearly 24% of the global disease burden, underscoring the critical impact of our surroundings on health. At the crossroads of this issue lies Diabetes, a rapidly growing non-communicable disease that highlights the delicate balance between human health and environmental sustainability. This epidemic offers a unique lens through which to explore how environmental factors contribute to the prevalence of Diabetes, revealing the complex interplay at work. Despite growing awareness, healthcare systems worldwide face challenges integrating environmental threats into more effective diabetes care strategies CONCLUSIONS: This perspective highlights the urgent need for collaborative efforts and innovative solutions that address the environmental dimensions of diabetes management. Doing so can build healthier communities and pave the way for a more sustainable future.

Investigating the prevalence burden of peptic ulcer disease in older adults aged 70+ from 1990 to 2019: an analysis of Global Disease Burden Studies

Background Peptic ulcer disease (PUD) affects individuals aged ≥70 years globally, exerting a significant impact on their health and well-being. Understanding its epidemiological evolution and associated factors is crucial for guiding interventions and improving management. Methods This study utilized Global Burden of Disease Study data to examine the prevalence and temporal changes of PUD in individuals aged 70 years and older between 1990 and 2019. The analysis included assessing estimated annual percentage changes (EAPCs) to investigate temporal trends and regional variations. Results Over the past 30 years, the number of individuals aged 70 years and above suffering from PUD globally has increased from 1 065 730 cases in 1990 to 1 608 463 cases in 2019. Despite an increasing number of cases, the prevalence of PUD among the elderly has exhibited a steady decline, with an EAPC of −1.47 (95% confidence interval: −1.57 to −1.37) over this timeframe. In 2019, the prevalence rates of PUD among individuals aged 70–74, 75–79, 80–84, and 85 years and older were 313.36, 365.77, 388.45, and 352.51 per 100 000 population, respectively. South Asia, high-income North America, and Central Sub-Saharan Africa were the regions with the highest prevalence rates of PUD in 2019, with rates of 624.90, 575.48, and 474.80 per 100 000 population, respectively. At the national level, Ireland, Australia, Brazil, Brunei Darussalam, and Bangladesh have effectively managed the burden of PUD among the elderly, achieving the greatest reduction. Additionally, regions with higher levels of socioeconomic development tended to have relatively lower burdens of PUD among the elderly, and prevalence rates varied across different regions and age groups. Conclusion Our study highlights the enduring burden of PUD among the global elderly population, emphasizing the significance of tailored interventions to address this pressing issue. This research underscores the critical need for targeted public health strategies aimed at improving outcomes specifically for older adults affected by PUD.

Dynamic trends of ischemic heart disease mortality attributable to high low-density lipoprotein cholesterol: a joinpoint analysis and age-period-cohort analysis with predictions

AimsThe purpose of this study was to analyze the dynamic trends of ischemic heart disease (IHD) mortality attributable to high low-density lipoprotein cholesterol (LDL-C).MethodsData on IHD mortality attributable to high LDL-C from 1990 to 2021 were extracted from the global disease burden database. Joinpoint software was used to estimate the average annual percentage change (AAPC) in the age-standardized mortality rate (ASMR). An age‒period‒cohort model was used to analyze the impacts of age, period, and cohort on these changes. The Bayesian framework was used to predict IHD mortality attributable to high LDL-C from 2022 to 2040.ResultsThe overall ASMR of IHD attributable to high LDL-C decreased from 50. 479 per 100,000 people in 1990 to 32.286 per 100,000 people in 2021, and ASMR of IHD attributable to high LDL-C was higher in males than in females. The longitudinal age curves of the overall IHD mortality attributable to high LDL-C showed a monotonic upward trend, especially after 65 years of age. The period and cohort effect relative risk (RR) values of overall IHD mortality attributable to high LDL-C showed a downward trend. The overall ASMR of IHD attributable to high LDL-C is predicted to show a downward trend, and male IHD mortality attributable to high LDL-C is expected to be higher than that of females.ConclusionThis study revealed a sustained decrease in IHD mortality attributable to high LDL-C over three decades, with a continued decline expected. Despite this, gender disparities persist, with males experiencing higher mortality rates and elderly individuals remaining a vulnerable group.

Perspectives of Japanese patients on psoriatic disease burden: Results from "Psoriasis and Beyond," the Global Psoriatic Disease Survey.

Psoriatic disease (PsD) is a chronic disease affecting skin (psoriasis) and joints (psoriatic arthritis, PsA) that has a significant impact on patients' quality of life (QOL). We report findings from the Japanese subgroup of patients included in Psoriasis and Beyond: The Global Psoriatic Disease Survey, a cross-sectional, quantitative online survey of patients with self-reported, healthcare professional (HCP)-diagnosed, moderate-to-severe plaque psoriasis, with or without PsA. Eligible patients who were recruited online completed a 25-min internet-based survey in Japanese. We assessed patients' understanding of the systemic nature of PsD, disease burden, perception towards their HCPs, treatment expectations, and satisfaction with care. Of the 148 patients, 74% were females. In total, 65% of patients were aware of the systemic nature of their disease. A minority of patients (27%) were aware that PsA was related to their psoriasis, and 30% and 42% of patients were unaware of any manifestations and comorbidities, respectively, related to PsD. Overall, 21% of patients reported that their disease has a "very large" to "extremely large" impact on their QOL (assessed by Dermatology Life Quality Index score), while the majority (61%) reported a "small" effect or "no effect" at all on QOL. Patients experienced stigma and discrimination and had a negative impact on relationships due to PsD. More patients with psoriasis and concomitant PsA (66%) were satisfied with their current treatment than those with psoriasis alone (46%). Overall, 41% of patients were not involved in deciding their treatment goals. These results suggest that Japanese patients may not be fully aware of the systemic nature of PsD, its manifestations and comorbidities. While these patients were somewhat satisfied with their current treatment, they were only occasionally consulted in deciding treatment goals. Policy measures are required to address the stigma and discrimination experienced by patients. Increased patient participation in their care supports shared decision-making and enhanced treatment outcomes.

Changing the regulation of human germline genome editing: what does a truly broad societal debate entail?

ABSTRACT How gene editing technologies should be regulated and whether Human Germline Genome Editing (HGGE) should become lawful remain very divisive questions in the legal, political and bioethical fields. At the same time, there is universal agreement that any changes in legislation should be preceded, or accompanied, by broad public deliberation. What does, however, a truly broad societal debate on HGGE regulation actually entail? In this paper, we focus on this issue and articulate a specific understanding of broadness for societal debates on the regulation of technological developments. We then apply it to the context of HGGE and show that a truly broad societal debate on its regulation would require reflecting: (1) on the significance of public preferences regarding genetically-related children for law and policy; and (2) on the potential of HGGE as a tool for global disease burden reduction. We conclude by outlining the implications for policymakers and further research.

A Review of the Therapeutical Perspective of Phytochemicals in the Treatment of HIV

Abstract: HIV/AIDS is one of the most widespread global diseases. It is caused by the human immunodeficiency virus (HIV), which leads to the development of acquired immunodeficiency syndrome (AIDS). In AIDS patients, the immune system progressively weakens, making them vulnerable to various infections and cancers. The virus can be transmitted through the exchange of bodily fluids such as blood, semen, vaginal fluid, and breast milk, where HIV can be found in both free virus particles and infected immune cells. Although drug resistance remains a challenge for HIV/AIDS treatment, researchers are exploring the use of natural substances in the development of anti-HIV drugs. Clinical trials based on plant-derived compounds are currently being conducted. Experimental research suggests that plants may have the potential to treat HIV. However, the identification of active compounds, testing of extracts, and creation of suitable bioassays are all complex processes. Natural product scientists face the challenge of separating these complicated extracts into their active components. Various phytochemicals found in Astragalus membranaceus Bunge, Chelidonium majus L, Combretum molle (R. Br. ex. G. Don.) Engl& Diels, Dittrichiaviscosa (L.) Greuter, Helichrysum populifolium, Hoodia gordonii (Masson) Sweet ex Decne, and Hypericumperf, have been investigated pharmacologically and pharmacokinetically. Further research is needed to optimize formulations and production in accordance with preclinical safety and efficacy studies.

Antiviral drug treatment profiles and clinical outcomes of COVID-19 patients at public hospitals in Erbil city

Background & objectives: The World Health Organization has identified COVID-19 as a rapidly spreading global disease. Some antiviral drugs have shown promising efficacy in treating COVID-19. This study aims to identify the effects of antiviral drugs and compare them with other therapies in COVID-19 patients, while reviewing the clinical outcomes of these treatments. Methods: This observational retrospective case study included 451 COVID-19 patients, comprising 57.0% males and 43% females, conducted in Rizgari, Erbil, at Central Emergency, Rozhawa Emergency, and Emirate Hospitals over one year from December 2020 to December 2021. COVID-19 cases were confirmed using reverse transcriptase polymerase-chain reaction (RT-PCR) assays, and treatment followed the WHO guidelines, involving antivirals (Remdesivir, Favipiravir), broad-spectrum antibiotics (levofloxacin, azithromycin, ceftriaxone, meropenem, imipenem), and supportive treatment with Becozym (Vitamins B1 + B2 + B3 + B5 + B6). Data were recorded in the statistical department of the hospitals. Results: The total age range of the 451 patients was 95 (18-113) with a mean ± SD of 59.408 ± 18.26 years. The death rate was 22.39%. A majority of the survival patients were in the young age group (95.1%), while the death rate was higher in the old age group (more than 75 years). The death rate of patients treated with antiviral drug Remdesivir was 15.30%, while it was 37.93%, 73.45%, 15.25%, and 14.15% in patients on levofloxacin, ceftriaxone, meropenem, and Becozyme, espectively. Logistic regression analysis did not show any role of treatments in decreasing mortality. Conclusions: Significant differences were observed in clinical outcomes; the majority of surviving patients were in the young age group, while older COVID-19 patients had worse illnesses and treatment outcomes. Diabetes and hypertension were significant predictors of COVID-19 mortality. Although Remdesivir treatment showed a statistically significant association between survival and death cohorts, it was not considered a predictor variable for survival. Antibiotics and supplement drugs like Becozyme were also not considered predictors of survival for COVID-19 patients.