Pharmaceutical and Biomedical Research
Volume:9 Issue: 4, Dec 2023

Drugs used in treating patients who contracted the coronavirus disease of 2019 (COVID-19) include chloroquine or hydroxychloroquine (CQ, HCQ), antiviral, steroid, and antibiotic. Treatment outcomes were characterized by positive and adverse reactions as therapeutic options were based on clinical trials coupled with diagnostic constraints. This study assesses the diagnostic processes and critically examines the drugs used in the clinical settings to treat COVID-19 in Nigeria.

The search was conducted on various databases with a focus on diagnoses and drugs used to treat COVID-19. Articles that did not meet selection criteria were excluded and the data collected from sampled articles were collated, analyzed, and evaluated. 

The finding showed a lack of sufficient evidence-based data to support the use of CQ/HCQ, remdesivir, lopinavir/ritonavir, and antibiotics, such as azithromycin as treatment options for COVID-19, even though patients responded partly to the drugs probably due to their action mechanisms. 

There is a lack of evidence-based scientific data to guide the definitive treatment of COVID-19 patients during the pandemic. Drugs used in the emergency were based on clinical trials. The efficacy of the drugs depends partly on the innate capability of the immune system of an affected individual.

Characterized by insulin insufficiency due to irreversible pancreas defects, type 1 diabetes is traditionally managed by regular insulin supplementation. Recently, tissue regenerative technology coupled with advanced-level surgical intervention has created hope for a cure. Research in this direction started with replacing defective pancreas with healthy ones. However, the strategy met showed limited success. Presently, extensive work is being conducted to replace the damaged β cells with healthy ones and create insulin-producing cells from stem cells. This study reviews various research strategies used to replace or regenerate β cells for curing diabetes.

The literature survey was done on PubMed and Google Scholar until June 2023. The keywords used were “type 1 diabetes,” “cure,” “techniques,” “islet transplantation,” “encapsulation of β cells,” and “stem cells,” etc. Full-length research and review articles were used as the basis for the preparation of the manuscript. Papers describing the basic features and rationale supporting the development of technologies were included, whereas clinical aspects and case studies were excluded.

Mainly, three important approaches were discussed. Treatment involves transplantation of whole organ (pancreas), islet, and stem cells derived β progenitor cells. A brief discussion was included for each technique, such as the extraction of β cells and generation of insulin-producing cells from stem cells, along with the essential findings obtained from each approach.

The review demonstrated various strategies researchers have undertaken to find a cure for type 1 diabetes in terms of insulin independence.

Neonates frequently experience acute pain from numerous procedures during routine patient care at the intensive care units. Oral sweet solutions (sucrose) are used as analgesics during minor procedures. According to the mechanism of the sucrose effect, this question was raised whether there is a relationship between the way it is consumed and the amount of pain reduction. This study aims to compare single vs divided doses of sucrose 24% for prophylaxis of pain before heel stick in neonates.

In this randomized double-blind controlled clinical trial, hospitalized newborns requiring heel lance were enrolled and randomly assigned to receive sucrose 24% as a single dose at 2 min or three divided doses at 2, 1.5, and 1 min before the procedure. To accurately record the incident, the video of the babies was recorded during the procedures. The changes in pain parameters were evaluated to determine sucrose’s analgesic effect using a premature infant pain profile-revised scale.

A total of 116 neonates were analyzed. Divided doses of sucrose decreased the pain score equally in term and preterm neonates (P=0.45). In contrast, the single dose method meaningfully reduced pain scores only in term neonates compared to preterm neonates (P=0.01). In the preterm infants’ group, the mean premature infant pain profile-revised scores were significantly decreased in the divided dose method (P=0.016).

The divided dose of sucrose was more effective than the single dose in both term and preterm infants. The single-dose method was more effective in term compared to preterm neonates. Administration of sucrose as a divided dose may be a more effective strategy for reducing pain in preterm neonates.

Plantago is a diverse genus of the Plantaginaceae family. Plantago lanceolata L. (P. lanceolata) and Plantago major L. (P. major) are used commercially worldwide as a traditional treatment for many diseases. A sensitive, simple, and reliable high-performance liquid chromatography (HPLC) method was developed to simultaneously quantify the three active ingredients: apigenin, catalpol, and gallic acid in P. lanceolata and P. major. 

HPLC analysis was carried out using C8 and C18 columns. The mobile phase comprised acetonitrile, orthophosphoric acid, or formic acid (different ratio V/V) with flow rates of 0.4, 0.8, and 1 mL/min. The eluted peaks were detected at 204, 210, 256, and 330 nm. The crude extracts were separated using the liquid-liquid extraction method.

HPLC analysis was performed using the C8 column with the mobile phase consisting of acetonitrile–orthophosphoric acid (1:1%) at a 1 mL/min flow rate. The detection of the eluted peaks was observed at 204 nm. Using this protocol, the detection and quantification limits for apigenin, catalpol, and gallic acid were 0.007 and 0.022 μg/mL, 0.04 and 0.14 μg/mL, 0.02 and 0.073 μg/mL, respectively. The calibration curve’s correlation coefficient indicated good linearity (r>0.9996, 0.9991, and 0.9978), with average recoveries for the three compounds between 100.02, 95.98, and 108.30%, respectively. Meanwhile, the intra-day and inter-day accuracy averages ranged from 100.07 to 99.95%, respectively. The results showed that using dichloromethane extracts of Plantago species leaves produced the highest yield of apigenin (1.08 and 0.58 μg/mg). At the same time, gallic acid was more abundant in methanolic, butanol, and aqueous extracts of P. lanceolata (3.33 μg/mg) and P. major (3.95, 4.34, and 4.72 μg/mg). The aqueous extract of P. lanceolata leaf and P. major root also showed more catalpol content (9.339 and 2.451 μg/mg). 

The developed method indicated reliable results with reproducibility, high accuracy in an analytical run, repeatability, acceptable intermediate precision, reproducibility, and stability of these working solutions. To the best of our knowledge, this study is the first report for the simple, simultaneous quantification of three compounds in Plantago spp. using HPLC.

3-monocholoropropan1-2diol (3MCPD) is a chlorohydrin glycerol known as a toxic substance in food processing. This substance can cause toxicity in various organs, such as the kidney, liver, reproductive system, etc. This study investigates the protective effect of resveratrol on hepatotoxicity and oxidative stress caused by 3MCPD in rats.

A total of 30 male adult rats were obtained and kept under standard conditions. Animals were divided into five groups of 6 rats, including the control group (normal saline), 3MCPD group (10 mg/kg), 3MCPD+resveratrol group (25 mg/kg), 3MCPD+resveratrol group (50 mg/kg), and 3MCPD+resveratrol (100 mg/kg) group. Injections were done intraperitoneally for 14 days. Then, 24 h after the last injection, the liver tissue was removed to evaluate oxidative parameters.

3MCDP could increase reactive oxygen species and decrease glutathione levels and mitochondrial activity; however, no significant lipid peroxidation was observed in the group receiving 3MCDP. Also, the simultaneous administration of resveratrol could reduce the level of reactive oxygen species and lipid peroxidation and increase the level of glutathione and mitochondrial activity.

3MCDP can cause toxicity in the liver of rats by inducing oxidative stress. Also, resveratrol, having antioxidant properties, can inhibit this toxicity.

Acute kidney injury (AKI) refers to a sudden and irreversible decline in kidney function over hours to days. It is diagnosed by a decrease in glomerular filtration rate and an increase in creatinine levels. The occurrence of AKI is usually accompanied by an increase in complications, potential progression to chronic kidney disease, and short-term and long-term mortality. AKI is classified into the following categories based on the anatomical site of involvement: prerenal, intrinsic renal, and postrenal. In most cases, AKI with intrinsic origin involves damage to the tubules, glomeruli, renal vessels, and interstitial tissue.

Case Report: 

A 40-year-old male patient presented to the emergency department with decreased consciousness and excessive sleepiness for over 48 h following the ingestion of 40 tablets of 20 mg methadone, 27 tablets of 10 mg nortriptyline, and 13 tablets of 2 mg clonazepam. The patient’s laboratory tests revealed increased levels of creatinine and creatine phosphokinase.

Although drug intoxication is not a life-threatening condition, it can serve as a predisposing factor in facilitating the damage caused by suicidal behaviors or even lead to the occurrence of other more dangerous injuries than suicide.

Anticoagulants are drugs that prevent blood clotting; however, inappropriate use can also increase the risk of blood clots or bleeding. Warfarin is a commonly prescribed anticoagulant, but its narrow therapeutic index and potential for drug interactions can make it challenging to manage. Direct oral anticoagulants have reduced the use of warfarin; however, it remains the preferred option for some patients. Clinicians must also be aware of drug-drug interactions, such as those between warfarin and antibacterial agents, such as amoxicillin-clavulanic acid (AMC). A case study is presented where an interaction between warfarin and AMC resulted in an elevated international normalized ratio (INR) and bleeding.

Case Report: 

A 64-year-old man with a history of hypertension, ischemic heart disease, and atrial fibrillation presented to the emergency department with new onset epistaxis. He was taking aspirin, metoprolol succinate, and warfarin, which had been in the therapeutic range for over a year. Two weeks before, he had been prescribed AMC for acute sinusitis without any dosage adjustments to his warfarin. Laboratory tests revealed an elevated INR of 5.6 and microscopic hematuria. The patient was treated with nasal packing and vitamin K, and his INR returned to normal. The case highlights the importance of monitoring drug interactions when prescribing anticoagulants.

Drug interactions between warfarin and AMC can cause bleeding complications and require close monitoring. Healthcare providers should consider alternative antibiotics for patients taking warfarin.