The reason for the striking differences in clinical outcomes of SARS-CoV-2 infected patients is still poorly understood. While most recover, a subset of people become critically ill and succumb to the disease. Thus, identification of biomarkers that can predict the clinical outcomes of COVID-19 disease is key to help prioritize patients needing urgent treatment. Given that an unbalanced gut microbiome is a reflection of poor health, we aim to identify indicator species that could predict COVID-19 disease clinical outcomes. Here, for the first time and with the largest COVID-19 patient cohort reported for microbiome studies, we demonstrated that the intestinal and oral microbiome make-up predicts respectively with 92% and 84% accuracy (Area Under the Curve or AUC) severe COVID-19 respiratory symptoms that lead to death. The accuracy of the microbiome prediction of COVID-19 severity was found to be far superior to that from training similar models using information from comorbidities often adopted to triage patients in the clinic (77% AUC). Additionally, by combining symptoms, comorbidities, and the intestinal microbiota the model reached the highest AUC at 96%. Remarkably the model training on the stool microbiome found enrichment of Enterococcus faecalis, a known pathobiont, as the top predictor of COVID-19 disease severity. Enterococcus faecalis is already easily cultivable in clinical laboratories, as such we urge the medical community to include this bacterium as a robust predictor of COVID-19 severity when assessing risk stratification of patients in the clinic.
Objective: To evaluate the antiepileptic activity of aqueous extract of Centella asciatica in maximal electroshock (MES) and pentylenetetrazole (PTZ) induced convulsions.
Methods:The anticonvulsant activity of leaves of Centella asciatica (200 mg/kg and 400 mg/kg) in mice was assessed using MES and PTZ induced seizure models. Abolition of tonic hind limb extension (MES and PTZ) and increase in seizure latency (PTZ) when compared to control group, were taken as a measure of protection. Statistical analysis was done using one-way ANOVA followed by Tukey-Kramer multiple comparisons test. The test was considered to be significant at p<0.05.
Results:The aqueous extract of Centella asiatica at a dose of 200 mg/kg has abolished tonic hind limb extension in 1 out of 6 animals in MES while there was no anticonvulsant action in PTZ convulsions. At a dose of 400 mg/kg body weight, the aqueous extract of Centella asiatica has shown a significant anticonvulsant effect against both MES and PTZ convulsions, where it has abolished tonic hind limb extension in 4 mice in MES method and in all 6 mices in PTZ method.
Conclusion:The aqueous extract of Centella asiatica showed efficacy in both MES and PTZ convulsions in mice at a dose of 400 mg/kg. Since the clinical correlates of MES seizures are tonic-clonic convulsions and correlates of PTZ seizures are absence seizures, the aqueous extract of Centella asiatica is likely to be useful in the treatment of tonic-clonic and absence seizures.
Objectives: Adverse drug reaction (ADR) is an important cause of morbidity, mortality, and prolonged hospitalization. The objective of this study is to measure the incidence, types, and nature of ADR in a tertiary care hospital located in Silchar, Assam.
Methods:A retrospective noninterventional analysis of all ADRs reported by ADR Monitoring Centre, Department of Pharmacology, Silchar Medical College, from March 2014 to February 2015 was performed. A total of 162 predesigned forms were used for collection of data. All forms were duly checked for completeness, if not, they were rejected.Results: A total of 162 forms were assessed of which 96 (59%) were females and 66 (41%) were males. The distribution of ADRs in different age groups were found to be 3 (1.85%) in 0-15 years, 71 (43.82%) in 16-30 years, 65 (40.12%) in 31-45 years, 8 (4.93%) in 46-60 years, and 15 (9.25%) in age group >60 years. 150 (92.6%) of the ADRs were serious and 12 (7.4%) were not serious. As per the World Health Organization causality assessment scale, 120 (74.07%) were probable and 42 (25.92%) were possible. The most common ADR was anaphylactic reaction (AR) in 69 (42.59%) patients. The drugs which commonly caused ADR were iron sucrose infusions, nevirapine, cephalosporins, antiprotozoals, nonsteroidal anti-inflammatory drugs, and quinolones followed by others.
Conclusion:The majority of ADRs were probable. The most common ADR was AR caused by iron sucrose infusion. Different drugs caused different ADRs. ADRs thereby increase morbidity and mortality in patients as well as socioeconomic burden.
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