Bioactive compounds and probiotics-a ray of hope in COVID-19 management

The use of bioactive compounds and probiotic bacteria against the viral diseases in human is known for a long time.Anti-viral,anti-inflammatory and anti-allergic properties of bioactive compounds and bacteria with probiotic properties in respiratory viral diseases may have significance to enhance immunity.This review highlights some of the important bioactive compounds and probiotic bacteria,suggesting them as a ray of hope in the milieu of the COVID-19 management.

Newly identified genetic variant rs2294693 in UNC5CL gene is associated with decreased risk of esophageal carcinoma in the J&K Population–India

Esophageal cancer is the second most common type of cancer after lung carcinoma in the state of Jammu and Kashmir(J&K).The understanding of genetics in Esophageal cancer development is poor in the state.Genome wide association studies(GWAS)has proved to be unsurpassed tool in identification of new loci associated with different cancers.GWAS in Chinese population has identified SNP rs2294693 present in UNC5CL(UNC-5 Family C-Terminal like)to be associated with non-cardia gastric cancer.We performed a case control association study and genotyped the SNP rs2294693 using Taqman allele discrimination assay in 566 individuals(166 esophageal cancer patients and 400 controls)belonging to the J&K population.A statistically significant protective association with allelic odds ratio of 0.73(0.56–0.94 at 95%CI)and p value=0.016 was observed.This is the first study in relation to esophageal cancer in the Jammu and Kashmir population,so far it has been studied in association with gastric carcinoma in the Chinese population only.The results indicate that the polymorphism rs2294693 is associated with esophageal cancer susceptibility and the mutant(T)allele might be a protective factor for esophageal cancer among Jammu and Kashmir population.Further the functional characterization of the variation is also warranted.

Degree of Male Mobility as a Risk Factor for HIV in High In-Migration Districts of Maharashtra, India

Background: Mobile males are vulnerable to HIV and are potential bridge for HIV transmission to their sex partners, including spouses. To understand how mobility accentuates vulnerability to HIV, we assessed the association of degree of male mobility with paid sex, alcohol use and condom use at all places visited by migrants in past two years. Methods: A cross-sectional survey was done among male migrant workers [n = 2991] in five high in-migration districts of Maharashtra in India during 2007-08. Results: Multivariate logistic regression analysis revealed that higher mobility [moving 3+ places in the past two years] was associated with “sexual debut” in paid sex [3.7% Vs 6.9%, AOR = 1.70, p < 0.001] and having sex with sex worker at the current place of destination [8.7% Vs 16.9%, AOR = 2.10, p < 0.001], at the previous place of destination [7.2% Vs 15.1%, AOR = 2.05, p < 0.001], and at the place of origin [0.6% Vs 1.6%, AOR = 2.31, p < 0.001]. However, higher mobility was associated with unpaid sex with non-marital female partners [28.4% Vs 37.2%, AOR = 1.48, p < 0.001] and less consistent condom use at the current place [26.6% Vs 23.4%, AOR = 0.45, p < 0.05] as well as at place of origin [12.2% Vs 7.2%, AOR = 0.48, p < 0.01]. In addition, alcohol use prior to sex was more among more mobile migrants relative to less mobile migrants at current place [6.1% Vs 11.2%, AOR = 1.82, p < 0.001] and previous place [7.0% Vs 13.0%, AOR = 1.77, p < 0.001] of destination. Conclusion: Findings suggest that compared to the less mobile, highly mobile men report higher HIV risk behaviours: paid sex, alcohol use prior to paid sex and inconsistent condom use, at all locations along the routes of mobility. Interventions need to target men who are highly mobile along the routes of mobility and not at destination sites alone.

Using focused pharmacovigilance for ensuring patient safety against antileishmanial drugs in Bangladesh’s National Kala-azar Elimination Programme

Background:Adverse effects of antileishmanial drugs can affect patients’quality of life and adherence to therapy for visceral leishmaniasis(VL)and post-kala-azar dermal leishmaniasis(PKDL).In Bangladesh,there are 26 treatment centers that manage leishmaniasis cases coming from 100 endemic upazilas(subdistricts)of 26 districts(these include VL,PKDL,treatment failure,and relapse VL and cutaneous leishmaniasis cases).This study aimed to investigate the feasibility of using focused pharmacovigilance for VL(VLPV)in Bangladesh’s National Kala-azar Elimination Programme for the early detection and prevention of expected and unexpected adverse drug reactions(ADRs).Methods:This activity has been going on since December 2014.Activity area includes secondary public hospital or Upazila health complex(UHC)in hundred sub districts and Surya Kanta Kala-azar Research Center(SKKRC)in Mymensingh District,a specialized center for management of complicated VL and PKDL cases.Communicable Disease Control(CDC)of the Directorate General of Health Services(DGHS)assigned twenty five of hundred UHCs and SKKRC(total 26)as treatment centers depending on their suitable geographical location.This was implemented for better management of VL cases with Liposomal Amphotericin B(AmBisome®)to ensure patient convenience and proper utilization of this expensive donated drug.A VLPV expert committee and a UHC VLPV team were established,an operational manual and pharmacovigilance report forms were developed,training and refresher training of health personnel took place at UHCs and at the central level,collected information such as patient data including demographics,treatment history and response,adverse events were analyzed.This report includes information for the period from December 2014 to December 2016.Results:From December 2014 to December 2016,1327 leishmaniasis patients were treated and 1066(80%)were available for VLPV.Out of these,57,33,9,and 1%were new VL,PKDL,VL relapse,and other cases,respectively.Liposomal amphotericin B was mostly used(82%)for case management,followed by miltefosine(20%)and paromomycin(3%).Out of the 1066 patients,26%experienced ADRs.The most frequent ADR was fever(17%,176/1066),followed by vomiting(5%,51/1066).Thirteen serious adverse events(SAEs)(eight deaths and five unexpected SAEs)were observed.The expert committee assessed that three of the deaths and all unexpected SAEs were possibly related to treatment.Out of the five unexpected SAEs,four were miltefosine-induced ophthalmic complications and the other was an AmBisome^(■)-induced avascular necrosis of the nasal alae.The Directorate General of the Drug Administration entered the ADRs into the World Health Organization Uppsala Monitoring Centre(WHO-UMC)VigiFlow database.Conclusions:This study found that VLPV through NKEP is feasible and should be continued as a routine activity into the public health system of Bangladesh to ensure patient safety against anti-leishmanial drugs.