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Anti-viral drug Molnupiravir may emerge as the game-changer in the fight against Covid-19 as studies suggest it can reduce the risk of hospitalization or death in newly diagnosed patients, an expert says.
Distinguished cardiologist and health systems expert Dr. Krishna Reddy Nallamalla believes that Molnupiravir as an effective oral drug for the treatment of Covid-19 assumes significance as cases are still being reported despite vaccines, which are not as effective against the spread of the virus and have lower efficacy against certain variants.
Almost two years since the onset of the pandemic, the world has reported close to 250 million positive cases and 5 million deaths, while half a million cases are still being reported every day.
"We have face masks, vaccines, and steroids to fight the pandemic. We also have the expensive injectable antiviral drug Remedesivir and the monoclonal antibody cocktail for those who can afford these. Most of the oral drugs, including chloroquine, ivermectin, anti-HIV drugs, anti-hepatitis drugs.. did not stand the scrutiny of scientific studies. Some others had weak evidence to be of large-scale," said Dr. Krishna Reddy, who is also President of InOrder, a nonprofit institute working to strengthen systems to secure the health and Regional Director (South Asia) of global health non-profit, ACCESS Health International.
"Despite the development of Covid-19 vaccines in a record time period, the world continues to witness daily positive cases of half a million. While vaccines have been effective against moderate to severe illness, they have not been as effective against the spread of the virus. In addition, the efficacy is lower against certain new variants. Another growing concern has been the rapid decline in neutralizing antibodies within six months after the second dose necessitating the booster dose in people at high risk," he said.
He also pointed out that the inequity in access to vaccines has been glaring within and between countries.
On how Molnupiravir helps, Krishna Reddy said that the basic building blocks of coronavirus are ribonucleic acids (RNA), and their analogs can produce mutations that are lethal to the virus. While Remedesivir is an analog and is demonstrated to reduce hospital stay in moderately-ill Covid patients, it is expensive and has to be given through the intravenous route.
"Molnupiravir was earlier developed as an oral drug against influenza. It is also an analog of ribonucleic acids, similar to Remedesivir. In a preprint published in June, virus isolation was noted in 1.6 per cent of those patients receiving Molnupiravir compared to 16.7 per cent of those receiving placebo on day 3 and 0 per cent and 11.1 per cent respectively on day 5," Krishna Reddy said.
Merck and Ridgeback have announced on October 11, the submission of an emergency use authorization application to the US FDA for the treatment of mild to moderate cases (room air oxygen saturation more than 93 per cent at rest).
The submission is based on positive results from a planned interim analysis from the phase 3 MOVe-OUT clinical trial, which evaluated Molnupiravir in non-hospitalized adults with mild to moderate Covid illness who were at risk to progress to severe Covid requiring hospitalization.
In the interim analysis, there was a 50 per cent reduction in risk of hospitalization or death (7.3 per cent with drug vs 14.1 per cent with placebo) with Molnupiravir. Full results of the trial are awaited.
Merck has previously announced that it has entered into non-exclusive voluntary licensing agreements for Molnupiravir with six established Indian generic manufacturers to accelerate the availability of the drug in more than 100 low- and middle-income countries (LMIC), following approval or EUA by their respective regulatory bodies.
The arrival of an effective and affordable oral drug has long been awaited in the fight against Covid-19 across the world and more so in LMIC which are yet to receive sufficient quantities of vaccines.
There is also growing concerned about the duration of efficacy of the vaccines and their efficacy against new variants. Many rich countries have started booster doses while many developing countries are still waiting for their first doses.
Krishna Reddy believes that India is in a unique position to supply the needed vaccines to countries awaiting them and also the affordable generic oral Molnupiravir, to derive significant geopolitical mileage.
"Reaching the milestone of one billion vaccine doses, India has exhibited remarkable resilience despite the devastating second wave that was driven by the Delta variant. It has restarted its vaccine exports to other countries. It is in a position to start exports of the new effective oral drug that the world has been eagerly awaiting," he added. (IANS/JB)
Keywords: India, Coronavirus, Medicines, Molnupiravir
The Asian countries have thrived in their discoveries of nature since time immemorial. They have studied the botany of their surroundings and have devised cures for various health conditions. Before modern medicine was born, the ancient civilizations trusted their health experts and the power of nature to heal their bodies. Two such systems are the Indian Ayurveda and Traditional Chinese Medicine.
India and China are geographical neighbors who also share common intellectual pursuits, be it for their intensely detailed religious practices, or diverse language systems. They share common scientific understandings dating back many centuries, and are known for their use of herbs, concoctions, and extracts in treating diseases.
The Chinese believe in the balance of the Qi, the vital life force that apparently surges through the body. Disturbance in this balance results in illness and disease. The familiar concept of yin and yang play a role in bringing normality to the body. The internal body organs are compared to the five elements of nature namely, earth, fire, wood, air, and water. Traditional medicine targeted these specific organs which were believed to be the hotbeds of possible imbalance. Treatments like massage, acupuncture, cupping, and burning herbs at the site of infection are important practices in this school of thought.
Traditional Chinese herbs being prepared for use in curing a specific illness Image source: wikimedia commonswikimedia commons
Ayurveda, on the other hand, is deeply rooted in the Hindu faith and mythology. It employs the instructions provided in the texts and is a system based on curing the imbalance in the doshas, which are the three governing forces within the body. Two of the doshas correspond to the sun and the wind, and the third is the response of the bodily fluids to the others. Treatment methods involve the five senses and must be carried out by an expert only.
The traditional medicine systems of Ayurveda and Chinese medicine are not too far separated from each other except through the origins and faith. They are similar in the core concept of balance and harmony within the human body. Ayurveda is well-received in the west, while Chinese medicine remains predominantly indigenous. In the modern world, allopathy is preferred to these systems because of it grants immediate relief. Gaining expertise in the ancient medical practice is a life-long process unlike with modern medicine.
Keywords: Medicine, Oriental, Chinese, Indian, Ayurveda, TCM
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An Ayurvedic poly-herbal formulation, NEERI-KFT, has the potential to not only slow down the progression of chronic kidney disease but also restore normalcy in functional parameters of the vital organ, a team of researchers has claimed.
In a review published in the latest edition of Saudi Journal of Biological Sciences, they said "phytopharmacological evaluation of NEERI-KFT suggests that it exhibits substantial potential against oxidative and inflammatory stress induced apoptosis by exerting antioxidant, nephroprotective and immunomodulatory effects in the patients associated with renal dysfunction or chronic kidney disease (CKD)".
The NEERI-KFT, a herbal medicine extracted from plants, has been found to correct oxidative as well as inflammatory stress known for reducing body's immunity, said the authors after drawing data on the formulation for kidney ailments from more than five electronic databases such as Science Direct, Google Scholar, Elsevier, PubMed, Springer, ACS publication from published database between 2000 and 2020.
The study, 'A systematic review on nephroprotective AYUSH drugs as constituents of NEERI-KFT' not only examined the impact of the herbal extract of NEERI-KFT prepared by the AIMIL Pharma interventions on patients, but also dwelled in detail the adverse events of the modern medicine used for the management of the kidney ailments.
The study also highlighted the herbal drug's efficacy in reducing "serum creatinine, blood urea, and serum uric acid as compared to placebo group" and described "its well-tolerated effect with no adverse hematological or biochemical abnormalities occurred to any subjects during clinical trial".
"It can be suggested that NEERI-KFT can be an alternative and complementary therapy at end-stage renal disease (ESRD) or complete loss of kidney function where frequent dialysis of renal transplant remains only a single option for continued survival CKD patients," researchers said.
K.K. Sharma, AIMIL Pharma Managing Director, attributed this to the "more than 20 different potent herbs like haridra, varuna, shirish, gokhru, punarnava and anantamul to name a few in the formulation which are known for their nephro corrective, anti-inflammatory and antioxidant properties and reparative regeneration of kidney cells.
It was after a string of stringent tests that this formulation has been developed to provide relief to kidney patients, he said.
K.N. Dwivedi from Banaras Hindu University said the herbal ingredients in NEERI-KFT are loaded with many anti-oxidants besides medicinal values which not only strengthen kidney but liver also.
"This is a very unique drug and we have found it very effective in our study also," he added.
Keywords: Ayurveda, Kidney, herbal medicine, disease
Well-known Mumbai-based neurosurgeon Dr. B.K. Misra has been conferred the prestigious American Association of Neurological Surgeons 'International Lifetime Achievement Award in Neurosurgery', an official said here on Thursday. Dr. Misra is the Head of the Department of Surgery and Division of Neurosurgery & Gamma Knife Radiosurgery at the P.D. Hinduja Hospital here. He becomes the first Indian to receive the AANS honour which was conferred on him at a virtual ceremony during the AANS Annual Scientific Meeting 2021 held in Orlando this week.
"We have the best of tech, infrastructure and skills at par with the best in the world to treat the most complex neurosurgical conditions and even have the potential to become the destination for neurological treatment," Dr. Misra said on receiving the award. The Hospital CEO Gautam Khanna lauded Dr. Misra's medical accomplishments and accolades as a testament to his dedication and treating thousands of patients under his care.
AANS is the world's apex body of neurosurgeons that has bestowed its highest global recognition to Dr. Misra -- the President of Asian Australasian Society of Neurological Surgeons and the World Federation of Skull Base Societies, and the 1st Vice-President of World Federation of Neurosurgical Societies.
With a long string of credits and firsts, he was the first in the world to execute an Image-Guided Aneurysm Microsurgery, first in South Asia to perform a Gamma Knife Radiosurgery and first in India to perform an Awake Craniotomy for brain tumours. Earlier, he received the Dr. B.C. Roy National Award-2018, and contributes through numerous publications to improve the quality of education in neurosurgery and facilitate spreading the treatment for neurosurgical patients in poor countries globally. (IANS/SB)