Volume 3, Issue Issue 3, Summer 2021

Original Research

Study on Phytochemical Screening and Antimicrobial Activity of Adhatoda Vasica

Avani Gohel; Vijay Upadhye; Tarun K Upadhyay; Esha Rami; Rakeshkumar Panchal; Suraj Jadhav; Rajesh Dhakane; Vijay Kele

Canadian Journal of Medicine, 2021, Volume 3, Issue Issue 3, Pages 105-113
DOI: 10.33844/cjm.2021.60509

Vasaka or Adhatoda vasica (L.) Nees is a well-known plant medication in Ayurvedic and Unani medicine. Cough, whooping cough, cold, and clinging phlegm in the mouth, throat, chest, or breast have been traditionally treated using Adhatoda vasica nees. The present study aimed to evaluate Adhatoda vasica's phytochemical analysis and antimicrobial activity. The preliminary phytochemical screening of alkaloids, steroids, saponins, phenols, and terpenoid yielded positive results. The antibacterial activity of ethanol and leaf extracts of Adhatoda vasica was investigated in this study. Based on the data presented herein, the largest zone of inhibition was found to be against Pseudomonas aeruginosa. The antifungal activity of Aspergillus clavatus was proven to have the maximum zone of inhibition. As a result, the current method may be effective in identifying new bioactive compound for the development of novel medications. Thus, it may be used as a strong antimicrobial agent against Pseudomonas aeruginosa pathogens.

Case Report

Hyperbaric Oxygen Therapy for Carbon Monoxide Poisoning can Lead a Perfect Result: A Case Report

Canan Bolcu Emir; Selin Gamze Sümen; Tuna Gümüş

Canadian Journal of Medicine, 2021, Volume 3, Issue Issue 3, Pages 114-120
DOI: 10.33844/cjm.2021.60510

Carbon monoxide poisoning (COP) is a common emergency worldwide, especially in the wintertime. It is known to cause serious morbidities, resulting in high mortality risk. COP is also reported to result in neurological complications for which hyperbaric oxygen therapy is likely to offer some benefits, which certainly makes it one of the potential treatment modalities.  Here, Case in the paper is of a 64-year-old female patient with carbon monoxide poisoning. Her neurological symptoms nearly disappeared after the application of hyperbaric oxygen therapy (HBOT) and conventional medical treatment. Our case guides for the key role of HBOT in the treatment process of a 64-year-old female patient with COP. Our clinical experience revealed that hyperbaric oxygen therapy could successfully reverse the symptoms of delayed neurological findings caused by COP, a serious and preventable health problem.

Original Article

NSAIDs/Nitazoxanide/Azithromycin Immunomodulatory Protocol Used in Adult, Geriatric, Pediatric, Pregnant, and Immunocompromised COVID-19 Patients: A Real-World Experience

Mina T. Kelleni

Canadian Journal of Medicine, 2021, Volume 3, Issue Issue 3, Pages 121-143
DOI: 10.33844/cjm.2021.60511

COVID-19 management still lacks a protocol of proven efficacy, and we present a novel COVID-19 immunomodulatory protocol based on our early pioneering article, re-purposing nitazoxanide/azithromycin combination for early COVID-19 diseases. Our findings were followed by two articles to justify the addition of non-steroidal anti-inflammatory drugs to nitazoxanide/azithromycin. Furthermore, another recent article of ours illustrated the potential immunomodulatory mechanisms by which all the drugs used in this manuscript might be beneficial for COVID-19 patients. We presented a case series of 34 confirmed and highly suspected COVID-19 patients. It is noteworthy that 13 PCR-confirmed COVID-19 patients were included while the others were diagnosed by other measures and all cases were managed by telemedicine. The patients included adult males and females as well as children. All patients have received a short 5-day-regimen of NSAIDs / nitazoxanide/ azithromycin +/- cefoperazone either in full or in part. The primary endpoint of this protocol was a full relief of all debilitating COVID-19 clinical manifestations, and it was fully achieved within two weeks. Most of the patients who were treated early have fully recovered during their described five days; the leucocytic/lymphocytic counts were significantly improved for those with prior abnormalities. Neither significant adverse effects nor post/para COVID-19 syndrome was reported. In conclusion, we present a pioneering 5-day protocol for the safe and effective treatment of COVID-19 using economic FDA-approved immunomodulatory drugs.  We recommend conducting double-blind, randomized clinical trials with sufficient strength at the earliest opportunity.


Intracholecystic Papillary-Tubular Neoplasms (ICPNs): A Pathology Report

Atena Azami; Fahimeh Shahjoei

Canadian Journal of Medicine, 2021, Volume 3, Issue Issue 3, Pages 144-146
DOI: 10.33844/cjm.2021.60512

We presented a 60-year-old man who underwent a colonoscopy examination of a polypoid mass with a wound surface of 1.1 cm in hepatic flexure. An adenocarcinoma of intestinal type was diagnosed based on the biopsy report, and patient was referred to the hospital for colectomy. In colonoscopy and biopsy, the polypoid mass was completely removed, and despite different sections of the whole specimen in the colectomy specimen, any mass was not found, while only one out of three identified lymph nodes were involved. In laboratory tests, CBC had anemia: (Hb: 10.8 mg/ dl), elevated CEA tumor marker (range: 18 ng/ml), and lipid profile disorder together with high cholesterol (300 mg/dl), indicating colon cancer manifestation.

Review Article

An Evaluation of the Potential of Heparin to Inhibit the Viral Entry of SARS-CoV-2

Sudipta Samadder; Peter Anto Johnson; John Christy Johnson; Austin Mardon

Canadian Journal of Medicine, 2021, Volume 3, Issue Issue 3, Pages 147-152
DOI: 10.33844/cjm.2021.60513

Heparin is an anticoagulant medicine that prevents the formation of harmful blood clots in the vessels. Following the outbreak of the novel coronavirus disease 2019 (COVID-19), heparin has helped to improve the health of affected patients beyond its anticoagulant effects. The potential antiviral activity of heparin has attracted speculation due to its highly sulfated profile, which allows it to have a high binding affinity to a wide range of viral components. Heparin’s successful binding to the ZIKA virus, human immunodeficiency virus, as well as the SARS CoV and MERS CoV spike proteins have demonstrated its potential to inhibit the entry of SARS-CoV-2 into the body. A high degree of sequence homology also enables heparin to have inhibitory binding potential on viral components. The SARS-CoV-2 virus exhibits significant differences in its spike glycoprotein (SGP) sequence compared to other coronaviruses. The SGP sequence in SARS-CoV-2 contains additional potential glycosaminoglycan (GAG) binding domains that may drive differences in the attachment and entry process of the virus. Findings from unbiased computational ligand docking simulations, pseudotyped spike protein experiments, and cell to cell fusion assays have also opened possibilities to investigate the antiviral properties of heparin in clinical trials

Original Article

Accuracy Measure of Separate and Joint Modelling for a Correlated Binary Outcome: The Case Study of Mother Education and Immunization in Bangladesh

Md Asadullah; Nahid Hosen; Mamunar Rashid; Priyanka Basu; Farjana Boby Mukta; Emon Ahmed

Canadian Journal of Medicine, 2021, Volume 3, Issue Issue 3, Pages 153-161
DOI: 10.33844/cjm.2021.60514

Joint modelling is a statistical approach that is used to analyze correlated data when two or more outcome variables are correlated. By joint modeling, we refer to the simultaneous analysis of two or more different response variables from the same individual. But in a separate model, it is unable to measure the effect of covariate simultaneously. This article focuses on separate and joint modelling for correlated discrete data, including logistic regression models for binary outcomes. Since most of the women are illiterate in Bangladesh and most of the people are living in urban areas, as a result, most of the women are not aware of immunization. But an educated mother is always aware of her child's health which is dependent on immunization. Therefore, mother education and immunization are interdependent. We jointly address the effect of maternal education and immunization. Joint modeling of these two outcomes is appropriate because mother education helps raise awareness of the child's health and immunization is the prevention of various diseases for the child's health. We also identified factors influencing maternal education and immunization among women in Bangladesh. By jointly modelling we found the correlation between maternal education and immunization and the most important contributing factor. The joint model removes a less significant impact of covariates as opposed to separate models. These findings further suggested that the simultaneous impact of correlated outcomes can be adequately addressed between different responses, which is overestimated or underestimated when examined separately.