A Symptom-Directed Paradigm for the Evaluation and Management of Upper Respiratory Tract Infections

Transforming respiratory tract infection diagnosis in the kingdom of saudi arabia through point-of-care testing: A white paper for policy makers

With the evident increased prevalence of respiratory tract infections (RTIs) such as Respiratory Syncytial Virus (RSV), influenza, Group A Streptococcus (GAS), and COVID-19, the conventional diagnostic methods are considered sub-optimal in providing timely management to patients in the Kingdom of Saudi Arabia (KSA). Gaps in current diagnostics are magnified by the Kingdom's unique demographic composition, comprising 11.9 million foreign workers, and the annual influx of over 10 million pilgrims. Current gaps in timely diagnosis leads to delays in treatment, misuse of antibiotics, and protracted hospital stays, subsequently compromising patient care, and escalating healthcare costs. KSA healthcare stakeholders suggest that the integration of rapid molecular Point-of-Care Testing (POCT) into the Kingdom's healthcare infrastructure is an absolute necessity. This publication serves as an urgent call for action aimed at healthcare policymakers in Saudi Arabia, to review the existing diagnostic challenges and include rapid POCTs in the Saudi healthcare strategy for respiratory infections.

A review of the safety profile, antioxidant, anti-inflammatory, and bronchorelaxant activities of Waltheria indica Linn (Malvaceae): A potential antiasthmatic phytomedicine

Introduction

Waltheria indica Linn (Malvaceae) is a widely distributed plant in West Africa. It is commonly used in Burkina Faso to treat inflammation-related diseases, including asthma. Previous reviews have focused on the ethnobotanical, traditional uses, phytochemistry, and pharmacological properties of Waltheria indica. This report aims to compile the biological and pharmacological activities that highlight the anti-asthmatic properties of Waltheria indica L. (W. indica).

Method

Electronic databases, such as PubMed, Scopus, Hinari, SciFinder, Google Scholar, and ScienceDirect, were used to gather data on Watheria indica. Data on the toxicological, anti-inflammatory, antioxidant, and bronchorelaxant effects of W. indica were collected.

Results

Twenty-three studies describing the biological and pharmacological activities relevant to assessing the anti-asthmatic properties of W. indica were found. Nine articles investigated the anti-inflammatory effects, and three manuscripts were found to have bronchorelaxant activity. Five publications reported the antioxidant activity of the plant extracts. Research on the extracts revealed a tolerable safety profile in rats and mice with an LD50 ranging from 300 to 5000 mg/kg body weight, depending on the parts of the plant used. Phenolic compounds, particularly flavonoids, alkaloids, and saponins, were found to be responsible for the activities involved in the assessment of anti-asthmatic properties.

Conclusion

The results of this review suggest that W. indica could be a valuable resource for the treatment of asthma and other respiratory diseases. However, further chemical and pharmacological investigations are needed to understand its mechanism of action in treating asthma.

The effectiveness and safety of Chaiqin Qingning Capsule in upper respiratory tract infections with fever: A prospective, double-blinded, randomized, multicenter controlled trial

BACKGROUND AND AIM

Presently, over-the-counter drugs that can treat upper respiratory tract infections (URTI) are rarely effective and safe. Chaiqin Qingning Capsule (CQQNC), a Chinese patent medicine, which has been verified by long-term clinical practice is recommended by Chinese experts for the treatment of URTI with fever. This study conducted a prospective, double-blinded, randomized, multicenter controlled trial to evaluate the effectiveness and safety of CQQNC in the treatment of URTI.

METHODS

The study was conducted at 4 clinical centers in China. Eligible subjects were recruited and randomized 1:1 to the CQQNC group and Qingkailing Capsule (QKLC) group. Both groups were administered orally three times a day for three consecutive days. Primary outcomes were the antipyretic onset time and the temperature recovery time. Secondary outcomes included the symptom disappearance rate, symptom score, and drug safety assessment.

RESULTS

A total of 269 subjects were analyzed (134 subjects in the CQQNC group, 135 subjects in the QKLC group). The antipyretic onset time and the temperature recovery time were significantly shortened in the CQQNC group (median: 5 h vs. 10 h, p < 0.0001, median: 19 h vs. 27 h, p < 0.0001). CQQNC was more effective than the QKLC in improving the symptoms of pharyngodynia and rhinobyon (85.07% vs. 71.11%, p = 0.008; 76.99% vs. 64.41%, p = 0.043), and in improving the overall symptom scores (-15.10 ± 3.23 vs. -13.35 ± 3.58, p < 0.0001). During the trial, no serious adverse events were reported in the two groups.

CONCLUSION

CQQNC is effective and safe in the treatment of URTI with fever, and worthy of clinical application. (http://www.chictr.org.cn, ChiCTR-IPR-16009049).