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Dutta S, Singhal S, Shah R. A Systematic Analysis of COVID-19 Clinical Trials Registered in the Clinical Trials Registry of India. Cureus 2024; 16:e57939. [PMID: 38738059 PMCID: PMC11082480 DOI: 10.7759/cureus.57939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND The Clinical Trials Registry - India (CTRI) database is a registry of various trials conducted in India and this study scrutinized the studies registered for COVID-19 from the database to detect patterns in trial design, appraising the target regions of therapies and comprehending the terrain of research endeavors. METHOD This was a cross-sectional study that analyzed the registered trials for COVID-19 between March 2020 and September 2023. A trial search was conducted on the CTRI database to include all types of studies registered for COVID-19 with keywords like "COVID" and "coronavirus" and studies conducted on conditions other than COVID-19 were excluded. The data regarding study characteristics were noted under various sections in a preformed proforma. RESULTS A total of 807 trials were taken for final analysis and there were about 344 prospective and 260 retrospective interventional trials, 35 prospective and 165 retrospective observational studies, and two prospective and one retrospective post-marketing surveillance study. The majority of the studies had duration under 12 months (91%). The maximum number of studies were registered from AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) and allied therapies (n = 283), with about 104 types of interventions, followed by the drug category having 119 trials registered and about 57 types of interventions. Kabasura Kudineer and yoga in the AYUSH category, molnupiravir, colchicine, and favipiravir in the drug category, and tocilizumab and convalescent plasma among biologics were some common interventions used. The majority of trials did not mention the trial phase and declared it as not applicable (54%), whereas 15% were registered as phase 2 and 13% as phase 3. About 54% of the studies were randomized and randomized parallel-group design (20%) was the most common study design. Only 6% of the trials were post-graduate thesis and the majority of the trials (n = 535) denied sharing their individual participant data. Only 0.86% and 0.61% of the trials were terminated and suspended, respectively, denoting proper design and conduct of the trials. CONCLUSION In the CTRI database, the majority of trials were prospective interventional studies, with a predominance of AYUSH therapies and drug interventions. Common interventions included Kabasura Kudineer and yoga in AYUSH, and molnupiravir, colchicine, and favipiravir in drugs. Most studies had durations under 12 months and randomized parallel-group design was the most common study design. The intention to use and promote an indigenous system of medicine looks promising in the absence of any definite therapy. A minute number of registered suspended and terminated trials might be a positive picture of meticulously designed and executed trials even during a pandemic situation in India.
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Affiliation(s)
- Siddhartha Dutta
- Department of Pharmacology, All India Institute of Medical Sciences, Rajkot, Rajkot, IND
| | - Shubha Singhal
- Department of Pharmacology, All India Institute of Medical Sciences, Rajkot, Rajkot, IND
| | - Rima Shah
- Department of Pharmacology, All India institute of Medical Sciences, Rajkot, Rajkot, IND
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Naseer B, Ali M, Azhar N. COVID-19 research in South Asia: a bibliometric analysis of the 100 most-cited articles. GMS HYGIENE AND INFECTION CONTROL 2023; 18:Doc22. [PMID: 37829254 PMCID: PMC10566035 DOI: 10.3205/dgkh000448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Background With the surge in the number of infected individuals during the COVID-19 pandemic, there was also a surge observed in the number of publications discussing its epidemiology, characteristics, path-o-phys-i-ol-o-gy, diagnosis, prevention and treatment. This bibliometric analysis focuses on the papers published on COVID-19 in South Asia. Methods We searched articles in the Scopus database from December 2019 to October, 2022. After manual screening, a list of the 100 most-cited articles was obtained, which was analyzed for various factors, including the type of article, citation count, author's affiliation, country of origin, funding bodies, etc. Results The majority of the top 100 articles (n=79) in South Asia were published during 2020. India was affiliated with the highest number of articles (n=68), followed by Bangladesh (n=18) and Pakistan (n=12). However, 7 articles were authored by a researcher in Bangladesh. Female authors were under represented (32.38%), with no female author in lists of authors with 4 or more articles. The average number of citations for each of the top 100 most-cited articles was 180.8. Original articles constituted the major portion of the publications (82%), followed by letters (11%) and reviews (4%). Half of the publications belonged to the field of medicine (n=49), while others were contributed by science, psychology, social sciences, and biochemistry and allied sciences (n=8). Vaccine trials were under-represented. Jahangirnagar University, Bangladesh was affiliated with the maximum number of articles. Most articles were published in Science of The Total Environment (n=8) while Indian Council of Medical Research (n=4) was the top funding body. Conclusion These findings highlight that South Asia has a great potential to conduct research addressing its challenging health problems. But lack of funds hinders conducting trials of new medications and vaccines. Thus, there is need for allocation of sufficient funds for research and clinical trials by governments and the private sector to enhance the research productivity of this region.
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Affiliation(s)
- Bisal Naseer
- King Edward Medical University, Lahore, Pakistan
| | - Mohsan Ali
- King Edward Medical University, Lahore, Pakistan
| | - Neha Azhar
- Khawaja Muhammad Safdar Medical College, Sialkot, Pakistan
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Namiot ED, Smirnovová D, Sokolov AV, Chubarev VN, Tarasov VV, Schiöth HB. The international clinical trials registry platform (ICTRP): data integrity and the trends in clinical trials, diseases, and drugs. Front Pharmacol 2023; 14:1228148. [PMID: 37790806 PMCID: PMC10544909 DOI: 10.3389/fphar.2023.1228148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction: Clinical trials are the gold standard for testing new therapies. Databases like ClinicalTrials.gov provide access to trial information, mainly covering the US and Europe. In 2006, WHO introduced the global ICTRP, aggregating data from ClinicalTrials.gov and 17 other national registers, making it the largest clinical trial platform by June 2019. This study conducts a comprehensive global analysis of the ICTRP database and provides framework for large-scale data analysis, data preparation, curation, and filtering. Materials and methods: The trends in 689,793 records from the ICTRP database (covering trials registered from 1990 to 2020) were analyzed. Records were adjusted for duplicates and mapping of agents to drug classes was performed. Several databases, including DrugBank, MESH, and the NIH Drug Information Portal were used to investigate trends in agent classes. Results: Our novel approach unveiled that 0.5% of the trials we identified were hidden duplicates, primarily originating from the EUCTR database, which accounted for 82.9% of these duplicates. However, the overall number of hidden duplicates within the ICTRP seems to be decreasing. In total, 689 793 trials (478 345 interventional) were registered in the ICTRP between 1990 and 2020, surpassing the count of trials in ClinicalTrials.gov (362 500 trials by the end of 2020). We identified 4 865 unique agents in trials with DrugBank, whereas 2 633 agents were identified with NIH Drug Information Portal data. After the ClinicalTrials.gov, EUCTR had the most trials in the ICTRP, followed by CTRI, IRCT, CHiCTR, and ISRCTN. CHiCTR displayed a significant surge in trial registration around 2015, while CTRI experienced rapid growth starting in 2016. Conclusion: This study highlights both the strengths and weaknesses of using the ICTRP as a data source for analyzing trends in clinical trials, and emphasizes the value of utilizing multiple registries for a comprehensive analysis.
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Affiliation(s)
- Eugenia D. Namiot
- Department of Surgical Sciences, Division of Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Diana Smirnovová
- Department of Surgical Sciences, Division of Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Aleksandr V. Sokolov
- Department of Surgical Sciences, Division of Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | | | - Vadim V. Tarasov
- Advanced Molecular Technology, Limited Liable Company (LLC), Moscow, Russia
| | - Helgi B. Schiöth
- Department of Surgical Sciences, Division of Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
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Chopra A, Tillu G, Chuadhary K, Reddy G, Srivastava A, Lakdawala M, Gode D, Reddy H, Tamboli S, Saluja M, Sarmukaddam S, Gundeti M, Raut AK, Rao BCS, Yadav B, Srikanth N, Patwardhan B. Co-administration of AYUSH 64 as an adjunct to standard of care in mild and moderate COVID-19: A randomized, controlled, multicentric clinical trial. PLoS One 2023; 18:e0282688. [PMID: 36928877 PMCID: PMC10019690 DOI: 10.1371/journal.pone.0282688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/28/2022] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVE Evaluate the efficacy of AYUSH 64, a standard polyherbal Ayurvedic drug in COVID-19. METHODS During the first pandemic wave, 140 consenting and eligible hospitalized adult participants with mild-moderate symptomatic disease (specific standard RT-PCR assay positive) were selected as per a convenience sample, and randomized (1:1 ratio) to an open-label (assessor blind) two-arm multicentric drug trial; standard of care (SOC as per Indian guidelines) versus AYUSH 64 combined with SOC (AYUSH plus). Participants were assessed daily and discharged once clinical recovery (CR, primary efficacy) was achieved which was based on a predetermined set of criteria (resolution of symptoms, normal peripheral oximetry, and negative specific RT-PCR assay). Each participant was followed using an indigenous software program(mobile phone) and completed a 12-week study period. The dose of AYUSH 64 was 2 tablets oral, 500 mg each, bid for 12 weeks (AYUSH plus only). Significant P was <0.05 (two-sided). On randomization, the groups were found well matched. RESULTS The mean interval time from randomization to CR was significantly superior in the AYUSH plus group [mean 6.45 days versus 8.26 days, 95% Confidence Interval of the difference -3.02 to -0.59 (P = 0.003, Student's 't test] as per-protocol analysis (134 participants); significant (P = 0.002) on an intention to treat analysis. 70% of the participants in AYUSH plus recovered during the first week (P = 0.046, Chi-square) and showed a significantly better change in physical health, fatigue, and quality of life measures. 48 adverse events, mostly mild and gut related, were reported by each group. There were 20 patient withdrawals (8 in AYUSH plus) but none due to an AE. There were no deaths. Daily assessment (hospitalization) and supervised drug intake ensured robust efficacy data. The open-label design was a concern (study outcome). CONCLUSIONS AYUSH 64 in combination with SOC hastened recovery, reduced hospitalization, and improved health in COVID-19. It was considered safe and well-tolerated. Further clinical validation (Phase III) is required. TRIAL REGISTRATION CTRI/2020/06/025557.
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Affiliation(s)
| | - Girish Tillu
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | | | - Govind Reddy
- Regional Ayurveda Research Institute, Nagpur, India
| | | | | | - Dilip Gode
- Datta Meghe Institute of Medical Sciences, Nagpur, India
| | | | - Sanjay Tamboli
- Target Institute of Medical Education & Research, Mumbai, India
| | | | | | | | | | - B. C. S. Rao
- Central Council for Research in Ayurvedic Sciences, New Delhi, India
| | - Babita Yadav
- Central Council for Research in Ayurvedic Sciences, New Delhi, India
| | | | - Bhushan Patwardhan
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
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Prajapati SK, Malaiya A, Mishra G, Jain D, Kesharwani P, Mody N, Ahmadi A, Paliwal R, Jain A. An exhaustive comprehension of the role of herbal medicines in Pre- and Post-COVID manifestations. JOURNAL OF ETHNOPHARMACOLOGY 2022; 296:115420. [PMID: 35654349 PMCID: PMC9150915 DOI: 10.1016/j.jep.2022.115420] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 05/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The coronavirus disease (COVID-19) has relentlessly spread all over the world even after the advent of vaccines. It demands management, treatment, and prevention as well with utmost safety and effectiveness. It is well researched that herbal medicines or natural products have shown promising outcomes to strengthen immunity with antiviral potential against SARS-COV-2. AIM OF THE REVIEW Our objective is to provide a comprehensive insight into the preventive and therapeutic effects of herbal medicines and products (Ayurvedic) for pre-and post-COVID manifestations. MATERIAL AND METHOD The database used in the text is collected and compiled from Scopus, PubMed, Nature, Elsevier, Web of Science, bioRxiv, medRxiv, American Chemical Society, and clinicaltrials.gov up to January 2022. Articles from non-academic sources such as websites and news were also retrieved. Exploration of the studies was executed to recognize supplementary publications of research studies and systematic reviews. The keywords, such as "SARS-COV-2, coronavirus, COVID-19, herbal drugs, immunity, herbal immunomodulators, infection, herbal antiviral drugs, and WHO recommendation" were thoroughly searched. Chemical structures were drawn using the software Chemdraw Professional 15.0.0.160 (PerkinElmer Informatics, Inc.). RESULT A plethora of literature supports that the use of herbal regimens not only strengthen immunity but can also treat SARS-COV-2 infection with minimal side effects. This review summarizes the mechanistic insights into herbal therapy engaging interferons and antibodies to boost the response against SARS-COV-2 infection, several clinical trials, and in silico studies (computational approaches) on selected natural products including, Ashwagandha, Guduchi, Yashtimadhu, Tulsi, etc. as preventive and therapeutic measures against COVID. We have also emphasized the exploitation of herbal medicine-based pharmaceutical products along with perspectives for unseen upcoming alike diseases. CONCLUSION According to the current state of art and cutting-edge research on herbal medicines have showed a significant promise as modern COVID tools. Since vaccination cannot be purported as a long-term cure for viral infections, herbal/natural medicines can only be considered a viable alternative to current remedies, as conceived from our collected data to unroot recurring viral infections.
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Affiliation(s)
- Shiv Kumar Prajapati
- Institute of Pharmacy, Ram-Eesh Institute of Vocational and Technical Education, Greater Noida, 201310, UP, India
| | - Akanksha Malaiya
- Nanomedicine and Bioengineering Research Laboratory, Department of Pharmacy, Indira Gandhi National Tribal University, Amarkantak, 484886, MP, India
| | - Gaurav Mishra
- Institute of Medical Sciences, Faculty of Ayurveda, Department of Medicinal Chemistry, Banaras Hindu University, Varanasi, 221005, UP, India
| | - Dolly Jain
- Department of Pharmacy, Oriental University, Indore, 453555, Madhya Pradesh, India; Adina College of Pharmacy, Sagar, 470002, MP, India
| | - Payal Kesharwani
- Institute of Pharmacy, Ram-Eesh Institute of Vocational and Technical Education, Greater Noida, 201310, UP, India
| | - Nishi Mody
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University, Sagar, 470003, MP, India
| | - Amirhossein Ahmadi
- Pharmaceutical Sciences Research Centre, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, 48175866, Iran
| | - Rishi Paliwal
- Nanomedicine and Bioengineering Research Laboratory, Department of Pharmacy, Indira Gandhi National Tribal University, Amarkantak, 484886, MP, India
| | - Ankit Jain
- Department of Materials Engineering, Indian Institute of Science, Bangalore, 560012, Karnataka, India.
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Chaudhari SS, Somvanshi PR. Methodological analysis of CTRI registered clinical trials on Ayurveda interventions for COVID-19 management. J Ayurveda Integr Med 2022; 14:100631. [PMID: 35971456 PMCID: PMC9365872 DOI: 10.1016/j.jaim.2022.100631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Clinical trial protocols provide important methodological information and are expected to be detailed. During COVID-19 pandemic several studies has been registered on CTRI regarding ayurveda for COVID-19. However, there is accumulating evidence that many protocols do not address important study elements. Therefore it is critical to analyze the clinical trial protocols and methodology of ayurveda clinical trials regarding COVID-19 registered on CTRI. OBJECTIVE To assess the methodological aspects of CTRI registered ayurveda trial for COVID-19, based upon available trial protocols, during 2020 and 2021. MATERIALS AND METHODS We searched the CTRI database for interventional trials protocols regarding ayurveda for COVID-19, during the year 2020 and 2021. We assessed the protocols for several methodological aspects such as study design, sample size, randomization, blinding, intervention (duration and type) and outcomes. RESULTS Total 140 clinical trial protocols were analyzed. The highest numbers of studies were registered in May, June, and July 2020 with steady decline thereafter despite rising COVID-19 cases. Total 90 trials were randomized and only 29 are blinded, however majority of the trials did not mention methods of randomization and blinding. Sample size in hospital-based studies ranged from 30 -500 and in community-based studies from 500-80000, however, sample size calculation details were not mentioned in the protocol. Most common intervention used were guduchi, ashwagandha, yashtimadhu, AYUSH-64, curcumin and chyavanprash. CONCLUSION Although there was a surge of clinical trials on CTRI regarding ayurveda for COVID -19, the methodological quality is not up to the mark with large scope for improvement.
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Affiliation(s)
| | - Pramod R Somvanshi
- Department of Systems and Computational biology, School of life sciences, University of Hyderabad, Hyderabad
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Bopaiah J, Garimella K, Kavuluru R. Opinions on Homeopathy for COVID-19 on Twitter. PROCEEDINGS OF THE ... ACM WEB SCIENCE CONFERENCE. ACM WEB SCIENCE CONFERENCE 2022; 2022:359-363. [PMID: 36112977 PMCID: PMC9472594 DOI: 10.1145/3501247.3531575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Homeopathy is a medical system originating in Germany more than 200 years ago. Based on prior investigations, mainstream health agencies and medical research communities indicate that there is little evidence that homeopathy can be an effective treatment for any specific health condition. However, it continues to be practiced as a popular form of alternative medicine in many countries, even during the ongoing COVID-19 pandemic. In this paper, we mine opinions on homeopathy for COVID-19 expressed in Twitter data. Our experiments are conducted with a dataset of nearly 60K tweets collected during a seven month period ending in July 2020. We first built text classifiers (linear and neural models) to mine opinions on homeopathy (positive, negative, neutral) from tweets using a dataset of 2400 hand-labeled tweets obtaining an average macro F-score of 81.5% for the positive and negative classes. We applied this model to identify opinions from the full dataset. Our results show that the number of unique positive tweets is twice that of the number of unique negative tweets; but when including retweets, there are 23% more negative tweets overall indicating that negative tweets are getting more retweets and better traction on Twitter. Using a word shift graph analysis on the Twitter bios of authors of positive and negative tweets, we observe that opinions on homeopathy appear to be correlated with political/religious ideologies of the authors (e.g., liberal vs nationalist, atheist vs Hindu). To our knowledge, this is the first study to analyze public opinions on homeopathy on any social media platform. Our results surface a tricky landscape for public health agencies as they promote evidence-based therapies and preventative measures for COVID-19.
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Kumar A, Rai A, Khan MS, Kumar A, Haque ZU, Fazil M, Rabbani G. Role of herbal medicines in the management of patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials. J Tradit Complement Med 2022; 12:100-113. [PMID: 35036347 PMCID: PMC8747767 DOI: 10.1016/j.jtcme.2022.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND AIM The management of the worldwide spreading COVID-19 consists of amelioration of its symptoms but no cure is yet available. Herbal medicines supplemented with the Western medicine have been applied for COVID-19 treatment in India, China, Iran, and other countries. This systematic review and meta-analysis of RCTs evaluates the effect and safety of herbal intervention in the management of COVID-19. EXPERIMENTAL PROCEDURE RCTs from databases like PubMed, Cochrane Library, ScienceDirect, Google Scholar, Science Direct, CTRI, AYUSH Research Portal, India, were reviewed and the data were extracted for study sample demographics, intervention details, clinical effect, inflammatory markers and safety monitoring. Outcomes were expressed as Risk-ratio (RR) with 95% CI for dichotomous data, and Mean-Difference (MD) with 95% CI for continuous data. RESULT AND CONCLUSION From the 32 eligible studies, a total of 3177 COVID-19 patients were included in the review. Herbal intervention as an adjuvant to Western medicine causes significantly higher improvement compared to Western medicine alone [Fever (RR = 1.09 CI 1.03, 1.15), Cough (Risk-Ratio = 1.22 CI 1.08, 1.37), Fatigue (Risk-Ratio = 1.27 CI 1.11, 1.44), Chest CT Improvement (Risk-Ratio = 1.15 CI 1.08, 1.23)]. The laboratory parameters were also better in the herbal medicine group compared to standard care group only WBC (MD = 0.36 CI 0.16, 0.55), Lymphocyte percentage (MD = 5.48 CI 3.05, 7.92), Absolute lymphocyte count (MD = 0.23 CI 0.07, 0.39), CRP (MD = -5.66 CI -7.96, -3.37). However, duration of hospital stays (MD = -1.82 CI -3.84, 0.21); IL-6 (MD = -3.67 CI -8.76, 1.43), ESR Level (MD = -10.38 CI -25.96, 5.21) were statistically insignificant. No significant adverse events for herbal medications were noted in the included RCTs, during the time of the studies. (n = 665, RR 0.93; 95% CI 0.76, 1.14).
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Affiliation(s)
- Ansul Kumar
- Rajendra Institute of Medical Sciences (RIMS), CTVS Department, Bariatu, Ranchi, 834009, India
| | - Arpita Rai
- Oral Medicine and Radiology, Dental Institute. Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi, 834009, India
| | - Mohd Saif Khan
- Critical Care Medicine, New Trauma Centre & Central Emergency, Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi, 834009, India
| | - Amit Kumar
- Rajendra Institute of Medical Sciences (RIMS) Dept of Lab Medicine, Bariatu, Ranchi, 834009, India
| | - Zeya Ul Haque
- Rajendra Institute of Medical Sciences (RIMS), CTVS Department, Bariatu, Ranchi, 834009, India
| | - Mohammad Fazil
- Hakim Ajmal Khan Institute of Literary and Historical Research in Unani Medicine, CCRUM, Jamia Millia Islamia Campus, New Delhi, 110025, India
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Srivastava A, Bala R, Devi TP, Anal L. Psychological trauma and depression in recovered COVID-19 patients: a telecommunication based observational study. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2021; 45:e20210381. [PMID: 34967182 PMCID: PMC10226770 DOI: 10.47626/2237-6089-2021-0381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/24/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) is adversely affecting the mental health of patients infected with the virus and the psychological impact on recovered COVID-19 patients is unclear. OBJECTIVES The study aimed to assess posttraumatic stress disorder (PTSD) and depression among COVID-19 patients after recovery from the disease. METHODS This cross-sectional study was conducted from November 9, 2020, to December 23, 2020. The study used a telemedicine model to enroll recovered COVID-19 patients from a database of patients provided by the health authorities. The National Stressful Events Survey PTSD Short Scale (NSESSS) for adults was used to assess PTSD symptoms and the Patient Health Questionnaire (PHQ-9) was used to assess depression. RESULTS The study enrolled 503 recovered COVID-19 patients with a mean age of 41.90 years. The majority were asymptomatic (64.6%), while 21.5% had had moderate to severe forms of the disease. Prevalence rates of PTSD symptoms and depression were 56.9 and 29% respectively. COVID-19 patients with severe forms of the disease were significantly more affected by PTSD symptoms (vs. mild, odds ratio [OR] = 18.7, 95%confidence interval [CI] 9.9-35.5) and depression (vs. mild, OR = 19.8, 95% CI 9.9-39.5). Similarly, patients who required oxygen or ventilator support reported significantly higher rates of PTSD symptoms (vs. managed at home, OR = 17.4, 95% CI 8.3-36.4) and depression (vs. managed at home, OR = 22.0, 95% CI 10.1-47.7). CONCLUSION This study reports that recovered COVID-19 patients suffered from a significant amount of depression and experienced significant PTSD symptoms. It will help with addressing a major psychological concern among the recovered subjects.
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Affiliation(s)
- Amit Srivastava
- Regional Research InstituteImphalManipurIndia Regional Research Institute, Imphal, Manipur, India.
| | - Renu Bala
- Regional Research InstituteImphalManipurIndia Regional Research Institute, Imphal, Manipur, India.
| | - Thokchom Priyobala Devi
- Regional Research InstituteImphalManipurIndia Regional Research Institute, Imphal, Manipur, India.
| | - Lily Anal
- Regional Research InstituteImphalManipurIndia Regional Research Institute, Imphal, Manipur, India.
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Joseph SM, Iyer DS, Pillai RV. Ayurvedic Response to COVID-19 Pandemic in Kerala, India and Its Impact on Quarantined Individuals - A Community Case Study. Front Public Health 2021; 9:732523. [PMID: 34722442 PMCID: PMC8554199 DOI: 10.3389/fpubh.2021.732523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
The SARS-CoV-2 infection has resulted in massive loss of valuable human lives, extensive destruction of livelihoods and financial crisis of unprecedented levels across the globe. Kerala, a province in India, like the rest of the country, launched preventive and control measures to mitigate the impact of COVID-19 early in 2020. The Government of Kerala started 1206 Ayur Raksha Clinics and associated Task Forces across the state in April 2020 to improve the reach and penetration of Ayurvedic preventive, therapeutic and convalescent care strategies for the COVID-19 pandemic. The implementation framework of the strategy was properly designed, and had a decentralized, people-centered, and participatory approach. Kerala has robust public health machinery with adequate human resource and infrastructure in the conventional medicine sector. This community case study examines how the decentralized organizational framework was effectively utilized for facilitating the delivery of Ayurvedic services in the COVID-19 situation. Key observations from the study are: Ayurvedic programs implemented systematically, under an organized framework with social participation enables wider utilization of the services. Such a framework is easily replicable even in resource-poor settings. Rather than a pluralistic approach, an integrative health system approach may be more viable in the Kerala scenario in public health emergencies.
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Affiliation(s)
| | - Divya S Iyer
- Department of Ayush, Government of Kerala, Thiruvananthapuram, India
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Mukherjee SK, Ganguly S, Das S, Chatterjee KK, Naskar KK, Dey S, Choudhury S, Paul A, Sarkar SS, Bhattacharyya S, Sengupta S, Alam SM, Bhattacharya P, Naskar S, Mukherjee S, Shamim S, Mandal D, Sardar S, Sarkar S, Ray B, Gole R, Dey A, Bhattacharya C, Saha S. Homeopathic Medicines Used as Prophylaxis in Kolkata during the COVID-19 Pandemic: A Community-Based, Cluster-Randomized Trial. HOMEOPATHY 2021; 111:97-104. [PMID: 34715718 DOI: 10.1055/s-0041-1734026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION There is some evidence that homeopathic treatment has been used successfully in previous epidemics, and currently some countries are testing homeoprophylaxis for the coronavirus disease 2019 (COVID-19) pandemic. There is a strong tradition of homeopathic treatment in India: therefore, we decided to compare three different homeopathic medicines against placebo in prevention of COVID-19 infections. METHODS In this double-blind, cluster-randomized, placebo-controlled, four parallel arms, community-based, clinical trial, a 20,000-person sample of the population residing in Ward Number 57 of the Tangra area, Kolkata, was randomized in a 1:1:1:1 ratio of clusters to receive one of three homeopathic medicines (Bryonia alba 30cH, Gelsemium sempervirens 30cH, Phosphorus 30cH) or identical-looking placebo, for 3 (children) or 6 (adults) days. All the participants, who were aged 5 to 75 years, received ascorbic acid (vitamin C) tablets of 500 mg, once per day for 6 days. In addition, instructions on healthy diet and general hygienic measures, including hand washing, social distancing and proper use of mask and gloves, were given to all the participants. RESULTS No new confirmed COVID-19 cases were diagnosed in the target population during the follow-up timeframe of 1 month-December 20, 2020 to January 19, 2021-thus making the trial inconclusive. The Phosphorus group had the least exposure to COVID-19 compared with the other groups. In comparison with placebo, the occurrence of unconfirmed COVID-19 cases was significantly less in the Phosphorus group (week 1: odds ratio [OR], 0.1; 95% confidence interval [CI], 0.06 to 0.16; week 2: OR, 0.004; 95% CI, 0.0002 to 0.06; week 3: OR, 0.007; 95% CI, 0.0004 to 0.11; week 4: OR, 0.009; 95% CI, 0.0006 to 0.14), but not in the Bryonia or Gelsemium groups. CONCLUSION Overall, the trial was inconclusive. The possible effect exerted by Phosphorus necessitates further investigation. TRIAL REGISTRATION CTRI/2020/11/029265.
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Affiliation(s)
- Shyamal Kumar Mukherjee
- Department of Community Medicine, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Subhasish Ganguly
- Department of Organon of Medicine and Homoeopathic Philosophy, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Satadal Das
- Department of Pathology & Microbiology, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Kalyan Kumar Chatterjee
- Department of Forensic Medicine & Toxicology, DN.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Kisor Kumar Naskar
- Department of Materia Medica, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Samit Dey
- Department of Repertory, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Saptarshi Choudhury
- Department of Practice of Medicine, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Amitava Paul
- Department of Community Medicine, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Sasanka Sekhar Sarkar
- Department of Surgery, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Soumya Bhattacharyya
- Department of Materia Medica, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Sumana Sengupta
- Department of Practice of Medicine, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Sk Monsur Alam
- Department of Repertory, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Pulakendu Bhattacharya
- Department of Organon of Medicine and Homoeopathic Philosophy, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Satyajit Naskar
- Department of Organon of Medicine and Homoeopathic Philosophy, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Sudeshna Mukherjee
- Department of Forensic Medicine & Toxicology, DN.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Saima Shamim
- Department of Materia Medica, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Dibyendu Mandal
- Department of Homoeopathic Pharmacy, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Sudeshna Sardar
- Department of Physiology, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Sanjib Sarkar
- Department of Anatomy, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Benoy Ray
- Department of Community Medicine, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Raghubir Gole
- Department of Obstetrics & Gynecology, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Avijit Dey
- Department of Community Medicine, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Chanchal Bhattacharya
- Department of Community Medicine, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Subhranil Saha
- Department of Repertory, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
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Umesh C, Ramakrishna KK, Jasti N, Bhargav H, Varambally S. Role of Ayurveda and Yoga-Based lifestyle in the COVID-19 Pandemic - A Narrative Review. J Ayurveda Integr Med 2021; 13:100493. [PMID: 34305355 PMCID: PMC8286865 DOI: 10.1016/j.jaim.2021.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 01/20/2023] Open
Abstract
The COVID-19 pandemic has posed an immense challenge to health care systems around the globe in terms of limited health care facilities and proven medical therapeutics to address the symptoms of the infection. The current health care strategies have primarily focused on either the pathogen on the environmental factors. However, efforts towards strengthening the host immunity are important from public health perspective to prevent the spread of infection and downregulate the potency of the agent. While a vaccine can induce specific immunity in the host, non-specific ways of improving overall host immunity are the need. This scenario has paved the way for the use of traditional Indian therapies such as Ayurveda and Yoga. This review aims at collating available evidence on Ayurveda, Yoga and COVID-19. Further, it draws inferences from recent studies on Yoga and Ayurveda on immunity, respiratory health and mental health respectively to approximate its probable role in prophylaxis and as an add-on management option for the current pandemic.
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Affiliation(s)
- Chikkanna Umesh
- Department of Integrative Medicine, NIMHANS, Bangalore, India
| | | | - Nishitha Jasti
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Hemant Bhargav
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Shivarama Varambally
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
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Malhotra N, Bajwa SJS, Joshi M, Mehdiratta L, Kurdi M. Second wave of COVID-19 pandemic and the surge of mucormycosis: Lessons learnt and future preparedness: Indian Society of Anaesthesiologists (ISA National) Advisory and Position Statement. Indian J Anaesth 2021; 65:427-433. [PMID: 34248184 PMCID: PMC8253000 DOI: 10.4103/ija.ija_520_21] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 06/19/2021] [Accepted: 06/19/2021] [Indexed: 12/29/2022] Open
Affiliation(s)
- Naveen Malhotra
- Department of Cardiac Anaesthesia and Pain Management Centre, PGIMS, Rohtak, Haryana, India
| | - Sukhminder Jit Singh Bajwa
- Department of Anaesthesia and Intensive Care, Gian Sagar Medical College and Hospital Patiala, Punjab, India
| | - Muralidhar Joshi
- Department of Anaesthesia, Virinchi Hospitals, Hyderabad, Telangana, India
| | - Lalit Mehdiratta
- Department of Trauma ICU and Trauma OT, Narmada Group of Hospitals, Bhopal, Madhya Pradesh, India
| | - Madhuri Kurdi
- Department of Anaesthesiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
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Bhapkar V, Sawant T, Bhalerao S. A critical analysis of CTRI registered AYUSH studies for COVID- 19. J Ayurveda Integr Med 2020; 13:100370. [PMID: 33262559 PMCID: PMC7690275 DOI: 10.1016/j.jaim.2020.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/23/2020] [Accepted: 10/23/2020] [Indexed: 12/13/2022] Open
Abstract
Background The COVID-19 pandemic has provided an opportune time to evaluate the efficacy of traditional medicine. Many clinical studies involving AYUSH systems are being initiated and registered with Clinical Trials Registry - India (CTRI) since last few months. Objective The present work is an analysis of different characteristics of these studies on the basis of available datasets. Material and Methods COVID-19 related clinical studies involving the healthcare systems of AYUSH, registered on CTRI between 1st February 2020 and 24th August 2020, were searched. They were analysed as per different characteristics such as registration month, study sites, aim, sample size, population, setting, sponsorship, intervention and comparators, duration & outcome measures. Results A total of 197 AYUSH studies were registered on CTRI of which majority (n = 113) were from Ayurveda, with another nine of them with an intra-AYUSH collaboration. The highest number of studies were registered in month of June (n = 57). Maximum study sites were in Maharashtra (n = 65). From the 197 total studies, only six were observational studies, with 191 being interventional studies. As an outcome, majority of the studies aimed at recovery (n = 112). Majority of studies (n = 105) were Government of India sponsored and proposed in AYUSH setting (n = 107). The proportion of comparative studies was more than single arm studies. Guduchi (Tinospora cordifolia) was the most frequently mentioned drug. Conclusion Our analysis revealed some interesting characteristics of the registered studies such as use of platform trial design, system specific criteria for assessment and personalized interventions. Though it was not possible to evaluate the quality of these studies in view of the limited dataset used for trial registration, we could notice variations in important characteristics like sample size, treatment arms, comparator used and study duration according to the primary aim of the studies. Overall, the present review underlines the formidable efforts of AYUSH sector in combating COVID-19 outbreak.
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Affiliation(s)
- Vedvati Bhapkar
- School of Ayurveda, D. Y. Patil Deemed to be University, Nerul, Navi Mumbai, India
| | | | - Supriya Bhalerao
- Interactive Research School for Health Affairs, Bharati Vidyapeeth Deemed to be University, Pune, India.
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