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The hyper-coagulopathy nature of COVID-19 is a prevalent consequence among patients. Free-floating right atrial thrombi are a relatively rare finding and the optimal therapy is a therapeutic dilemma. We present a 37-year-old woman with acute dyspnea and fatigue. Several ground glass opacities were shown on computed tomography of chest that further proved to be associated with severe COVID-19 disease. A transthoracic echocardiography revealed a mobile right atrial mass with bilateral pulmonary embolism. She was considered high risk for surgical therapy by cardiovascular surgeons. She was then started on anticoagulation therapy for 5 days however the size regression of the thrombus remained unchanged. A regimen of low dose (24 mg) ultra-slow (24 h) intravenous infusion of alteplase, without bolus was initiated. Following the third day of thrombolytic therapy, the control echocardiography demonstrated complete resolution of the thrombus. Prolonged infusion of low dose fibrinolytics can be an alternative treatment to surgery for right heart thrombi. [ABSTRACT FROM AUTHOR]

Background: Chulalongkorn Stroke Center is a comprehensive stroke center (CSC) located in Bangkok, Thailand. Our stroke network consists of different levels of spoke hospitals, ranging from community hospitals where thrombolytic treatment is not available, to those capable of onsite thrombolytic therapy. This study aimed to assess the time to treatment and outcomes among acute ischemic stroke patients who received thrombolytic treatment in the Chulalongkorn Stroke Network by 1.) Direct arrival at the CSC (mothership) 2.) Telestroke-assisted thrombolytic treatment with secondary transfer to the CSC (drip-and-ship) 3.) Referral from community hospital to the CSC for thrombolytic treatment (ship-and-drip).Methods: Acute ischemic stroke patients who received thrombolytic treatment during January 2016-December 2017 in the Chulalongkorn Stroke Network were studied. Time to treatment and clinical outcomes were compared among treatment groups.Results: There were 273 patients in the study including 147, 87, and 39 patients in mothership, drip-and-ship, and ship-and-drip paradigms, respectively. The door-to-needle-time (DTN) and onset-to-needle-time (OTN) times were significantly longest in ship-and-drip group (146.5 ± 62/205.03 ± 44.88 mins) compared to mothership (38 ± 23/155.2 ± 60.54 mins) and drip-and-ship (63.0 ± 44/166.09 ± 87 mins), P < 0.05. There was no significant difference regarding functional independence defined by modified Rankin Scale (mRS) ≤ 2 at 3 months (P = 0.12), in-hospital mortality (P = 0.37), mortality at 3 months (P = 0.73), and symptomatic intracerebral hemorrhage (P = 0.24) among groups.Conclusion: Thrombolytic treatment with drip and ship method under teleconsultation is feasible in Thailand. There was no difference of clinical outcome among the 3 treatment paradigms. However, DTN time and OTN time were longest in the ship-and-drip paradigm. [ABSTRACT FROM AUTHOR]

Background: Hopea Odorata, locally known as Telsur (Bangladesh), has some traditional uses as folk medicine. This study aims to investigate the antioxidant, antidiarrheal, hypoglycemic and thrombolytic activities of H. odorata leaf extracts as new therapeutic prospects predicting the activity of some of the isolated compounds of this plant. Methods: Leaves of Hopea odorata was extracted with pure methanol (MEHO), ethanol (EEHO) and water (AEHO). The extract was tested for antioxidant activity by using reducing power and H2O2 scavenging assay. Antidiarrheal effects were assayed by three standard methods of bioassay: Castor oil-induced diarrhea, Castor oil induced enteropooling and gastrointestinal transit test. Hypoglycemic effect was determined by normoglycemic model of mice. Thrombolytic activity was evaluated by clot lyses test for human and mice blood. In silico PASS prediction was applied for phytoconstituents namely Balanocarpol, Hopeaphenol and Ampelopsin H isolated from this plant. Result: Among the all extracts, MEHO exhibited strong antioxidant activity in both reducing power and H2O2 scavenging assay. Phenol content of MEHO was 297.22 ± 0.78 mg/g and flavonol content was 91.53 ± 1. 82 mg/g. All the experiment of extracts at dose of 200 and 400 mg/kg and the standard drug loperamide (5 mg/kg) showed significant (p < 0.001) inhibition against castor oil induced diarrhea and castor oil induced enteropooling in mice. There were also significant (p < 0.01) reduction in gastrointestinal motility in the charcoal meal test. Leaf extract showed no significant (P < 0.01) decrease of blood glucose compared to Glibenclamide in normoglycemic mice. Using an in vitro thrombolytic model, MEHO showed the highest and significant clot lysis of human and mice blood compared to Streptokinase. PASS predicted the wide range of antioxidant, free radical scavenger, Nitric oxide scavenger, cardioprotectant, hepatoprotectant, thrombolytic, fibrinolytic, antibacterial, antifungal, anticarcinogenic, anthelmintic and anti-inflammatory activity of examined phytoconstituents. Conclusion: These findings suggest that the plant may be a potential source of new antidiarrheal, thrombolytic and antioxidative agents but it is found to have no antidiabetic capability. PASS prediction matched with present study for the extracts. Further study needs to identify the PASS predicted biological actions of the phytoconstituents. [ABSTRACT FROM AUTHOR]

Background: Callistemon citrinus (Curtis.) (Family- Myrtaceae) is a popular evergreen shrub in Bangladesh. In the present study, the leaves of this plant have been assessed comprehensively for free radical scavenging, thrombolytic and membrane stabilizing activities. Methods: The leaves were collected, powdered and extracted with methanol. The extract was then concentrated and successively fractionated into petroleum ether, carbon tetrachloride, chloroform and aqueous soluble fractions. The extractives were investigated for free radical scavenging, thrombolytic and membrane stabilizing activities. Results: In case of 1,1 diphenyl-2-picrylhydrazyl (DPPH) and hydrogen peroxide radical scavenging assays, the crude methanol extract of the leaves showed the highest free radical scavenging activity among the tested materials including standard ascorbic acid (p = 0.0000). Besides, this extract was also found significantly rich (p = 0.0000) in phenolics and flavonoids compared to other organic fractions. In thrombolytic study, the petroleum ether fraction exhibited significantly stronger thrombolysis (p = 0.024) than other leaf extractives but was weaker than the standard streptokinase. In membrane stabilizing assay, the activity of chloroform fraction was similar to that of standard acetylsalicylic acid (p= 1.000) in hypotonic solution induced hemolysis. However, membrane stabilization activity of this chloroform fraction was found significantly stronger than that of the standard (p = 0.0000) in heat induced hemolysis. Conclusion: This study has revealed the medicinal capabilities of different organic fractions of C. citrinus displaying free radical scavenging, thrombolysis and membrane stabilizing antiinflammatory potentials. Further bioactivity guided isolation is required to obtain pharmacologically secondary metabolites. [ABSTRACT FROM AUTHOR]

Background: Drynaria quercifolia L. (Family- Polypodiaceae) is a fern grows in Bangladesh used in traditional healing by the Garo tribe of Mymensingh district. In the current study, rhizomes and fertile foliage fronds of this plant have been investigated comprehensively to assess their in vitro membrane stabilizing, thrombolytic and antioxidant properties. Methods: Rhizomes and fertile foliage fronds of D. quercifolia were collected, dried, powdered and extracted with methanol. Later on, crude methanol extracts of the plant parts were fractionated into petroleum ether, carbon tetrachloride, chloroform and aqueous soluble fractions. The extractives were then subjected to membrane stabilizing, thrombolytic and antioxidant assays. Results: In membrane stabilizing assay, crude methanol extracts of rhizomes and fertile foliage fronds and their petroleum ether fractions were found to be very effective for stabilizing erythrocyte membrane in hypotonic solution. In case of thrombolytic study, crude methanol extract of rhizomes and its aqueous fraction exhibited noticeable clot lysis. However, in antioxidant assays, crude methanol extracts of the tested plant parts and their aqueous fractions exhibited potent 1,1-diphenyl-2-picrylhydrazyl (DPPH), hydrogen peroxide and 2, 2'-azinobis (3-ethylbenzothiazoline sulphonic acid) (ABTS) radical scavenging activity. Besides, these extractives also displayed substantial ferric reducing potential in ferric reducing antioxidant power (FRAP) assay. Crude methanol extracts of the plant parts and their aqueous fractions were also found rich in phenolics. Conclusion: This study demonstrates the medicinal potentials of D. quercifolia and justifies the local uses of it by the Garo tribal people of Bangladesh for multiple disease management. [ABSTRACT FROM AUTHOR]

Background: Hopea Odorata, locally known as Telsur (Bangladesh), has some traditional uses as folk medicine. This study aims to investigate the antioxidant, antidiarrheal, hypoglycemic and thrombolytic activities of H. odorata leaf extracts as new therapeutic prospects predicting the activity of some of the isolated compounds of this plant., Methods: Leaves of Hopea odorata was extracted with pure methanol (MEHO), ethanol (EEHO) and water (AEHO). The extract was tested for antioxidant activity by using reducing power and H 2 O 2 scavenging assay. Antidiarrheal effects were assayed by three standard methods of bioassay: Castor oil-induced diarrhea, Castor oil induced enteropooling and gastrointestinal transit test. Hypoglycemic effect was determined by normoglycemic model of mice. Thrombolytic activity was evaluated by clot lyses test for human and mice blood. In silico PASS prediction was applied for phytoconstituents namely Balanocarpol, Hopeaphenol and Ampelopsin H isolated from this plant., Result: Among the all extracts, MEHO exhibited strong antioxidant activity in both reducing power and H 2 O 2 scavenging assay. Phenol content of MEHO was 297.22 ± 0.78 mg/g and flavonol content was 91.53 ± 1.82 mg/g. All the experiment of extracts at dose of 200 and 400 mg/kg and the standard drug loperamide (5 mg/kg) showed significant (p < 0.001) inhibition against castor oil induced diarrhea and castor oil induced enteropooling in mice. There were also significant (p < 0.01) reduction in gastrointestinal motility in the charcoal meal test. Leaf extract showed no significant (P < 0.01) decrease of blood glucose compared to Glibenclamide in normoglycemic mice. Using an in vitro thrombolytic model, MEHO showed the highest and significant clot lysis of human and mice blood compared to Streptokinase. PASS predicted the wide range of antioxidant, free radical scavenger, Nitric oxide scavenger, cardioprotectant, hepatoprotectant, thrombolytic, fibrinolytic, antibacterial, antifungal, anticarcinogenic, anthelmintic and anti-inflammatory activity of examined phytoconstituents., Conclusion: These findings suggest that the plant may be a potential source of new antidiarrheal, thrombolytic and antioxidative agents but it is found to have no antidiabetic capability. PASS prediction matched with present study for the extracts. Further study needs to identify the PASS predicted biological actions of the phytoconstituents.