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Aim: To study the efficacy of intravenous vitamin C in management of moderate and severe COVID-19. Objective: To determine the efficacy of intravenous vitamin C in reducing in-hospital mortality in moderate and severe cases of COVID-19. Design: Parallel, double-blinded randomized controlled trial with placebo. Ethical clearance was obtained from the institutional ethics committee, AIIMS Patna. The trial was registered with the Clinical Trials Registry – India (registration number- CTRI/2020/11/029230.) Setting: A tertiary care centre in Bihar, India Participants: All patients above the age of 18 years both males and females, admitted in ICU with a diagnosis of moderate and severe COVID-19 (on the basis of a positive reverse transcriptase polymerase chain reaction (RT–PCR) report) at our facility during the study period (01/10/2020–31/12/2020) not having any of the exclusion criteria. Intervention: The patients in the intervention arm were given 1 gram (2 ampoules of 2 ml each containing 500 mg of vitamin C mixed in 100 ml normal saline) intravenous vitamin C 8 hourly for four days. The patients in the placebo arm received similar looking ampoules (2 ampoules of 2 ml sterile water for injection mixed in 100 ml normal saline) intravenously 8 hourly for four days. The rest of the treatment was given as per the standard operating procedure (SOP) of the institute with adjustments as per treating team's judgement. Outcome Measures: Primary outcome was reduction in in-hospital mortality. Secondary outcomes were improvement in qSOFA score, pO2/fiO2 ratio, fall in inflammatory markers, need for mechanical ventilation and vasopressors. Results: Regarding primary outcome, 10 (33.3%) patients died in intervention group compared to 13 (43.3%) in placebo. Worth noting from baseline characteristics is that 86.7% in intervention arm were of severe category compared to 66.7% severe category patients in placebo group. Though number of severe cases were more in intervention arm there has been comparatively less mortality in this group. Regarding secondary outcomes, amongst 30 patients in vitamin C group, 11 (36.7%) required invasive mechanical ventilation compared to 14 (46.7%) out of 30 in placebo group but the difference was not statistically significant. Although there were a greater number of moderate cases in placebo group, invasive ventilation requirement (and NIV requirement) was more in this group, thus it could be considered that vitamin C might have a role in reducing the severity of disease. The need for vasopressor therapy was higher in intervention arm 33.3% compared to 26.7% in placebo but not significant statistically. The secondary outcomes of the study such as improvement in organ failure score (qSOFA Score), fall in level of inflammatory markers, improvement in respiratory index (pO2/fiO2 ratio), need for mechanical ventilation and need for vasopressors also shown encouraging results but not up to the statistically significant level due to moderate dosage of the drug and small sample size. Conclusion: In the current study, by the observations and results of the double-blind placebo controlled randomised trial, we concluded that as the primary outcome of the study, there was reduction in In-hospital mortality and need for mechanical ventilation in the vitamin C intervention group compared to placebo, although these results did not reach statistical significance due to small sample size and use of moderate dose of IV vitamin C. The secondary outcomes of the study such as improvement in organ failure score (qSOFA Score), fall in level of inflammatory markers, improvement in respiratory index (pO2/fiO2 ratio), need for mechanical ventilation and need for vasopressors also shown encouraging results but not up to the statistically significant level due to moderate dosage of the drug and small sample size. In summary, high dose of intravenous vitamin C may reduce inflammatory reaction, improve oxygen support status, and reduce mortality in COVID-19 patients, without adverse events. High dose intravenous vitamin C may be a promising therapy for patients of moderate to severe COVID-19. [ABSTRACT FROM AUTHOR]

Background: Samarakhai (Byttneria herbacea Roxb.), family Sterculiaceae, is one of the reputed folklore medicinal herbs, found in many parts of India. Although consumed as a vegetable since long time, its root and leaves are not yet reported for its nutritive value and antioxidant activities. Aim: The aim of this study was to evaluate nutritional value and antioxidant potential of root and leaf of B. herbacea Roxb. Materials and methods: Nutritional parameters such as carbohydrate, fat, protein, energy value, calcium, iron, zinc, manganese, phosphorus and vitamin C were evaluated. Antioxidant activity was evaluated through three test methods, i.e., 1,1-diphenyl-2-picrylhydrazyl, ferric-reducing antioxidant power (FRAP) and phosphomolybdenum assay. Results: B. herbacea roots and leaves showed the presence of total carbohydrate 46.39 g/100 g and 40.12 g/100 g, total fat 0.63 g/100 g and 1.20 g/100 g, true protein 11.46 g/100 g and 10.49 g/100 g, energy content 237.07 kcal/100 g and 213.24 kcal/100 g, iron 821.10 ppm and 889.64 ppm, zinc 9.2 ppm and 47.98 ppm, manganese 329.86 ppm and 474.59 ppm, phosphorus 0.40 ppm and 0.10 ppm and calcium 4856.84 ppm and 14964.49 ppm, respectively. The half-maximal inhibitory concentration values of the methanol extract of root, leaf and ascorbic acid were found to be 217.25 μg/ml, 131.42 μg/ml and 178.88 μg/ml, respectively. In FRAP assay, antioxidant activity of methanol extract of leaf (129.15 μM) was found to be more than root (73.13 μM). Conclusion: B. herbacea root contains high amount of true protein, carbohydrate and energy value, while micronutrients such as iron, zinc, manganese and calcium are more in its leaf. Both roots and leaves exhibited potent antioxidant activity where the leaves possess more values than the roots. [ABSTRACT FROM AUTHOR]

Background: Several studies using animal models have shown that oxidative stress during pregnancy may play an important role in causing birth defects. Congenital anomalies affect an estimated 270,000 newborns who die during the first 28 days of life every year from different birth defects. Hence, at present many research works are going on to reduce the infant mortality from congenital anomaly.[1] Objective: The objective was to measure the oxidant and antioxidant level in the serum of newborn babies with the congenital anomaly and compare these levels with age and sex matched normal neonates. This is to identify any role of oxidative stress in the causation of congenital anomaly. Materials and Methods: This case-control study included 159 participants: 106 newborns with the congenital anomaly and 53 healthy newborns. The markers of oxidative stress like serum malondialdehyde (MDA) level, protein carbonyl (PC) level, and the activity of antioxidants such as Vitamin C, glutathione were measured in both cases (neonates with congenital anomaly) and controls (normal healthy neonates). These parameters were statistically compared. Results: MDA levels and PC levels were significantly higher (P < 0.0001), and Vitamin C and reduced glutathione levels were significantly lower (P < 0.0001), in newborns with congenital malformation than in healthy newborns. Conclusions: Increased lipid peroxidation and protein carbonylation might play an important role in the pathogenesis of congenital anomaly. Impairment of the free radical/antioxidant balance is leading to increased free radical damage in neonates with congenital malformation. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression form commonest stress-induced psychiatric disorders. To combat the biochemical changes which occur as a result of stress, there is antioxidant defence in the biological system. Secondary defence is by the nonenzymatic antioxidants like vitamins E (alphatocopherol), C (ascorbic acid), and β-carotene. Therefore, the authors interest was aroused to examine the status of these antioxidants in the biological system of patients suffering from stress-induced psychiatric disorders. Aims: This study was carried out to find out whether patients with generalized anxiety disorder (GAD) and depression have any difference in blood serum levels of vitamins A (β-carotene), C, and E in comparison to the normal healthy control group and whether supplementation of adequate doses of vitamins A (β-carotene), C, and E leads to improvement in anxiety and depression and reduction in scores of the patients. Materials and Methods: Eighty subjects in the age group of 20-60 years, who attended a psychiatric clinic of a private hospital and who met inclusion and exclusion criteria of the study and consented for psychological evaluation and blood screening to find out the serum levels of vitamins A, C, and E, were included in the study. Approval was sought from the institutional ethics committee for collecting the blood sample of these subjects before and after vitamins A, C, and E supplements given for a period of 6 weeks. Statistics Analysis: It was observed that patients with GAD and depression had significantly lower levels of vitamins A, C, and E in comparison to healthy controls. After dietary supplementation of these vitamins for a period of 6 weeks, a significant reduction in anxiety and depression scores of patients was observed (P<0.001). A significant increase in the blood levels of antioxidants was observed in patients (P<0.05) except that of vitamin E in the group of depressed patients. Results and Conclusion: The findings suggest that antioxidant supplement therapy as an adjuvant therapy is useful in patients with stress-induced psychiatric disorders and the results have been discussed. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate the in vitro antioxidant and antimicrobial activities along with phytochemical screening of organic and aqueous extracts of leaf and stem of Suaeda maritima (Dumort), a mangrove associate from Bhitarkanika of Odisha, India. Methods: Antioxidant activity of the crude extracts was evaluated in terms of total antioxidant capacity, total phenol content, ascorbic acid content, DPPH radical scavenging, metal chelating, nitric oxide scavenging, and reducing power etc. The antimicrobial activity of the plant was determined by agar well diffusion method along with MIC and MBC carried out by microdilution techniques against 10 gram positive and gram negative human pathogenic bacteria. The qualitative and quantative phytochemical screening were carried out by standard biochemical assays. Results: Out of the seven antioxidant bioassays, both the leaf and stem extracts were found to posses strong antioxidant properties of 70 % to 92 % for phenol, total antioxidant capacity, DPPH free radical scavenging activity and fairly good ascorbic acid content, metal chelating (1.33 %-22.55 %), reducing power (0.01-0.12) and nitric oxide scavenging (0.84 %-66.99 %) activities. Out of the four extracts evaluated for antimicrobial activity, two leaf extracts such as acetone and ethanol showed promising activity against four pathogenic bacteria and one stem methanol extracts against one pathogenic bacteria when compared with amoxcycillin as standard. The MIC and MBC values of the antimicrobial extracts ranged between 2.5 to 5.0 mg/mL. Screening of phytochemicals showed presence of carbohydrates, protein, tannins, alkaloids and flavonoids in comparatively higher amount than other phytochemicals tested. Conclusions: The present study reveals the presence of potential antioxidants and antimicrobial properties in the plant extract which could be exploited for pharmaceutical application. [Copyright &y& Elsevier]

BACKGROUND: The incidence of the cancers of the oral cavity, pharynx, esophagus and larynx in different population groups of India is amongst the highest reported in Asian countries. There is evidence that high dietary carotenoids and vitamin C may possibly decrease the risk of laryngeal cancer. Limited data is available from India on the association between these micronutrients and the risk of laryngeal cancer. AIMS: To assess the levels of vitamin A, vitamin C and zinc in laryngeal cancer patients and healthy controls. SETTING AND DESIGN: A hospital based case-control study. MATERIAL AND METHODS: One hundred and fifty five laryngeal cancer patients and a control group of 155 healthy individuals constituted the study population. Individuals in the control group were individually matched with the patients for their age ± 2 years, sex and place of residence. Venous blood was drawn from the cases and controls and estimations of vitamin A, zinc and vitamin C was done utilizing the standard procedures. STATISTICAL ANALYSIS USED: Paired 't' test to compare the mean serum levels of vitamin A and zinc and plasma vitamin C between laryngeal cancer patients and controls. Univariate logistic regression analysis to calculate the odds ratios and the confidence intervals. RESULTS: The mean serum vitamin A, zinc and plasma vitamin C levels were significantly lower in laryngeal cancer patients as compared to the controls. CONCLUSIONS: The findings of the present study indicated a strong association of these micronutrients with laryngeal cancer in the Indian population. [ABSTRACT FROM AUTHOR]