Severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) affects millions of people worldwide. The article aims to review the therapeutic perspective on natural antioxidants, their mechanism of action, pharmacokinetics in management and cure of COVID‐19/ SARS‐CoV‐2 infection. We conducted a literature search including World Health Organization and National Institute of Health guidelines and clinical trials registered with ClinicalTrials.gov limited to antioxidants in COVID‐19 management. Elderly, immunocompromised patients, and others with underlying health conditions or multiple comorbidities have a high mortality rate. Disrupted redox homeostasis and oxidative stress seem to be biological pathways that may increase personal vulnerability to infection. Antioxidants like vitamins C, D, E, epigallocatechin‐3 gallate, and morin have been reported to protect against COVID‐19 disease. Reactive oxygen species are immunological regulatory elements of viral replication. Natural antioxidants exhibit potential action in preventing inflammation and organ dysfunction during viral infection. They also increase glutathione level, oxygenation rate, and immunological responses in the treatment of sepsis and acute respiratory distress syndrome. No wonder the selection of prevention, treatment, and cure of COVID‐19 and SARS‐CoV‐2 mainly depends upon the antiviral and immunoregulatory activity which they possess. Yet, their efficacy against COVID‐19 is of great concern and demands extensive study.

In the present study was to determine the anti-inflammatory activity of the aqueous extract of the bark and root of Myrica esculenta and their active phytoconstituents through in vitro and in silico studies. The bioactive phytoconstituent of Myrica esculenta was determined by GC-MS spectroscopy techniques. After that, total phenolic and flavonoid content of both bark and root extract was determined. Furthermore, in vitro anti-inflammatory activity was determined in both extracts. The molecular docking analysis determined the binding affinity of bioactive compounds against inflammatory proteins such as COX-1, COX-2, IL-10, and TNF-α. The present study revealed that bark extract of Myrica esculenta has the highest total phenolic and flavonoid content compared with root extract (553.44 ± 18.38 mg GAE/g equivalent and 336.02 ± 8.04 mg quercetin/g equivalent, respectively). Similarly, the bark extract showed good inhibitory activity with 5-LOX and HYA assay (IC₅₀ 11.26 ± 3.93 and 21.61 ± 8.27 µg/mL, respectively), but 15-Lox inhibitory assay root extract showed the highest inhibitory activity, IC₅₀ 16.95 ± 5.92 µg/mL. The docking result showed that myricetin, arjunolic acid, and myricanone have the highest binding affinity with all inflammatory proteins in respective order: myricetin > arjunolic acid > celecoxib > myricanone > myricitrin > 3-epi-ursonic acid. The MD simulation of COX-1 and myricetin showed the highest stability and low deviation at 310 K through RMSD values (1.07–2.3 Å) as compared with COX-1 and myricitrin (0.193–1.885 Å) and TNF-α and myricanone (1.377 to 3.457 Å), respectively, when analyzed at 100 ns time frame. The extracts and their active constituents showed good anti-inflammatory activity. Further study is essential to define their mechanism of action.

Background: Antibiotic resistance in recent years has become a major threat to public health globally. In dental practice, antibiotics and analgesics are commonly used for infection control and management of pain. The knowledge, attitude and practice skills of antibiotic prescription by dental practitioners should be continuously evaluated. The aim of this study was to assess the knowledge, attitude and practice regarding antibiotic prescription among dental practitioners.Methods: A descriptive cross-sectional study was carried out to determine the knowledge, attitude and practice regarding antibiotic prescription among dental practitioners. A self-administered questionnaire was used to collect information which was adopted from previous studies. A briefing was given to the participants about the nature of the study and the procedure of completing the questionnaire was explained. After completion of the questionnaire, data was collected, reviewed, organized and expressed as counts/percentages and statically analyzed using SPSS version 16.Result: The current study showed that majority of the participants had average knowledge (52.7%) regarding antibiotic resistance but despite of that they have been prescribing antibiotic without proper guidelines. In this study, Amoxicillin (69.1%) followed by amoxicillin-clavulanic acid (25.5%) combination were the most commonly prescribed drugs used for the management of oral infections, but were prescribed based on symptoms without taking care of guidelines.Conclusion: Dental practitioners had knowledge of antibiotic prescription and its resistance however they have been prescribing antibiotic without proper guidelines. It is deemed necessary to update the knowledge and enhance the careful use of antibiotics.

Introduction: Upper respiratory tract infection (URTI) like pharyngitis, tonsillitis, sinusitis, laryngitis and otitis media are the most common infections encountered in ENT outpatients. As these infections are caused by the microorganism they should be treated with the antimicrobial agents. The aim of this study was to determine the prescribing pattern of antibiotics in ENT outpatients of tertiary Care Hospital in Bharatpur, Nepal. Methods: It was prospective observational study which was carried out in the ENT Department of College of Medical Science, Bharatpur, Chitwan, Nepal. Total 267 prescriptions were studied. Patient of all age groups and sex were included in the study. Prescriptions were evaluated based on the World Health Organization (WHO) core drug prescribing indicators. Results on categorical measurements are presented in numbers and percentage which was used to generate tables and graphs. Data analysis was done by SPSS software version 20.0. Results: A total of 267 prescriptions were collected and analyzed during the study. Average number of drugs per prescription was 3.12 in which average number of antibiotic per prescription was 1.041. Commonly prescribed antibiotics belongs to the penicillin group (52%) followed by macrolide (27%). Most of the drugs were prescribed by their brand names (92%). Besides antibiotics the common adjuvant drugs that are being prescribed were nasal decongestant (44%) followed by anti-histaminics (27.7%). Conclusions: The present study highlights the wide use of Amoxicillin and clavulanic acid combination for ENT infections. Measures to emphasize the use of generic names are necessary to promote rational drug use.

Introduction: Infections at surgical sites are a major problem all over the world. Pathogens linked to postoperative infections are becoming increasingly resistant to antibiotics, which presents a significant therapeutic challenge for surgeons and raises the financial burden placed on patients. The study aimed to find the prevalence of multidrug resistance among patients with surgical site infections in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted from 3 November 2022 to 2 May 2023 among post-operative patients with surgical site infection after receiving ethical approval from the Institutional Review Committee. Swab samples were sent for antimicrobial susceptibility testing. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 147 patients with surgical site infection, the prevalence of multi-drug resistance was 95 (64.63%) (56.90-72.36, 95% Confidence Interval). Among them, 51 (53.68%) patients were in the 21-40 years age group and most of them were male 53 (55.79%). Conclusions: The prevalence of multidrug-resistant cases was similar to other studies done in similar settings.

The global pandemic situation caused by rare viral pneumonia occurs in late December 2019 in Wuhan, China, which we now recognize as COVID-19. The molecular docking was used to identify potential phytoconstituents of Moringa oleifera and reference drug hydroxychloroquine on SARS-CoV-2 main protein by using AutoDock 4.2.6 and Auto dock Vina. All the physicochemical and bioactive parameters (ADME, toxicity study, receptor interaction, PASS analysis, drug-likeness) were determined using different online validated software. The binding energy of all SAR-CoV-2 proteins with selected phytoconstituents of Moringa oleifera were found to be beta carotene, vitamin E; myricetin, quercetin showed the highest binding affinity with all interacting proteins comparable with other drugs and reference drug hydroxychloroquine as an order: beta carotene > myricetin > quercetin > vitamin E> hydroxychloroquine>quinic acid. The MD simulation analysis of viral protein (6MOJ) with beta carotene, vitamin E and myricetin demonstrated strong stability at 300 K. All three complexes exhibit persistent RMSDs value (0.25 – 1.5 Å) of protein side-chain Cα atoms during the 3 ns MD simulation time scale. The minor changes of all three ligands with 2 different viral proteins increasing the compactness of ligands with protein in radius of gyration suggested the strong structural activity of ligands and the least fluctuation during the MD simulation (31.2, 30.0 and 31.2), respectively. In the present study revealed that all the active constituents of Moringa oleifera show good binding affinity, but beta carotene and myricetin have an excellent affinity with SARS-CoV-2 proteins respectively.