In this review, we describe and discuss the phytoconstituents present in Hedychium species and emphasize their potential as drug candidates. Though they are widely validated in vitro and in vivo models, to date, no efforts have been made to compile in a single review all the pharmacologically active phytoconstituents from Hedychium species, and their pharmacological and toxicity profile. In this study, we present a reinvestigation of the chemical constituents present in Hedychium species obtained from the essential oil and solvent extraction of the flowers, leaves and rhizomes under consideration. Key databases such as PubMed, Science Direct, Scopus, and Google Scholar amongst others were probed for a systematic search using keywords to retrieve relevant publications on this plant. An exhaustive electronic survey of the related literature on Hedychium species resulted in around 200 articles. Articles published between the years 1975–2021 were included. The studies conducted on either crude extracts, solvent fractions or isolated pure compounds from Hedychium species reported with a varied range of biological effects such as anti-inflammatory, analgesic, antidiabetic, potentially anti-asthmatic, and cytotoxic, among other related activities of the chemical constituents present in its essential oil and solvent extract deployed in this review. Traditional and herbal medication around the world that uses different parts of Hedychium species were considered for anti-inflammatory, skincare, analgesic, anti-asthmatic, anti-diabetic, antidotal uses, among others. These uses support the idea that chemical constituents obtained from solvent extraction may also exert the same action individually or in a synergistic manner. The review concluded that there is scope for computation and biological study to find out possible new targets for strengthening the potency and selectivity of the relevant compounds, and to find a commercial method for extraction of active pharmaceutical ingredients.

Nobiletin is an abundant phytoconstituent having multiple pharmacological activities. Various citrus species like orange (Citrus sinensis), lemon (Citrus limon), grapefruit (Citrus paradisi) and tangerine (Citrus tangirina) having flavanones, flavones, flavon aglycon, and Polymethoxyflavones (Nobiletin & Tangeretin). Nobiletin (HMF); Hexamethoxyflavone {2-(3, 4)-dimethoxyphenyl)-5,6,7,8-tetramethoxychromen-4-one}is extracted from non-edible orange peel rich in polymethoxyflavones (PMFs). Many are suggesting Nobiletin as chemo-sensitizing agent induces nuclear retention of tumor suppressor protein and Tyrosinase inhibitor, inhibiting hepatitis B virus replication. It is also proposed that 2-aryl-4H-chromen-4-one derivative may be effective in Chikungunya Virus, and other suggested multiple activities. Citrus species are traditionally used in Ayurveda as immune modulator which is effective in viral disease because of their antioxidant properties. To study the ability as drug of an independent phyto-active Nobiletin (HMF) is under consideration, HMF is lipophilic in nature, its physiochemical properties may by enhanced by increasing water solubility for more bioavailable, and prospective as a therapeutic agent or as broad-spectrum antiviral. Graphical abstract

BACKGROUND The clinical spectrum of SARS–CoV-2 infection encompasses asymptomatic infection, mild upper respiratory tract infection, and severe viral pneumonia with respiratory failure and even death. This study attempts to estimate the time interval between symptoms onset to severity, time taken for hospitalization, length of stay in hospital along with demographic and clinical characteristics of deceased patients infected with Covid-19. METHODS This retrospective study was conducted in SSMC associated Dedicated Covid Hospital, Rewa district, India. Covid-19 positive deaths (112) that occurred from May 2020 to January 2021 in this institute were considered for this study. Information regarding socio-demographic profile, systemic diseases / underlying medical conditions, signs and symptoms of the disease, clinical course, and investigations were collected and analysed. Time duration variables included were time from the initial symptom to breathlessness, time taken to seek treatment, delay in hospitalization, and length of stay in the hospital. RESULTS Elderly males with 2 or more comorbid conditions were found to be at higher risk of mortality. Median duration from onset of initial symptom to treatment seeking / hospitalization in DCH was 5 days. While mean duration from onset of initial symptoms to onset of breathlessness was 2 days 6 hrs. There was a delay of 3 days in hospitalization after experiencing breathlessness. 90 % patients had bilateral lung involvement at the time of admission. More than half of the patients had multiple organ involvement. Positive correlation was observed in delay in hospitalization, with syndrome severity at the time of admission and negative correlation with length of stay in hospital. CONCLUSIONS Delay in hospitalization is observed as an important factor which affects clinical course. Disease severity increases and length of stay decreases with delayed presentation at the time of admission. It should be addressed with awareness generation activities in community and self-assessment tool appropriate and suitable for implementing in general population. KEYWORDS Covid 19, Covid Infection, Mortality, Time Delay, Length of Stay (LoS)