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The SARS CoV-2 virus, the causative agent of COVID-19 uses the ACE-2 receptor of the host to penetrate and infect the cell, mainly in the pulmonary, renal, and cardiac tissues. The earlier reported Delta and the recent Omicron are the variants of concern. The mutations in the RBD region of spike protein are associated with increased RBD-ACE-2 receptor interaction. This binding affinity between spike protein and the receptor is greater in Omicron than in the Delta variant. Moreover, the Omicron variant has numerous hydrophobic amino acids in the RBD region of the spike protein, which maintain its structural integrity. Gallic acid is a phytophenol and shows high binding affinity toward the ACE-2 receptors, which may be helpful for better outcomes in the treatment of COVID-19 pathogenesis. In the present study, significant data were collected from different databases i.e., PubMed, Scopus, Science Direct, and Web of Science by using keywords like anti-oxidative, anti-inflammatory, and antimicrobial properties of gallic acid, in addition to receptor-based host cell interaction of SARS CoV-2 virus. The finding shows that gallic acid can reduce inflammation by attenuating NF-κB and MAPK signaling pathways to suppress the release of ICAM-1, a cell surface glycoprotein; various pro-inflammatory cytokines like TNF-α, IL 1-β, IL-6, IL-10, and chemokines like CCL-2,5, CXCL-8 along with tissue infiltration by immune cells. The purpose of this review is to highlight the therapeutic potential of gallic acid in COVID-19 pathogenesis based on its strong anti-oxidative, anti-inflammatory, and anti- microbial properties., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

To evaluate the early vaccine landscape relative to challenges faced by low- and middle-income countries (LMIC), we conducted a cross-sectional study of all COVID-19 vaccines in clinical trials in 2021 (n = 123) using a structured 13-point analytic framework. Supply sustainability was defined as a composite metric of four manufacturing and regulation variables. Vaccine desirability was defined as a composite metric of nine development and distribution variables. Ten vaccines in phases 2/3, 3, or 4 and five vaccines in phases 1 and 1/2 had a sustainability score equal to or above 0.5. Ten vaccines in phases 2/3, 3, or 4 and seven vaccines in phases 1 and 1/2 had a desirability score equal to or above 0.5. No vaccines in Phases 2/3, 3, or 4 met more than one distribution criterion. Structured assessment COVID-19 vaccine candidates in clinical trials in 2021 revealed numerous challenges to adequate access in LMICs. Key policy recommendations included increasing technology transfer to LMICs, developing international legal mechanisms to prevent export bans, and increasing investment in vaccine candidates with more favorable distribution profiles.

Introduction: Large-scale sero-prevalence studies with representation from all age groups are required to estimate the true burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the community. Serial serological surveys in fixed cohorts enable study of dynamics of viral transmission and correlates of immune response over time in the context of gradual introduction of COVID-19 vaccines and repeated upsurge of cases during the pandemic., Methods: This longitudinal study will involve follow-up of a cohort of 25,000 individuals (5,000 per site) aged 2 years and above recruited from five existing demographic surveillance sites in India. The cohort will be tested for the presence of IgG antibodies against S1/S2 spike protein subunits of SARS-CoV-2 in four rounds; once at baseline and subsequently, at intervals of 4 months for a year between January 2021 and January 2022. Neutralization assays will be carried out in a subset of seropositive samples in each round to quantify the antibody response and to estimate the durability of antibody response. Serial serological surveys will be complemented by fortnightly phone based syndromic surveillance to assess the burden of symptomatic acute febrile illness/ influenza like illness in the same cohort. A bio-repository will also be established to store the serum samples collected in all rounds of serological surveys., Discussion: The population based sero-epidemiological studies will help to determine the burden of COVID-19 at the community level in urban and rural Indian populations and guide in monitoring the trends in the transmission of SARS-CoV-2 infection. Risk factors for infection will be identified to inform future control strategies. The serial serological surveys in the same set of participants will help determine the viral transmission dynamics and durability of neutralizing immune response in participants with or without symptomatic COVID infection., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Nair, Raju, Roy, Dandge, Chethrapilly Purushothaman, Jayaraman, Kangusamy, Shrivastava, Arora, Rose, Juvekar, Jammy, Singh, Mehendale, Rajkumar and Malik.)

Background: Before the coronavirus disease 2019 (COVID-19) pandemic, medical students training in neurosurgery relied on external subinternships at institutions nationwide for immersive educational experiences and to increase their odds of matching. However, external rotations for the 2020-2021 cycle were suspended given concerns of spreading COVID-19. Our objective was to provide foundational neurosurgical knowledge expected of interns, bootcamp-style instruction in basic procedures, and preinterview networking opportunities for students in an accessible, virtual format., Methods: The virtual neurosurgery course consisted of 16 biweekly 1-hour seminars over a 2-month period. Participants completed comprehensive precourse and postcourse surveys assessing their backgrounds, confidence in diverse neurosurgical concepts, and opinions of the qualities of the seminars. Responses from students completing both precourse and postcourse surveys were included., Results: An average of 82 students participated live in each weekly lecture (range, 41-150). Thirty-two participants completed both surveys. On a 1-10 scale self-assessing baseline confidence in neurosurgical concepts, participants were most confident in neuroendocrinology (6.79 ± 0.31) and least confident in spine oncology (4.24 ± 0.44), with an average of 5.05 ± 0.32 across all topics. Quality ratings for all seminars were favorable. The mean postcourse confidence was 7.79 ± 0.19, representing an improvement of 3.13 ± 0.38 (P < 0.0001)., Conclusions: Feedback on seminar quality and improvements in confidence in neurosurgical topics suggest that an interactive virtual course may be an effective means of improving students' foundational neurosurgical knowledge and providing networking opportunities before application cycles. Comparison with in-person rotations when these are reestablished may help define roles for these tools., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Bariatric and metabolic surgery (BMS), the only effective option for patients with obesity with or without comorbidities, has been stopped temporarily due to the ongoing novel corona virus disease (COVID-19) pandemic. However, there has been a recent change in the governmental strategy of dealing with this virus from 'Stay at Home' to 'Stay Alert' in many countries including India. A host of health services including elective surgeries are being resumed. In view of the possibility of resumption of BMS in near future, Obesity and Metabolic Surgery Society of India (OSSI) constituted a committee of experienced surgeons to give recommendations about the requirements as well as precautions to be taken to restart BMS with emphasis on safe delivery and high-quality care.

Remi Shrivastava,1 Megha Vijay,2 Nathalie Maneby,1 Ravishekhar Shrivastava1 1VITROBIO Research Institute, Issoire, 63500, France; 2Mudra Clincare, Navi Mumbai, IndiaCorrespondence: Ravishekhar Shrivastava Email rs@vitrobio.comBackground: Covid-19 infection is a multifactorial disease where the virus mainly enters through the nasal cavity, grows, triggers inflammation, and destroys nasal mucosa cells, allowing systemic virus entry and infection of other organs. When symptoms appear, the disease physiopathology is already established. The immune system tries to control the infection but if the infection persists, it gets tired, fatigued, stressed, and finally, there is burnout. Therefore, an effective treatment should be multi-targeted and should not focus only on one parameter. Minimizing virus concentration, reducing nasal mucosa inflammation, and keeping the nasal surface clean should lessen systemic infection and the probability of developing severe respiratory distress. We evaluated clinical efficacy and safety of an osmotic nasal surface cleaning, virus and cytokine trapping polymeric film, in early-stage Covid-19 positive symptomatic patients.Methods: A randomized, multicentric, observational study was performed to evaluate the efficacy and safety of the osmotic film in 213 patients, randomized in 2 equal arms, and confined for 14-days just after the RT-PCR+ test. Due to ethical reasons, all patients received symptomatic treatments (ST). In addition, the patients in Arm-1 received the test product (ST+TP, 2– 3 sprays, 4– 5 times/day) for 14-days. Leicester Cough Questionnaire, Visual Analogue Scale, and Covid-19-associated symptoms such as fever, pain, taste, smell, and headache were evaluated daily. Home-confined patients were immediately hospitalized in case of aggravation of any life-threatening clinical sign.Results: Among 213 patients, 98 in the ST and 102 in the ST+TP group completed the study. Thirteen patients did not complete the study as 8 in the ST group and 5 in the ST+TP group were hospitalized during the study due to low blood oxygen levels or sudden health deterioration and were excluded from the study. In the remaining control standard treatment group (n=98), clinical signs sharply aggravated on day 1– 2 followed by stabilisation between days 3– 6 and progressive reduction thereafter. In the test product group (n=102), symptoms were stabilized just after the first application and improved progressively. Only 42/102 patients in the test product group presented nasal discharge or irritation due to the osmotic properties of the product.Conclusion: The continuous multi-target approach of detaching and neutralizing virus particles and pro-inflammatory cytokines from the nasal surface to minimize systemic virus exposure is a very logical and efficient approach to avoid Covid-19-induced systemic pathology.Keywords: clinical trial, Covid-19, osmotic filmogen barrier

Ravi Shrivastava,1 Remi Shrivastava,1 Bianca Johansen,1 Thibault Allain2,3 1VITROBIO Research Institute, Issoire, 63500, France; 2Laboratoire SANABEL, Paris, 75011, France; 3UMR 152 Pharma Dev, Université de Toulouse, IRD, UPS, Toulouse, FranceCorrespondence: Ravi Shrivastava Email rs@vitrobio.comBackground: Covid-19 infection starts in the nasal cavity when viral S1 and RBD proteins bind to the host cell ACE2 receptors, the virus multiplies, causes cell lysis, and enters the circulation. This triggers a strong cytokine release and inflammation of the nasal mucosa. A multitarget approach of cleaning the nasal mucosa and suppressing chances of nasal and systemic inflammation should minimize severe respiratory consequences. Unfortunately, no such treatments are yet available.Methods: We describe the conception of an osmotic polymeric film using an in vitro nasal mucosa mimicking model, containing polymers to neutralize Covid-19 specific viral S1, RBD proteins and selected proinflammatory cytokines.Results: The filmogen barrier forms a stable and osmotic film on the nasal mucosa. Hypotonic liquid exudation from the nasal surface detaches and drains the inflammatory cytokines and other contaminants towards the film where selected polymers bind and neutralize SARS-CoV-2 spike S1 and RBD protein as well as Covid-19 disease-specific key pro-inflammatory IL-6, TNF-α, IL-10, IL-13, and GM-CSF cytokines.Conclusion: Minimizing the nasal surface concentration of pro-inflammatory cytokines and viruses should help nasal mucosa repair and avoid immune stress. This nearly instant, simple, scientific, safe, and logical approach should help attenuate Covid-19 induced systemic inflammation at an early stage without being affected by viral S1 spike protein mutations.Keywords: filmogen glycerol, antiviral, anti-cytokines, anti-inflammatory, Covid-19, S1, RBD

CORONA virus disease -19 (COVID-19) is a disease caused by SARS-CoV-2. The outbreak started from Wuhan, China in Dec'2019 and became a pandemic. Human to human transmission occurs through droplet, fomites, aerosol and contaminated surfaces.This study shows that use of portable air purifier in patient's room can actually reduce the viral load in the room air that might minimize the risk of acquiring COVID through air-borne transmission by heath care professional taking care of the COVID patients. The study was carried out in room/cabins of special ward in LN Hospital, New Delhi where recently detected (within 48 Hr of RT-PCR +Ve results) COVID-19 patient with cough were admitted for treatment.The COVID-19 patients were asked to cough on the petri dish fixed with a polyvinylidene fluoride (PVDF) membrane filter (80 mm in diameter and 3 um pore size) keeping it within 2 feet distances from his/her nose for 15 mins. Then the membrane was then removed and added to falcon tube (15ML) containing 3 ML of viral transport medium (VTM). The tube were sent to PCR lab in an ice box. Air sampler was run for 1Hr keeping it at 3 Meter distance from recently diagnosed COVID-19 patient. RT-PCR done from particulate matters collected in VTM from the air sampler.Air sampler was run similarly and RT-PCR was done from PM collected in the filter of air sampler. The primary air suction was done at two different air flow 16.7 and 27 litre per minute (LPM), after which both RDRP and E gene were positive, after the use of purifier both the genes were still positive but with increased Ct values. With continous use of the air purifier the viral load of COVID-19 present in the air of ICU with paitents is primarily reduced but not completely eliminated. [ABSTRACT FROM AUTHOR]