Hamdard University

Respiratory failure is a complication of pneumonia known to contribute substantially to worldwide morbidity and mortality, given that, in most cases, it necessitates ventilatory support to maximize oxygenation and prevent deterioration of the patient's clinical status. Noninvasive ventilation (NIV) has emerged as a possible alternative to invasive mechanical ventilation (IMV) with noteworthy advantages, including reduced ICU admissions, lower intubation rates, and fewer ventilator-associated complications. This retrospective study aims to analyze the efficacy of NIV in promoting clinical outcomes in pneumonia patients suffering from acute respiratory failure (ARF). A total of 840 patients were analyzed. The mean age was 52.62 years (SD = 21.08), with equal distribution concerning gender. There was a mean distribution of 2.53 comorbidities (SD = 1.66), with an average duration of symptoms of 15.21 days (SD = 8.13) before admission. Oxygenation parameters increased significantly following NIV intervention, with a mean SpO₂ post-treatment of 90.31% (SD = 5.68) and a mean PaO₂ of 74.64 mmHg (SD = 14.69). Clinical outcomes showed that NIV achieved an average decrease in ICU admission of 49.3% and an average decrease in intubation rates of 50.7%. The mortality rate remained very high at 49.7%, while the readmission rate stood at 50.0%, suggesting a continuing clinical hazard even after the patient recovered for some time. Quality-of-life scores averaged 5.74 on a 10-point scale, indicating moderate improvement after treatment. There was also evidence that more than half of the patients required rehabilitation support after discharge from the hospital. This highlights the paramount need for structured post-acute care. NIV has drawbacks, as it was not efficacious for all patients, and patient selection criteria, timing of intervention, and severity of illness heavily influenced the outcomes of treatment. There is a definite promise for NIV to be used as the first-line intervention for ARF associated with pneumonia, as it improves oxygenation, reduces the necessity for IMV, and assists recovery post-treatment. Further studies are required to standardize ventilatory regimens, triage patients, and investigate long-term outcomes. Therefore, because of its advantages in clinical care, NIV should be considered a critical management modality for treating respiratory failure due to pneumonia.

Antimicrobial resistance (AMR) poses a serious threat to human health globally. Expeditious discovery and development of new drugs has become indispensable for addressing this challenge. In this context, a novel benzopyrone derivative, designated as 82B1, has been isolated from S. chrestomyceticus strain ADP4. This compound exhibited significant inhibitory activity against different Candida species including C. albicans, C. tropicalis, C. krusei, C. parapsilosis and C. auris with minimum inhibitory concentration (MIC₉₀) values in the concentration range of 25-125 µg/mL. The structure of 82B1 was elucidated through analyses of the spectral data obtained using liquid chromatography-tandem mass spectrometry (LCMS/MS), Nuclear Magnetic Resonance (NMR), Fourier Transform Infrared Spectroscopy (FTIR) and Ultraviolet (UV) spectroscopy, that led to its identity as 7, 13, 14-trihydroxy-6H-benzo-[c]-chromen-6-one8-[1'β-carboxycyclopentanyl]-2'β-[8'β-ethylcyclopentane]. It significantly inhibited the major virulence factors of C. albicans such as yeast to hyphae transition, biofilm formation, and secretion of hydrolytic enzymes at its subinhibitory concentrations. It did not display cytotoxicity on human hepatoblastoma cell line (HepG2 cells), signifying its potential as a candidate for anti-Candida drug development.

The study aims to develop and optimize extended-release cinitapride matrix pellets using lipid wax glyceryl monostearate (GMS) and ethyl cellulose (EC) for treating functional dyspepsia and gastrointestinal reflux disease. Pellets were prepared using the extrusion spheronization technique by applying central composite design (CCD), keeping EC-7cps (matrix former), spheronization speed, and time as variables. The drug release, sphericity, and aspect ratio were quality parameters. The predicted optimized formulation was evaluated for chemical interaction, thermal stability, accelerated stability, and surface morphology. EC effectively controlled the overall Cinitapride release for up to 12 h, but burst release was reduced by sintering the matrix pellets. A direct relationship was observed between the sphericity and aspect ratio of the pellets with the spheronization speed and time. F_pred followed the Korsmeyer-Peppas model, demonstrating a non-fickian diffusion at all pH levels. The bioavailability of F_pred was compared with reference immediate release tablet by applying in silico PBPK modeling and comparable relative bioavailability. The PBPK predicted C_max, T_max, AUC_0-t, and AUC_0-∞ was 361.93 pg/mL, 6.88 h, 4567.8 pg/mL/h, and 5204.7 pg/mL/h, respectively. Lipid-cellulose-based extended-release Cinitapride matrix pellets were successfully prepared and can be effectively used as a single dose regimen for treating functional dyspepsia and gastrointestinal reflux disease.