The researchers have been facing several challenges in the designing of the treatment strategies to fight against the cancer. Since ancient times, the addition of natural foods in the diet has been reported for the prevention of several diseases including cancer.[1] The recent advancements have shown immense attention in the discovery of drug utilizing the herbal products with minimal toxicity.[2] Several studies support the claim that more than 30% cancer related death could be avoided by including high amount of natural foods in the diet.[3] Noticeably, almost half of the drugs that have been made available in the market in the last three decades are either directly from the plants or altered chemically.[4] Numerous studies demonstrated the use of plant materials in different ways as the crude extracts, bioactive secondary metabolites etc. as phytomedicine.[5] The phytomedicines also known as nutraceuticals, are exploited individually or in  combination with chemotherapeutic agents in the chemoprevention as well treatment of different types of cancers.[6,7]. However, the major downsides of most of the phytomedicines are the variability in the acidic pH, insolubility, low bioavailability, that can lead to minimal therapeutic index.[8] Keeping these challenges into considerations, the researchers have made immense attention to design the effective strategies to utilize their maximum potential without any adverse effects. In the last two decades, the researchers have proposed different types of delivery systems as niosomes, phytosomes, nanoparticles, microspheres, emulsions, liposomes etc . These carriers have opened the new vistas for the delivery of phytomedicines to augment their therapeutic potential. Among them, the liposomal formulations have several advantages in the efficacy of phytoconstituents due to enhanced stability of the carriers and bioavailability of the payloads with  minimal toxicity as reviewed by Cheng et al. 2022.[9] The liposomes  are the colloidal vesicles with varying range from 15 nm to 5 mm in diameter that are formed spontaneously following the hydration of various lipids in the aqueous solution. The liposomes can encapsulate the hydrophobic payloads in the phospholipid bilayer, hydrophilic in the aqueous core and amphiphilic in the bilayer surface according to the lipophilicity of the drugs. They can have single or multiple concentric membranes represented as unilamellar (ULV) or multilamellar vesicles (MLV) respectively. However, the ULVs can also be categorized into two sub classes as larger unilamellar (LUV) and small unilamellar vesicles (SUV). So far, the herbal extracts or phytoconstituents encapsulated many liposomal formulations have been characterized and evaluated against different types of cancer models in vitro as well as in vivo . Among them, several liposomal formulations of phytomedicine have been exhibited to augment the solubility, bioavailability, prolonged release and site-specific delivery of payloads as well. Therefore, these carriers of herbal drugs are categorized into four generations according to their characteristics and functions, as conventional, stimuli responsive, sterically stabilized, actively targeted and theranostic liposomes.[10–12] Currently, the use of conventional liposomes has been limited in the preparation of herbal drug formulations due to their rapid clearance from the bloodstream, degradation, aggregation, and coalescence. However, the selection of lipids, their molar concentration with phase-transition temperature (Tc), surface charge, size and the methods of preparation define the characteristics of liposomes. Several studies suggested the inclusion of cholesterol in the suitable amount enhance the stability of conventional liposomes.[13–15] The stealth or sterically stabilized liposomes are commonly used in the clinical trials, increase the stability in circulation and reduce their uptake by reticuloendithelial system (RES). These liposomes are also called PEGylated liposomes as the polyethylene glycol (PEG), a hydrophilic polymer is coated on the surface of conventional liposomes.[16] Recently, my research group prepared and characterized the PEGylated liposomal formulations of diallyl disulfide (DADS) and demonstrated the use of DADS to enhance the activity of oxaliplatin in colorectal cancer (CRC) model in vitro. [17] Subsequently, we also exhibited the chemopreventive effect of diallyl trisulfide (DATS) encapsulated PEGylated liposomes in azoxymethane induced CRC model in vivo. [18] Besides, we have developed the stealth liposomes of thymoquinone and reported the stability, increased sensitivity to lung cancer cells in vitro and safety level of doses in vivo. [19] The stimulus responsive liposomes are prepared by modifying the conventional liposomes with the addition of different phospholipids and other chemical constituents to trigger the structure that are capable of releasing the high concentration of herbal drugs at tumor sites. Several strategies have been proposed by the researchers in the activation of this class of liposomes using internal as well as external stimuli. According to the form of triggering approaches, they denoted as thermosensitive, ultrasound responsive, enzyme responsive and pH-sensitive liposomes to name a few.[20] Recently, we developed the novel PEGylated pH-responsive liposomal formulation of thymoquinone considering low solubility of the compound and pulmonary delivery challenges. We reported the inhibition of cancer promotion and progression in the lungs and protection of liver metastasis as well  in chemically induced small cell lung carcinoma model in vivo. [21] The engraftment of targeted ligand or antibody on the surface of liposomes, to specific receptors specifically expressed on the cancer cells is the third-generation strategy of the liposomal formulation for site specific delivery of herbal drugs.[22] The fourth generation theranostic liposomes have the competence of site-directed delivery of phytomedicine with controlled release responsive to the triggering mechanism and imaging efficiency with diagnostic agents.[23] Certainly, the various classes of liposomes as carriers of herbal drugs have shown great potential and will significantly promote the drug designing approaches. Therefore, it is concluded that different strategies should be applied according to the characteristics of the molecule/s for the development of novel delivery system of phytomedicines.

Objective: It is important to understand the factors associated with vaccination hesitancy for a given population for successful coronavirus disease-2019 (COVID-19) immunization program. This survey aimed to examine the prevalence of vaccine hesitancy and associated sociodemographic factors. Methods: A cross-sectional online survey was undertaken by circulating through social media platforms. Survey questions included sociodemographics and vaccination acquisition-related questions. Results: The study comprised a total of 3621 respondents. Over one-fifth of the unvaccinated population were identified as vaccine hesitancy group. Ethnicity and district indicated significant associations with vaccine hesitancy (P < 0.05). Indian Tamils (Odds Radio [OR] 2.222; 95%Confidence interval [CI], 1.150–4.294; P = 0.018), Sri Lankan Tamils (OR 1.714; 95% CI, 1.181–2.488; P = 0.005), and SriLankan Moors (OR 1.913; 95% CI, 1.316–2.781; P = 0.001) had significantly higher odds of vaccine hesitancy when compared to the Sinhalese. People in rural areas also had greater odds of vaccine hesitancy (OR 1.339; 95% CI, 1.000–1.793; P = 0.05) compared to municipal council areas. Conclusion: Vaccine hesitancy was considerably high in this survey population. Our results emphasize the need of the Sri Lankan government taking appropriate efforts to establish a targeted COVID-19 vaccination campaign plan for rural and Colombo district residents. Attention should also be given to ethnic minority groups.

Objective: The major purpose of the present study was to predict the structure of Radical s-adenosyl-L-methionine Domain 2 (RSAD2), the most targeted protein of the Zika virus using comparative modeling, to validate the models that were generated and molecular dynamics (MD) simulations were performed. Methods: The secondary structure of RSAD2 was estimated using the GarnierOsguthorpe-Robson, Self-Optimized Prediction method with Alignment, and PositionSpecific Iterative-Blast based secondary structure prediction algorithms. The best of them were preferred based on their DOPE score, then three-dimensional structure identification using SWISS-MODEL and the Protein Homology/Analogy Recognition Engine (Phyre2) server. SAVES 6.0 was used to validate the models, and the preferred model was then energetically stabilized. The model with least energy minimization was used for MD simulations using iMODS. Results: The model predicted using SWISS-MODEL was determined as the best among the predicted models. In the Ramachandran plot, there were 238 residues (90.8%) in favored regions, 23 residues (8.8%) in allowed regions, and 1 residue (0.4%) in generously allowed regions. Energy minimization was calculated using Swiss PDB viewer, reporting the SWISS-MODEL with the lowest energy (E = −18439.475 KJ/mol) and it represented a stable structure conformation at three-dimensional level when analyzed by MD simulations. Conclusion: A large amount of sequence and structural data is now available, for tertiary protein structure prediction, hence implying a computational approach in all the aspects becomes an opportunistic strategy. The best three-dimensional structure of RSAD2 was built and was confirmed with energy minimization, secondary structure validation and torsional angles stabilization. This modeled protein is predicted to play a role in the development of drugs against Zika virus infection.

Objectives: Cervical cancer is increasing worldwide and is becoming resistant to the existing drugs in clinical practice. Here, ethanolic extract of fruit body of Pleurotus florida was evaluated as antioxidant, anticancer agent against HeLa cell lines and anti-tumor against cervical cancer in mice model. Methods: Fruit bodies of P. florida in 90% ethanol, and the P. florida ethanolic extract (PFEE) was subsequently investigated for its antioxidant content and activity, anticancer properties against the cervical cancer cell line, HeLa, and antitumor activity against HeLa implanted mice. Results: The antioxidant activity bioassay showed that the IC50 of PFEE was 41.17 ± 1.42a µg/ml. The cytotoxicity assay revealed that PFEE caused inhibition of cell proliferation. At the highest dose (1,250 µg/ml) after 24 h, 48 h, or 72 h of treatment, the percentages of cell growth inhibition were 75.22%, 77.77%, and 84.65%, respectively. It revealed that PFEE-treated cells became rounded and the nuclei became fragmented. PFEE induced intracellular generation of reactive oxygen species and reduced the mitochondrial membrane potential. PFEE also led to an up regulation of the apoptotic genes for caspases-3, -9, and Bax, whereas Bcl-2 gene was down regulated, and it also promoted the expression of p53. Cell cycle analysis revealed that cell cycle was arrested at the G0/G1 checkpoint. PFEE suppressed metastasis and colonization. At a dosage of PFEE of 50 mg/kg of body weight, a 66.72% reduction in the size of tumors and an 87.44% reduction in the tumor weight were observed in mice. Conclusions: It has demonstrated that PFEE is a highly potent anti-cervical cancer agent in vitro and in vivo

Objectives: Actual world data on vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are imperative for future immunization decisions. We studied the reactogenicity and IgG response in a cohort dually vaccinated with the ChAdOx1 nCoV-19 vaccine. Methods: This prospective study recruited 494 ChAdOx1 nCoV-19 vaccine recipients at the University Hospital KDU between January 30 and February 5, 2021, and followed up for 9 months. The two doses of the vaccine were administered 3-month apart, followed by a booster dose with the BNT162b2 (Pfizer-BioNTech) vaccine 6 months later. One-week post-vaccination surveillance ascertained the reactogenicity of the vaccine. Seroprevalence of IgG antibodies before each vaccination dose was determined using a commercially available quantitative ELISA kit (WANTAI SARS-CoV-2 IgG Quantitative ELISA Beijing China). Reactogenicity profiles after vaccination doses were compared. Association of pre-vaccination seropositivity and demographic variables with antibody levels was assessed. Results: Reactogenicity was reported by 78.5% (329/419) and 25.4% (104/410) participants after the first and second doses, respectively, with a significantly high mean total score of vaccine-related symptoms following the first dose (P = 0.015). Post-first dose seroconversion rate was 97.1%, and the immune response was more robust among pre-vaccination seropositive participants and females. Following the second dose, 100% seroconversion was observed. Subgroup analysis of 196 participants revealed persistent antibodies at nine months with a rise in the previously measured levels among 78.1% compared to 21.9% with declining titers. Antibody waning was significantly associated with pre-vaccination seropositivity (P = 0.015) and female gender (P = 0.022). Conclusions: High seroconversion rates and longevity of antibody response in the absence of serious concerns regarding reactogenicity suggest that the vaccine is immunogenic and safe. Significant antibody waning among females and prevaccination seropositive participants warrant further research.

Objectives: Little is known about ethnic differences in bone geometry, nor their association with 25-hydroxyvitamin D (25(OH)D), especially among ethnicities living in the same country. The purpose of this preliminary study was to investigate differences in bone geometry at the radius and tibia, as well as in 25(OH)D status, between Arab (A), South Asian (SA), and Caucasian (C) premenopausal women residing in the UK. The potential association between 25(OH)D concentration and indices of bone geometry was also assessed. Methods: Fifty-seven healthy premenopausal women (17 A, 18 SA, and 22 C), ranging in age from 18 to 51 years, underwent assessment of their volumetric bone mineral density and 25(OH)D concentration. Ethnic differences were assessed using ANOVA. Spearman’s rho was used to analyze associations between 25(OH)D and pQCT bone variables. Results: At the 4% radius, Arab women had a lower BMC, as well as a smaller total bone area and trabecular area than did Caucasian women. At the 4% tibia, Arab women had a lower total vBMD than did South Asian women. Serum 25(OH)D among Arab (36.5(22.4SD)) and South Asian (31.4 (16.8SD)) women was significantly lower than in Caucasian women (81.9(20.0SD)) (P < 0.05). There were no statistically significant correlations between 25(OH)D and pQCT bone variables in any ethnic group. Conclusions: This study suggests a possible need for attention to bone health in premenopausal Arab women as well as improvement in Vitamin D status in Arab and South Asian populations.

Objectives: The objectives of the study were to describe the burden, etiology, and fatality rates of heart failure in Nigerian children. Methods: We searched PubMed database, Google scholar, TRIP database, EMBASE, African Index Medicus, and reference lists of selected articles for studies on burden, etiology, and fatality rates of heart failure in children in Nigeria published from 1977 to 2016. Two researchers reviewed the papers independently. Ten studies were selected that included 14,921 children and 1353 with heart failure. Results: The overall prevalence of heart failure using all the studies reviewed was 8.3% (95% CI: 4.9–12.6). The prevalence was 13.4% (95% CI: 10.9–16.3) in studies that excluded neonates and 4.5% (95% CI: 2.8–6.5) in studies that included neonates. The most common causes of heart failure were severe anemia (38.9%, 95% CI: 30.0–49.4), respiratory tract infections (32.4%, 95% CI: 25.5–39.7), congenital heart disease (8.4%, 95% CI: 6.8–10.2), and sepsis (7.6%, 95% CI: 3.0–14.0). The overall fatality rate was 16.0% (95% CI: 9.0 – 24.6) and was higher in studies that include neonates. Conclusion: Heart failure is common in children hospitalized in Nigeria. Its etiology is largely from non-cardiac conditions associated with severe hypoxia and mortality rates are high in children in Nigeria

Hidradenitis suppurativa is a rare, chronic, and recurrent skin disease that affects the pilosebaceous-apocrine unit. Its diagnosis is challenging and it usually manifests in advanced stages due to a lack of knowledge about this entity. To date, there are no standardized therapeutic protocols available for its management. We present a case of a 22-year-old woman with the left axillary hidradenitis suppurativa and underwent surgical treatment successfully. This report emphasizes the importance of educational programs among primary care professionals and public awareness campaigns about this disease, which is under-reported in our community, to avoid physical and psychological complications.