Journal of Current Medical Research and Opinion

A Feasibility Study of an Outpatient Pulmonary Exercise Training Program (Opetp) For Post Covid-19 Patients

Anmol Kaur Manjit Singh — 2026-03-02

Background: SARS-CoV-2 infection (COVID-19) can cause persistent respiratory, physical, psychological, and multi-system impairments, including breathlessness, fatigue, reduced functional capacity, and poorer quality of life. Exercise training in pulmonary rehabilitation (PR) is vital to prevent further deconditioning after hospital discharge. This study aims to assess the feasibility of a ten-week Outpatient Pulmonary Exercise Training Program (OPETP) for post-COVID-19 patients and evaluate its effects on breathlessness, exercise capacity, functional status, dyspnoea, quality of life, and functional sequelae.

Method: Post-COVID-19 patients referred to OPETP underwent a 10-week program with weekly supervised and home-based aerobic/resistance training. Feasibility was measured by uptake, adherence, tolerability, and safety. Effects were assessed via 6MWT, mMRC, SF-CRQ, and PCFS scores for exercise capacity, dyspnoea, quality of life, and functional sequelae.

Results: Of 118 post-COVID-19 patients referred, 72 (61%) were lost to follow-up and 46 (39%) consented (mean age 55 ± 16 years; 57% male; 59% severe/critical cases). Thirty-two (27%) completed the OPETP. Adherence (≥7 sessions) was achieved by 28– 41% depending on duration; 66% tolerated training. Significant gains included increased 6MWD (369 ± 114 m to 439 ± 122 m), improved dyspnoea (mMRC: –0.8 ± 0.7; p < 0.001), better quality of life (SF-CRQ: 75%), and enhanced functional status (PCFS: 66%).

Discussion: Limited pre-referral education reduced PR uptake (61% non-attendance), yet enrolled patients improved 6MWD and quality of life, underscoring benefits of flexible, patient-centred post-COVID rehabilitation.

Conclusion: OPETP is feasible, safe, and may improve breathlessness, fatigue, function, exercise capacity, and quality of life in symptomatic post-COVID-19 patients.

Staffing Resource Use: Medications for Opioid Use Disorder Cost Impact Model in Carceral Facilities

Chris Poole — 2026-03-21

Aims
Medications for opioid use disorder (MOUD) are not widely available within United States carceral settings despite the high prevalence of opioid use disorder. Financial barriers, including staff shortages, represent common obstacles to implementation. A nationally representative survey found that among jails not providing MOUD, nearly half cited inadequate staffing as the primary reason. The purpose of this study was to develop a cost impact model to assess staffing time and costs associated with administering different forms of MOUD within carceral settings.
Materials and Methods
A cost impact model was developed in Microsoft Excel to simulate staff time required to administer MOUD within carceral settings. The model compared methadone, oral buprenorphine, extended-release buprenorphine (BUP-XR; SUBLOCADE* monthly and BRIXADI* weekly or monthly injectable formulations), and extended-release naltrexone (XR-NTX) for treatment of 100 incarcerated individuals per month. Information on clinician and security officer time and responsibilities was compiled using expert opinion, targeted literature reviews, prescribing information, and timestamps from manufacturer MOUD administration videos. Total staffing costs were calculated using a micro-costing approach with US Bureau of Labor Statistics national mean hourly wages for licensed practical nurses and correctional security officers.
Results
The model estimated that monthly SUBLOCADE reduced total staffing hours by 318 hours compared to methadone, 747 hours compared to oral buprenorphine, 192 hours compared to weekly BRIXADI, 1 hour compared to monthly BRIXADI, and 6 hours compared to XR-NTX per 100 patients per month. Corresponding monthly staffing cost reductions ranged from $23 to $22,148 compared to other MOUD formulations.
Limitations and Conclusions
Limitations include reliance on assumptions for certain administration times and escorting procedures, and exclusion of medication acquisition costs. Despite these limitations, long-acting injectable buprenorphine formulations reduce total staffing time and costs compared to other MOUD, potentially helping relieve the operational capacity burden that represents a major institutional barrier to MOUD program implementation in carceral settings.

Natural Compounds of Ethanolic Fruit Extract of Citrullus Colocynthis Screening and Assessment of Its Antifungal Activity

Ahmed A.A Zwaid — 2026-03-03

Citrullus colocynthis is also known as bitter cucumber, bitter apple and colocynth. It is now classified as Citrullus colocynthis, where it used to be called Colocynthis citrullus. Medicinal plants have secondary metabolism to produce organic compounds, including tannins, alkaloids, carbohydrates, triterpenoids, steroids, flavonoid compounds, etc. These compounds possess physiological influences on human beings and antimicrobial action on a range of microbes. Based on the peak (%), the prevalent bioactive compounds were 1H-Pyrrole-2-carboxaldehyde, 2'-Hydroxy-5'-methylacetophenone, 3-Nonyn-2-ol, spiro[3H-chromene-2,1'-cyclobutane]-4-one, 4-propanoylphenyl 2,2-dimethylpropanoate, 6-Hydroxyhexanoic acid lactone, Octadecanoic acid, tetradecyl ester, 4-(3-Hydroxy-1-propenyl)-2-methoxyphenol, 4-Phthalimidobutyric acid, n-Tetradecanal, 3-Trifluoroacetoxydodecane, octahydropyrrolo[1,2-a]azocin-5(1H)-one, (R)-alpha-Hydroxy-gamma-butyrolactone, N-(4-Methoxyphenyl)-acetylacetamide, 1-Pentanol, 2,3-dimethyl, Glutaraldehyde, 3-methyl, 3,3-Diphenyldihydrofuran-2(3H)-one, Catechol diethyl ether, 1H-Indole, 2,3-dihydro-2-methyl and 9,12-Octadecadienoic acid, ethyl ester. Bioactivity of Hollyhock (Citrullus colocynthis) methanolic crude extract and ethanol fraction in inhibiting three fungi in comparison to traditional antibiotics. besides the popular antibiotics Posaconazole (PCZ) and Itraconazole (ICZ). Observed on Aspergillus flavus (18.08±0.39, 21.00±0.43, 31.09±0.52 and 25.00±0.46). Monitored on F. oxyporum (16.96 20.08, 12.00 22.08 and 19.45). Repeated versus Cladosporium herbarum concomitantly (24.58±0.45, 19.00±0.40, 34.00±0.57, and 27.95±0.50). The activity of citrullus colocynthis metabolites was very high (24.58±0.45) towards Cladosporium herbarum.

Efficacy of Topical Bioactive Plant Extracts in Burn Wound Healing: A Systematic Review of Clinical and Preclinical Evidence

Israa J. Abdul-Rasul — 2026-03-19

The proposed systematic review should be an in-depth review of the effectiveness of topical bioactive plant extracts in the healing of burn wounds of all types (thermal, chemical, electrical, and radiation) and all depths (first-, second-, and third-degree). The objectives are: To evaluate the efficacy of plant extracts in enhancing the most important outcome, such as time to heal, infection, pain, scar, and biological (e.g., IL-6, VEGF, collagen deposition) outcomes. To clarify the mechanistic apparent working action such as, anti-inflammatory, antimicrobial and angiogenic. The review aims at well-investigated plant extracts, such as Aloe vera, Centella asiatica, Curcuma longa, Calendula officinalis, Hippophae rhamnoides, and Betula pendula, since they are proven to be effective and applicable in burn management. This systematic review is convincing that bioactive plant extracts, specifically, Aloe vera, Centella asiatica, and Curcuma longa, hasten the healing of burn wounds, alleviate pain, enhance the quality of scars, and decrease the rate of infection in superficial and partial-thickness burns. Nevertheless, the heterogeneity, scarce information on both deep burns and the necessity of large-scale RCTs make additional investigations. The clinical adoption of plant-based therapies could be improved with standardized formulations, novel delivery methods such as hydrogels, and follow-up studies to determine the long-term outcomes and/or improve the clinical results of patients with burn injuries and decrease the socioeconomic price of burn care.

Application of New Syncretic Antifungal Formulations against Candida Species Associated with Oral Cancer

Shatha Ghani Abbas — 2026-03-23

Background: Human oral microbiomes constitute from diverse and multifaceted structure of microorganisms including fungi and bacteria. That complex structure is dynamic and plays important roles in human health and disease. They might influence the progress of infectious diseases like oral cancer. Some of oral mycobiota may transform to bloodstream causing severe systematic diseases and a greater risk of sickness and death up to 79% of oral cancer patients. Oral cancer isolates were detected to be more virulent compared with other studied isolates including non-cancer isolates.

Aims: The aims of this study were to investigate the in vitro effects of ZnO NPs and apple cider vinegar (ACV) independently against Iraqi isolates of Candida albicans and Candida tropicalis isolated from oral cancer patients and healthy individuals. Dual and triple combinations of ZnO NPs or/and ACV combined with fluconazole (Flu) and Amphotericin B (AmphB) were tested against Candida isolates and first applied as alternative therapies in Iraq and in some application points around the world.

Methods: The two most common types C. tropicalis (P128), (H25) and C. albicans (P111), (H10) were selected against a range of concentrations of ZnO NPs, Flu and amphB (0.01-0.06 and 0.1 µg/ml) and six concentrations of ACV (50,000-780µg/ml) using micro dilution method. The minimum inhibitory concentrations (MICs) and minimum fungicidal concentrations (MFCs) for each antifungal agent and their interactions among these drugs were also detected.

Result: The oral cancer isolates were more resistance to tested antifungals and their combinations compared with non-cancer isolates. Dual and triple combinations were synergistic and showed significant reductions in fungal growth in a dose dependent matter. The triple combination of ZnO NPs and ACV with Flu or AmphB revealed notable reduction in MICs and MFCs values.

Conclusion: These concentration-dependent interactions may have critical effects that need further study in animal models of investigated species.

The dual combination of ZnO NPs and ACV had a significant similarity with triple antifungal combinations of antifungal activity against Candida tropicalis.

Availability of Multidrug-Resistant Ornithobacterium rhinotracheale in Broiler Flocks with Swollen Head Syndrome in Iraq: Prevalence, Phylogeny, and Therapeutic Implications

Walid Hahid Salih — 2026-03-27

Background: The cause of Swollen Head Syndrome (SHS) in poultry is multifactorial and includes Nitrobacterium rhinorrhea (ORT) as the primary bacterial agent. The world is seeing Occupationally/Multi-Resistant (AMR) as a more widespread threat to its control. In Iraq, a major poultry-producing country, no recent data are available on ORT susceptibility profiles.

Methods: Three cross-sectional studies on 30 SHS affected broiler flocks (8,000-11,000 birds) in Diyala Province, Iraq. ORT was first isolated from tracheal swabs and sinus exudates using selective culture, and was subsequently confirmed by 16S rRNA PCR and locus sequencing. The confirmed isolates (n=7) were ascertained for antimicrobial susceptibility against 10 agents using a disc diffusion method. The co-circulation of the avian metapneumovirus subtype B (aMPV-B) by reverse transcription was in a single exercise polymerase chain reaction (RT-PCR).

Results: Out of the total, 7 flocks were confirmed cases of ORT (23.3% prevalence). All isolates (100%) were calculated to be multidrug resistant (MDR) to at least 3 classes of antimicrobials. Of the three classes, resistance was found to be universal (100%) to enrofloxacin, erythromycin, and lincomycin. Of the remaining classes, high resistance rates were found to be approximately 85.7 to ampicillin and 71.4% to oxytetracycline. On the other hand, susceptibility was retained to florfenicol (85.7%) and doxycycline (71.4%). Eighteen phylogenetic strains were analyzed. The Iraqi ORT strains clustered with serotype A isolates from Iran and Turkey. amp-B was detected in fifteen (16.7%) flocks, of which 3 (10%) were co-infected with ORT. However, no significant epidemiological association was found (p=0.325).

Conclusions: This is the first report from Iraq and it reveals a significant AMR crisis in ORT, with isolates being resistant to all first-line antimicrobials. The findings, therefore, warrant an urgent change to evidence-based therapy employing florfenicol or doxycycline and greatly highlight the necessity for regional poultry industry antimicrobial stewardship to be implemented.

Anti-Diabetic and Anti-Inflammatory Effects of Oral Administration of a Leaf Extract of Origanum majorana in Rats and Investigate Its Natural Components

Rusul Hamed Obaid — 2026-03-31

The ancient methods of healing in the past were based on natural remedies and herbs. The last few decades have seen an upsurge in the interest of drug discovery researchers in herbs, as they may cause fewer problems and adverse effects. Medicinal and pharmacological research has been on the increase all over the world due to the increase in demand. In case of inappropriate use of glucose by the body a disease occurs, and the disease is termed as diabetes mellitus. It is a chronic disease that is accompanied by a disproportionate increase in the level of blood glucose, and is caused by either inadequate production of insulin or lack of enough sensitivity of the cells to its activity. An abrupt rise in the level of glucose in the blood, excessive urination, excessive thirst, and inexplicable weight loss are some of the symptoms of this condition. The main objective of this research was to examine the active components of an Origanum majorana leaf extract and the anti-inflammatory and anti-diabetic properties of this extract on mice. Twenty bioactive compounds were identified in the present study: Bis(2,4 dimethylpentadienyl)ruthenium(II), Pentacosanoic acid, methyl ester, 10-Octadecenoic acid, trans, Triacontanoic acid, octadecyl ester, Docosanedioic acid, dimethyl ester, 1,1'-Bicyclopentyl, 2-hexadecyl, Phenol, 2,6-bis(1,1-dimethylethyl), 6,10,14-Trimethylpentadecan-2-ol, n-Hexadecanoic acid methyl ester, 9-Octadecenoic acid (9Z)-, methyl ester, L-Proline, 1-acetyl, Oleoyl chloride, Dimethyl 2-methylisophthalate, Butanoic acid, 3-hexenyl ester, (E)-, 2,4,7-trimethyl-1H-indene, tau-Cadinol, 2-Octanol, 2,6-dimethyl, 7-Pentadecanone, 7-Pentadecanone, Phytol, and 2,2,3,5-Tetramethylhexane. The impacts of Origanum majorana Leaf methanolic crude extract were observed on the serum enzymes SGPT, SGOT and ALP in rats. The means of the extract given orally to the rats are (79.00±3.95, 89.02±4.67 and 26.00±1.89) in the Origanum majorana Leaf methanolic crude extract group, The values of the inhibitory power against Alpha-amylase were obtained as (76.00±4.90, 58.52±3.86, 31.00±2.18 and 27.06±1.15) respectively, depending on the type of extract (methanol crude extract, ethanol fraction, ethyl acetate fraction and Acarb. It was measured at (48.05±3.61, 35.00±2.70, 22.09±1.03 and 17.00±0.94) respectively. Most likely, the source of this anti-inflammatory potential is the presence of polyphenolic chemicals with anti-inflammatory effects and which may be used in the treatment of disorders related to diabetes.