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According to recent reports, researchers from IIT Hyderabad have developed nanofiber-based, controlled-release oral tablets of amphotericin B, a drug that is currently being used to treat COVID-related fungal infections such as black, white and yellow fungal infections, and is available only in an injectable form. 
Two years ago, the researchers innovated this new formulation to treat kala azar or black fever, a severe form of leishmaniasis caused by protozoan parasites. The reports add that at present, kala azar treatment is being used to treat post-Covid fungal infections and the presence of amphotericin B oral tablets can be helpful to treat patients with the condition.
Let's know more about it.
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About The Research
In 2019, the researchers from IIT Hyderabad's Creative and Advanced research lab who are involved in nanomaterials have reported manufacturing of the amphotericin B oral tablets by using gelatin nanofibers.
The oral tablets were innovated for use in the treatment of kala azar, a parasitic disease which is affecting around 0.5 million people a year, the majority from Nepal and India. According to a study, there were no effective orally administered drugs for kala azar, except for the injection. 
Earlier, black fever was treated with four weeks of injection of sodium stibogluconate. Though the treatment showed positive results in around 37-64 per cent of patients, it has also shown some serious side effects related to cardiotoxicity in around 7-10 per cent of people and treatment-related deaths in around 5-10 per cent of individuals.
The toxicity and high cost of the injection have affected its wide use in developing countries where kala azar is epidemic.
However, with the development of amphotericin B oral tablets, the researchers are confident that now kala azar might be treated effectively, and this innovation can also be effective for the treatment of recent ongoing fungal infections related to COVID-19.
Symptoms Of Kala Azar
Kala azar is a fatal condition if not treated immediately. Some of the symptoms of kala azar include: 
- Cachexia, a condition characterised by extreme weight loss and muscle wasting.
- Hepatosplenomegaly, a condition in which the spleen gets larger than liver
- Lymphadenopathy, a condition characterised by swollen or enlarged lymph nodes.
- Pancytopenia, low counts of all the three types of blood cells, RBCs, WBCs and platelets.
- Hypergammaglobulinemia, a chronic liver disease.
What Are COVID-Related Fungal Infections?
Among many post-treatment COVID-19 symptoms, fungal infections such as black fungus, white fungus and yellow fungus have gained attention due to their fatality during the middle and later stages of the disease, especially in critically ill patients. 
Patients who are admitted to ICU, on ventilation or in hospital stay for a longer duration (longer than 50 days) are more likely to develop fungal infections mainly due to weakened immune system.
Common symptoms of COVID-related fungal infections include:
- Sinus pain
- Nasal congestion
- Skin infections
- Swelling of the skin
- Skin tenderness
- Blackened skin tissues
- Redness of the skin
Amphotericin- B injections which are currently used in the treatment of black fungal infections cost lakhs of rupees. A 50 mg vial costs around Rs 4000 and 60-100 vials are required for a single patient which often cost them lakhs of rupees.
The oral tables of amphotericin- B could be less expensive and affordable for patients. It could cost Rs 200 per tablet of 60 mg dose, as said by Dr Chandra Shekhar Sharma, Associate Professor in the Chemical Engineering department at IIT-Hyderabad.
The innovation is yet to be patented and made available for public use. The manufacturing of the drug will also require pharmaceutical companies who can conduct clinical trials on the drug and help in the large-scale manufacturing of amphotericin B oral tablets.
1. Can amphotericin B be given orally?
Earlier, no oral drug of amphotericin B was available, but as per the recent reports, researchers from IIT Hyderabad have developed oral forms of amphotericin injections, which could be effective to treat fungal infections related to recent COVID-19.
2. What is amphotericin B used to treat?
Amphotericin B is usually used in the treatment of fungal and protozoal infections such as kala azar, candidiasis, urinary tract infection and candidiasis yeast infection.
3. How should amphotericin B be administered?
Amphotericin B is injected slowly intravenously over a time of around 2-6 hours once daily, depending on the condition and dose.
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