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Jun 4: A malaria drug President Donald Trump took to try to prevent COVID-19 proved ineffective for that in the first large, high-quality study to test it in people in close contact with someone with the disease.

Results published Wednesday by the New England Journal of Medicine show that hydroxychloroquine was no better than placebo pills at preventing illness from the coronavirus.

The drug did not seem to cause serious harm, though -- about 40% on it had side effects, mostly mild stomach problems.

 “We were disappointed. We would have liked for this to work,” said the study leader, Dr. David Boulware, an infectious disease specialist at the University of Minnesota.

“But our objective was to answer the question and to conduct a high-quality study,” because the evidence on the drug so far has been inconclusive, he said.

Hydroxychloroquine and a similar drug, chloroquine, have been the subject of much debate since Trump started promoting them in March.

Hydroxychloroquine has long been used for malaria, lupus, and rheumatoid arthritis, but no large studies have shown it or chloroquine to be safe or effective for much sicker patients with coronavirus, and some studies have suggested the drugs may do harm.

Trump took a two-week course of hydroxychloroquine, along with zinc and Vitamin D, after two staffers tested positive for COVID-19, and had no ill effects, according to results of his latest physical released by his doctor Wednesday.

Federal regulators have warned against hydroxychloroquine's use except in hospitals and formal studies because of the risk of side effects, especially heart rhythm problems.

Boulware's study involved 821 people in the United States and Canada living with someone diagnosed with COVID-19 or at high risk of getting it because of their job -- doctors, nurses, ambulance workers who had significant exposure to a sick patient while not wearing full protective gear.

They were randomly assigned to get either the nutrient folate as a placebo or hydroxychloroquine for five days, starting within four days of their exposure. Neither they nor others involved in the research knew who was getting which pills.

After 14 days in the study, 12 per cent on the drug developed COVID-19 symptoms versus 14 per cent in the placebo group, but the difference is so small it could have occurred by chance, Boulware said.

“There's basically no effect. It does not prevent infection,” he said of the drug. Even if it were to give some slim advantage, “we'd want a much larger effect” to justify its use and risk of side effects for preventing illness, he said.

Results were no different among a subgroup of participants who were taking zinc or vitamin C, which some people believe might help make hydroxychloroquine more effective or fight the coronavirus.

There are some big caveats: The study enrolled people through the Internet and social media, relying on them to report their own symptoms rather than having them tracked in a formal way by doctors.

Participants were not all tested for the coronavirus but were diagnosed as COVID-19 cases based on symptoms in many cases. And not all took their medicines as directed.

The results “are more provocative than definitive,” and the drug may yet have prevention benefits if tried sooner or in a different way, Dr. Myron Cohen of the University of North Carolina at Chapel Hill wrote in a commentary in the journal.

Others were glad to see a study that had a comparison group and good scientific methods after so many weaker reports on hydroxychloroquine.

“This fits with everything else we've seen so far which suggests that it's not beneficial," said Dr. Peter Bach, director of a health policy center at Memorial Sloan Kettering Cancer Center in New York.

This study was in younger relatively healthy people, but the results “would make me very discouraged about trying to use this in older people” who are most vulnerable to serious illness from the coronavirus, Bach said.

“If it does work, it doesn't work very well.” Dr. Dan Culver, a lung specialist at the Cleveland Clinic, said there's still a chance that giving the drug sooner than four days after someone's exposure to the virus may help prevent illness.

But the study “takes 'home run' off the table” as far as hopes for the drug, he said.

The study was mostly funded by David Baszucki, founder of Roblox, a California-based game software company, and other private donors and the Minnesota university.

Boulware also is leading a study testing hydroxychloroquine for treating COVID-19. The study is finished and results are being analyzed now.

On Tuesday, the journal Lancet posted an “expression of concern” about a study it published earlier this month of nearly 15,000 COVID-19 patients on the malaria drugs that tied their use to a higher risk of dying in the hospital or developing a heartbeat problem.

Scientists have raised serious questions about the database used for that study, and its authors have launched an independent audit.

That work had a big impact: the World Health Organization suspended use of hydroxychloroquine in a study it is leading, and French officials stopped the drug's use in hospitals. On Wednesday, the WHO said experts who reviewed safety information decided that its study could resume.

Washington, May 28: US President Donald Trump has warned social media giants that his government could "strongly regulate" or "close them down" after Twitter fact-checked one of his tweets for the first time.

"Republicans feel that Social Media Platforms totally silence conservatives voices," Xinhua news agency reported citing Trump as saying in a tweet to his 80 million followers on Wednesday.

"We will strongly regulate, or close them down, before we can ever allow this to happen."

Later in the day, he said that Twitter "has now shown everything we have been saying about them... is correct" and vowed "big action to follow".

The President's remarks came after Twitter slapped a warning label on one of his tweets on Tuesday, cautioning readers "Trump makes unsubstantiated claim that mail-in ballots will lead to voter fraud".

It was in response to Trump's tweet, without providing evidence, said: "There is NO WAY (ZERO!) that Mail-In Ballots will be anything less than substantially fraudulent."

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It is unclear what regulatory steps the president could take without new laws passed by Congress, the BBC reported.

The White House is yet to offer further details.

Earlier, Trump has accused Twitter of interfering in this year's US presidential election scheduled for November, saying the company was "completely stifling free speech, and I, as president, will not allow it to happen".

With more than 52,000 tweets currently to his name, Trump is a prolific tweeter and relies on the platform to disseminate his views to millions of people.

He has used Twitter to launch attacks on opponents, with targets ranging from North Korean leader Kim Jong-un to his political rivals in the US.

In 2017 he used anti-Muslim tweets aimed at London Mayor Sadiq Khan to serve a domestic political purpose of warning about immigration.

Washington, Jan 11: US President Donald Trump has signed an executive order imposing another set of crippling sanctions against Iran, targeting several of its top leaders, military commanders, and its infrastructure industry, according to a statement from the White House on Friday.

Trump said the executive order authorises the imposition of sanctions against any individual or entity operating in the construction, manufacturing, textiles, or mining sectors of the Iranian economy or anyone assisting those who engage in this sanctioned business.

The sanctions are the latest in a series of retaliatory measures between the two nations.

Iran's powerful military commander Qasem Soleimani was killed last Friday in US drone strikes, ordered by President Trump, bringing the entire Gulf region close to a full-blown conflict.

Regional tensions remained high after Iran on Wednesday fired missiles at two bases in Iraq used by US forces.

"Today, I am holding the Iranian regime responsible for attacks against United States personnel and interests by denying it substantial revenue that may be used to fund and support its nuclear program, missile development, terrorism and terrorist proxy networks, and malign regional influence," said Trump on Friday, after signing the executive order.

"This order will have a major impact on the Iranian economy, authorising powerful secondary sanctions on foreign financial institutions.

"The Iranian regime has threatened United States military service members, diplomats, and civilians, as well as the citizens and interests of our allies and partners, through military force and proxy groups. The United States will continue to counter the Iranian regime's destructive and destabilising behaviour," the president said.

Trump said the economic sanctions will remain till the Iranian regime changes its behaviour.

Earlier at a White House news conference, Treasury Secretary Steven Mnuchin, along with cabinet colleague Secretary of State Mike Pompeo, said the US will continue its economic and diplomatic sanctions on Iran till Tehran announces it will not pursue the nuclear weapons program and stop its destabilising behaviour in the region.

The eight senior Iranian regime officials against whom sanctions have been issued include Ali Shamkhani, the Secretary of Iran's Supreme National Security Council, Mohammad Reza Ashtiani, the Deputy Chief of Staff of Iranian armed forces, and Gholamreza Soleimani, the head of the Basij militia of the Islamic Revolutionary Guards Corps (IRGC).

The sanction on the Iranian officials would mean denial of visa to the US and seizure of assets, among others.

In addition, the treasury designated 17 Iranian metals producers and mining companies, a network of three China-and Seychelles-based entities, and a vessel involved in the purchase, sale, and transfer of Iranian metals products, as well as in the provision of critical metals production components to Iranian metal producers.

"The United States is targeting senior Iranian officials for their involvement and complicity in Tuesday's ballistic missile strikes," Mnuchin said.

"We are also designating Iran's largest metals manufacturers, and imposing sanctions on new sectors of the Iranian economy including construction, manufacturing, and mining. These sanctions will continue until the regime stops the funding of global terrorism and commits to never having nuclear weapons," he added.

Pompeo told reporters that Iran was planning "broad, large-scale attacks" against American interests in the Middle East, including embassies.

The latest round of sanctions are aimed at striking at the heart of Iran's internal security apparatus, he said.

"The president has been very clear: we will continue to apply economic sanctions until Iran stops its terrorist activities and commits that it will never have nuclear weapons," Mnuchin said.