ABSTRACT
Introduction: Coronavirus disease or COVID-19 emerged in December 2019 in China and thereafter spread to all regions of the world including India. In the Himalayan state of Himachal Pradesh, India, the first case was identified in the month of March 2020. As the most populous district of the state of Himachal Pradesh, Kangra not only identified the first case in the state but also thereafter suffered disproportionately due to the virus causing severe health and economic disruption. The study was carried out to better understand the pattern and trends of COVID-19 pandemic in the district since its emergence, covering the first and the second wave to use the data to prepare the future course of action. Materials and Methods: A robust database comprising real-time data in a line list format was created. The observations covered all confirmed COVID-19 cases in the district from March 20, 2020, to June 30, 2021, in terms of disease progression and distribution in time, place, and person, and the possible risk factors for severe disease. Results: During the study period, 45,871 cases and 1030 deaths were reported in Kangra district, with a case fatality rate of 2.2%. Of the 12 districts of the state, Kangra reported the highest number of cases (22.6%) and deaths (29.7%). Ninety percent of all cases occurred during the second wave. While the first wave peaked in December 2020 with 2596 cases, the highest number of cases occurred in May 2021 when as many as 25,625 cases were reported. The test positivity rate of 15.2% during the second wave which was many times higher than that seen during the previous year. The case fatality rates during the first and second waves were 2.2% and 2.1%, respectively. Conclusions: The study highlights an explosive surge in COVID-19 cases during the second wave, indicating the highly infectious nature of the virus. While absolute number of deaths was several times greater during the second wave, the case fatality rates did not differ greatly between the two waves.
ABSTRACT
Nutrient recovery from source-separated human urine has attracted interest as it is rich in nitrogen and phosphorus that can be utilized as fertilizer.However,urine also contains pharmaceuticals,steroid hormones,etc.and their removal is crucial as they have detrimental effects on the environment and human health.The current study focuses on investigating the degradation of pharmaceuticals using a double-chamber microbial fuel cell (MFC).Urine was spiked with four pharmaceuticals (trimethoprim,lamivudine,levofloxacin,and estrone) at a concentration of 2 μg/mL.The MFC was operated for 7 months in batch mode with this spiked urine as feed.The degradation efficiency of the MFC was studied,for which a selective liquid chromatography-tandem mass-spectrometric method was developed for the quantitation of compounds used in the spiking experiments and was validated with a lower limit of quantification of 0.39 ng/mL.The maximum removal rate achieved was 96％± 2％.The degradation mechanism involved processes like sorption and anoxic biodegradation.The voltage curve obtained showed that the presence of pharmaceuticals had an initial negative impact on power generation along with increased organic content;however,after the reactor acclimatization,increased power output was achieved with maximum organics removal at 30 h of retention time.This work opens a new perspective for the anoxic biodegradation of pharmaceuticals and can be useful in future bioremediation studies.
ABSTRACT
Background: The WHO in 2009 published the surgical safety checklist (SSC) for reducing the surgical complications. For its successful implementation it is imperative to identify the current knowledge, attitude and practices of the involved personnel and explore the anticipated barriers. Objective of this study was to evaluate the knowledge, attitude and practices of the participants about the SSC and determine the possible challenges in its implementation.Methods: This study is a descriptive, cross-sectional study involving the use of a pre-tested questionnaire carried out in a teaching hospital. All personnel involved in the operation theater who gave their written consent were enrolled.Results: Awareness regarding the SSC is high and existing practices are favorable towards patient safety amongst Hospital personnel. Attempts should be made to educate all personnel to gain complete knowledge regarding the checklist. The anticipated barriers, of which lack of knowledge was found to be the most prominent, should be dealt with.Conclusions: A strategy aimed at proper education, stepwise implementation, alleviating the hindrances and regular feedbacks can result in decreasing the surgery related complications and morbidities through implementation of the surgical safety checklist.
ABSTRACT
The word “poly” is Greek and means many or much. However, the term polypharmacy has been given definitions connected both to the use of more than a certain number of drugs concomitantly and to the clinical appropriateness of drug use. Polypharmacy is the use of multiple medications by a patient, generally older adults (those aged 60 or over 65 years). More specifically, it is often defined as the use of 5 or more regular medications. It sometimes alternatively refers to purportedly excessive or unnecessary prescriptions. The term polypharmacy lacks a universally consistent definition with an increasing share of population in this age group, it is natural to expect an increase in the problems associated with them as well. Health problems are supposed to be the major concern of this section of the society, and it is reported that use of medications has increased significantly among the elderly in the last decade. Objective: The objective of this study is to assess the prevalence of polypharmacy among elderly patients in different Indian states, to make a comparison, and also to study the patterns of polypharmacy and its associated aspects. Materials and Methods: Literature review comprising of original articles, reviews, and case studies was studied to identify articles which correspond to research done on polypharmacy in various different ways published between the years 2010 and 2018. As the review focuses on the geriatric population, so considerable data were searched and collected for the use of medication in geriatrics to assess what makes them prone to polypharmacy, what pattern of polypharmacy they follow, and how they are affected by the consequences. Results: Uttaranchal, Karnataka, and Telangana reported a higher level of polypharmacy with 93.14%, 84.6%, and 82.8%, respectively, whereas Andaman and Nicobar Islands (2%) and West Bengal (5.82%) showed the lowest polypharmacy. Conclusion: Overall comparisons made show that there are more studies needed to assess the level of polypharmacy and ways and measures should be incorporated by the government in states showing high polypharmacy.
ABSTRACT
Obesity is an underestimated condition of clinical and public health importance across the world. Obesity has been associated with Left ventricular hypertrophy and insulin resistance, both of which are associated with cardiovascular morbidity and mortality. The aim of present study to determine relationship between left ventricular mass index and Insulin resistance in obese subjects. Methods: The present study is a observational study conducted in Guru Nanak Dev Hospital attached to Govt. Medical college Amritsar. Total 50 normotensive nondiabetic obese subjects of both genders were included in the study. Results: There was strong positive correlation of Left Ventricular Mass Index (LVMI) with HOMA-IR. Pearson’s correlation coefficient (r) = 0.298 and P value was < 0.05. Left ventricular hypertrophy was present in 38% and 70% of obese subjects when left ventricular mass was indexed to body surface area and height respectively. Conclusion: The present study concludes that left ventricular mass index is strongly related with insulin resistance in normotensive nondiabetic obese subjects. So their earlier detection will reduce cardiovascular morbidity and mortality.