ABSTRACT
India is ranked 120 among 165 nations with respect to sustainable development and critically suffers from insufficient waste treatment provisions and amenities. And the abrupt occurrence of the COVID-19 virus has aggravated the issue of managing of medical waste in India, manifolds. As a result, the safe disposal of a huge volume of hazardous medical waste has become a top priority. This conceptual study evaluates India's management of medical waste during the COVID-19 pandemic. Additionally, this article aims to highlight the inadequacies in India's implementation of the BMW 2016 standards by a synthesis of multiple agency reports (government and non-government) and data obtained directly from the Central Pollution Control Board (CPCB). The findings indicate that India is well behind in terms of COVID-19 waste management and requires comprehensive monitoring and implementation systems to enable the achievement of SDGs related to environmental health.
ABSTRACT
We propose a unique theoretical methodology because of the global high priority rating to search for the repurposed drugs that outfit clinical suitability to SARS-CoV-2. The approach is based on the exploration of structural analysis, computation of biothermodynamics, interactions and the prediction of entropy sign successively via molecular dynamics. We tested this methodology for Favipiravir/Dolutegravir drugs on the apo form of SARS-CoV-2 main protease. This theoretical exploration not only suggested the presence of strong interactions between (SARS-CoV-2 + Favipiravir/Dolutegravir) but also emphasized the clinical suitability of Favipiravir over Dolutegravir to treat SARS-CoV-2 main protease. The supremacy of Favipiravir over Doultegravir is well supported by the results of global clinical trials on SARS-CoV-2 infection. Thus, this work will pave the way for incremental advancement towards future design and development of more specific inhibitors to treat SARS-CoV-2 infection in humans.Communicated by Ramaswamy H. Sarma.
ABSTRACT
Introduction: Diabetes has been linked with poorer outcomes in coronavirus disease (COVID-19) patients. However, the question to whether continue or withdraw metformin therapy in COVID-19 patients with type 2 diabetes mellitus remains contentious. This study aims to investigate the association between metformin and poor COVID-19 outcomes. Methods: Eligible studies published up to 21 October 2020 were included and appraised for validity, importance, and applicability. The included studies were further ranked according to the level of evidence (LOE). Results: Nine studies were included for further assessments, of which seven studies stated that metformin was not associated with poor COVID-19 outcomes (LOE II-V), while the other two with poorer designs stated otherwise (LOE V). Although metformin may increase the risk of developing acidosis and lactic acidosis (LOE IV), the observed risks were more accentuated in patients with severe COVID-19 disease or kidney impairment and in patients with > 2 daily metformin doses. Interestingly, one study revealed that metformin may even yield therapeutic role in reducing the risk of COVID-19 mortality (LOE II), although further studies are required to confirm these findings. Conclusions: Our findings indicated that metformin may be safely continued in COVID-19 patients. The benefit of metformin therapy with simultaneous continuous monitoring of COVID-19 severity and kidney function may outweigh the risks of lactic acidosis, of which incidence is relatively rare. Supplementary Information: The online version contains supplementary material available at 10.1007/s13410-021-00924-w.