ABSTRACT
Background: Saskatchewan, a Canadian Prairie province, faces a complicated HIV epidemic characterized by high rates of transmission due to injection drug use (IDU) and disproportionate representation of younger persons, women, and persons of Indigenous ethnicity. HIV incidence in Saskatchewan in 2021 was 19.7 per 100,000, 4.5 times higher than the Canadian average. Concurrently, during the COVID-19 pandemic, the recreational use of synthetic opioids such as fentanyl increased, leading to high numbers of overdose events & deaths. We characterized the difference in cascade of care outcomes & mortality amongst people with HIV (PWH) living in southern Saskatchewan during the COVID-19 pandemic. Method(s): We conducted a retrospective cohort study for all PWH cared for in the Infectious Diseases Clinic (IDC) at Regina General Hospital between December 31/19 and June 10/22. Age, sex, ethnicity & primary mode of HIV acquisition were collected from the IDC database, along with cascade of care & mortality data. Deaths, including most likely cause of death were characterized via individualized case review. Result(s): On December 31/19, IDC cared for 518 PWH. This increased to 585 by June 10/22. Amongst the current cohort, 245 (42%) were female, 163 (28%) were <= 35 years old, 306 (52%) were Indigenous, and 318 (54%) had acquired HIV through IDU. Cascade of care indicators worsened during the COVID-19 pandemic. 58.1% of the cohort were retained in care & 76.1% virally suppressed (HIV RNA <= 200 copies/mL) in December 2019, decreasing to 51.3% retained (p=0.02) & 68.8% suppressed (p=0.06) by June 2022. There were 80 deaths during the study period, representing 15.4% of the cohort from the end of 2019. Most deaths (49, 61.3%) were due to suspected or confirmed drug overdose. 10 (12.5%) additional deaths occurred due to complications from IDU (i.e., sepsis). No deaths were directly attributable to COVID-19. Most who died acquired HIV from IDU (69/80, 86%). Conclusion(s): We describe intersecting epidemics of HIV and IDU disproportionately affecting high-risk populations, leading to significant morbidity & mortality during the COVID-19 pandemic. Contributing factors may have included disruption of safe opioid supply and disrupted access to harm reduction services due to COVID-19. Comprehensive population-level harm reduction and addictions management strategies are urgently needed to reduce morbidity & mortality from drug use amongst PWH in Saskatchewan.
ABSTRACT
COVID-19 is a global pandemic caused by the novel coronavirus. Although the surfaces pose a low risk of transmission, it is beneficial to use a handheld key-like device to avoid touching the surfaces, especially in public places. The present article reveals a novel design for a multifunctional handheld device, termed the COVID key. The proposed COVID key exhibits ten distinct features, viz. doorknob opener, pushing, pulling, forceps action, sharp edge, key chain, smartphone stand, and a linear and angular scale frequently used in daily life. Theoretical and computational analyses are carried out to check the validity of the design under different loading conditions resembling everyday use. Topological optimization is carried out to achieve the best stiffness-to-weight ratio. The final design is 3D printed in two different materials, ABS (acrylonitrile-butadiene-styrene) and PLA (poly-lactic-acid), using fused deposition based additive manufacturing. Testing and validation of the design are carried out with everyday actions. The COVID keys are distributed among a group of ten unbiased users. The user satisfaction score is recorded based on six basic metrics, viz. ease of use, size, strength, appearance, material and ease of carrying. A satisfaction score of 85% is reported, with ABS being the preferred material of choice.
ABSTRACT
A widespread but underexplored aspect of the Covid-19 pandemic in India has been the prevalence of stigma and denial at different levels in the community mediated by state policy and actions. Based on a fi eld study in three districts of Tamil Nadu between the two waves of the pandemic, this article explores the nature of stigma and denial and their consequence for health-seeking behaviour and access to healthcare. © 2022 Economic and Political Weekly. All rights reserved.
ABSTRACT
Coronavirus Disease – 2019 (COVID–19) caused by the novel coronavirus, SARS-CoV2 has plagued the world in pandemic for the past few months. Currently, many groups are investigating on a potent candidate for treating this highly infectious disease. Phytocompounds from many medicinal plants are reported to possess anti-viral and anti-inflammatory properties. The current study emphasizes on evaluating the inhibition efficacy of the phytocompounds from Andrographis paniculata against 10 structural and non-structural SARS-CoV2 proteins by virtual screening. Molecular docking, binding interactions, ADME and toxicity profiling of the selected fifty one phytocompounds were analysed and compared against 10 well studied repurposed drugs. The best docked complexes were subjected to MD simulation for 50 nanoseconds and the compound stigmasterol was observed to be outperforming in the simulation studies. We report that A.paniculata constitutes 65.78% druggable phytocompounds against SARS‐CoV2. We found that the two phytosterols, stigmasterol and stigmasta-5,22-dien-3-ol act as potential lead molecules against multiple target proteins of SARS–CoV2. Based on the literature evidence on Andrographis paniculata and our detailed analysis, this plant and its phytocompounds could be repurposed as a potential anti-COVID agent.