PHARMACOVIGILANCE IN THE ERA OF COVID-19: A CONCISE REVIEW OF THE CURRENT SCENARIO, IMPLICATIONS, AND CHALLENGES

The pandemic of Coronavirus Disease 2019 (COVID-19) has now affected the entire globe which was first surfaced in China in December 2019. In absence of effective therapy to manage COVID-19, repurposed therapies were being used to manage the condition. In view of an urgent need for definitive therapy, multiple repurposed drugs, and investigational drug candidates are being tried in clinical trials which may lead to the emergence of unknown short term and long term adverse drug reactions (ADRs), and hence it is crucial to assess the safety of the tried therapeutic interventions. The lag in the pharmacovigilance activities in the midst of this pandemic fosters under-reporting of ADRs. Difficulty in causality assessment due to factors like wide variations in clinical presentation, concomitant use of multiple drugs, associated comorbidities, drug-drug and drug-disease interaction which forestalls the appropriate causality assessment. Hydroxychloroquine, a repurposed antimalarial drug has been a part of hue and cry at present because of its in-question safety in patients with cardiac disorders. National and International Drug monitoring centers have stressed upon reporting of ADRs and to boost up the process and come up with various recommendations. We can overcome these issues by working cohesively, motivating HCPs and patients to report ADRs electronically, and by setting up dedicated pharmacovigilance rapid response team to tackle the issues at the earliest

AN OVERVIEW ON INFECTION PREVENTION AND CONTROL PRACTICES AND BIOMEDICAL WASTE MANAGEMENT (BMWM) IN COVID-19 ERA

The ongoing Coronavirus disease (COVID-19) pandemic has affected the almost entire world and has hit the healthcare and economic sector with a hard blow. The Government imposed lockdowns in almost all part of the world has not only affected the global economy but also has harsh effects on physical and mental health of people around the world. To date, there is no specific and defined treatment or vaccine available for its prophylaxis and treatment; hence preventive strategies like Infection prevention and control (IPC) practices and proper disposal of biomedical waste (BMW) play key role in preventing transmission of the infection in the healthcare sector among healthcare professionals. Ethically, we all should follow the IPC and BMW guidelines soulfully to prevent ourselves and fellow workers from getting infected. The review highlights the salient features of the IPC and BMWM (Biomedical waste management) practices in concise manner for better understanding and implementation at this crucial period of COVID-19 pandemic

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Determination of band alignment at two-dimensional MoS2/Si van der Waals heterojunction

To understand the different mechanism occurring at the MoS2-silicon interface, we have fabricated a MoS2/Si heterojunction by exfoliating MoS2 on top of the silicon substrate. Raman spectroscopy and atomic force microscopy (AFM) measurement expose the signature of few-layers in the deposited MoS2 flake. Herein, the temperature dependence of the energy barrier and carrier density at the MoS2/Si heterojunction has been extensively investigated. Furthermore, to study band alignment at the MoS2/Si interface, we have calculated a valence band offset of 0.6660.17 eV and a conduction band offset of 0.4260.17 eV using X-ray and Ultraviolet photoelectron spectroscopy. We determined a type-II band alignment at the interface which is very conducive for the transport of photoexcited carriers. As a proof-of-concept application, we extend our analysis of the photovoltaic behavior of the MoS2/Si heterojunction. This work provides not only a comparative study between MoS2/p-Si and MoS2/n-Si heterojunctions but also paves the way to engineer the properties of the interface for the future integration of MoS2 with silicon

Scrub typhus: an important differential diagnosis of acute and subacute febrile illness

Background: Scrub typhus is an acute febrile illness caused by an obligate intracellular organism Orientia tsutsugamushi. The name is derived from the vegetation type that usually harbors the vectors. Scrub typhus is endemic to a distinct region, the tsutsugumashi triangle, which include Japan, Taiwan, China and South Korea.Scrub typhus is known to occur all over India including the north hilly areas. Cases of scrub typhus from State of Bihar are few and that too reported from hospitals of other states. Objectives: This study was undertaken to determine the prevalence of scrub typhus in patients presenting with acute and subacute febrile illness, to study the clinical profile and to assess the utility of Enzyme-Linked Immunosorbent Assay for sero diagnosis of scrub typhus.Methods: We undertook a retrospective , cross sectional study at a tertiary care super speciality teaching hospital in over a period of 18 months from January 2016 to July 2017. Patients presenting with acute and sub-acute undifferentiated febrile illness, admitted in department of general medicine were included in the study Results: Out of total 144 admitted patients of acute and sub-acute undifferentiated febrile illness, 18 were found to be suffering from scrub typhus. It was 12.5% of total cases of undifferentiated febrile illness. The disease was prevalent in all age group including old age. 61% of patients with scrub typhus were female and 39% were male. All 18 patients had fever as chief complaint. Other common complaints were chills, myalgia, abdominal pain and yellow discoloration of urine. Eschar were found in five patients.Conclusions Early diagnosis is essential to reduce the morbidity and mortality in scrub typhus. Laboratory diagnosis is based mainly on serological tests

Highly selective and reversible NO2 gas sensor using vertically aligned MoS2 flake networks

We demonstrate a highly selective and reversible NO2 resistive gas sensor using vertically aligned MoS2 (VA-MoS2) flake networks. We synthesized horizontally and vertically aligned MoS2 flakes on SiO2/Si substrate using a kinetically controlled rapid growth CVD process. Uniformly interconnected MoS2 flakes and their orientation were confirmed by scanning electron microscopy, x-ray diffraction, Raman spectroscopy and x-ray photoelectron spectroscopy. The VA-MoS2 gas sensor showed two times higher response to NO2 compared to horizontally aligned MoS2 at room temperature. Moreover, the sensors exhibited a dramatically improved complete recovery upon NO2 exposure at its low optimum operating temperatures (100 degrees C). In addition, the sensing performance of the sensors was investigated with exposure to various gases such as NH3, CO2, H-2, CH4 and H2S. It was observed that high response to gas directly correlates with the strong interaction of gas molecules on edge sites of the VA-MoS2. The VA-MoS2 gas sensor exhibited high response with good reversibility and selectivity towards NO2 as a result of the high aspect ratio as well as high adsorption energy on exposed edge sites