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

DNA Fingerprinting of Crops and Its Significance in Crop Improvement

One of the improvements made possible by the era of genomics is DNA fingerprinting. DNA fingerprinting can be used to detect a variety of genetic changes. In breeding programmes fingerprinting is used to improve productivity and performance. Variety differentiation was relied on morphological characteristics prior to the introduction of genomics and proteomics approaches. Although morphological markers have been used for decades, protein-based markers like isozymes were discovered in the middle of the twentieth century and used for fingerprinting and crop genetic variety assessments. But nowadays, the emergence of genome sequencing has led to the widespread use of genetic markers for crop fingerprinting. The discovery of DNA-based genetic markers has improved genetic research. For genetic diversity estimation, crop evolution, gene mapping and phylogeny, diploid/haploid crop appraisal, heterosis analysis, varietal identification by using marker assisted selection (MAS), highly polymorphic DNA markers are generated. The use of DNA markers for crop fingerprinting started with RFLPs that did not involve PCR and subsequently advanced to PCR amplifiable markers such as AFLPs, RAPDs, SSRs, ISSRs, SNPs, and GBS.This review will provide an outlook on several types of markers and their significance in DNA fingerprinting of crops and possible applications, as well as suggestions for further research

Evaluation of Statin Prescribing Guidelines, Practices, Safety, Efficacy, and Pharmacoeconomic Study of Chronic Statin Therapy

Hyperlipidemia is a medical health condition, defined as increased total cholesterol, low-density lipoprotein cholesterol or triglycerides and low high-density lipoprotein cholesterol or a combination of such abnormalities. Statins are the most commonly used drugs in the present scenario in cardiovascular diseases for dyslipidemia condition. However, recent studies have shown a wide range of interventions regarding its use in patients receiving statin therapy. This study aims to evaluate various parameters that contribute in the choice of statin therapy which includes the prescribing habits of statins in accordance with the guidelines, safety, efficacy; prevalence of adverse drug reaction associated with statins and cost effectiveness analysis of statin tablets of different brands which are varying in their price. A hospital-based prospective study was conducted in Cardiology Department of Aster Prime Hospital, Hyderabad. A total of 170 cases were collected in case collection forms. Data in relation to age, gender, investigations done to obtain final diagnosis, and type of statin therapy opted based on the diagnosis made were collected. The results of the study are validated statistically using SPSS software which incorporates mean, standard deviation method, t test, and Chi-square test. Results obtained illustrate that Rosuvastatin was associated with less adverse effects and is considered to be more cost saving, safe, and efficacious when compared with Atorvastatin. It is crucial to find an effective and an equally safe treatment of statins to reduce the further risk of comorbidities associated with hyperlipidemia

A case of chromoblastomycosis in immune compromised patient

Chromoblastomycosis is a slowly growing fungal infection of skin and subcutaneous tissue. It is caused by a variety of pigmented fungal species growing in soil and decaying vegetation. We report a case of cutaneous chromoblastomycosis in a patient, who received chemotherapy and radiotherapy for carcinoma of gall bladder. A 40 years female patient had presented with vesiculobullous lesions coalesced to form plaques on both thighs and legs. Biopsy from vesiculobullous lesions was done. Histological features and special stains confirmed the diagnosis of Chromoblastomycosis

Cutaneous manifestations among COVID 19 patients admitted to a COVID hospital in South India

Introduction: COVID‐19 disease is caused by SARS COV-2 virus. Though it primarily affects the lower respiratory tract, recent reports have indicated that specific cutaneous manifestations are associated with COVID-19.Aim: To identify the cutaneous manifestations present among COVID-19 infected patients. Methods: A descriptive study on patients with active COVID-19 disease at a designated district COVID hospital was conducted for two months from Sept 1 to Oct 31, 2020. The demographics, severity of COVID disease, and co-morbidities were noted. The cutaneous examination was done to record the type of rash, site, and symptoms of rash. The results were statistically analyzed. Results: 1065 patients were included in our study, with 626 males and 439 females. The COVID disease severity was mild in 88.08% of patients. 48 cases (4.51%) had skin manifestations, of which 52.08% were males, and 47.92% were females. The majority, 33.34% of patients with skin manifestations, were in the age group of over 60 years, followed by 31.25 % of patients in the 41 – 60 years age group. 89.58% of these patients developed skin rash after the appearance of COVID symptoms. 85.42% of patients with rash had mild COVID disease. The most common symptom was itching (70.83%). Urticaria and Pruritus were the most common manifestations (25%), followed by Vesiculopapular Rash, Acral Erythema, Maculopapular Rash, Irritant Contact Dermatitis, Aphthous Ulcer, Herpes Zoster, Purpura, and others. The most common site of rash was the abdomen (29.17%).Conclusion: Prevalence of cutaneous manifestations among COVID-19 patients was 4.51% in our study, but more extensive research is required to further our knowledge on the relation between skin and COVID-19