Pharmacoenvironmentology – a component of pharmacovigilance

According to WHO, Pharmacovigilance activities are done to monitor detection, assessment, understanding and prevention of any obnoxious adverse reactions to drugs at therapeutic concentration on animal and human beings. However, there is also a growing focus among scientists and environmentalists about the impact of drugs on environment and surroundings. The existing term 'Ecopharmacology' is too broad and not even defined in a clear manner. The term 'Pharmacoenvironmentology' seeks to deal with the environmental impact of drugs given to humans and animals at therapeutic doses

Green Production and Structural Evaluation of Maize Starch–Fatty Acid Complexes Through High Speed Homogenization

© 2020, Springer Science+Business Media, LLC, part of Springer Nature. The current study describes the production of maize starch–fatty acid complexes through high speed homogenization, a novel field of research, without heat or any chemical treatment. The starch–fatty acid complexes were produced with three different fatty acids, i.e. stearic acid (T1), palmitic acid (T2) and lauric acid (T3). The complexes were analyzed through various techniques. The results reveal that the complexing index (CI), swelling power (SP) and solubility (S) for T1 were significantly higher compared to T2 and T3. In X-ray diffraction (XRD) studies, relatively lower crystalline (V-type pattern) structures were obtained for the samples T1–T3, where T2 showed the highest crystallinity amongst all. Fourier transformed infrared (FTIR) spectra showed characteristic bands i.e., OH, C=O, C–O and long-chain CH2 functionalities thus confirming the overall incorporation of acids into glycoside moieties. The Scanning electron microscopy (SEM) analysis showed sub-crystalline matrix structures with fewer or no spherulites indicating the overall incorporation of acids in starch. The samples showed relatively low thermal stability in the thermal gravimetric analysis (TGA) in the range of 180 to 280 °C. These results suggest that high speed homogenization had the potential for the development of green and biocompatible maize starch–fatty acid complexes

Rural road management in Botswana

This paper discusses the management of rural roads in Chobe in Botswana, which are mainly tertiary and access roads. These roads are low-volume roads and mostly gravelled. It was observed that the maintenance management of these roads was based on engineering judgement through visual inspection all over the country, without having any economic or technical analysis. Therefore, a comprehensive pavement management system for rural roads' maintenance is needed in Chobe and also in all the council areas of Botswana, which would consist of data collection, database, use of the Highway Development and Management Model to undertake efficient decision making project preparation, funding, implementation and feedback. A partial implementation of pavement management system in Chobe has been highlighted in this paper. The present analysis reveals that total demand for the road network in Chobe was 41·29 million pula, the backlog was 34·86 million pula and the first-year backlog demand was 20·63 million pula. Furthermore, the analysis found the long-term periodic maintenance strategy for the network at 6·43 million pula when there is no backlog. This huge backlog indicates that roads are not being maintained appropriately. The paper also estimates current road asset value in Chobe at 55·48 million pula. Finally, the paper recommends several solutions for the efficient preservation of road assets in Botswana

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Factors influencing failure of bank protection Embankment of Surma River

This paper highlights the probable causes of failure of existing bank protection works of the River Surma for safety of Sylhet, the northeastern city of Bangladesh. In this study, eight places were selected where the concerned authority implemented bank protection works. Observation shows that the soil particle of the embankment carries significant amount of clay, fine silt and fine dust, indicating that the soil of such areas is subjected to be eroded, which poses a great risk to the safety of this city. Moreover, the grain size analysis of all the selected locations shows that the effective diameter (d10) of the soil sample is much lower than the value used in the design calculation of the authority. In consequence of this the scour depth would be more than the calculated one. However, the study will give a better understanding of those factors causing deterioration to the protective structures

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

BackgroundTranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding.MethodsWe did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124.FindingsBetween July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98).InterpretationWe found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial.</div