Analysis of Dynamical Systems for Synthesis of Phenobarbital

The use of mathematical methods for the analysis of chemical reaction systems is one of the useful tools. Phenobarbital (a barbiturate type medication also called phenobarb) is a prescription drug used to control seizures, relieve anxiety, treat epilepsy (in some countries), and prevent withdrawal symptoms in people dependent on other barbiture drugs. We approaches it with matrix analysis and ODE system. It helps us understand the chemical stoichiometry of these synthesis reactions. Supervisor: Prof. Seonguk Kim, Ph

Engaging for-profit providers in TB control: lessons learnt from initiatives in South Asia.

There has been a huge expansion in the private health-care sector over the past two decades, particularly in South Asia, resulting in over 80% of patients seeking care from private health providers. Despite concerns about the quality and equity of private sector service provision, most government public health bodies recognize that the private sector reaches individuals that public institutions cannot cater to, thereby being important in moving closer to universal health coverage. Numerous initiatives have been launched and are being planned to involve private practitioners in effectively diagnosing, reporting and managing infectious diseases such as tuberculosis. However, there is a notable dearth of papers discussing which elements of private sector engagement strategies are more or less successful and the ethical issues that arise when engagement strategies are operationalized. This article brings together the authors' experiences of working on projects to engage private allopathic health providers in Pakistan, Bangladesh and India for improved tuberculosis control. Motivations of and strategies required to engage private allopathic heath providers, specifically doctors, diagnostic laboratories and pharmacies, and some of the ethical issues that arise when designing programmes for engagement are discussed

A Game Theoretic Analysis of International Justice Disputes

This paper works toward analyzing international justice disputes, through a game theoretic lens. The result of such an analysis is an accurate working model for the international justice dispute resolution process, limiting its scope to those disputes that fall under the International Court of Justice’s jurisdiction post 1986. This time limitation on the explanatory power of the model was deduced from all of the court’s findings since its inception. The game can be formed in four ways: perfect information, incomplete information, no information, and partial information, all of which have their own unique equilibria, which are formed and discussed individually

A Carrier Without Sympathy

This paper talks about the series of events that happened before and after Mary Mallon, more commonly and widely known as Typhoid Mary, was officially identified as the first asymptomatic and healthy carrier of typhoid. The paper highlights the ways the authorities and health officials dealt with Mary Mallon with respect to her intersectional identities of gender, race, class, and immigration status. It briefly reflects on some of the literary pieces surrounding Typhoid Mary as supporting sources to explore and understand how communities react and approach such situations and the ways authorities handled unknown contagious diseases and critique how specific elements within the aspect of storytelling portray these diseases in literature and the ethical and moral concerns of both. More specifically, it was identified how storytelling impacted the way the story of Mary Mallon is told to this day and how imagery served a supporting role to storytelling. It also addresses extensively the idea of individual autonomy and how that was challenged when Mary Mallon was quarantined and whether her quarantine was in fact isolation or merely a politically sheltered version of incarceration. The essay can be viewed as a reflective exercise of our past reactions, individual and communal, to new and unknown illnesses, especially during the current pandemic, to see how we can better prepare ourselves to appropriately handle similar situations in the future. This was an exercise to recognize and understand how we have channeled unknown emotions into fear and hatred and to what extent can such actions affect an individual’s life

Drug-drug interactions between antiretrovirals and bedaquiline

Tuberculosis (TB) is a leading cause of morbidity and mortality worldwide. People living with HIV are particularly susceptible to TB infection, and treatment of HIV-TB co-infection is challenging for multiple reasons, including potential drug-interactions. Drug-resistant TB is difficult to treat and is associated with high treatment failure rates, mainly because the antimycobacterial drugs currently available are ineffective against drug-resistant TB. Bedaquiline is a new antimycobacterial drug which has shown great promise through its excellent efficacy for treating drug-resistant TB. Being a new drug, however, potential drug interactions with antiretrovirals are a major concern. Bedaquiline is metabolized in the liver by an enzyme called cytochrome P450 3A (CYP3A). The antiretrovirals nevirapine, efavirenz, and lopinavir/ritonavir (LPV/r) can affect the activity of this enzyme, and consequently affect the concentration of bedaquiline in the patient's blood. Nevirapine and efavirenz increase the activity of CYP3A, which may result in increased metabolism of bedaquiline, thus decreasing the concentration of bedaquiline, with consequent risk of treatment failure or the further development of drug-resistance. LPV/r inhibits the CYP3A enzyme, which may result in decreased bedaquiline metabolism, thus causing high concentration of bedaquiline in the blood, with consequent risk of toxicity. We conducted a pharmacokinetic study in 43 adult patients with drug-resistant TB to evaluate the drug-interactions between bedaquiline and the antiretrovirals nevirapine and LPV/r. We did serial measurements of the bedaquiline concentration in their plasma over 48 hours, and compared these concentrations in patients who were on antiretroviral and those who were not on antiretrovirals. Our results showed that nevirapine had no significant effect on bedaquiline concentrations, while patients on LPV/r had bedaquiline concentrations 2 fold higher than patients not on antiretrovirals. We could not determine the clinical significance of this, but recommend that patients receiving LPV/r and bedaquiline in combination must be closely monitored for side-effects