Including emergency and acute care as a global health priority

A recent important global meeting to set the international action agenda concerning non-communicable diseases (NCDs) failed to draw substantial attention from the emergency medical and surgical community. Advocacy efforts on the part of emergency clinicians should be increased to highlight the critical services we provide and create an approach to addressing NCDs with the most effective balance of preventive and acute care services. Acute care, which encompasses all frontline treatment services for sudden or unexpected injury or illness, can serve as a focal point for the development of the common language and body of research needed to draw the attention of global leaders and policy makers

A Review on Various Analytical Methodologies for Etoricoxib

Etoricoxib belongs to the class of highly selective COX-2 inhibitor NSAIDs. It is mostly used for the treatment of pain, arthritic conditions including rheumatoid arthritis and osteoarthritis. The current study focuses primarily on analytical and bioanalytical method development methodologies, as well as numerous methods established for the estimation of etoricoxib, whether in pharmaceutical dose form or in bulk. Analytical procedures are critical for determining compositions, as they allow us to obtain both qualitative and quantitative results utilising advanced analytical tools. The analytical method for Etoricoxib may be chromatographic, electrochemical, spectral or hyphenated.  These methods aid in the comprehension of critical process parameters as well as the minimization of their impact on precision and accuracy. Analytical method development is required to sustain high commercial product quality standards and to meet regulatory requirements. Following the reference, regulatory organisations in several nations have established standards and procedures for providing approval, authentication, and registration. Bioanalytical methods are designed to quantify the concentration of drug, metabolite, or typical biomarkers from various biological fluids including serum, urine, saliva and tissue extracts

Assessment of microbial contamination and oral health risks associated with handling of Indian currency notes circulating in Bengaluru city: A cross-sectional survey

Introduction: Accumulated data obtained over the last 20 years on the microbial status and survival of pathogens on currency notes indicate that this could represent a potential cause of sporadic cases of food borne illness. Objectives: To identify the micro-organisms present on the Indian currency notes and the oral health risks due to microbial contamination of Indian currency notes circulating in Bengaluru city. Materials and Methods: A cross-sectional survey was conducted and the Indian currency notes of various denominations (Rs. 10, Rs. 20, Rs. 50, Rs. 100, Rs. 500, and Rs. 1000) were collected from fruit vendors, hawkers, vegetable vendors, bus conductors, railway ticket counters, hotel counters, and butchers. Sample size was determined to be 70 Indian currency notes. Convenience sampling technique was used. Microbiological analysis of the collected currency notes was done. Results: The contamination rate of collected currency notes from the butchers and hawkers were 80% and 60% respectively. Staphylococcus aureus was present on 15 currency notes (21.42%) and was found to be higher in Rs. 10 than in other currency denominations. Streptococcus pyogenes was present on four currency notes (5.714%) of Rs. 10. Conclusion: The Indian currency notes circulating in Bengaluru city were contaminated with pathogenic bacteria. The oral health risks due to microbial contamination of Indian currency notes are acute pharyngitis, peritonsillar or retropharyngeal abscess, mastoiditis, sinusitis, otitis media, mild cellulitis, angular cheilitis, some endodontic infections, osteomyelitis of the jaw, parotitis, and oral mucositis

Haemorrhage control in severely injured patients

Most surgeons have adopted damage control surgery for severely injured patients, in which the initial operation is abbreviated after control of bleeding and contamination to allow ongoing resuscitation in the intensive-care unit. Developments in early resuscitation that emphasise rapid control of bleeding, restrictive volume replacement, and prevention or early management of coagulopathy are making definitive surgery during the first operation possible for many patients. Improved topical haemostatic agents and interventional radiology are becoming increasingly useful adjuncts to surgical control of bleeding. Better understanding of trauma-induced coagulopathy is paving the way for the replacement of blind, unguided protocols for blood component therapy with systemic treatments targeting specific deficiencies in coagulation. Similarly, treatments targeting dysregulated inflammatory responses to severe injury are under investigation. As point-of-care diagnostics become more suited to emergency environments, timely targeted intervention for haemorrhage control will result in better patient outcomes and reduced demand for blood products. Our Series paper describes how our understanding of the roles of the microcirculation, inflammation, and coagulation has shaped new and emerging treatment strategies

Sprayable Foams Based on an Amphiphilic Biopolymer for Control of Hemorrhage Without Compression

Hemorrhage (severe blood loss) from traumatic injury is a leading cause of death for soldiers in combat and for young civilians. In some cases, hemorrhage can be stopped by applying compression of a tourniquet or bandage at the injury site. However, the majority of hemorrhages that prove fatal are “non-compressible”, such as those due to an internal injury in the truncal region. Currently, there is no effective way to treat such injuries. In this initial study, we demonstrate that a sprayable polymer-based foam can be effective at treating bleeding from soft tissue without the need for compression. When the foam is sprayed into an open cavity created by injury, it expands and forms a self-supporting barrier that counteracts the expulsion of blood from the cavity. The active material in this foam is the amphiphilic biopolymer, hydrophobically modified chitosan (hmC), which physically connects blood cells into clusters via hydrophobic interactions (the hemostatic mechanism of hmC is thus distinct from the natural clotting cascade, and it works even with heparinized or citrated blood). The amphiphilic nature of hmC also allows it to serve as a stabilizer for the bubbles in the foam. We tested the hmC-based hemostatic foam for its ability to arrest bleeding from an injury to the liver in pigs. Hemostasis was achieved within minutes after application of the hmC foams (without the need for external compression). The total blood loss was 90% lower with the hmC foam relative to controls