Biomedical Waste Management – A Review

Bio-medical waste is generated mainly by health care establishments. The management of Bio-medical waste is still infant all across the world. It consists of Bio-medical waste as well as chemical waste with a portion of solid waste. This is a review paper which is prepared from the surveys of various research papers on improper biomedical waste. This research article is to survey the practice of biomedical waste such as collection, storage, transportation and disposal along with the amount of generated biomedical waste in various hospitals. Biomedical waste management is one of the biggest challenges of the present day times. It has a direct impact on the health of the citizen of that city. It is hazardous in nature. It’s safe and proper disposal is extremely important. As in many developing countries the generation of biomedical waste has increased significantly over the last few decades, management of this kind of waste continues to be a major challenge. Biomedical waste is generated in hospitals, research institutions, health care teaching institutes, clinics, laboratories, blood banks, animal houses and veterinary institutes. For proper management of bio-medical waste the Ministry of Environment and Forests has promulgated the Bio-Medical Waste (Management and Handling) Rules, 1998. Purpose of study was to highlight certain aspects of hospital waste management status. This paper will sensitize the reader about the impacts of improper waste management. Proper handling, treatment and disposal of the biomedical waste material are most important issue for the health of the human beings. The inadequate knowledge about the proper handling of biomedical waste can be dangerous to the health of common man as well as of health care personnel. This review discusses about various types of waste, its hazards and management

Computer aided Warship Stability Assessment

Computer aided warship stability assessment, software program effectively puts a ship stability expert onboard and provides ship board personnel with a rapid and accurate means to assess changes in vessel's stability. These changes may be :Routine - as the ship is loaded/unloaded in harbour or due to consumables enroute.Emergency - when the ship suffers collision/battle damage underway and begins to take on water.After assessing the stability status, the program helps the crew to determine the actions needed to restore optimum stability

Study on the Fecundity and Gonado somatic index of Rastrelliger kanagurta (Cuvier, 1817) of southern coast of Maharashtra, India

Investigation of fecundity and gonado somatic index (GSI) of Rastrelliger kanagurta were carried out from March 2011 to February 2012. Fecundity was determined at different length, weight and ovary ranges of different individual fishes. Study revealed that at 5% significant level significant average absolute fecundity was found to be 1,08,266 and relative fecundity ranged from 407 to 1499. The number of ova generally increased with increase in length and weight. However, variations in fecundity with respect to length and weight were also noticed. The gonado-somatic index (GSI) was calculated for each individual fish (592 numbers) and was averaged for each month. The average GSI values were plotted against each month to analysed monthly variations. GSI showed wide variations between sex and it was highest for both males and females during the month of April and September, showing occurrence of more ripe individuals. Analysis of regression showed that there were significant relationship between the fecundity with the fish length, body weight and ovary weight

Treatment gap and barriers for mental health care: A cross-sectional community survey in Nepal.

CONTEXT: There is limited research on the gap between the burden of mental disorders and treatment use in low- and middle-income countries. OBJECTIVES: The aim of this study was to assess the treatment gap among adults with depressive disorder (DD) and alcohol use disorder (AUD) and to examine possible barriers to initiation and continuation of mental health treatment in Nepal. METHODS: A three-stage sampling technique was used in the study to select 1,983 adults from 10 Village Development Committees (VDCs) of Chitwan district. Presence of DD and AUD were identified with validated versions of the Patient Health Questionnaire (PHQ-9) and Alcohol Use Disorder Identification Test (AUDIT). Barriers to care were assessed with the Barriers to Access to Care Evaluation (BACE). RESULTS: In this sample, 11.2% (N = 228) and 5.0% (N = 96) screened positive for DD and AUD respectively. Among those scoring above clinical cut-off thresholds, few had received treatment from any providers; 8.1% for DD and 5.1% for AUD in the past 12 months, and only 1.8% (DD) and 1.3% (AUD) sought treatment from primary health care facilities. The major reported barriers to treatment were lacking financial means to afford care, fear of being perceived as "weak" for having mental health problems, fear of being perceived as "crazy" and being too unwell to ask for help. Barriers to care did not differ based on demographic characteristics such as age, sex, marital status, education, or caste/ethnicity. CONCLUSIONS: With more than 90% of the respondents with DD or AUD not participating in treatment, it is crucial to identify avenues to promote help seeking and uptake of treatment. Given that demographic characteristics did not influence barriers to care, it may be possible to pursue general population-wide approaches to promoting service use

Changes in expression of polyamines and ethylene biosynthesis genes in groundnut (Arachis hypogaea L.) genotypes during Sclerotium rolfsii infection

Stem rot disease caused by fungal pathogen, Sclerotium rolfsii Sacc., is potential threat to groundnut production in warm and humid condition. After host-pathogen interaction, a multitude of plant resistance associated reactions are initiated. In the present investigation we studied the role of polyamines and ethylene during host-pathogen interaction in stem rot tolerant (CS319, GG17 and GG31) and susceptible (TG37A) groundnut genotypes at 24, 48 and 72 h after infection. Stem rot tolerant genotypes showed higher expression of polyamine biosynthesis genes ornithine decarboxylase (Ordec), spermine synthase (Sms) and lipoxygenase1 (LOX1) gene at 72 h after infection than that of susceptible genotype TG37A. The expression analysis of ethylene biosynthesis genes (1-aminocyclopropane-1-carboxylate oxidase: ACCO and (ACCS) showed up regulation in stem rot susceptible genotype TG37A than that of tolerant genotypes after infection at all stages (24, 48 and 72 h after infection). The expression of amine oxidase (AMO) gene was observed highest in stem rot susceptible genotype TG37A while minimum in GJG31. Expression of this gene was remarkably induced in TG37A which may leads to higher accumulation of H2O2. Higher content of a polyamine, putrescine was found in the leaves of stem rot tolerant genotypes at 48 and 72 h after infection. These results implied that tolerant genotypes induced higher polyamine biosynthesis which may involve in plant defense and impart tolerance/ resistance. While, susceptible genotype (TG37A), utilized higher flux of S-Adenosyl methionine (SAM) for ethylene biosynthesis which may leads to necrosis of plants. Thus, stem rot resistant genotypes may be developed through genetic manipulation of polyamine biosynthesis pathway

Experimental study of neutron irradiation effect on elementary semiconductor devices using Am-Be neutron source

40-47An experiment has been conducted to evaluate the lifetime, reliability and operational performance of elementary semiconductor devices in the neutron radiation environment which supports to reduce the fatal in measurements and plan the preventive actions in nuclear facilities. It will also support the enhancement of electronics for nuclear facilities. The elementary semiconductor devices used in the experiment are Diode (1n4007), Zener Diode (5.1v), Light Emitting Diode, Transistor (BC547, 2n3904), Voltage controlling IC (7805), Operational Amplifier (LM741) and Optocoupler (4n35). The selection of devices has been made by keeping in mind their application in transmitting devices (i.e. Temperature transmitter, pressure transmitter, flow transmitter, monitors and controllers) for Indian test blanket system in ITER. Such devices are also used in general nuclear electronics. The devices have been irradiated in the Am-Be neutron source environment. The maximum fluence has been given up to 1011 n/cm2. The neutron source has energy range from low to high. All semiconductor devices have been characterized before and after irradiations. The deviation of 5 - 10% is observed in diodes I-V characteristics whereas transistors show a bit higher deflection in basic functionality. Optocoupler shows more than 50% deviation in its basic characteristics whereas voltage-controlling IC is not even functioning after the irradiation of 1011 n/cm2. The paper describes the details of the experiment and the behavior of semiconductor devices after irradiation. The experiment supports the selection and further research of the Indian test blanket system instruments

A Genetically Hard-Wired Metabolic Transcriptome in Plasmodium falciparum Fails to Mount Protective Responses to Lethal Antifolates

Genome sequences of Plasmodium falciparum allow for global analysis of drug responses to antimalarial agents. It was of interest to learn how DNA microarrays may be used to study drug action in malaria parasites. In one large, tightly controlled study involving 123 microarray hybridizations between cDNA from isogenic drug-sensitive and drug-resistant parasites, a lethal antifolate (WR99210) failed to over-produce RNA for the genetically proven principal target, dihydrofolate reductase-thymidylate synthase (DHFR-TS). This transcriptional rigidity carried over to metabolically related RNA encoding folate and pyrimidine biosynthesis, as well as to the rest of the parasite genome. No genes were reproducibly up-regulated by more than 2-fold until 24 h after initial drug exposure, even though clonal viability decreased by 50% within 6 h. We predicted and showed that while the parasites do not mount protective transcriptional responses to antifolates in real time, P. falciparum cells transfected with human DHFR gene, and adapted to long-term WR99210 exposure, adjusted the hard-wired transcriptome itself to thrive in the presence of the drug. A system-wide incapacity for changing RNA levels in response to specific metabolic perturbations may contribute to selective vulnerabilities of Plasmodium falciparum to lethal antimetabolites. In addition, such regulation affects how DNA microarrays are used to understand the mode of action of antimetabolites

Kinetics and Ligand-Binding Preferences of Mycobacterium tuberculosis Thymidylate Synthases, ThyA and ThyX

Mycobacterium tuberculosis kills approximately 2 million people each year and presents an urgent need to identify new targets and new antitubercular drugs. Thymidylate synthase (TS) enzymes from other species offer good targets for drug development and the M. tuberculosis genome contains two putative TS enzymes, a conventional ThyA and a flavin-based ThyX. In M. tuberculosis, both TS enzymes have been implicated as essential for growth, either based on drug-resistance studies or genome-wide mutagenesis screens. To facilitate future small molecule inhibitors against these proteins, a detailed enzymatic characterization was necessary.After cloning, overexpression, and purification, the thymidylate-synthesizing ability of ThyA and ThyX gene products were directly confirmed by HPLC analysis of reaction products and substrate saturation kinetics were established. 5-Fluoro-2'-deoxyuridine 5'-monophosphate (FdUMP) was a potent inhibitor of both ThyA and ThyX, offering important clues to double-targeting strategies. In contrast, the folate-based 1843U89 was a potent inhibitor of ThyA but not ThyX suggesting that it should be possible to find ThyX-specific antifolates. A turnover-dependent kinetic assay, combined with the active-site titration approach of Ackermann and Potter, revealed that both M. tuberculosis enzymes had very low k(cat) values. One possible explanation for the low catalytic activity of M. tuberculosis ThyX is that its true biological substrates remain to be identified. Alternatively, this slow-growing pathogen, with low demands for TMP, may have evolved to down-regulate TS activities by altering the turnover rate of individual enzyme molecules, perhaps to preserve total protein quantities for other purposes. In many organisms, TS is often used as a part of larger complexes of macromolecules that control replication and DNA repair.Thus, the present enzymatic characterization of ThyA and ThyX from M. tuberculosis provides a framework for future development of cell-active inhibitors and the biological roles of these TS enzymes in M. tuberculosis

Treatment patterns and clinical outcomes

BACKGROUND: Treatment resistant depression (TRD) characterizes a subgroup of 10-30% of patients with major depressive disorder, and is associated with considerable morbidity and mortality. A consensus treatment for TRD does not exist, which often leads to wide variations in treatment strategies. Real-world studies on treatment patterns and outcomes in TRD patients in Europe are lacking and could help elucidate current treatment strategies and their efficacy. METHODS: This non-interventional cohort study of patients with TRD (defined as treatment failure on ≥2 oral antidepressants given at adequate dose and duration) with moderate to severe depression collected real-world data on treatment patterns and outcomes in several European countries. Patients were started on a new treatment for depression according to routine clinical practice. RESULTS: Among 411 patients enrolled, after 6 months, only 16.7% achieved remission and 73.5% showed no response. At Month 12, while 19.2% achieved remission and 69.2% showed no response, 33.3% of those in remission at Month 6 were no longer in remission. Pharmacological treatments employed were heterogenous; 54 different drugs were recorded at baseline, and the top 5 treatment types according to drug classes accounted for 40.0% of patients. Even though remission rates were very low, at Month 12, 60.0% of patients had not changed treatment since enrolment. CONCLUSIONS: The heterogeneity of treatments highlights a lack of consensus. Moreover, despite low response rates, patients often remained on treatments for substantial periods of time. These data further support existence of an unmet treatment need for TRD patients in Europe.publishersversionpublishe

Healthcare resource utilization

Background: Treatment resistant depression (TRD) is diagnosed when patients experiencing a major depressive episode fail to respond to ≥2 treatments. Along with substantial indirect costs, patients with TRD have higher healthcare resource utilization (HCRU) than other patients with depression. However, research on the economic impact of this HCRU, and differences according to response to treatment, is lacking. Methods: This multicenter, observational study documented HCRU among patients with TRD in European clinical practice initiating new antidepressant treatments. Data regarding access to outpatient consultations and other healthcare resources for the first 6 months, collected using a questionnaire, were analyzed qualitatively according to response and remission status. The economic impact of HCRU, estimated using European costing data, was analyzed quantitatively. Results: Among 411 patients, average HCRU was higher in non-responders, attending five times more general practitioner (GP) consultations and spending longer in hospital (1.7 versus 1.1 days) than responders. Greater differences were observed according to remission status, with non-remitters attending seven times more GP consultations and spending approximately three times longer in hospital (1.7 versus 0.6 days) than remitters. Consequently, the estimated economic impacts of non-responders and non-remitters were significantly greater than those of responders and remitters, respectively. Limitations: Key limitations are small cohort size, absence of control groups and generalizability to different healthcare systems. Conclusion: Patients with TRD, particularly those not achieving remission, have considerable HCRU, with associated economic impact. The costs of unmet TRD treatment needs are thus substantial, and treatment success is fundamental to reduce individual needs and societal costs.publishersversionpublishe