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Hospital waste has always been a concern for the society. Recently the government has changed the BMW handling rules in 2016. However, mere introduction of laws is not sufficient for proper disposal of BMW. Awareness of these laws is also essential. Hence, this study was conducted with the objectives to assess the Knowledge, awareness, attitude & practice (KAP) towards biomedical waste management in Health care providers (HCP) and prevalence of needle-stick injury (NSI) in them.This was a cross-sectional study done from August 2018 to January 2019 in KIMS among 400 participants. A pre-tested, close ended questionnaire was used with few added questions related to new rules. An overall average level of KAP among HCP and grade 4 workers regarding BMW Rules and management 2016 with 86.49% doctors, 91.04% dentists, 79.55% nurses and 80% grade 4 workers securing average marks in the assessment. Moreover, 14 (20 .59%) doctors, 10 (14 .71%) dentists, 30 (44 .12%) nurses and 14 (20.59%) grade 4 workers reported that they had experienced NSI in the past 12 months. Overall prevalence of NSI is found to be 17%. We found an average level of knowledge, attitude and practice among HCP and grade 4 workers regarding BMW management. It is recommended that regular monitoring and training are required at all levels of Health Care System and the rules should be sincerely followed and practiced.

Background: Human in close inhabitation with the cattle due to unventilated or inadequately ventilated establishments or inadequate living space, is always at a risk of sustaining infection from the cattle through different modes of disease transmission. This study hints at the increased incidences in respiratory infections among dairy workers in unorganized and small scale dairy farms due to amendable unhygienic practices. Methods: This survey was part of a larger study, conducted after ethics approval. Number of households involved in dairy work surveyed were 60. From every house, two members actively involved in dairy work were chosen and total respondents were 120. The study tool was a semi structured, mixed questionnaire. Results: 67.5% dairy workers self-reported occurrence of respiratory symptoms which included the complaints like cough,breathing difficulty on exertion. None of the dairy workers were vaccinated against any milk borne disease.Conclusion: The housing, civic amenities accessed by them and their awareness are probably the main reasons for wide variety of self perpetuated practices and deviations of standard requirement.Use of protective gear (gloves,caps,masks) should be strictly emphasized and popularized.

Wrist fractures are one among the common injuries of the elderly leading to reduced quality of life and impaired functionality, if not treated and restored adequately. Factors like asymmetry of vestibular function, decreased plantar sensation, unstable posture and functional disability have been more commonly associated with fall related wrist fractures among the geriatric population. Since wrist fractures are considered as an indicator for fracture incidence in the future specially for hip fractures, preventive measures like improving balance, function of the balance system in the inner ear and feeling in people’s feet can be timely adopted which in addition might be helpful in rehabilitation of patients with fractured wrist.To determine effect of multi sensory training (MST) on posture (muscle strength), vestibular function, vibration perception, tactile sensation and functional ability compared to wrist stabilization training (WT) among elderly with fall related wrist fractures.Experimental research design was adopted for the study among the 130 follow up cases of wrist fracture where 88 participants were randomized to Multi Sensory Training and 42 received Wrist stabilization Training. The training period was 12 weeks, with 4 supervised sessions by a physiotherapist and home exercises for both groups. Pre and post training measurements included Head Shake Test (HST), Semmes–Weinstein Monofilaments (SWM), Vibration perception Test, 10m Walk Test (10MWT), Five Times Sit to Stand Test (FTSTS), Activities Specific Balance Confidence (ABC) and Dizziness Handicap Inventory Scales (DHI). FTSTS, ABC, DHI were found to be statistically significant between the 2 groups. In contrast to wrist stabilization training, MST was more helpful in improving HST (p=0.001). Vestibular function among the cases of wrist fracture was better with Multi Sensory Training. It may be applied as a routine training intervention post fracture treatment. A robust sample size can be taken up to generalize its effectiveness.

Drug induced liver injury (DILI) is a rare but severe adverse drug reaction seen in pharmacotherapy and a major cause of post-marketing drug withdrawals. Advances in genome-wide studies indicate that genetic and epigenetic diversity can lead to inter-individual differences in drug response and toxicity. It is necessary to identify how the genetic variations, in the presence of environmental factors can contribute to development and progression of DILI. Studies on microRNA, histone modification and DNA methylation, SNPs related to DILI were retrieved from databases and were analyzed for the current research and updates develop this narrative review. We have compiled some of the major genetic, epigenetic, pharmacogenetic factors leading to DILI. Many validated genetic risk factors of DILI, such as variants of drug-metabolising enzymes, HLA alleles and some transporters were identified. In conclusion, these studies provide useful information in risk alleles identification and implementing personalised medicine.

A virtual screening approach based on a five-feature pharmacophoric model for negative modulators of GLI1 was applied to databases of commercially available compounds. The resulting quinoline derivatives showed significant ability to reduce the GLI1 protein level and were characterized by submicromolar antiproliferative activity toward human melanoma A375 and medulloblastoma DAOY cell lines. Decoration of the quinoline ring and chemical rigidification to an oxazino-quinoline scaffold allowed us to deduce SAR considerations for future ligand optimization.

Needle stick injuries are preventable causes of fearsome diseases like Hepatitis B and HIV. In spite of this knowledge, the health care providers are quite negligent, and the institutional support too is compromised due to the increased demand for services. The current study is a dipstick audit of the knowledge and practices on NSI (prevention and management) among exposed health care workers, with specific reference to HIV infection in a private health facility in Bhubaneswar city, using an unorthodox tool of Focus Group Discussions among the participants.: The exercise was a part of the academic activity of health promotion on World AIDS Day 2021. Health care workers such as doctors, paramedical staff & utility staff voluntarily participated in the FGD session. Total 3 FGDs were conducted at 3 different places inside the hospital premises. Three moderators were selected previously and after discussing the theme of World AIDS Day, they guided the FGDs with similar probing questionnaires. The sessions were recorded with the help of a recorder and also noted down along with Sociograms. The data gave a real picture of how even premier institutions are complacent regarding the problem. Only 27% knew about the SOPs, and in none of the stations,SOPs were displayed or a register was maintained regarding NSI in their work area. None of the participants were aware of Post Exposure Prophylaxis for the same. This indeed highlighted an ignored aspect of quality health care. The data was an eye-opener in a tertiary care center and from time to time there should be refresher training or sessions to increase the level of awareness.

PurposeAfter each of the COVID-19-induced lockdowns, an unprecedented surge in leisure travel was observed, resulting in tourists flocking to places of tourist interest. This phenomenon was termed revenge travel in popular literature. The purpose of this study is to explore the phenomenon of revenge travel in detail through an academic lens. It examines the psychological and emotional motivations for revenge travel while studying the differences in travel behaviour pre- and post-pandemic.Design/methodology/approachThe study applies an interpretive phenomenological approach to explore post-pandemic travel behaviour. Data were collected via personal in-depth semi-structured interviews. Thematic analysis of the transcripts was conducted to arrive at discussion themes.FindingsDrawing on the established theories, the findings of the study indicate that lockdown fatigue coupled with mortality salience induced individuals towards leisure travel. This in turn led to mood alleviation and compensation for the deprivation undergone.Practical implicationsThe study reveals important insights into post-pandemic preferences of travel destinations (off-beat locations near urban clusters), accommodation options (more travellers choosing home stays and stand-alone properties) and vacation itineraries (a gradual shift towards slow tourism with more focus on immersive experiences). Further, there are indications that hotels may develop “workcations” and “staycations” as a new line of offering.Originality/valueThe study adds to the small body of knowledge on revenge travel. It adopts a phenomenological approach, thereby capturing the “lived experiences” of the participants and providing an in-depth look into the psychological and emotional motivations of revenge travel that have not been explored previously. The study provides insights into the travellers' psychology post a period of withdrawal and restraint.

A new polymeric membrane sensor for Cd(II) ion based on methyl acrylate-acrylonitrile-methyl methacrylate terpolymer as membrane carrier has been synthesized via atom transfer radical polymerization (ATRP) method at 60 ºC. Preliminary investigation with the membrane exhibited promising selectivity for Cd(II) ion with a slope of 32.02 mV/decade and the same could be estimated in the concentration range of 1 × 10-6 − 1 × 10-1 M in the working pH range of 4-6 for up to 90 days. The potentials generated across the membrane were reproducible and the response time was less than one minute. The electrode works well even in a partially non-aqueous media. The effect of surfactant and detergent on the working of Cd(II) selective electrode was also studied. A decrease in potential was observed in the presence of appreciable amount of surfactant and detergent. Addition of plasticisers was found to greatly improve the performance of membrane, best results being obtained with the membrane ratio (NaTPB:TP:TBP::1:100:06), exhibiting a working concentration range of 1 × 10-6 − 1 × 10-1 mol L-1 with a short response time of 10 s. The proposed sensor shows significantly good selectivity toward Cd(II) ion in comparison with some alkali, alkaline earth, transition and heavy metal ions. It was successfully employed as an indicator electrode in potentiometric titration of cadmium(II) ions against EDTA solution.

Visceral leishmaniasis is a neglected protozoan disease with high mortality. Existing treatments exhibit a number of limitations, resulting in a significant challenge for public health, especially in developing countries in...

Background: Dairy work is thought to be predominantly a rural occupation. However, due to preferences we see a lot of urban residents consume fresh milk and hence, few people even in the urban areas take up cattle rearing as a cost effective profession. In the midst of much talked re-emerging diseases, caused by close habitation of animals and man, it would be very relevant to see living conditions of these populations and their hygiene practices in a space compromised scenario. In urban settings, they stay in close proximity and due to socioeconomic conditions, dairy workers in do not have appropriate amenities to tend on the cattle,clean or even scope for proper waste disposal. This in nutshell, leads to a disease enabling environment and the study aims at reviewing these living conditions. Besides, an assessment of health conditions of the dairy workers, their awareness regarding the milk borne diseases(MBD) was done. The findings helped generate recommendations for improvement of the profession and ultimately the quality of the milk. Objectives:1) Assess the hygiene practices during the stages of milk collection, storage and transport of milk among the sampled dairy workers from urban unorganized settings of Bhubaneswar. 2) Assess awareness of these workers regarding milk borne diseases. Methodology: This cross?sectional survey was part of a larger study and was conducted in unorganized sector of dairy workers in Bhubaneswar. 60 dairy households were surveyed and from each household, 2 members actively involved in dairy work were selected.The study tool was a semi structured, mixed questionnaire. The questionnaire had 3 sections; A was regarding household information(General sociodemographic details and Housing conditions for 60 HHs); B was to elicit the hygiene status of dairy workers(n=120) during each step of their work, their milk handling details during milk collection, storage and transportation; C had questions to assess the awareness of dairy worker regarding MBD. Results: Hygiene practices were very dismal at all points like milking,storage and transportation. Only 5.0% dairy households practised cleaning udder twice- prior to and after milking. Only 35% households kept the milk storage containers covered. 44.2% workers agreed that “MBD” is a community health problem. On general examination, pallor and icterus was found among workers. This strongly brings out that this group not only have the potential to be infected by zoonotic diseases, but can also transmit it to through the milk they are selling. A felt need is assessed for these workers in terms of creating standards of hygiene practices of cattle and milk handling and also impart them training on improving their occupational practices.

Selective permeability of the blood-brain barrier restricts the treatment efficacy of neurologic diseases. Berberine (BBR) and curcumin (CUR)-loaded transferosomes (TRANS) were prepared for the effective management of Alzheimer's disease (AD). The study involved the syntheses of BBR-TRANS, CUR-TRANS, and BBR-CUR-TRANS by the film hydration method. Vesicles were characterized to ensure the formation of drug-loaded vesicles and their in vivo performance. The particle sizes of BBR-TRANS, CUR-TRANS, and BBR-CUR-TRANS were 139.2 ± 7, 143.4 ± 8, and 165.3 ± 6.5 nm, respectively. The presence of diffused rings in the SED image indicates the crystalline nature of the payload. Low surface roughness in an AFM image could be associated with the presence of a surface lipid. BBR-CUR-TRANS showed 41.03 ± 1.22 and 47.79 ± 3.67% release of BBR and 19.22 ± 1.47 and 24.67 ± 1.94% release of CUR, respectively, in phosphate buffer saline (pH 7.4) and acetate buffer (pH 4.0). Formulations showed sustained release of both loaded drugs. BBR-TRANS, CUR-TRANS, and BBR-CUR-TRANS exhibited a lower percentage of hemolysis than pure BBR and CUR, indicating the safety of the payload from delivery vesicles. Lower percentages of binding were recorded from BBR-CUR-TRANS than BBR-TRANS and CUR-TRANS. Acetylcholinesterase inhibition activity of the prepared transferosomes was greater than that of pure drugs, which are thought to have good cellular penetration. The spatial memory was improved in treated mice models. The level of malondialdehyde decreased in AD animals treated with BBR-TRANS, CUR-TRANS, and BBR-CUR-TRANS, respectively, as compared to the scopolamine-induced AD animals. BBR-CUR-TRANS-treated animals showed the highest decrease in the NO level. The catalase level was significantly restored in scopolamine-intoxicated animals treated with BBR-TRANS, CUR-TRANS, and BBR-CUR-TRANS. The immunohistochemistry result suggested that the BBR-TRANS, CUR-TRANS, and BBR-CUR-TRANS have significantly decreased the regulation of expression of BACE-1 through antioxidant activity. In conclusion, the study highlights the utility of formulated transferosomes as promising carriers for the co-delivery of drugs to the brain.

Background: Coronavirus disease 2019 (COVID-19) has become a global challenge to the health care system. A novel agent to combat this deadly virus is still a matter of research. Herbal molecules have served humanity since the beginning. Objectives: This narrative review aims to study the antiviral properties of medicinal plants, which are already effectively used in the past against various viruses. It derives the importance of exploration of such phytochemicals, which can be complementarily used to treat COVID-19. Methods: Studies related to traditional medicine and treatment for viruses were retrieved from databases including PubMed, Google scholar until December 2020 using the keywords SARS-CoV-2, COVID-19, Immunological, Phyto-chemicals, Traditional Medicine. The resulting publications were analyzed to develop a narrative review on the traditional Indian phytochemicals that have been shown to effectively treat various viral infections and potentially treat or prevent COVID-19. Results: Many of the researches are showing that Indian herbal compounds have a significant potential against viral diseases. Plants like Azadirachta indica, Withania somnifera, Tinospora cordifolia, Ocimum basilicum, and many more have been shown tremendous antiviral, anti-inflammatory, and immune-modulatory activities. Conclusion: Phytochemicals obtained from the herbs can be helpful in the treatment and prevention of SARS-CoV-2via various modes such as inhibition of attachment, penetration, uncoating, replication, assembly, and release of respiratory viruses. Further analysis of the potential phytochemicals in treating SARS-CoV-2 in clinical trials is warranted.

Background: Quality in diabetic management is the need of the hour, in eye of the menacing increase in the disease in India. Hence, a sensitive qualitative handling of outpatient visits is warranted and an inbuilt mechanism of Quality of life scales (which are proxy of the patient’s response to disease) and Diabetic care scales (proxy for patient’s satisfaction to the care extended), would offer supportive evidence to physicians, of areas where they will have to be more careful. Aims and Objectives: To assess the Diabetic Care scale (DCS) for the subjects seeking management from the diabetic care unit. To find out the factors associated with the DCS and derive inferences to improve upon quality of management in the given sample Methodology: Diabetics were made to answer to Quality of Life in Diabetics (QOLID) and Diabetic Care Scale (DCS), validated and pretested for Indian populations; and factors affecting patient’s responses were ascertained, to improve care. Final sample of 599 interviews were assessed. To identify the predictors of diabetic care, diabetic care scale was dichotomized on the basis of its median value. Results: QOLID domains were inversely correlated with DCS, strongly significant (treatment satisfaction, general health, symptom botherness, financial worries, emotional health and physical endurance). Role limitations to physical health were also positively related to DCS (-0.422; p

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a human coronavirus (HCoV) that has created a pandemic situation worldwide as COVID-19. This virus can invade human cells via angiotensin-converting enzyme 2 (ACE2) receptor-based mechanisms, affecting the human respiratory tract. However, several reports of neurological symptoms suggest a neuroinvasive development of coronavirus. SARS-CoV-2 can damage the brain via several routes, along with direct neural cell infection with the coronavirus. The chronic inflammatory reactions surge the brain with proinflammatory elements, damaging the neural cells, causing brain ischemia associated with other health issues. SARS-CoV-2 exhibited neuropsychiatric and neurological manifestations, including cognitive impairment, depression, dizziness, delirium, and disturbed sleep. These symptoms show nervous tissue damage that enhances the occurrence of neurodegenerative disorders and aids dementia. SARS-CoV-2 has been seen in brain necropsy and isolated from the cerebrospinal fluid of COVID-19 patients. The associated inflammatory reaction in some COVID-19 patients has increased proinflammatory cytokines, which have been investigated as a prognostic factor. Therefore, the immunogenic changes observed in Parkinson’s and Alzheimer’s patients include their pathogenetic role. Inflammatory events have been an important pathophysiological feature of neurodegenerative diseases (NDs) such as Parkinson’s and Alzheimer’s. The neuroinflammation observed in AD has exacerbated the Aβ burden and tau hyperphosphorylation. The resident microglia and other immune cells are responsible for the enhanced burden of Aβ and subsequently mediate tau phosphorylation and ultimately disease progression. Similarly, neuroinflammation also plays a key role in the progression of PD. Several studies have demonstrated an interplay between neuroinflammation and pathogenic mechanisms of PD. The dynamic proinflammation stage guides the accumulation of α-synuclein and neurodegenerative progression. Besides, few viruses may have a role as stimulators and generate a cross-autoimmune response for α-synuclein. Hence, neurological complications in patients suffering from COVID-19 cannot be ruled out. In this review article, our primary focus is on discussing the neuroinvasive effect of the SARS-CoV-2 virus, its impact on the blood-brain barrier, and ultimately its impact on the people affected with neurodegenerative disorders such as Parkinson’s and Alzheimer’s.

Malaria, a global threat to the human population, remains a challenge partly due to the fast-growing drug-resistant strains of Plasmodium species. New therapeutics acting against the pathogenic asexual and sexual stages, including liver-stage malarial infection, have now attained more attention in achieving malaria eradication efforts. In this paper, two previously identified potent antiplasmodial hydroxyethylamine (HEA) compounds were investigated for their activity against the malaria parasite's multiple life stages. The compounds exhibited notable activity against the artemisinin-resistant strain of P. falciparum blood-stage culture with 50% inhibitory concentrations (IC50) in the low micromolar range. The compounds' cytotoxicity on HEK293, HepG2 and Huh-7 cells exhibited selective killing activity with IC50 values > 170 μM. The in vivo efficacy was studied in mice infected with P. berghei NK65, which showed a significant reduction in the blood parasite load. Notably, the compounds were active against liver-stage infection, mainly compound 1 with an IC50 value of 1.89 μM. Mice infected with P. berghei sporozoites treated with compound 1 at 50 mg kg−1 dose had markedly reduced liver stage infection. Moreover, both compounds prevented ookinete maturation and affected the developmental progression of gametocytes. Further, systematic in silico studies suggested both the compounds have a high affinity towards plasmepsin II with favorable pharmacological properties. Overall, the findings demonstrated that HEA and piperidine possessing compounds have immense potential in treating malarial infection by acting as multistage inhibitors.