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Hand Wash: Preventive Measure For Covid-19

InnoHEALTH magazine digital team — Fri, 10 Mar 2023 10:15:00 +0000

The human body skin or other body cavities can provide a wide entry platform for disease-causing germs like bacteria, fungi, viruses and many more which further replicate, causing serious infection.

In recent times, a novel type of viral infection has emerged in Wuhan City of China, with new genome sequence CoVs, which is called as novel CoV strain (2019-nCoV) or severe acute respiratory syndrome CoV-2 (SARS-CoV-2)

It is imperative to vigilance the readers about COVID-19 virus which is transmitted through direct contact with respiratory droplets which produces through coughing / sneezing of an infected person or touching contaminated surfaces where viruses can survive for several days. Simple personal hygiene procedures can protect humans from COVID 19 infections. Promoting clean hand hygiene by use of soap or alcohol containing sanitizer are the most basic, cheapest and powerful tools to reduce risk of spread of such SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome) a global pandemic. Here we cover the numerous personal hygiene practices, spreading pathway of COVID19 infection, classification of COVID 19 virus, details regarding hand wash techniques. We here summarize structural details of CoronaVirus like envelope composition, genetic composition and numerous classification aspects of the virus. Also basics of mechanism of soap for destruction of virus and importance / effectiveness of soap against COVID 19 virus. We address these important points regarding hand-wash techniques and necessary care for hand-wash. Parameters regarding selection of effective sanitizer.

The human body skin or other body cavities can provide a wide entry platform for disease-causing germs like bacteria, fungi, viruses and many more which further replicate, causing serious infection. In the past decades, numerous new diseases have emerged in different geographical regions, like Zika, Ebola, Nipah, and corona viruses (CoVs). Since December 2019, a novel type of viral infection has emerged in Hunan seafood market ,Wuhan City of China, with new genome sequence CoVs, which called as novel CoV strain (2019-nCoV)or severe acute respiratory syndrome CoV-2 (SARS-CoV-2), the virus outbreak has been affirmed a public health emergency of International concern by World Health Organization (WHO) as officially a pandemic situation. Since knowledge about COVID-19 virus is hastily evolving, readers are urged to modernize themselves recurrently for recent development and preventive measures.

Maintaining excellent hygiene is the foremost step to living a healthy life. These infections can be avoided by various good hygienic practices which are denoted in below Figure 1.

Here we discuss healthy hygienic practices and their implementation parametes along with various effective hand washing techniques. It also focuses on various aspects like details regarding structure of COVID-19 virus, classification of COVID-19 virus, spreading phenomenon, preventive measure.

Figure 1: Healthy practices for personal hygiene

One significant mode to reduce the risk of infections is good hand hygiene. Clean hands can stop the spread of germs from one person to another. Washing hands with soap and water or using alcohol-based hand rub kills viruses like SARS-CoV-2, the Corona Virus and which acts as an effective shield against COVID-19 infection.

Numerous spreading phenomenons for CoronaVirus (COVID-19)

COVID-19 is assumed to be initiated from an animal host (Zoonotic origin) such as bats followed by human-to-human transmission.
Coronavirus is a respiratory illness; which mostly spreads through virus-laden droplets from coughs and sneezes.
Respiratory viruses like coronavirus disease (COVID-19) spread when mucus /droplets containing the virus are exposed to eyes, nose or throat and cause infection.
COVID-19 virus consists of an envelope which is made up of lipid bilayer, which is shaped like a tadpole consisting of polar or hydrophilic head and nonpolar tail/ hydrophobic tail. It describes the structure of two layers piled to form a micelle-like structure as shown in Figure 2 as the hydrophilic head/ polar head part of the virus is very sticky which may be a vital reason for spread of infection from contaminated areas.
COVID-19 is spread through direct close contact with a person who is infected
Virus can spread between people close contact with each other (about 6 feet)
Virus can adhere on smooth surfaces such as tables, phones
Sars-CoV retain viable for five days at 22-25 degree centigrade and relative humidity at 40-50 %
This virus specifically attacks specific body parts like lungs, liver and small intestines because of Furin enzyme present Host. The sugars on the spike act as camouflage
RNA recombination in corona viruses is typically responsible for the evolution and emergence of novel coronaviruses and frequency of recombination is higher in the S gene which codes for viral spike (S) glycoprotein.

Washing hands with soap why protect against CoronaVirus (COVID-19)

Washing hands with warm water and soap can prevent the spread of infectious diseases due to destruction of viruses.
COVID-19, are encased in a lipid envelope — basically, a layer of fat.
Soap/ detergent molecules also have similar tadpole structure as virus (explained in Numerous spreading phenomenons for CoronaVirus) ; therefore lipid bilayer molecules attracted towards soap molecules which are responsible for breaking of virus shell/ envelope which are made up of bilayer.
Soap can break that fat apart and make the virus unable to infect you as shown in below Figure 2.

Figure 2: How soap destroy Corona Virus particles

Corona viruses are Spherical or pleomorphic enveloped, non-segmented ,single-stranded positive-sense RNA viruses that possess large viral RNA genomes, capsid and envelope with club-shaped glycoprotein projections

Classification of Corona viruses / Toro viruses as follows:

Figure 3: Numerous classification for CoronaVirus

Figure 4: Structure of CoronaVirus

Clean hands can stop the spread of germs from one person to another. Washing hands with soap and water or using alcohol-based hand rub kills viruses like SARS-CoV-2, the Corona Virus and which acts as an effective shield against COVID-19 infection.

Hand washing with soap is the only effective way to reduce the spread of COVID 19 virus, which is also able to destroy the virus particle (Figure 5).

Figure 5: Details of hand washing techniques

Important points related to hand wash technique:

Using clean, running water is important.
After washing your hands with soap, use a new tissue to hold the faucet and turn off the water tap.
Do not use common towels or do not touch door handles in the bathroom, toilet flush handles as they can re-contaminate your hands.
Frequent washing of hands reduce the risk of infection
Use of hand sanitizer/hand-rub (60% ethanol or 70% iso-propanol)

COVID-19 virus chiefly spreads through the respiratory droplet and contact transmission through contaminated surfaces by infected person. Thus, hands can spread virus to other surfaces like mouth, nose or eyes by touching. Hand Hygiene is one of the most effective practices that help to diminish the spread of virus and prevent COVID-19 virus infections.

Composed by: “Priyatama V. Powar and Devendra D. Shirode are professors from Dr. D. Y. Patil College of Pharmacy, Pune.”

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Autoimmune Disease

InnoHEALTH magazine digital team — Tue, 05 Apr 2022 05:52:49 +0000

The immune system is a shield that guards against foreign invaders like bacteria and the virus. That’s the actual functioning of the immune system. When the immune system senses the existence of any foreign particle in the body, it immediately makes the antibodies to eliminate them. In autoimmune diseases, the immune system becomes a war zone. It misinterprets the body’s healthy nerves as foreign bodies and attacks them, reducing the ability to fight against infection and viruses.

One such condition is Guillain Barre Syndrome (GBS), one of the rarest autoimmune disorders that affect one in one lakh people in the USA. It affects the peripheral nervous system, severity ranging from mild weakness to depending on the life support system for breathing. Fortunately, there is 80% recovery after diagnosis and 5 – 10% delayed or incomplete recovery. It can affect anyone irrespective of the age group.

The reason for GBS onset is not known, but it is evident that the immune system attacks itself. The immune system produces antibodies when foreign bodies try to attack; these antibodies are nothing but the immune response towards the foreign bodies.

The reason for GBS onset is not known, but it is evident that the immune system attacks itself. The immune system produces antibodies when foreign bodies try to attack; these antibodies are nothing but the immune response towards the foreign bodies. But in the case of autoimmune disorder, when any viral or bacterial infection attacks the body, these bacteria or the virus start to resemble the nerves, and the immune system attacks the healthy nerves by mistake.

The onset of symptoms can be a very mild tingling sensation in the limbs to severe breathing difficulty. It starts from the lower body and moves up to the lungs leading to breathlessness, and sometimes occasionally, it starts from the upper body and moves down the lower body. The severity of the symptoms may vary from person to person, depending on the level of nerve damage. Weakness leading to restriction in the limb movement seeks immediate medical treatment.

Additional symptoms may include:

Severe pain in the nights
Blood pressure as a secondary symptom
Indigestion and loss of control over bladder
Sometimes coordination problems due to nerve damage which fails to send signals

The symptoms can get severe with the period if not treated immediately and sometimes may lead to paralysis, which can be life-threatening. When a person is affected with GBS, his nerves are damaged. Nerves are nothing but conducting wires. Nevers have axons covered with an insulating layer called myelin sheath that carries electric signals from the brain to the central and peripheral nervous system leading to immediate action or response towards the brains’ command.

In GBS patients, the myelin sheath is damaged and sometimes the entire axon results in complete failure in signal transmission, and the muscles start to lose their ability to respond to the brain’s command. Breathing can be weak, leading to a dependency on the life support system. Nerve damage may also cause abnormal transmission of signals that give spontaneous sensations called paresthesias, which is nothing but the tingling sensation that generates difficulty in limb movements.

The nerve damage occurs due to molecular mimicry theory, where the molecules of the nerve resemble the molecules of some microorganisms. Hence the microbes and the myelin sheath look similar, and when these microbes attack the immune system, they mistake the microbes for myelin sheath and attacks the healthy nerves treating them as foreign bodies. As a result, the immune system fails to recognise its nerves.

So the immune system basically produces antibodies for bacterial infection caused by Campylobacter jejuni, which attacks the axon in the motor nerves causing acute motor axonal neuropathy, which is one variant of GBS having acute paralysis, loss of reflexes but no sensory loss. This bacterial infection is caused by consuming contaminated food or uncooked food, especially meat.

This syndrome cannot be diagnosed in the initial stages due to the symptoms’ variation and intensity. Generally, the physician will examine and check if the symptoms are shown on both sides. Initially, the reflexes start to slow down in the joints. Sometimes, these reflexes are absent as the velocity of signal transmission slows down, which brings us to nerve conduction velocity tests the ability to transmit signals. So in GBS, the cerebrospinal fluid starts to change, and there has been some evidence stating that in GBS patients, the cerebrospinal fluid contains higher protein levels than usual. So the sample is collected from the lumbar region to examine the fluid.

Other diagnostic symptoms include

Abnormal sensation like tingling in the feet along with weakness
Diminished reflexes
High protein levels in cerebrospinal fluid

Treatment

Generally, short-term therapies can treat it to reduce the severity and lessen the recovery time. So the treatment includes Plasma exchange, and the other one is high dose immunoglobulin therapy (IVIg). Plasma exchange removes the blood with the help of a catheter via veins. Fresh plasma is extracted and returned to the patient. Plasma contains antibodies, so the PE removes the nerve-damaging plasma and reduces the severity of GBS.

Immunoglobulins are the proteins that produce antibodies against disease-causing microorganisms.

Immunoglobulins are the proteins that produce antibodies against disease-causing microorganisms. In IVIg therapy, the immunoglobulins are injected through intravenous infusion into the patient’s body. These immunoglobulins have been developed from healthy donors. Researchers have stated that this therapy shortens the recovery time, has fewer complications, and lowers the chances of the antibodies attacking its nerves by diluting with non-specific antibodies.

As the patients recover, they are moved to rehabilitation care for physical and mental health improvement. Physiotherapy for the muscles and limbs movement and therapy for mental health is a must to regain confidence during the recovery stage. It is a slow process, and the patient may tend to lose hope.

Composed by: “Sunayana is presently working as research Associate for Hetero Labs limited Hyderabad in formulation R&D injectables department (Non Onco).”

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The Human Vaccines Project (HVP)

InnoHEALTH magazine digital team — Thu, 25 Feb 2021 04:13:45 +0000

Dr. Frans van den Boom has served as the Vice President, Country and Regional Programs and Executive Director Europe of the International AIDS Vaccine Initiative (IAVI) for ten years, he is responsible for vaccine preparedness and community mobilization programs, the social and behavioral sciences program, and resource mobilization. Earlier he served as Executive Director of Policy,planning and evaluation at Qatar Foundation and also as Executive director of the Dutch Top sector Life Sciences and Health. He joined the Human Vaccines Project three years ago as an Executive Director.

Sachin Gaur interviews him on his viewpoints about the initiatives taken by The Human Vaccines Project amid covid-19 pandemic.

The Human Vaccines Project (HVP) is a nonprofit public-private partnership with a mission to decode the human immune system and accelerate the development of vaccines and immunotherapies across major global diseases.

1. Tell us briefly about the organisation you represent and if your organisation planned any support actions during the covid-19 pandemic

The Human Vaccines Project (HVP) is a nonprofit public-private partnership with a mission to decode the human immune system and accelerate the development of vaccines and immunotherapies across major global diseases. The Project brings together leading academic research centers, industrial partners, nonprofits and governments to answer core questions about how the human immune system fights disease and pioneer a new era in human health.

The project has three pillars: the Human Immunomics Initiative, a collaboration with the Harvard T.H. Chan School of Public Health; the Newborn Immunity Initiative, a partnership between HVP and the Telethon Kids Institute, the Newborn Immunity Initiative Cincinnati Children’s Hospital, and Université Libre de Bruxelles; and the COVID Vaccine Initiative (CVI).

The CVI seeks to learn as much as possible from the current COVID-19 pandemic to enable it to better respond to and perhaps stop the next before it starts. The CVI is working with industrial partners to understand how and why COVID-19 vaccines have been so successful, and to understand how well such vaccines work in vulnerable groups such as older adults where vaccines often do not work well. The CVI through its Global Lab Meeting and COVID Report has provided indispensable, unbiased updates from the world’s leading researchers in the COVID space.

The CVI is now at the forefront of thinking about how to stop the next pandemic, thinking forward to a universal coronavirus vaccine capable of stopping the next pandemic before it starts.

This pandemic has taught us that an infectious disease agent can have an enormous impact on every aspect of life.

Q2. Vaccine development takes enormous time and money, that was our understanding prior to covid-19. Do you think Covid-19 has changed that for good, or is too early to say that.

As always, the future will tell. However, I am optimistic that SARS-CoV-2 and COVID-19 will change things for good. This pandemic has taught us that an infectious disease agent can have an enormous impact on every aspect of life. The human, social, cultural and economic toll is enormous. It has been estimated that the current pandemic will end up costing between USD 8 and 16 trillion globally, but there is also an estimate that it will cost USD 16 trillion for the US only. Surely this has opened the eyes of decision makers that a continuous investment in infectious disease R&D and the underlying basic mechanisms to understand infection, disease development and severity, and immune response is necessary. We now have platforms such as mRNA and others that have allowed us to develop vaccines faster than ever. These new platforms rested on decades of research and investment and are capable, as we have seen, of bringing vaccines faster to the public faster than ever. Despite these advances we still have much work to do on the research side in understanding how to generate immunity to disease that works across all populations and including the really tough diseases like HIV or malaria where we need effective vaccines.

Q3. A shorter vaccine development cycle is raising eyebrows, especially around safety concerns, there are population groups missing in clinical trials that we discover as the vaccine is administered. If we were to do it again, how can we do it better? Also, what can be done to improve the communication around vaccine campaigns in general?

It is important to realize here that the risks taken were financial, not on safety. We were able to bring vaccines to market so fast because we had invested billions in the development of new platforms like mRNA in the decades before this outbreak. Second, governments around the world started building highly expensive manufacturing plants before we knew the vaccines would work at a great cost and risk to capital. Usually the vaccine industry waits to see if the vaccines look like they will work before making such an investment stretching the development time to years. So the acceleration of the cycle was really due to previous investments and willingness to take financial risk.

I believe it has been shown that a quicker vaccine development cycle and market authorization do not have to go against safety. Safety is the key issue for industry, regulatory agencies and policy makers, and the vaccines went through the standard safety testing and clinical process. That said we have to acknowledge that risks from vaccines are few, but real. The harms coming from vaccines are almost always seen in a short time—allergic reactions being the most common by far. So large trials with shorter observation periods are adequate to find these even if they are unusual. We also have systems for seeking very rare events after vaccines are in use (one event per million doses), and those are now being used. But traditional vaccine and drug development has a lot of delays that don’t really add to safety of the product. That being said, policy makers and politicians should not put pressure on industry and regulatory agencies to move faster if that would jeopardize safety.

Secondly: Yes, population groups were missing in the clinical trials, which is common practice in vaccine R&D: children, pregnant and lactating women, people with (severe) underlying health conditions were not included in the first trials. Elderly people were included, but not in very large numbers. This means that additional studies are needed, as we are witnessing now: studies are carried out amongst immune-depressed patients, cancer patients, people with auto-immune diseases, children etc. This is not an easy issue to be fixed in clinical trials, because the golden rule is that you enrol ‘healthy’ volunteers, usually people between 18 and 55. This needs a lot of thinking and a careful balancing of risks and benefits if you are going to enrol vulnerable populations. Again, this is where post-marketing surveillance systems or additional clinical trials after the vaccine is being distributed, can help without slowing down access to a life-saving intervention.

Thirdly, improving communication around vaccine campaigns in general. Vaccine hesitancy is a big issue worldwide. WHO identified vaccine hesitancy as one of the top 10 threats to global health. The challenge for public health authorities stretches beyond COVID-19. I believe that we are entering a completely new paradigm around vaccination. Social media and social networks have become important shapers of the frame, as we have seen in so many countries with the introduction of the HPV vaccine; opinion makers and leaders – whether in media, science, politics, religion – can make or break vaccination programs; lack of consistency and trust are critical issues.

On top of that, given the enormous amount of time spent on reporting on COVID-19, people are becoming more knowledgeable about vaccines and vaccine development: herd immunity, level and duration of efficacy; side effects; halting trials because of (serious or severe) adverse events. The public also is gaining an understanding of gaps in our knowledge after a vaccine has been licensed such as the level of protection against new virus variants, the efficacy of a vaccine in the aging population and in people with pre-existing morbidity. Last but not least, the top 3 categories for vaccine hesitancy (scientific evidence; knowledge and awareness; religion/culture/gender/socio-economic) remain relatively constant, but even the most cited category (scientific evidence – risk benefit) only accounted for less than a quarter of all categories cited, emphasizing the complexity and variability of vaccine hesitancy globally. So this is a daunting challenge for public health authorities.

I believe it is key to (re)establish trust. And trust is created by being honest / transparent, fair, reasonable and realistic. A recent study showed that the most important determinant for being vaccinated is that people believe and are confident that vaccines are important for their own safety and health. That in my opinion is going to be critical. Communicate clearly and consistently about the impact of vaccination on life expectancy; invest in understanding why some are hesitant and some confident; invest in making immunisation accessible, affordable and acceptable. Understand community dynamics and social and peer group pressure. I believe it is critically important to involve social and behavioral scientists in order to understand the social and behavioural dynamics.

Q4. What are the barriers that prevent vaccine development and a well-coordinated global effort. If you were to suggest top three recommendations for a healthier and safer world through timely vaccine development, what would they be?

Sharing real-time information if an infectious agent is identified as the cause of a (potential) pandemic in order to start working on a vaccine
Communicate as much as possible and don’t shy away from saying sorry, if new insights require different approaches.
Develop a MoU between biopharma and the international community (WHO, World Bank) on advance market and advance purchase commitments, and other innovative financing mechanisms.

Q5. What are the other promising directions that you see coming in near future that can enable a healthier and safer world?

Obviously, our ability to decode the human immunome. The recent convergence of technological advances in biomedical, computing and engineering sciences will lead to the next revolution in health, including but not limited to vaccine discovery and development.

The microbiome is made up of around 100,000 billion microbes, which is more than all the human cells of your body. Most of these microbes are bacteria, and they are vital to your health.

Q6. Are all viruses bad? About 8% of the human genome is ancient viruses! What is the relationship of life in general and humans with viruses? Are we against them all the time?

Viruses may have a bad reputation. Because of the SARS-CoV-2 pandemic, their reputation seems worse than ever before. However, we would not survive if our body did not host its share of viruses. Wishing to be ‘virus free’, actually is a bad idea. The great majority of viruses are actually not ‘interested’ in humans at all, but in bacteria. These ‘bacteriophages’, or bacterial viruses destroy bacteria and keep bacteria populations under control.

Everybody carries around a huge number of microbes, known as the microbiome. The microbiome is made up of around 100,000 billion microbes, which is more than all the human cells of your body. Most of these microbes are bacteria, and they are vital to your health. Nevertheless, these bacteria need to be kept under control. That is why the bacteriophages in your body outnumber the bacteria 10 to 1. Nature uses bacteriophages as a sort of ‘biological pest control’ for bacteria, which prevents humans from being overwhelmed with bacteria. We would die without viruses.

Q7. Any message that you would like to share with the readers of our magazine.

Stay safe and stay healthy. Remember that behavioural modifications limiting exposure of you and those around you are a crucial protection against COVID-19 that can work together with vaccines to defeat this pandemic.

Interviewed by Sachin Gaur, Executive Editor, InnoHEALTH Magazine

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Post Antibiotic World

InnoHEALTH Magazine — Mon, 18 Nov 2019 09:25:20 +0000

Like the ‘guardians of the galaxy’ the futuristic prospect of this world will be a place where the microbes have become resilient against antibiotics and the fight against infection has ceased to find its way through antibiotics. Though most of the antibiotics that are consumed are metabolized by the body, a negligible amount is passed through us as waste, which is further carried to wastewater treatment plants.

Also Read: Health and Oral Health Diseases

The basic methodology to clean the wastewater in plants is through membrane bioreactor that uses both biological as well as filtration process where bacteria are acclimatized to consume the waste products and help in metabolization. The antibiotic waste breakdown by bacteria often expresses resistance genes that reduce the effectiveness of the medicines. In the long run, the horizontal gene transfer develops whose expression pass from one generation to the next and the resistance genes gain prominence over the years. With the passing phase, the bacteria grow and thrive itself therefore often giving rise to biomass. The biomass is produced in tonnes by wastewater plants nearly every day. After treatment, they are often disposed of as landfills, fertilizers for agriculture and feed crops for livestock. A minute quantity of resistant bacteria and free-floating DNA often finds its way through effluent of the pharmaceutical industries. The studies have further shown that gene elements called plasmids carry resistance genes for several different types of antibiotics, therefore, resulting in a positive correlation between one type of antibiotic and the resistance gene of another. It creates a dangerous dormant situation that can erupt like an active pandemic under the favourable situation. Plasmids are a thousand times smaller than bacteria and their free-floating nature often surpasses the treatment barriers of the filtration system of the treatment process, therefore making exit through effluents. They further contaminate the surface water and groundwater – the two important sources of drinking water. Researchers have found that even low concentrations of just a single type of antibiotic in the water supply leads to resistance in multiple classes of antibiotics and hence leads to antimicrobial resistance (AMR).

Also Read: Health Card of Indian States

Water, as we all know, is the utmost need of our survival. Human body comprises around 60% water and the fact that less consumption of water leads to various diseases in the future. Apart from facts and figure, one simple question we often forget to inquire is where this water is coming from? Surface water i.e. lakes, rivers and ponds or groundwater i.e. tube wells, bore well, well as these are the two sources that give us a glass of water.

Also Read: Passenger Gave Birth to a Baby on Jetliner

Our health concern and the credulous brainwash of our mind by the various available water filter present scenario and save our planet from the harmful effect of self-made destruction.Effective treatment and management of wastewater from the pharmaceutical industry will help in overcoming antimicrobial resistance. Advanced treatment methods such as reverse osmosis, nano filtration, and membrane bioreactors have shown to be promising processes for cleaning micro pollutants with nano gram per litre (ng/L) concentration levels.The nation where the trial/testing of most of the antibiotic occurs, there are rarely any constraints implemented on the disposal of pharmaceutical wastewater to the surface water. The current scenario of environmental issue foresees that in the near future there will be scarcity of drinking water and our hope was restored when global challenge was taken to in the market often diverts us from our prime concern of keeping our planet safe from water pollution. The pollution of water bodies has been initiated by us and still we are invariably helping it grow with every passing day. As discussed earlier, the various point sources from domestic to industrial pave the way for antibiotic to contaminate the water bodies. According to the latest report of UNICEF, 2.1 billion people lack the access to clean and safe drinking water.

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How do we remove the problem? What do we do to save ourselves from the harmful effects?

The encouraging words of Normal Vincent Peale, American author ‘Every problem has in it the seeds of its own solution. If you don’t have any problems, you don’t get any seeds’ gives us the hope that we will successfully overcome the present scenario and save our planet from the harmful effect of self-made destruction.Effective treatment and management of wastewater from the pharmaceutical industry will help in overcoming antimicrobial resistance. Advanced treatment methods such as reverse osmosis, nano filtration, and membrane bioreactors have shown to be promising processes for cleaning micro pollutants with nano gram per litre (ng/L) concentration levels.The nation where the trial/testing of most of the antibiotic occurs, there are rarely any constraints implemented on the disposal of pharmaceutical wastewater to the surface water. The current scenario of environmental issue foresees that in the near future there will be scarcity of drinking water and our hope was restored when global challenge was taken to curb the antimicrobial resistance from environment. Remedial measures taken towards eradication are further discussed.

Also Read: Rising burden of non-communicable diseases

Political commitments: International efforts: World Health Organization Jaipur declaration on antimicrobial resistance 2011 recognized AMR as a serious public health threat. With the 2014 WHO Report, the extraordinary rates of AMR prevalent in India came into focus. After this report, joint efforts were made by India and WHO. While WHO labelled AMR as the Flagship Priority area for South East Asia Regional Office (SEARO), the Indian Medical Association launched an awareness programme to train the physicians and sensitize the general public. In 2015, the 68th World Health Assembly decided to incorporate the concept of One Health in the fight against AMR and a Global Action Plan was initiated. All member countries, including India, agreed to frame their own National Action Plans (NAPs) for AMR by 2017.

Also Read: Specific health situation of Indian states

National efforts: The Government of India formulated a Core Working Group on AMR that drafted a NAP for the country. Six strategic priorities were listed in NAP, all of which incorporated considerations for AMR in the environment, directly or indirectly. Further, each strategic priority has defined interventions, activities and outputs, the fulfillment of which is delineated by a timeline projected for the next five years. The NAP, although promising, has not yet come into full action in any of the Indian states so far. To curtail the prevalent malpractice of over-the-counter (OTC) sale of drugs, the Central Drugs Standard Control Organization implemented Schedule H1 in India in 2014. It, however, encompasses only a few selected antimicrobial groups. In June 2017, the Food Safety and Standards Authority of India (FSSAI) published the list of maximum residue levels for antimicrobials in foods prepared from animal, poultry and fish.

Health Organization in India: To know the near-exact extent of AMR, AMR surveillance networks were initiated by the Indian Council of Medical Research (ICMR) and the National Centre for Disease Control (NCDC) in 2013 and 2014, respectively. In 2015, these two organizations along with the support from Centers for Disease Control and Prevention (CDC) USA, started a systematic assessment of the prevailing IPC practices in India with the aim of formulating new guidelines for preventing hospital-acquired infections.

Also Read: Rising risks for cardiovascular diseases & diabetes

These activities, however, cater basically to the emerging AMR in the healthcare settings and do not include special provisions for AMR in the environment. Similarly, the National Health Mission’s National Health Systems Resource Centre and the National Accreditation Board deal with IPC practices and strengthening of laboratories/hospitals and not with the AMR in the environment per se. The importance of AMR in the environment has been realized recently by the national health authorities and The National Health Policy 2017 calls for a rapid standardization of guidelines regarding antibiotic use, limiting the use of antibiotics as OTC medications, banning or restricting the use of antibiotics as growth promoters in animal livestock, and pharma co-vigilance including prescription audits inclusive of antibiotic usage – in the hospital and community.

Innovative ideas: The National Health Mission of India started the Swachh Bharat Abhiyan or the Swachh India Mission to improve the basic hygiene and sanitation in all spheres of life. As a part of this massive programme, education was imparted through mass media on the health hazards of open defecation. UNICEF data shows that out of one billion openly defecating people in the world, 60 percent reside in India. It is further argued that it is a behavioural problem with the Indians as other poverty struck nations of Africa and South East Asia did not have the problem of open defecation to this an extent. To deal with such socio-cultural issues, innovative ideas along with mass media are needed in India.

Also Read: How to write a funding proposal?

So far in India, antimicrobial resistance in the environment has been a topic of least priority. With an ever-increasing threat of AMR in the environment, immediate action is required to halt its progress and spread. A combined effort of multidisciplinary and multi-sectoral approach will be able to eradicate the problem in the near future.

About the author

Dr. Debleena Bhattacharya is an independent researcher. She is presently working as an Assistant Professor in the Department of Environmental Science and Engineering at MEFGI, India. She holds a doctoral degree in Environmental Science from IIT (Indian School of Mines) Dhanbad (India). Her specialisation is in the field of wastewater treatment and biotechnology.

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Resistant STIs on Rise

InnoHEALTH Magazine — Thu, 29 Nov 2018 07:34:24 +0000

This article is written by Dr. Sarita Jaiswal and Pooja Yadav

When we discuss life in general, we run across various issues that influence our lives, some which we physically observe and some which we candidly feel. As such, the subject of sex in India is surrounded by a multitude of social standards, religious confinements, and taboos which leave no scope for discussion about the sexually transmitted disease.

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There are more than 20 types of sexually transmitted infections (STIs) which are caused by bacteria, parasites, viruses, and yeasts. Bacterial infections such as gonorrhea, chlamydia, and syphilis are such little-discussed STIs. Though gonorrhea is as pervasive as chlamydia, it is rarely diagnosed and tested. These infections may cause infertility in women as well as in men and have the potential to become the next SUPERBUG within a decade.

From Khajuraho to condoms, we as a country are known for hypocrisy about ‘SEX’ in our mindset. A nation that has swung from the extremes of religious rigors to the extremes of uninhibited debauchery, STIs duck and display voluntarily. It leaves us no surprise when ongoing reports point at expanding patterns of STIs among teenagers. The reasons are their undisclosed curiosity and no sex education at schools or at home. Numerous reports point towards increasing number of child abuse reports in both rich and economically backward sections of our country.

Many people in India, consider STI as an ‘appearance from God,’ ‘an indication of developing youthfulness,’ ‘an indication of development,’ ‘the consequence of eating nettle leaves’ and ‘from sex with menstruating lady’. Not just in our country, such misleading thoughts regarding the causation of STIs are common throughout the world with shifting accentuation.

STIs are in general, more dynamic than other existing community infections. It is important to keep track of epidemiological changes in STIs especially in a densely populated country like India. A thorough understanding of the patterns of infections spread in a geographical region is important for planning its control strategies. Each year about 357 million STIs (chlamydia, gonorrhea, syphilis, and trichomoniasis) are reported worldwide. As per the warning from the World Health Organization (WHO), antimicrobial resistance in gonorrhea is emerging strongly while cases of untreated chlamydia and syphilis with reported antibiotic resistance are also making the news. Multidrug-resistant (MDR) is defined as resistance to at least ≥3 antimicrobial categories which are used earlier successfully. The gonococcus mutates rapidly and acquiring resistance even against new classes of antibiotics. Chlamydia is the world’s most common non-viral STI and gonorrhea is the second most common MDR infection. Gonorrhea might have existed since ages but its authentic records in India can only be found during and after the British Empire in India. It was referred to as “clap” disease before the actual cause was discovered and is caused by the obligate pathogen Neisseria gonorrhoeae which infect only humans. Chlamydia and syphilis are caused by Chlamydia trachomatis and Treponema palladium respectively.

Researchers in India have isolated around 124 strains of gonorrhea from Delhi, Hyderabad, Mumbai, Pune, and Secunderabad for testing antimicrobial susceptibility. As per their results, 98% isolates were resistant to ciprofloxacin, 52% to penicillin, 56% to tetracycline and 5% to azithromycin. Irrational use of antibiotics, gradual accumulation of antibiotics in the food chain, innate antimicrobial resistance and development of resistance due to mutation were major culprits for developing resistance. MDR in Neisseria gonorrhoeae is a big public health challenge.

Peoples, who have chlamydia, are more susceptible to gonorrhea and syphilis. These infections do not spread by shaking hands or toilet seats. The bacteria that cause syphilis can enter the body through a cut in the skin or through contact with a partner’s syphilis sore. It can also be passed from mother to newborn as the baby passes through the infected birth canal.

The incubation period, the time from exposure to the bacteria until symptoms develop depends on the sex of the patient, age and immune status of the infected person. In the case of gonorrhea, it is usually several hours to 4-5 days in males while in women it takes much longer and ranges from 7 to 14 days. In younger people, it proceeds rapidly, and its incubation period is also very brief. In older patients, sometimes infection is asymptomatic, progress to become chronic and eventually evident after a few months. In case the infected person was taking antibiotics for other medical ailments, its incubation period may extend further. In chlamydia, the incubation period is one to three weeks while in syphilis it is 21 days but can range from 10 to 90 days.

Infection and symptoms of chlamydia and gonorrhea are common which makes it difficult to distinguish these from each other. In comparison to men, women are around five times more prone to have asymptomatic urogenital infections. This infection can spread throughout the body, and affect joints, heart valves or other vital organs which can be deadly.

Symptoms of syphilis include 3 stages. In the primary stage of syphilis, it first appears as a painless chancre which goes away without treatment in 3-6 weeks. If it is not treated, the second stage begins as the chancre is healing or several weeks after the chancre has disappeared, when a rash may appear. The rash usually appears on the soles of the feet and palms of the hands, flat warts may be seen on the vulva. Some patients may exhibit flu-like symptoms. The rash and other symptoms may go away in a few weeks or months, but that does not mean the infection is gone. It still exists and referred to as the latent stage of its infection.

Unlike testing for chlamydia and gonorrhea, routine screening for syphilis is not recommended for women who are not pregnant. Diagnosis of these is cumbersome and time-consuming. Also, one may be tested for chlamydia and gonorrhea at a time as these two often occur together. Oral medicines and injectable antibiotics are prescribed in general to the patient and his/her partner to kill the infection and prevent its spread.

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Indoor lifestyle impacts the diversity of bugs

InnoHEALTH Magazine — Tue, 24 Apr 2018 08:26:01 +0000

A survey of urban households reveals how room layout and indoor lifestyle impacts the diversity of our tiniest roommates.

Humans have lived under the same roof with bugs since we first began building shelters 20,000 years ago. Now, scientists are studying how physical factors of our homes— from the floor plan and the number of windows to even how tidy we are—may play a role in the diversity of the multi-legged communities populating the indoor environment.

Researchers from the California Academy of Sciences, North Carolina State University, and the Natural History Museum of Denmark published findings recently in Scientific Reports revealing that a greater number of bug species can be found in high-traffic, ground level, carpeted rooms with many windows and doors. (And a word of comfort for pet owners with messy habits: don’t worry, bugs don’t really care.)

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“We are just beginning to realize— and study—how the home we create for ourselves also builds a complex, indoor habitat for bugs and other life,” says Dr. Misha Leong, lead author and postdoctoral researcher at the Academy. “We’re hoping to better understand this age-old coexistence, and how it may impact our physical and mental well-being.”

Humans spend most of their time indoors. Aside from pests, most life within the home—be it bacteria, fungi, or arthropods (a group that includes insects and their close relatives like spiders and millipedes)—has rarely been studied. The scientific team surveyed 50 urban homes in Raleigh, North Carolina to see what it is about a home that might lead to a buggier abode.

FROM THE ATTIC TO THE BASEMENT

Next time you climb the stairs, remember that insects, too, prefer lower levels. Survey findings revealed that as floor numbers increase, fewer types of insects thrive. Larger rooms, especially on the ground floor (or even below ground), harbored more insect diversity. More varied types of insects were also observed in carpeted rooms versus those with bare floors as well as “airier” rooms with more windows and doors offering greater accessibility to the outdoors. Species diversity within the home tends to mirror the life thriving outside, with neighborhood affluence playing an important and recently studied role.

“While the idea of uninvited insect roommates sounds unappealing, bugs in houses may contribute to health in a roundabout way,” says Dr. Michelle Trautwein, senior author and the Academy’s Schlinger Chair of Diptera. “A growing body of evidence suggests some modern ailments are connected with our lack of exposure to wider biological diversity, particularly microorganisms— and insects may play a role in hosting and spreading that microbial diversity indoors.”

ROOM TO ROOM

Bugs can also vary from room to room. An analysis of core representative species—like book lice, fruit flies, and ladybugs—revealed how common areas like living rooms hosted more diverse communities when compared to bathrooms, kitchens, and bedrooms. Basements also proved unique: these dark, damp, and cavernous spaces lent to diverse communities of caved welling insects like spiders, mites, millipedes, camel crickets, and ground beetles.

Every room within the home revealed a complex ecological structure of predator and prey— with scavenger species, strays from the outdoors, and transient go-among all playing critical roles. The study also noted how indoor ecology is much like island ecology—a scientific discipline that examines what lives where, and why. Once species permeate inside, they tend to colonize their new “island” habitat and disperse across the household.

“We’re beginning to see how houses can be a passive go-between for insects traveling through the surrounding landscape,” says Trautwein. “The more numerous the entry points of windows and doors, the more diverse the community that thrives inside.”

No need to de-clutter; cats and pups are a-ok For the messy among us, rest assured: study findings revealed that tidiness does not play a significant role in insect diversity except for the presence of cellar spiders—delicate, long legged critters of the family Pholcidae typically spotted in damp crawl spaces. While more cluttered areas hosted a greater number of these web-spinners, overall human behavior played a minimal role in determining the composition of bug communities in the survey.

The presence of cats or dogs, houseplants, pesticides, and dust bunnies revealed no significant impact, suggesting that our indoor communities are more strongly influenced by the environment outside the window than how tidily we live inside with Fido and Kitty.

“Even though we like to think of our homes as shielded from the outdoors, wild ecological dramas may be unfolding right beside us as we go about our daily lives,” says Leong. “We’re learning more and more about these sometimes invisible relationships and how the homes we choose for ourselves also foster indoor ecosystems all their own.”

This study is part of a seven-continent exploration to understand overlooked life in the home: how our tiniest roommates arrive and thrive, and the unknown impacts—both harmful and benign—that stem from living together in close quarters.

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Food for thought

InnoHEALTH Magazine — Thu, 01 Feb 2018 06:41:42 +0000

How important is your Mental health for your physical performance

By Edwina Coram

Do you have days when your mind feels foggy; when you can’t seem to think straight or concentrate on anything no matter how hard you try? If your answer is yes, then it might be time to re-evaluate your diet and daily habits.

Some things that we do deplete the body’s system and in turn will affect the ability to think clearly and concentrate. Not eating regular healthy meals can be a drain on the brain, affecting your ability to focus without becoming distracted.

Iron is essential for the transportation of oxygen to the brain, too little iron in your diet means that the brain literally suffocates. Inadequate oxygen supply prevents cells from converting glucose and other calorie containing foods to energy, quick enough to meet your cellular needs. In such case, many cell functions will either slow down or stop altogether. Leaving you feeling tired, and irritable. You may also find it difficult to think clearly or concentrate.

Smoking has similar adverse effects. The nicotine in tobacco smoke constricts the blood vessels and interferes with circulation. This can gradually reduce the number of brain cells, increasing free radicals. These in turn, damage the whole system, due to oxygen deprivation. Again this can make feel sluggish and will also be a burden on your immune system.

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Acute or chronic stress can also result in the inability to concentrate and thus reduce the effect of short-term memory. Likewise, high blood pressure is linked to reduced attention span and memory loss. Concentration can further be affected by lack of physical exercise and obesity.

Smartening up your diet

If you want to restore you concentration and memory skills then a good place to start is with your diet. Mental performance and relaxation can both be improved by choosing the right combination of foods.

Foods rich in iron include whole grains, beans, and fortified cereals. Though these are generally more difficult to absorb than animal sources, vitamin C will help enhance your intake, so you should consider including sources such as citrus fruit, strawberries, red peppers, broccoli, potatoes, watermelon, cantaloupe, cauliflower, and kiwis in your meal.

There are two amino acids in the brain (L-tryptophan and L-tyrosine) which compete with each other to control brain function. The brain uses L-tyrosine to synthesize neurotransmitters such as dopamine and norepinephrine. Both these chemicals are essential to the processes of alertness, clear thinking and concentration. L-tyrosine production is stimulated by protein rich foods such as beans, nuts and soya. The brain uses L-tryptophan to synthesize the neurotransmitter serotonin, which is responsible for relaxation and satiety and slowing down reaction time. L-tryptophan production is stimulated by foods such as sunflower seeds, milk and carbohydrate rich food. Because these chemicals compete with each other, if you want to stay focused and alert throughout the day, then the best thing it to eat protein rich foods. That way L-tyrosine will reach the brain first, thus keeping your mental performance at maximum potential.

If you don’t allow your body a chance to self-cleanse then poor concentration and fatigue can become daily problems. You can help your body relieve itself of toxins by adjusting your dietary routine. Including alfalfa sprouts soybeans, brown rice, sesame salt, miso, and sea vegetables can help to clear toxins from your body and enervate your digestive and metabolic processes.

Adding friendly microflora to your digestive system by eating yogurt or probiotic supplements can also help to detoxify your system and prevent buildup of damaging bacteria in the intestines.

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There are also a number of herbal drinks, which are nutritious as well as helpful for detoxification processes. Dandelion, licorice root, yellow dock root, milk thistle, red clover and burdock root taken in extract or tablet form will each help to remove toxins from the body and boost the immune system. Lemon, beet, carrot, wheat grass and the juices of all leafy greens are the best juices for purifying the blood because as they help to build up essential nutrients.

Several mini-meals and snack throughout the day rather than a few large meals with long intervals will help your metabolism function better by balancing nutrients and keeping the brain supplied with oxygen. A moderate meal every four hours is adequate to balance brain chemical and improve mood and blood sugar levels. But don’t be tempted to nibble, this will lead to craving and gorging and will disrupt concentration further. It is also beneficial to increase your water intake to at least 6 glasses daily, and to limit caffeine (coffee, tea, and coke) to two beverages per day. Remember, if you are consuming less than 2,500 calories daily then it is advisable to at least consider taking a moderate vitamin supplement, but don’t be tempted to use supplements as replacements for nutritious foods.

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