Disinfection by 1% sodium hypochlorite through cold fogging: an innovative appropriate technology against COVID-19 in public health

Background: SARS-CoV-2 is an enveloped virus with a fragile outer lipid envelope that makes it more susceptible to disinfectants compared to non-enveloped viruses. In this article, dispensation through cold Fogger was innovated as a measure against aerosol-based transmission of COVID-19 in large, enclosed spaces like hospitals, nursing homes, isolation centers and quarantine facilities.Methods: Ecological exploratory to study 1% sodium hypochlorite through cold fogging as an innovative appropriate technology. Study setting included medical college in Western Maharashtra and the selected COVID-19 hospitals Statistical analysis-The data was collated in MS excel and analysed using IBM SPSS version 23.0.Results: Average of 2.9 % HCWs got infected in hospitals where the innovation was used to disinfect, as compared to infections rates of 21.5% in other premier health institutes. There was strong negative correlation between percentage of health care infected and liters of sodium hypochlorite used with R2=0.56. Also, on applying Spearman correlation coefficient there was good negative correlation (-0.8).Conclusions: This appropriate technology has shown significant reduction in infection, with antecedent benefit of decreased morbidity and mortality of precious trained manpower. It gives much better dis-infection at 07 times less the cost and can be conveniently used for dis-infection against COVID-19 at the very periphery of primary health care delivery done at Sub-centres and PHCs.

Recent Developments in Microbe–Plant-Based Bioremediation for Tackling Heavy Metal-Polluted Soils

Soil contamination with heavy metals (HMs) is a serious concern for the developing world due to its non-biodegradability and significant potential to damage the ecosystem and associated services. Rapid industrialization and activities such as mining, manufacturing, and construction are generating a huge quantity of toxic waste which causes environmental hazards. There are various traditional physicochemical techniques such as electro-remediation, immobilization, stabilization, and chemical reduction to clean the contaminants from the soil. However, these methods require high energy, trained manpower, and hazardous chemicals make these techniques costly and non-environment friendly. Bioremediation, which includes microorganism-based, plant-based, microorganism-plant associated, and other innovative methods, is employed to restore the contaminated soils. This review covers some new aspects and dimensions of bioremediation of heavy metal-polluted soils. The bioremediation potential of bacteria and fungi individually and in association with plants has been reviewed and critically examined. It is reported that microbes such as Pseudomonas spp., Bacillus spp., and Aspergillus spp., have high metal tolerance, and bioremediation potential up to 98% both individually and when associated with plants such as Trifolium repens, Helianthus annuus, and Vallisneria denseserrulata. The mechanism of microbe’s detoxification of metals depends upon various aspects which include the internal structure, cell surface properties of microorganisms, and the surrounding environmental conditions have been covered. Further, factors affecting the bioremediation efficiency and their possible solution, along with challenges and future prospects, are also discussed.

Research on the Educational Issues of the Emerging Tourism Industry in Developing Countries

This research explores emerging concepts of tourism education, training, and entrepreneurship development. Nowadays, the discourses on this theme have been growing in both developed and developing countries, especially to reduce unemployment rates through the education of young people. For this purpose, this study uses secondary data sources to analyze individual rationality and the creativity of educated young people for entrepreneurship development in the business sector. The analytical framework begins from the investigation of the tourism industry and the processes for empowering those people since tourism industry is considered as one of the agents of economic changes in developing countries, such as Nepal. However, skilled and trained manpower are required to operate well. The main theme of this study is that the aforesaid manpower can be developed with entrepreneurship skills by providing education and training in this business. This study entirely agrees that once the tourism industry is well run by removing the hurdles seen in this sector, there would be an increase in employment opportunities and a raise in the country’s revenue in addition to solving many other social problems.

Detection of COVID-19 from Chest CT Images Using CNN with MLP Hybrid Model

COVID-19 when left undetected can lead to a hazardous infection spread, leading to an unfortunate loss of life. It’s of utmost importance to diagnose COVID-19 in Infected patients at the earliest, to avoid further complications. RT-PCR, the gold standard method is routinely used for the diagnosis of COVID-19 infection. Yet, this method comes along with few limitations such as its time-consuming nature, a scarcity of trained manpower, sophisticated laboratory equipment and the possibility of false positive and negative results. Physicians and global health care centers use CT scan as an alternate for the diagnosis of COVID-19. But this process of detection too, might demand more manual work, effort and time. Thus, automating the detection of COVID-19 using an intelligent system has been a recent research topic, in the view of pandemic. This will also help in saving the physician’s time for carrying out further treatment. In this paper, a hybrid learning model has been proposed to identify the COVID-19 infection using CT scan images. The Convolutional Neural Network (CNN) was used for feature extraction and Multilayer Perceptron was used for classification. This hybrid learning model’s results were also compared with traditional CNN and MLP models in terms of Accuracy, F1-Score, Precision and Recall. This Hybrid CNN-MLP model showed an Accuracy of 94.89% when compared with CNN and MLP giving 86.95% and 80.77% respectively.

Assessing a chip based rapid RTPCR test for SARS CoV-2 detection (TrueNat assay): A diagnostic accuracy study

COVID-19 testing is required before admission of a patient in the hospitals, invasive procedures, major and minor surgeries etc. Real Time Polymerase chain reaction is the gold standard test for the diagnosis, but requires well equipped biosafety laboratory along with trained manpower. In this study we have evaluated the diagnostic accuracy of novel TrueNat molecular assay for detecting SARS CoV-2. TrueNat is a chip-based real time PCR test and works on portable, light weight, battery powered equipment and can be used in remote areas with poor infrastructure. In this study 1807 patients samples were collected for both TrueNat and RTPCR COVID-19 testing during study period. Of these 174 (9.7%) and 174 (15%) were positive by RTPCR and TrueNat respectively and taking results of RTPCR as gold standard TrueNat test showed a sensitivity, specificity and diagnostic accuracy of 69.5, 90.9% and 89.2% respectively. It can be concluded that TrueNat is a simple, easy to use, good rapid molecular diagnostic test for diagnosis of COVID-19 especially in resource limited settings and will prove to be a game changer of molecular diagnostics in future.

Evaluation of Microchip-Based Point-Of-Care Device “Gazelle” for Diagnosis of Sickle Cell Disease in India

Sickle cell disease is a major public health problem in India. Lack of rapid and reliable diagnostic methods result in many avoidable deaths in affected population. Current diagnostic tools are laboratory based, expensive and need trained manpower. Here, we evaluated the performance of a microchip-based cellulose acetate electrophoresis test, “Gazelle” in the tribal-dominated Indian states of Chhattisgarh and Madhya Pradesh. A total of 1,050 patients were screened by sickle cell solubility, hemoglobin (cellulose acetate) electrophoresis, high-performance liquid chromatography (HPLC) and Gazelle. Of the total 1,027 test results obtained, 960 tests were “Valid” (93.5%) and included in the analysis. Gazelle identified all patients with disease (HbSS and Thalassemia Major) with 100% accuracy. Gazelle demonstrated 100% sensitivity when comparing sickle cell disease (SCD) vs. sickle cell trait and SCD vs. normal. Specificity was 98.9% and 99.5% when comparing SCD vs. trait and trait vs. normal, respectively. Specificity was 99.8% when comparing SCD vs. normal and sensitivity was 99.3% when comparing trait vs. normal. Overall, Gazelle yielded a high accuracy (99.0%) compared to reference standard tests (hemoglobin electrophoresis and HPLC). Gazelle is a low-cost, rapid diagnostic test with high accuracy for detecting SCD both quantitatively and qualitatively. Gazelle can be a potential screening tool for the rapid diagnosis in resource limited settings and developing countries with high burden of hemoglobin disorders.

304 - Mental healthcare services and advocacy for older people amidst the COVID crisis: Voices from South Asia

Asia has some of the fastest developing economies and largest conglomerations of populations in the world. One such geographically unique region is South Asia, which accounts for nearly 25% of the global population and one-fifth of the psychiatric morbidity worldwide. This region is also ageing rapidly compared to rest of the world due to modifications in healthcare facilities, hygiene, and lifestyle as well as improved sanitation and infection control. Besides, some of the South Asian countries have also been worst-hit by the COVID-19 pandemic which has led to an exaggerated psychosocial crisis among their older people. Many of these nations face issues with community psychiatric care, trained manpower, socio-economic resources, legislation catering to psychological care and health inequalities. However, recent years have also witnessed paradigm shift in mental health policies, infrastructure and technology among these nations. Climate changes, migration, displacement and ecological characteristics further make South Asia unique in mental health needs and challenges.With this background, leaders in the field of psychogeriatric care from some of the South Asian nations come together to discuss and highlight upcoming strategies for mental health advocacy and service delivery among older people in these regions. Mutual collaboration and cross-country research are globally called upon.Panelists:1. Dr. Gautam Saha (President, Indian Psychiatric Society) [email protected]. Dr. G.Prasad Rao (President, Indian Association of Geriatric Mental Health) [email protected]. Dr. Sudarshan Narsingh (President, Psychiatrists’ Association of Nepal & President, SAARC Psychiatric Federation) [email protected]. Dr. Wazizul Alam Chowdhury (President, Bangladesh Associa tion of Psychiatrists) [email protected]. Dr. Afzal Javed (President, World Psychiatric Association and Chairman, Pakistan Psychiatric Centre, Fountain House, Lahore) [email protected]:Dr. Debanjan Banerjee (Old Age Psychiatrist, NIMHANS, Bangalore; Member, IPA Public Awareness and Advocacy Committee) [email protected]

Sub-specialty in neurosurgery: Time has come for Nepal

With over 90 practicing neurosurgeons in the country, should we be developing sub-specialty in neurosurgery? The number of trained manpower has risen steadily, since neurosurgery was first practiced in Nepal in 1961.1Though we are halfway to the milestone of achieving a ratio of 1 neurosurgeon for every 1 lac population, the situation here is much better than in other Sub-Saharan African and south east Asian countries.2 All the seven states have now neurosurgeons working in its hospitals, though most are still concentrated in the capitals and major towns. Recently for the last five years, despite of lack of training opportunities for sub-specialty in the country, we have seen young neurosurgeons getting trained in skull base, spine, minimally invasive or endoscopic neurosurgery, functional neurosurgery, pediatric neurosurgery and vascular neurosurgery from abroad. There is a variation in nature and period of training, ranging from observership of a few weeks to fellowship of over a year. The interest seems to be getting stronger as the facilities and complexities of cases are increasing. In such scenarios, rather than few individuals we need units or teams offering these sub-specialized services from key centers and start supervised systematic training for the interested.

Development of Freeze-dried Reagents based Multiplex PCR Assay for the Detection of Common and Emerging Abortion-causing Pathogens

Bovine abortion is economically one of the most devastating problems faced by dairy farmers. Apart from non-infectious causes, several infectious pathogens are responsible for abortions, which sometimes manifests as abortion storms. Vaccine against several pathogens is available, in spite of that, abortions cause huge economic losses for the dairy sector. Timely and accurate identification of the etiological agent helps in adopting the mitigation steps to control the damage caused. In addition to the common abortion-causing pathogens such as Brucella abortus, Bovine herpesvirus-1 (BHV-1), bovine viral diarrhea virus (BVDV), several emerging viral causes are being investigated for their possible role in abortion, either exclusively or as co-infection. Molecular methods are widely accepted for the identification of the involved pathogens. However, these assays require individual screening against each pathogen which is time-consuming and uneconomical, hence the multiplex format of PCR assays has been adopted by several laboratories. Multiplexing in real-time PCR is a sensitive and reliable technique, but it requires trained manpower and sophisticated equipment which is largely unavailable in regional disease diagnostic laboratories in India. Hence, in this study, a user-friendly, ready-to-use, gel-based RT-PCR multiplex assay was developed for simultaneous detection of three common pathogens (B. abortus, BHV-1, and BVDV) and two emerging pathogens; bluetongue virus (BTV) as a cause of abortions in bovine and Schmallenberg virus (SBV). After the standardization of the assay, a panel of 211 samples was screened. A high degree of concordance was observed which indicates the developed multiplex PCR assay is reliable and has the potential for screening at regional diagnostic laboratories.

Low awareness and common misconceptions about schistosomiasis in endemic lowland areas in Western Ethiopia: a mixed-methods study

Background Understanding the health behavior of the target population is crucial for sustainable schistosomiasis control. The aim of this study was to assess schistosomiasis related levels of knowledge, attitude, and practices of communities in lowland areas of western Ethiopia, where schistosomiasis is endemic. Methods A community-based multilevel triangulation mixed-methods design was conducted in three schistosomiasis endemic villages in the Abbey and Didessa valleys of the Benishangul Gumuz Region of Western Ethiopia, where mass drug administration (MDA) was done 30 years back and again the last 5 years. A structured survey questionnaire, in-depth interviews, focused group discussions, and observation was conducted to assess levels of knowledge, attitude, and practices related to schistosomiasis in the communities. Results Among the survey participants, 13% reported having heard of schistosomiasis, locally called Pecka (meaning worm). The majority of this 13% believe that schistosomiasis is caused by the biting of the worm Pecka, while others say drinking dirty water is the cause of infection, or they didn’t know what the cause is. A majority of respondents answered “I don’t know” to most of the questions about established knowledge of schistosomiasis. Male participants and students were more aware of schistosomiasis than their counterparts, and awareness increased with the educational level. Only one participant perceived that schistosomiasis was a serious disease. There were negative attitudes and misconceptions about the drug used in the mass treatment and many complaints were raised related to the size of the tablet and its side effects. There was no local budget and specific plan to prevent and control the disease. Local health personnel had insufficient knowledge about schistosomiasis, and the diagnosis and treatment capacities of local health institutions were poor. Conclusion In the current research area, schistosomiasis prevention and control recommendations should be redesigned to change the knowledge, attitudes, and practices of the community and local health workers. It is also necessary to have the local budget and trained manpower in order to diagnose and treat schistosomiasis locally. There is a great need to have a safer Praziquantel pediatric formulation.