How we handled COVID crisis? Experience of an Indian tertiary level NICU

Background: Coronavirus disease (COVID-19) has imposed several challenges in clinical care. With rapid increase in the disease, there has been lot of incidences of COVID-19 positive exposure among the healthcare workers resulting in major crisis. Aim: The aim of the study was to emphasize various methods that can be used to manage COVID-19 crisis due to accidental exposure. Methods: An unprecedented exposure occurred to a COVID-19 positive healthcare worker in the Neonatal Intensive Care Unit (NICU), which led to quarantine of almost 90% of the primary staff. The methods undertaken included communication and continuation of clinical care through teleconsultation (video calling, zoom meetings for clinical decision, telecharting of daily prescription, and facilitating manpower from allied departments [only one pediatric resident each day], and restoration of services with come back). Results: There were total 11 babies at the time of exposure. Two babies were on respiratory support. The parents were counseled through teleconsultation. Nine babies could be discharged during quarantine period and there was no significant deterioration in the clinical condition of the two babies on respiratory support. All the babies were tested for COVID-19 as per post-exposure protocol and remained negative. Conclusion: With the help of teleconsultation and support from allied specialties and other health facilities, the crisis of COVID-19 exposure can be handled well.

Severe Keratitis Caused by Acanthamoeba Genotype T12 in Thailand: A Case Report

Acanthamoeba keratitis is predominantly caused by genotype T4. We report a case of severe keratitis caused by Acanthamoeba in a 39-year-old man who had prior accidental exposure to a corrosive chemical. The patient developed central full thickness ring infiltration and epithelial defect with hypopyon that required keratoplasty. The acanthamoebae isolated from the patient exhibited thermotolerance phenotype with the capability to grow well at ambient temperature and at 42°C. Analysis of a near complete 18S rRNA gene of this isolate revealed a distinct sequence that can be unequivocally assigned to genotype T12, a rare genotype incriminated in corneal infections.

Cancer risk assessment of polycyclic aromatic hydrocarbons in the soil and sediments of Iran: a systematic review study

Polycyclic aromatic hydrocarbons (PAHs) are organic pollutants containing several hydrocarbon rings affecting human health according to the published monitoring data. Most of these compounds can be absorbed by the soil and sediments due to the abundance of production resources of these compounds in the soil around the cities and sediments of the Iranian coast. Cancer risk assessment (CRA) is one of the most effective methods for quantifying the potentially harmful effects of PAHs on human health. In this study, the published papers that monitored PAHs in Iran’s soil and sediments were reviewed. The extraction of different data and their equivalent factors were performed according to BaP equivalent, which is the main factor for calculating CRA of PAHs. The highest concentrations of PAHs were found in the sediments of Assaluyeh industrial zones (14,844 μg/kg), Khormousi region (1874.7 μg/kg), and Shadegan wetland (1749.5 μg/kg), respectively. Dermal exposure to sediments was 96% in adults, and 4% in children, and ingestion exposure to sediment was 99% in adults and 99.2% in children. Children dermal exposure to soil was 53%, and the accidental exposure to soil was 47%. In adults, dermal exposure to soil was 96% and the accidental exposure was 4%. The results of the present study indicated a significant, the carcinogenic risk of Polycyclic Aromatic Hydrocarbons in sediments of southern regions and soils of central regions of Iran is significant.

White paper on peanut allergy – part 1: Epidemiology, burden of disease, health economic aspects

Peanuts are Leguminosae, commonly known as the legume or pea family, and peanut allergy is among the most common food allergies and the most common cause of fatal food reactions and anaphylaxis.The prevalence of peanut allergy increased 3.5-fold over the past two decades reaching 1.4–2% in Europe and the United States. The reasons for this increase in prevalence are likely multifaceted. Sensitization via the skin appears to be associated with the development of peanut allergy and atopic eczema in infancy is associated with a high risk of developing peanut allergy.Until recently, the only possible management strategy for peanut allergy was strict allergen avoidance and emergency treatment including adrenaline auto-injector in cases of accidental exposure and reaction.This paper discusses the various factors that impact the risks of peanut allergy and the burden of self-management on peanut-allergic children and their caregivers.

Signaling through TLR5 mitigates lethal radiation damage by neutrophil-dependent release of MMP-9

Acute radiation syndrome (ARS) is a major cause of lethality following radiation disasters. A TLR5 agonist, entolimod, is among the most powerful experimental radiation countermeasures and shows efficacy in rodents and non-human primates as a prophylactic (radioprotection) and treatment (radiomitigation) modality. While the prophylactic activity of entolimod has been connected to the suppression of radiation-induced apoptosis, the mechanism by which entolimod functions as a radiomitigator remains poorly understood. Uncovering this mechanism has significant and broad-reaching implications for the clinical development and improvement of TLR5 agonists for use as an effective radiation countermeasure in scenarios of mass casualty resulting from accidental exposure to ionizing radiation. Here, we demonstrate that in contrast to radioprotection, neutrophils are essential for the radiomitigative activity of entolimod in a mouse model of lethal ARS. Neutrophils express functional TLR5 and rapidly exit the bone marrow (BM), accumulate in solid tissues, and release MMP-9 following TLR5 stimulation which is accompanied by an increase in the number of active hematopoietic pluripotent precursors (HPPs) in the BM. Importantly, recombinant MMP-9 by itself has radiomitigative activity and, in the absence of neutrophils, accelerates the recovery of the hematopoietic system. Unveiling this novel TLR5-neutrophil-MMP-9 axis of radiomitigation opens new opportunities for the development of efficacious radiation countermeasures to treat ARS following accidental radiation disasters.

Cosmetic Nd:YAG Laser-assisted Maculopathy Treated with Early Anti-vascular Endothelial Growth Factor Antibody

Purpose: To report a follow up of early intravitreal anti-vascular endothelial growth factor (VEGF) antibody treatment in a patient with maculopathy after accidental exposure to a high-powered cosmetic Nd:YAG laser.Case summary: A 36-year-old female patient visited our clinic with decreased visual acuity in the right eye after accidental exposure to a high-powered cosmetic Nd:YAG laser. The best-corrected visual acuity of the right eye was 0.1 and subretinal hemorrhage on the foveal area was observed during fundus examination. Optical coherence tomography revealed serous retinal detachment with hyperreflective disruption of the ellipsoid zone and retinal pigment epithelium-Bruch’s membrane complex. Intravitreal bevacizumab (Avastin®, 1.25 mg/0.05 mL; Roche Korea, Seoul, Korea) injections were performed three times. Visual acuity was unchanged at 6 months after the first visit. However, complete resolution of the subretinal hemorrhage was observed and there were no signs of secondary choroidal neovascularization or recurrence of choroidal hemorrhage.Conclusions: Early anti-VEGF antibody treatment in a patient with subfoveal hemorrhage and choroidal rupture after high-powered cosmetic Nd:YAG laser exposure improved morphology and prevented secondary choroidal neovascularization.

Do Social Media Matter?

Political experiences on social media—such as being targeted by electoral mobilization, seeing politically supportive messages, and accidentally encountering news—contribute to citizens’ repertoires of political participation. These associations are, on average, stronger for electoral mobilization than for accidental exposure, while exposure to supportive political content lies in between. Political experiences on social media do not disproportionally encourage participation in relatively easier, less resource-intensive activities, nor in activities primarily occurring in digital spaces, but foster hybrid participatory repertoires that combine higher-threshold and lower-threshold endeavors occurring both online and face to face. When placed amid the many different factors that affect participation, political experiences on social media play a distinctive and important role. However, their impact may be weaker than that of long-standing differences in resources and motivations among different groups of citizens.

Of Arguments, Accidents, and Asks

In Western democracies, most social media users are not part of political echo chambers but encounter a mix of views they agree and disagree with. It is mostly users who are heavily involved in politics and frequently discuss it online who predominantly see content that supports their views. Conversely, accidental exposure to political news on social media is widespread and reaches beyond the types of citizens who are typically more involved in politics. Substantial numbers of social media users are also targeted by electoral mobilization, and these users tend to be more politically involved than average. Different groups of users have distinctive types of political experiences on social media, and there are stark differences between the United States and other countries: American social media users are more likely to be exposed to politically supportive content, to accidentally encounter news, and to be targeted by electoral mobilization on social media.

Nanosystems in Cosmetic Products: A Brief Overview of Functional, Market, Regulatory and Safety Concerns

Nanosystems exhibit various innovative physico-chemical properties as well as a range of cosmetic functions, including increased skin retention for loaded compounds. The worldwide nano-market has therefore been consistently extensive in recent decades. This review summarizes the most important properties of nanosystems that are employed in cosmetics, including composition, functions and interactions with skin, with particular attention being paid to marketed products. Moreover, the worldwide regulatory landscape of nanomaterials used as cosmetic ingredients is considered, and the main safety concerns are indicated. In general, advanced physico-chemical characterization is preliminarily needed to assess the safety of nanomaterials for human health and the environment. However, there is currently a shortfall in global legislation as a universally accepted and unambiguous definition of a nanomaterial is still lacking. Therefore, each country follows its own regulations. Anyhow, the main safety concerns arise from the European context, which is the most restrictive. Accordingly, the poor dermal permeation of nanomaterials generally limits their potential toxic effects, which should be mainly ascribed to unwanted or accidental exposure routes.