Colonial Legacies and Maternal Health in South Asia

This chapter provides important insights into why culturalist, technocratic, and neoliberal approaches to maternal and neonatal health have persisted in South Asia despite critiques by bringing together a historical analysis of the ‘problem of childbirth’ under colonialism with the interdisciplinary literature on the medicalization of childbirth. This chapter establishes the central role of British women doctors who fashioned themselves as colonial experts on maternal health in shaping developmental discourses regionally and internationally. British women doctors’ professional project drove their participation in a wider international epistemic community and the creation of infrastructure to improve maternal health in South Asia which emulated British maternalist discourses. Their interventions influenced anti-colonial nationalist attempts to reform reproduction and initiatives by middle-class South Asian women. These reformist discourses, which braided eugenicist concerns with communal polarization and marginalized subaltern medical auxiliaries, continue to pervade post-colonial interventions. The chapter also explores the emergence of international health organizations in the interwar period which produced a discourse linking health and governance to which critiques of conditions of maternity in South Asia responded.

Clusters of science and health related Twitter users become more isolated during the COVID-19 pandemic

COVID-19 represents the most severe global crisis to date whose public conversation can be studied in real time. To do so, we use a data set of over 350 million tweets and retweets posted by over 26 million English speaking Twitter users from January 13 to June 7, 2020. We characterize the retweet network to identify spontaneous clustering of users and the evolution of their interaction over time in relation to the pandemic’s emergence. We identify several stable clusters (super-communities), and are able to link them to international groups mainly involved in science and health topics, national elites, and political actors. The science- and health-related super-community received disproportionate attention early on during the pandemic, and was leading the discussion at the time. However, as the pandemic unfolded, the attention shifted towards both national elites and political actors, paralleled by the introduction of country-specific containment measures and the growing politicization of the debate. Scientific super-community remained present in the discussion, but experienced less reach and became more isolated within the network. Overall, the emerging network communities are characterized by an increased self-amplification and polarization. This makes it generally harder for information from international health organizations or scientific authorities to directly reach a broad audience through Twitter for prolonged time. These results may have implications for information dissemination along the unfolding of long-term events like epidemic diseases on a world-wide scale.

Antimicrobial resistance in the protracted Syrian conflict: halting a war in the war

The Syrian conflict has damaged key infrastructure and indirectly affected almost all parts of the Middle East and Europe, with no end in sight. Exhausting conditions created by the Syrian crisis and related massive displacement promote the emergence of numerous public health problems that fuel antimicrobial resistance (AMR) development. Here, we explore the current situation of the Syrian displaced population, and AMR inside Syria and among refugees in host countries. We then suggest a roadmap of selected key interventions and strategies to address the threat of AMR in the context of the Syrian crisis. These recommendations are intended to urge health policy-makers in governments and international health organizations to optimize and push for implementing an effective policy taking into consideration the current obstacles.

Pharmaceutical regulations in Iraq: from medicine approval to post-marketing

Background: Recent information on regulation of the pharmaceutical sector in Iraq is scarce. Aim: This report summarizes the regulations governing pharmaceutical products in Iraq, assesses the challenges faced and makes recommendations to tackle these issues. Methods: The Iraq pharmaceutical country profile 2020, prepared by the Iraqi Ministry of Health in collaboration with the World Health Organization (WHO) in 2020, was the main source of information. Results: Despite all the efforts by the Ministry of Health to provide adequate and safe medicines, the Iraqi pharmaceutical sector has several challenges, including inadequate budget allocated to the ministry, shortages in essential medicines, underutilization of electronic technologies in the management of regulation-related work, a large number of substandard and falsified medications in the private sector and a stagnant national pharmaceutical industry. Conclusion: The Ministry of Health needs more financial support from the federal government to fund its activities and technical support from international health organizations to provide training and resources.

Use of Azithromycin to Treat Covid-19: A Critical View

This article aims to understand the pharmacological properties of AZT and analyze possible reasons for its use in the treatment of COVID-19 alone or associated with chloroquine (CQ) or hydroxychloroquine (HCQ). For this, a bibliographical research was carried out in the following databases: Scientific Electronic Library Online (SciELO), US National Library of Medicine (PUBMED) and ScienceDirect. In the study, data on the pharmacology of Azithromycin (AZT) were collected, its history, its uses, highlighting the research conducted in 2020 with this drug for the treatment of COVID-19. It should be noted that AZT is an antibiotic of the macrolide subclass with varied pharmacotherapeutic use, especially in the treatment of bacterial, respiratory, genitourinary and enteric infections. During the SARS-COV-2 pandemic, HCQ-associated AZT was considered for the treatment of the disease due to its in vitro results. There was much debate about the use of the combination of these drugs and even before the results of clinical studies were published, the Ministry of Health has already made recommendations regarding the use of these drugs to treat COVID-19. National and international health organizations were more cautious and highlighted the lack of scientific evidence for this use. The information collected in this review of the literature suggests that the administration of AZT or AZT associated with HCQ or CQ was not effective in the treatment of COVID-19 patients for both mild and moderate or severe cases.

Potential Mucosal Irritation Discrimination of Surface Disinfectants Employed against SARS-CoV-2 by Limacus flavus Slug Mucosal Irritation Assay

Preventive measures have proven to be the most effective strategy to counteract the spread of the SARS-CoV-2 virus. Among these, disinfection is strongly suggested by international health organizations’ official guidelines. As a consequence, the increase of disinfectants handling is going to expose people to the risk of eyes, mouth, nose, and mucous membranes accidental irritation. To assess mucosal irritation, previous studies employed the snail Arion lusitanicus as the mucosal model in Slug Mucosal Irritation (SMI) assay. The obtained results confirmed snails as a suitable experimental model for their anatomical characteristics superimposable to the human mucosae and the different easily observed readouts. Another terrestrial gastropod, Limacus flavus, also known as “ Yellow slug “, due to its larger size and greater longevity, has already been proposed as an SMI assay alternative model. In this study, for the first time, in addition to the standard parameters recorded in the SMI test, the production of yellow pigment in response to irritants, unique to the snail L. flavus, was evaluated. Our results showed that this species would be a promising model for mucosal irritation studies. The study conducted testing among all those chemical solutions most commonly recommended against the SARS-CoV-2 virus.

Effectivity Analysis of SARS-CoV-2 Nasopharyngeal Swab Rapid Testing Kits in Pakistan: A Scenario of Inadequate COVID-19 Diagnosis

COVID-19 pandemic has urged the need of rapid detection of SARS-CoV-2 in limited time frame. To cope with current, COVID-19 expanding scenario, accurate diagnosis of SARS-CoV-2 should be ensured by both national and international health organizations. Sporadic marketing of SARS-CoV-2 rapid detection kits raises questions regarding quality control and assurance. To aim of this study was to examine the effectiveness of SARS-CoV-2 nasopharyngeal swab based rapid detection kits, in comparison to gold standard USFDA approved triple target real-time polymerase chain reaction. A cross-sectional study of 1500 suspected COVID-19 patients was conducted. 100 RT-PCR confirmed patients nasopharyngeal swabs were evaluated for RDT. The COVID-19/SARS-CoV-2 NSP based RDT analysis showed 78% reactivity. Among RT-PCR confirmed negative subjects, 49.3% showed false positivity. The positive predictive analysis revealed 67.82% values, while the negative predictive vales of were 64.40%. The NSP RDTs showed limited sensitivities and specificities compared to gold standard RT-PCR. Accurate surveillance of COVID-19 is dependent upon authentic and validated SARS-CoV-2 detection nation-wide, which needs to be monitored by higher authorities. This study is critical for designing adequate measures by several COVID-19 strategic organizations to prevent future viral epidemics.

A probabilistic model to evaluate the effectiveness of main solutions to COVID-19 spreading in university buildings according to proximity and time-based consolidated criteria

University buildings are one of the most relevant closed environments in which the COVID-19 event clearly pointed out stakeholders’ needs toward safety issues, especially because of the possibility of day-to-day presences of the same users (i.e. students, teachers) and overcrowding causing long-lasting contacts with possible “infectors”. While waiting for the vaccine, as for other public buildings, policy-makers’ measures to limit virus outbreaks combine individual’s strategies (facial masks), occupants’ capacity and access control. But, up to now, no easy-to-apply tools are available for assessing the punctual effectiveness of such measures. To fill this gap, this work proposes a quick and probabilistic simulation model based on consolidated proximity and exposure-time-based rules for virus transmission confirmed by international health organizations. The building occupancy is defined according to university scheduling, identifying the main “attraction areas” in the building (classrooms, break-areas). Scenarios are defined in terms of occupants’ densities and the above-mentioned mitigation strategies. The model is calibrated on experimental data and applied to a relevant university building. Results demonstrate the model capabilities. In particular, it underlines that if such strategies are not combined, the virus spreading can be limited by only using high protection respiratory devices (i.e. FFP3) by almost every occupant. On the contrary, the combination between access control and building capacity limitation can lead to the adoption of lighter protective devices (i.e. surgical masks), thus improving the feasibility, users’ comfort and favorable reception. Simplified rules to combine acceptable mask filters-occupants’ density are thus provided to help stakeholders in organizing users’ presences in the building during the pandemic.

Endocrine Disruptor Potential of Short- and Long-Chain Perfluoroalkyl Substances (PFASs)—A Synthesis of Current Knowledge with Proposal of Molecular Mechanism

Endocrine disruptors are a group of chemical compounds that, even in low concentrations, cause a hormonal imbalance in the body, contributing to the development of various harmful health disorders. Many industry compounds, due to their important commercial value and numerous applications, are produced on a global scale, while the mechanism of their endocrine action has not been fully understood. In recent years, per- and polyfluoroalkyl substances (PFASs) have gained the interest of major international health organizations, and thus more and more studies have been aimed to explain the toxicity of these compounds. PFASs were firstly synthesized in the 1950s and broadly used in the industry in the production of firefighting agents, cosmetics and herbicides. The numerous industrial applications of PFASs, combined with the exceptionally long half-life of these substances in the human body and extreme environmental persistence, result in a common and chronic exposure of the general population to their action. Available data have suggested that human exposure to PFASs can occur during different stages of development and may cause short- or/and long-term health effects. This paper synthetizes the current literature reports on the presence, bioaccumulation and, particularly, endocrine toxicity of selected long- and short-chain PFASs, with a special emphasis on the mechanisms underlying their endocrine actions.

Sexual violence against women by so-called Islamic state of Iraq and Syria (ISIS): protocol for a systematic review

Background Violence against women and girls (VAWG) has been significantly increased by the rise of conflict and insecurity in the territories under controlling so-called Islamic State of Iraq and Syria (ISIS). This review aims to provide an understanding of the consequences of ISIS sexual violence against women. Methods Electronic databases including MEDLINE, Cochrane Central Register of Controlled Trials, JSTOR, Web of Science, Scopus, Science Direct, ProQuest, and Google Scholar are searched for the articles published from 2014 to 2020. Then, two reviewers will systematically identify the articles which will meet the inclusion criteria. Using a standard checklist, methodological quality of articles is assessed. The findings will be summarized, and a narrative synthesis of data will be reported. Discussion This systematic review with a narrative synthesis approach will provide the important information about the gap in knowledge and detailed summary of the existing evidence on consequences of ISIS's systematic sexual violence against women. The evidence is useful for the international health organizations to plan and develop clinical guidelines with interest to reduce the consequences of sexual violence in the armed conflict territories. Systematic review registration PROSPERO CRD42019124215