EXPEDITIOUS RESPONSE TO EPIDEMICS: THE CHRONICLE OF NIPAH IN KERALA

Kerala witnessed a catastrophic outbreak of the Nipah virus (NiV) in May 2018, with a fatality rate of 40-75 per cent. The Nipah virus is recognised by the World Health Organization (WHO) as a significant public health concern, and it's one among the priority diseases for accelerated R&D due to the severe lack of available countermeasures against it. There is no vaccine or cure for the infection. The state of Kerala showed an exemplary response to the outbreak. This involved rapid and effective dissemination of necessary precautions to the broader public. Internet social media played a crucial role in spreading these messages. Although the disease claimed 21 lives, it could have been a lot worse if the state had not taken the measures for proper mitigation. This work gives a brief overview of the Nipah virus, followed by a comprehensive outline of the Kerala outbreak. Community and individual responses to the Nipah outbreak have been analysed to illustrate how various groups and individuals, from health care and tourism departments to religious leaders, played a role in successfully eradicating the virus. Kerala's experience in containing epidemics is expected to become a reference point for other states and regions that may find similar situations.

Microbial and Chemical Characteristics of Doogh (Iranian Fermented Milk Drink)

Background. Regarding the increasing public health concerns about the safety of foodstuffs, the current survey was designed to argue the presence of preservatives (e.g., sodium benzoate (SB), potassium sorbate (PS), and natamycin) and also the level of salt and fungi in 148 samples of yoghurt drink “Doogh.” Methods. The enumeration of fungi and determination of salt content of samples were performed according to the standard procedures. Preservative determination was performed by reverse phase high-performance liquid chromatography with UV detection (RV-HPLC-UV). Results. 0.1% of the total analyzed samples was above the permitted level of Iranian standard for SB (0%), while PS was not detected in any of them. Furthermore, natamycin in 0.11% of the analyzed samples had more than the permissible level of Iranian standard. Additionally, about 15% of the tested samples was higher than the Iranian standard level for fungi (<102 CFU/mL). The average amount of salt in the tested Doogh samples and also in the examined Kefir samples was significantly ( P < 0.001 ) lower than the standard amount of salt (<0.8 g/100). Conclusion. In conclusion, the quality of Doogh and Kefir samples were acceptable in terms of salt content. Kefir had a significantly ( P ≤ 0.001 ) lower amount of salt in comparison with Doogh. Taken together, underlining the results of the present study, no significant public health concern would exist respecting the mentioned additives.

Green Approaches of Flavonoids in Cancer: Chemistry, Applications, Management, Healthcare and Future Perspectives

In epidemiologic research, a cancer preventive benefit from plant-derived meals has been discovered with unusual consistency. However, identifying individual components responsible for this effect has been difficult. The polyphenols phytochemicals have been found to have biological activity, and they may work together to prevent cancer. Cancer is a significant public health concern in both developed and developing countries. Celery, chamomile, Ginkgo biloba, mint, red paper plants synthesized anticancer agents like taxol, irinotecan, camptothecin, topotecan, and vinblastine, vincristine, etoposide being used in clinical trials. In addition, Flavopiridol, roscovitine, combretastatin A-4, betulinic acid, and silvestrol are promising anticancer compounds. Flavonoids in vegetables, fruits, roots, and stems have demonstrated a wide range of anticancer properties, including modulating ROS, scavenging enzyme activities, participating in cell cycle arrest inducing apoptosis autophagy, and suppressing growth of tumour cell and invasiveness. This review highlighted flavonoids, cancer cell mechanism of action, applications in tumour management, and future perspectives. This review may play a significant role for industrialists and scientists working in this field.

Preponderance of blaKPC-Carrying Carbapenem-Resistant Enterobacterales Among Fecal Isolates From Community Food Handlers in Kuwait

Carbapenem-resistant Enterobacterales (CRE) are pathogens that have been found in several countries, with a significant public health concern. Characterizing the mode of resistance and determining the prevailing clones are vital to the epidemiology of CRE in our community. This study was conducted to characterize the molecular mode of resistance and to determine the clonality of the CRE fecal isolates among community food handlers (FHs) vs. infected control patients (ICPs) in Kuwait. Fecal CRE isolates obtained from FHs and ICPs from September 2016 to September 2018 were analyzed for their resistance genes. Gene characterization was carried out by polymerase chain reaction (PCR) assays and sequencing. Clonality of isolates was established by multilocus sequence typing (MLST). Of the 681 and 95 isolates of the family Enterobacterales isolated from FHs and ICPs, 425 (62.4%) and 16 (16.8%) were Escherichia coli, and 18 (2.6%) and 69 (72.6%) were Klebsiella pneumoniae, respectively. A total of 36 isolates were CRE with a prevalence of 5.3% among FH isolates and 87 (91.6%) among the ICPs. Of these, carbapenemase genes were detected in 22 (61.1%) and 65 (74.7%) isolates, respectively (p &lt; 0.05). The detected specific genes among FHs and ICPs were positive for blaKPC 19 (86.4%) and 35 (40.2%), and blaOXA 10 (45.5%) and 59 (67.8%), in addition to blaNDM 2 (9.1%) and 32 (36.8%), respectively. MLST assays of the E. coli and K. pneumoniae isolates revealed considerable genetic diversity and polyclonality as well as demonstrated multiple known ST types and eight novel sequence types. The study revealed a relatively high number of CRE harboring predominantly blaKPC-mediated CRE among the community FH isolates vs. predominant blaOXA genes among the ICPs. Those heterogeneous CRE isolates raise concerns and mandate more efforts toward molecular surveillance. A multinational study is recommended to monitor the spread of genes mediating CRE in the community of Arabian Peninsula countries.

Prediction of Breast Cancer using Extremely Randomized Clustering Forests (ERCF) Technique

cancer in breast indeed a significant public health concern in both developed and developing countries female population. It is almost one in three cancers diagnosed in all women. Data mining and pattern recognition applications in conjunction have been proven to be quite useful and relevant to extract the information useful for the medical purpose. This research work reflects the work based on Extremely Randomized Clustering Forests (ERCF) technique which is nothing but a type of pattern recognition technique that may be implemented as the prediction model for Breast Cancer (BC). The accuracy achieved through ERCF has also been compared with that of k-NN(Correlation) and k-NN(Euclidean) in this research work (where k-NN refers to k-Nearest Neighbours technique) and thereafter, final conclusions have been drawn depending upon the testing attributes. The results show that the accuracy of ERCF in the forecasting of breast cancer is so much larger than that of the exactness of k-NN(Correlation) and k-NN(Euclidean). Hence, ERCF, a randomized technique for pattern classification, is best

Improving Birth Weight Measurement and Recording Practices in Kenya and Tanzania: a Prospective Intervention Study With Historical Controls

Background Low birth weight (LBW) is a significant public health concern given its association with early-life mortality and other adverse health consequences that can impact the entire life-cycle. In many countries, accurate estimates of LBW prevalence are lacking due to inaccuracies in collection and gaps in available data. Our study aimed to determine LBW prevalence among facility-born infants in selected areas of Kenya and Tanzania, and to assess whether the introduction of an intervention to improve the accuracy of birth-weight measurement would result in a meaningfully different estimate of LBW prevalence than current practice. Methods We carried out a historically-controlled intervention study in 22 health facilities in Kenya and three health facilities in Tanzania. The intervention included: provision of high-quality digital scales, training of nursing staff on accurate birth weight measurement, recording and scale calibration practices, and quality maintenance support that consisted of enhanced supervision and feedback (prospective arm). The historically-controlled data were birth weights from the same facilities recorded in maternity registers for the same calendar months from the previous year measured using routine practices and manual scales. Results Between October 2019 and February 2020, we prospectively collected birth weights from 8,441 newborns in Kenya and 4,294 in Tanzania. Historical data were available from 9,318 newborns in Kenya and 12,007 in Tanzania. In the prospective sample, the prevalence of LBW was 12.6% (95% confidence intervals [CI]: 10.9%-14.4%) in Kenya and 18.2% (12.2%-24.2%) in Tanzania. In the historical sample, the corresponding prevalence estimates were 7.8% (6.5%-9.2%) and 10.0% (8.6%-11.4%). Compared to the retrospective sample, the LBW prevalence in the prospective sample was 4.8%-points (3.2%-6.4%) higher in Kenya and 8.2%-points (2.3%-14.0%) higher in Tanzania, corresponding to a risk ratio of 1.61 (1.38–1.88) in Kenya and 1.81 (1.30–2.52) in Tanzania. Conclusion Routine birth weight records under-estimate the risk of LBW among facility born infants in Kenya and Tanzania. The quality of birth-weight data can be improved by a simple intervention consisting of provision of digital scales and supportive training.

Introduction

Obsessive-compulsive disorder (OCD) was once considered a rare and untreatable condition. Over the past half-century, however, a dramatic surge in research has led not only to a clearer understanding of this problem but also to the realization that it is fairly common and impairing, afflicting up to about 3% of the population. When the prevalence and functional impairment are considered together with the anxiety and distress that individuals with this OCD experience, one recognizes that this condition represents a significant public health concern. With this in mind, the present volume focuses on advances and emerging clinical implications in the field of OCD and related disorders with respect to assessment, treatment, treatment augmentation, and basic science.

The Effect of Meteorological, Pollution, and Geographic Exposures on Death by Suicide: A Scoping Review

Suicide is a significant public health concern worldwide and in the United States. Despite the far-reaching impact of suicide, risk factors are still not well understood and efforts to accurately assess risk have fallen short. Current research has highlighted how potentially modifiable environmental exposures (i.e., meteorological, pollution, and geographic exposures) can affect suicide risk. A scoping review was conducted to evaluate the strength of the historical and current literature on the environment’s effect on suicide and suicide risk. Three databases (i.e., Medline, Embase, and PsychInfo) were reviewed to identify relevant studies and two authors independently reviewed studies considering pre-determined inclusion criteria. A total of 46 meteorological studies were included as well as 23 pollution studies and 12 geographic studies. Descriptive statistics, including counts, percentages, review of studies’ sample size (minimum, maximum, median, and interquartile range), were calculated using Excel and SAS 9.4. Overall, strong evidence supports that exposure to sunlight, temperature, air pollution, pesticides, and high altitude increases suicide risk, although effect sizes range from very small to small.

Combating the COVID-19 Pandemic: Experiences of the First Wave From Nepal

Unprecedented and unforeseen highly infectious Coronavirus Disease 2019 (COVID-19) has become a significant public health concern for most of the countries worldwide, including Nepal, and it is spreading rapidly. Undoubtedly, every nation has taken maximum initiative measures to break the transmission chain of the virus. This review presents a retrospective analysis of the COVID-19 pandemic in Nepal, analyzing the actions taken by the Government of Nepal (GoN) to inform future decisions. Data used in this article were extracted from relevant reports and websites of the Ministry of Health and Population (MoHP) of Nepal and the WHO. As of January 22, 2021, the highest numbers of cases were reported in the megacity of the hilly region, Kathmandu district (population = 1,744,240), and Bagmati province. The cured and death rates of the disease among the tested population are ~98.00 and ~0.74%, respectively. Higher numbers of infected cases were observed in the age group 21–30, with an overall male to female death ratio of 2.33. With suggestions and recommendations from high-level coordination committees and experts, GoN has enacted several measures: promoting universal personal protection, physical distancing, localized lockdowns, travel restrictions, isolation, and selective quarantine. In addition, GoN formulated and distributed several guidelines/protocols for managing COVID-19 patients and vaccination programs. Despite robust preventive efforts by GoN, pandemic scenario in Nepal is, yet, to be controlled completely. This review could be helpful for the current and future effective outbreak preparedness, responses, and management of the pandemic situations and prepare necessary strategies, especially in countries with similar socio-cultural and economic status.

Medications against drugs: Development of medications to prevent and treat substance use disorders

Substance use disorder (SUD) is a significant public health concern. Unfortunately, there are few safe and effective medications to treat SUD and efficacy is suboptimal. There are important financial and scientific obstacles to develop new compounds, but recent advances in the discovery of new brain receptors and neurocircuits are offering opportunities to develop new pharmacotherapies. A systematic scientific approach to develop medications is required to demonstrate their safety and efficacy, bring it to market, and prescribe it to patients. The purpose of this manuscript is to provide a general overview of the challenges and opportunities in medications development for SUD, describe the phased approach of this development, the medications approved, and those that appear most promising.