Syntheses of five new layered quaternary chalcogenides SrScCuSe3, SrScCuTe3, BaScCuSe3, BaScCuTe3, and BaScAgTe3: crystal structures, thermoelectric properties, and electronic structures

Five new layered transition metal-based chalcogenides (SrScCuSe3, SrScCuTe3, BaScCuSe3, BaScCuTe3, and BaScAgTe3) were discovered by the exploratory solid-state method.

Pattern of Drug Utilisation in the Management of Hyperpigmentary Disorders in a Tertiary Care Hospital- An Observational Study

Introduction: Hyperpigmentary disorders, a common skin disorder affecting individuals with darker skin especially Asians, Blacks, Hispanics and American Indians, has a great impact on patient’s Quality of Life (QOL) with physical distress and psychological impact, and studies have shown that there is an improvement in QOL after treatment. The topical medications include sunscreens, demelanising agents, immunomodulators like tacrolimus, retinoids and Glucocorticoids (GCs). Systemic therapy includes GCs and antioxidants. Physical therapy includes chemical peels, microderma abrasion, Laser and light therapies and mesotherapy. Aim: To determine the pattern of drug use in hyperpigmentary disorders, to assess the tolerability of therapy and to analyse the effect of hyperpigmentary disorders of skin to the prescribed medications on the QOL before and after treatment. Materials and Methods: This was a prospective, observational study conducted on 102 newly diagnosed and untreated participants with hyperpigmentary disorders, who attended Dermatology Outpatient Department of a tertiary care hospital, Bangalore, India. The pattern of drug therapy, route of administration and Adverse Events (AEs) to the therapy was documented and analysed using descriptive statistics. The QOL using Dermatology Life Quality Index (DLQI) was assessed before and after treatment using Analysis of Variance (ANOVA). The patients were monitored every 30 days for three months to study the appropriateness, changing trends in prescription pattern, tolerability and QOL. Results: A total of 102 participants were enrolled for the study. The mean age was 33.71±10.68 years in males and 34.07±10.27 years in females. The different classes of drugs used were demelanising agents, sunscreens, antifibrinolytics, calcineurin inhibitors, keratolytics, glucocorticoids. The number ranged from 2-4 drugs per participant with a mean of 3.01±1.01. A significant improvement in the QOL was observed after treatment (p-value <0.01). Most of the AEs were self limiting except a few (acneiform eruption, rosacea) which were topical GCs induced. Conclusion: The individualised prescription pattern by treating physician was in concurrence with the standard line of therapy as they fulfilled the desired objectives. Hydroquinone (HQ), tranexamic acid and triple formula were the mainstay of treatment. The QOL improved after treatment.

Factors affecting self-medication practices among people living with type 2 diabetes in India- A systematic review

Self-medication practices of type 2 diabetes in India include the use of both traditional and western medications. It is important to understand the factors influencing self-medication. A total of 3257 studies were screened and nine studies (six quantitative and three qualitative) were included. The Hawker tool and Joanna Briggs Institute Critical Appraisal tool were used to assess the quality of studies. The findings of the quantitative studies were descriptively analysed while thematic analysis was performed to identify key themes from the qualitative studies. The analysis indicated that participants had greater trust in traditional medications regardless of their socioeconomic and/or educational backgrounds as these were often recommended by friends and family members. Low cost, ease of availability and perceived lower side effects of traditional medications were some of the factors contributing to greater trust. It is suggested that ongoing management of type 2 diabetes requires stringent policies and regulations in the dispensing of traditional and western medications. Continual education to inform people on the use of self-medications and its possible adverse effects is also required.

Production and application of polyclonal antibodies against SARS-CoV-2 viral spike protein. Development to rapid, highly sensitive diagnosis kit for early Corona viral detection among the population

Pathogenic novel coronavirus SARS-CoV-2 is a recently rising infection that causes a high death rate in contaminated individuals. Many of the individuals who are infected are unaware of the infection because they may be asymptomatic carriers of the virus.To early analyze the viral disease, we proposed advancement of SARS-CoV-2 spike (S) proteins-explicit polyclonal antibodies-based kit described in this specific circumstance. The tests, if made accessible from variety of makers, can help smooth out early immunodetection of the crown viral infection. The survey Safe and Patient Friendly Healthcare suggests early diagnosis as the key to patients recovering from this deadly ailment.

Mobilizing Policy (In)Capacity to Fight COVID-19: Understanding Variations in State Responses

The objective of this collection of essays is to gain insights into the different national-level state responses to COVID-19 around the world and the conditions that shaped them. The pandemic offers a natural experiment wherein the policy problem governments faced was the same but the responses they made were different, creating opportunities for comparison of both the kinds of policy tools being used and the factors that accounted for their choice. Accordingly, after surveying on-line databases of policy tools used in the pandemic and subjecting these to topic modelling to reveal the characteristics of a 'standard' national pandemic response, we discuss the similarities and differences found in specific responses. This is done with reference to the nature and level of policy capacity of respective governments, highlighting the critical roles played by (in)adequate preparation and lesson-drawing from past experiences with similar outbreaks or crises. Taken together the articles show how the national responses to the COVID-19 pandemic were shaped by the opportunity and capacity each government had to learn from previous pandemics and their capacity to operationalize and build political support for the standard portfolio of policy measures deployed to deal with the crisis. However, they also show how other factors such as the nature of national leadership, the organization of government and civil society, and blindspots towards the vulnerabilities of certain population segments also helped to shape policy responses to the pandemic.

Perception, Knowledge, and Attitude of Problem-based Learning among Dental College Students in India: A Closed-ended Questionnaire Study

Context:

Problem-based learning (PBL) is mostly a student-centered learning method, and it is a new method used in medical and dental education all over the world. In India, PBL is a part of the learning process sparingly followed. Contrary to other institutions, PBL has been introduced in dental curriculum along with the traditional curriculum very recently.

Aim:

The aim of this study was to evaluate the newly introduced PBL curriculum among the dental students using a closed-ended questionnaire on a five-point scale.

Materials and Methods:

The questionnaire on PBL was prepared in Google Forms, comprising 22 closed-ended questions on a five-point Likert scale, ranging from strongly disagree (1) to strongly agree (5). We carried out a pilot study in 10% of the target population to check validity and feasibility. Final study was conducted in the targeted population of 185 dental students who had undergone PBL sessions.

Results:

The responses for the questionnaire thus received from the students were compiled and analyzed using Google Forms software. Overall rating of PBL by the respondents was as follows. The majority of the student’s responses were agreed with 54.6% and a significant number of students strongly agreed with PBL at 33%.

Conclusions:

This study shows the responses of the students on aspects of group learning, imparting content knowledge, improvement of group skills, improvement of communication skills, and carrying out self-directed learning within the Indian context of dental health education.

Systemic Solutions for Addressing Non-Communicable Diseases in Low- and Middle-Income Countries

Non-communicable diseases (NCDs) have been on the rise in low- and middle-income countries (LMICs) over the last few decades and represent a significant healthcare concern. Over 85% of "premature" deaths worldwide due to NCDs occur in the LMICs. NCDs are an economic burden on these countries, increasing their healthcare expenditure. However, targeting NCDs in LMICs is challenging due to evolving health systems and an emphasis on acute illness. The major issues include limitations with universal health coverage, regulations, funding, distribution and availability of the healthcare workforce, and availability of health data. Experts from across the health sector in LMICs formed a Think Tank to understand and examine the issues, and to offer potential opportunities that may address the rising burden of NCDs in these countries. This review presents the evidence and posits pragmatic solutions to combat NCDs.

Exploring the synergistic effect of NixSn2xS4x thiospinel with MWCNTs for enhanced performance in dye-sensitized solar cells, the hydrogen evolution reaction, and supercapacitors

Trifunctional nickel tin sulfide (NixSn2xS4x) with a thiospinel-like structure composited with multiwalled carbon nanotubes (MWCNTs) (M-NixSn2xS4x) was synthesized by a facile method. The unit cell arrangement of the prepared composite was studied by density functional theory, and the theoretical interpretation satisfactorily inferred the presence of a synergistic effect between the thiospinel and MWCNTs. The high metallic conductivity and superior electrocatalytic activity of the M-NixSn2xS4x composite endow it with diverse applications. The composite shows promise as a counter electrode for dye-sensitized solar cells (efficiency of 4.67% for fluorine-doped indium tin oxide compared to 5.23% for platinum); an efficient catalyst for the hydrogen evolution reaction with good cycling stability and a low overpotential of -41 mV at a cathode current density of 10 mA cm2 and a Tafel slope of 43 mV dec-1 on a graphite sheet electrode; and an impressive capacitance material on a graphite sheet electrode alternative to expensive current collectors such as Ni foam, with a specific capacitance value of 1200 F g-1 at a current density of 1 A g-1 and a long life span of 92.6% that is retained for up to 15 000 cycles.

Evaluation of Knowledge, Psychological, Social and Economic Aspects of Covid-19 Pandemic among Dental Professionals- A Cross-sectional Study

Introduction: Medical as well as dental professionals are always at an increased risk of contracting infections in pandemics. The novel Coronavirus (nCoV), the causative agent of the COVID-19 pandemic is more contagious than other known members of Coronaviridae family. Aim: This research aims to evaluate the knowledge, psychological, social, and economic aspects of COVID-19 pandemic among dental professionals using a closed-ended questionnaire study. Materials and Methods: A cross-sectional study with close ended questionnaire was planned. The questionnaire form was prepared in the Google platform after receiving ethical clearance, with 39 questions under the headings of General Information, Knowledge, Psychological aspects, and Social and Economic aspects. The questionnaire link was circulated among dental professionals known to the research team through Email, WhatsApp, and Messenger. A total of 504 dental professionals participated in this study in five days. Knowledge score was calculated, and psychological stress was calculated using Likert scale. Economic aspect was measured using yes/no answers. Data were entered in an excel sheet and the data obtained were statistically analysed using the SPSS software, version 11.5. Chi-square test was done to evaluate whether there is an association between knowledge score and demographic factors and p-value was obtained. Results: There was almost equal gender distribution of respondents in the study. p-value obtained from chi-square test results correlating knowledge score with various demographic factors was not significant. A 59.9% of study participants were poorly informed on methods used to diagnose COVID-19 infection. A 44.4% of the respondents were psychologically stressed about infecting their family members and 72.22% were economically affected because of their profession. A 98.61% of the participants reported that they will wash their hands frequently, avoid crowded places and cancel travel plans in the near future. Conclusion: The present study evaluated the knowledge, psychological, social and economic aspects of COVID-19 pandemic among dental professionals. We identified that there is an urgent need to intensify the knowledge on COVID-19 and also to give psychological, social and economic support to dental professionals

Management and Disposal of Mercury and Amalgam in the Dental Clinics of South India: A Cross-Sectional Study

Context

Dental offices are known to be one of the largest users of inorganic mercury in the preparation of amalgam-a restorative material which, if not handled and disposed through scientific methods, can pose grave threats to the biosphere.

Aims

The objective of this study was to assess and record the mercury management and disposal strategies of dental practitioners belonging to the two South Indian states, Kerala and Tamil Nadu.

Subjects and Methods

A questionnaire regarding the usage and disposal of a filling material containing mercury (amalgam) was designed and distributed online. The 150 dental practitioners partaking in this study responded anonymously.

Results

The results were statistically analyzed using chi-square test and the P value was evaluated. The usage of amalgam was correlated with the age of the practitioner and the nature of practice and it was found to be statistically significant. The number of fillings was correlated with the years of practice and locality of the clinic, which were found to be statistically significant.

Conclusions

This study showed that mercury was widely preferred and utilized even today as a restorative material by dentists and dental specialists, despite the availability of other alternative strategies. Only a minor section of practitioners were found to be aware of the global changes in the guidelines pertaining to the handling and disposal of amalgam. We feel that Safe Mercury Amalgam Removal Technique, amalgam safety rules, and amalgam-free practice should be a part of the academic curriculum and continuing dental education.

Understanding the enhanced electrical properties of free-standing graphene paper: the synergistic effect of iodide adsorption into graphene

Free-standing graphene (FSG) paper plays a vital role in a wide variety of applications as an electrode material. Specifically, the electrical properties of FSG are the most important factor affecting its use as an electrode material. Herein, the vacuum filtration technique is utilized to fabricate GO paper, which is then reductively treated with HI. Initially, the electrical conductivity is measured for GO papers with different thicknesses by varying the concentration of GO precursor as well as the reduction time. The FSG paper with a thickness of 3 microns exhibits the lowest sheet resistance and further characterization is carried out to reveal the origin of this enhancement of electrical properties. The low resistance is attributed to its crystalline nature, stacking height (L_c), in-plane crystallite size (L_a) and defect density (n_D). Meanwhile, iodide ions intercalated into the graphene layers act as hole-carriers, and their intercalation is favoured over adsorption at the surface.

Synergistic effect of electrical properties for tri-iodide adsorbed free-standing graphene paper upon different exposure time of GO papers in HI reducing agent for 0.5 hour (FSG1), 1 hour (FSG2) and 24 hour (FSG3).

Assessment of pattern and outcomes of pesticides poisoning in a tertiary care hospital

OBJECTIVES

To assess the socio-demographic profile, pattern and treatment outcomes of pesticides poisoning.

METHODS

A prospective observational study was conducted at the department of emergency medicine of a South Indian tertiary care hospital for 1.5 years to study the pattern and outcomes of poisoning cases due to pesticides. Level of significance (P) <0.05 was considered as statistically significant.

RESULTS

A total of 375 poisoning victims with intentional/accidental exposure to pesticides were followed up and documented. The male-female ratio was 1:0.32; mean age was 31.65 ± 13.10 years. 72% of cases were rural residents. Organophosphorus compounds were the most implicated pesticides. Mean Glasgow Comatose Score (GCS) of the patients was 12.22 ± 3.86. 80.3% of patients recovered while 6.4% died. About 13.3% patients were lost to follow-up as they were discharged against medical advice (DAMA).

CONCLUSION

There was a statistical significance seen in the implication of pesticides for intentional poisoning with age, route of administration, area of residence and occupation of the victims. However, there was a strong association of the outcomes of poisoning with the toxic agent implicated for the poisoning.

Liquid chromatography/electrospray ionization tandem mass spectrometry study of repaglinide and its forced degradation products

RATIONALE

Stress stability studies of drugs have been recognized as an essential part of the drug development process. These studies are used to investigate the intrinsic stability of the drugs and for the development of a selective stability indicating assay method (SIAM). Stress testing is also useful for the formulation and packaging development, shelf-life determination and designing of manufacturing processes. As per regulatory guidelines, stress degradation studies and structural characterization should be carried out to establish degradation pathways of the drug, which is essential from both the efficacy and safety point of view. As the stress stability studies of repaglinide have not been reported in the literature, the present study has been undertaken.

METHODS

Repaglinide (RP), an oral anti-diabetic drug, was subjected to hydrolysis (acidic, alkaline and neutral), oxidation, photolysis and thermal stress conditions as per International Conference on Harmonization (ICH) guidelines Q1A (R2). The chromatographic separation of the drug and its degradation products (DPs) was achieved on an Agilent XDB C-18 column using the gradient elution method with a mobile phase consisting of 20 mM ammonium acetate and acetonitrile at flow rate of 1.0 mL min^-1 . The DPs were characterized using liquid chromatography/electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS) in combination with accurate mass measurements.

RESULTS

The drug degraded under hydrolytic and oxidative stress, while it was stable under thermal and photolytic stress conditions. In total, six DPs were formed and the LC/MS method described here can resolve all DPs from the parent as well as from each other under various stress conditions. To elucidate the structures of DPs, fragmentation of the [M + H]⁺ ions of RP and its DPs was studied by using LC/ESI-MS/MS combined with accurate mass measurements.

CONCLUSIONS

The forced degradation of RP carried out as per ICH guidelines results in the formation of six degradation products which have been characterized using LC/MS/MS in combination with accurate mass measurements.

Program design, implementation and performance: the case of social health insurance in India

Published works on health insurance tend to focus on program design and its impact, neglecting the implementation process that links the two and affects outcomes. This paper examines the National Health Insurance [Rashtriya Swasthya Bima Yojana (RSBY)] in India with the objective of assessing the role of implementation structures and processes in shaping performance. The central question that the paper addresses is: why does the performance of RSBY vary across states despite similar program design? Using a comparative case study approach analyzing the program's functioning in three states, it finds the answer in the differences in governance of implementation. The unavoidable gaps in design of health care program allow abundant scope for opportunistic behavior on the part of different stakeholders. The study finds that the performance of the program, as a result, depends on the extent to which the governance mechanism is able to contain and channel opportunistic behavior during implementation. By opening up the black box of implementation, the paper contributes to improving the performance of national health insurance in India and elsewhere.