An Eco-Friendly Synthesis Approach for Enhanced Photocatalytic and Antibacterial Properties of Copper Oxide Nanoparticles Using Coelastrella terrestris Algal Extract.

Background: In the current scenario, the synthesis of nanoparticles (NPs) using environmentally benign methods has gained significant attention due to their facile processes, cost-effectiveness, and eco-friendly nature. Methods: In the present study, copper oxide nanoparticles (CuO NPs) were synthesized using aqueous extract of Coelastrella terrestris algae as a reducing, stabilizing, and capping agent. The synthesized CuO NPs were characterized by X-ray diffraction (XRD), UV-visible spectroscopy (UV-Vis), Fourier transform infrared spectroscopy (FTIR), dynamic light scattering (DLS), and field emission scanning electron microscopy (FE-SEM) coupled with energy-dispersive X-ray spectroscopy (EDS). Results: XRD investigation revealed that the biosynthesized CuO NPs were nanocrystalline with high-phase purity and size in the range of 4.26 nm to 28.51 nm. FTIR spectra confirmed the existence of secondary metabolites on the surface of the synthesized CuO NPs, with characteristic Cu-O vibrations being identified around 600 cm-1, 496 cm-1, and 440 cm-1. The FE-SEM images predicted that the enhancement of the algal extract amount converted the flattened rice-like structures of CuO NPs into flower petal-like structures. Furthermore, the degradation ability of biosynthesized CuO NPs was investigated against Amido black 10B (AB10B) dye. The results displayed that the optimal degradation efficacy of AB10B dye was 94.19%, obtained at 6 pH, 50 ppm concentration of dye, and 0.05 g dosage of CuO NPs in 90 min with a pseudo-first-order rate constant of 0.0296 min-1. The CuO-1 NPs synthesized through algae exhibited notable antibacterial efficacy against S. aureus with a zone of inhibition (ZOI) of 22 mm and against P. aeruginosa with a ZOI of 17 mm. Conclusion: Based on the findings of this study, it can be concluded that utilizing Coelastrella terrestris algae for the synthesis of CuO NPs presents a promising solution for addressing environmental contamination.

Asterarcys quadricellulare algae-mediated copper oxide nanoparticles as a robust and recyclable catalyst for the degradation of noxious dyes from wastewater.

The present article explores the synthesis of copper oxide nanoparticles (CuO NPs) utilizing Asterarcys quadricellulare algal extract and examines the effect of various reaction parameters on the size and morphology of the nanoparticles. The samples were thoroughly characterized using XRD, FTIR, UV-vis, FE-SEM, and EDS techniques. The XRD analysis disclosed that the size of the synthesized nanoparticles could be controlled by adjusting the reaction parameters, ranging from 4.76 nm to 13.70 nm along the highest intensity plane (111). FTIR spectroscopy provided evidence that the phytochemicals are present in the algal extract. We have compared the photocatalytic activity of biologically and chemically synthesized CuO NPs and observed that biologically synthesized CuO NPs showed better photocatalytic activity than chemically synthesized CuO NPs. The biosynthesized CuO NPs (S8) demonstrated outstanding photodegradation activity towards four different organic dyes, namely BBY, BG, EBT, and MG, with degradation percentages of 95.78%, 98.02%, 94.15%, and 96.04%, respectively. The maximum degradation efficacy of 98.02% was observed for the BG dye at optimized reaction conditions and 60 min of visible light exposure. The kinetics of the photodegradation reaction followed the pseudo-first-order kinetic model, and the rate constant (k) was calculated using the Langmuir-Hinshelwood model for each dye. This study provides an efficient and sustainable approach for synthesizing CuO NPs with superior photocatalytic degradation efficiency towards organic dyes.

Evaluation of uranium content and annual ingestion dose in the surface and ground water bodies of Chittorgarh, Rajasthan, India.

Uranium, naturally occurring radionuclide is chemotoxic and nephrotoxic beyond acceptable limit. The presence of uranium beyond acceptable limit in surface and ground water, adversely affecting people's health. In the present investigation, the uranium concentration in surface and ground water of Chittorgarh, Rajasthan was studied along with the physico-chemical parameters of water (n = 87). The ground water was further sub-categorised into well water, handpump water, and borewell water. The mean uranium concentration was observed at 2.5 ± 1.9 µgL-1 and 16.5 ± 1.4 µgL-1 in the surface and ground water samples, respectively. In sub-categories of ground water, the highest uranium concentration was found in borewell water (23.3 ± 17.0 µgL-1), followed by handpump water (13.5 ± 9.1 µgL-1) and well water (6.0 ± 5.5 µgL-1). The uranium concentration was correlated significantly with the depth of the ground water table. It also correlated significantly with electrical conductivity, total dissolved solids and nitrate concentration. 100% of surface water and 88.9% of ground water samples carried uranium concentration within the acceptable limit of WHO (30 µgL-1). The annual ingestion dose was found at 3.8 µSvy-1 (for males) and 2.8 µSvy-1 (for females) in surface water and 25.4 µSvy-1 (for males) and 18.5 µSvy-1 (for females) in ground water. In the sub-categories of the ground water sample, the annual ingestion dose followed the trend in males 35.8 µSvy-1 (borewell water) > 20.7 µSvy-1 (hand pump water) > 9.2 µSvy-1 (well water) and in females 26.1 µSvy-1 (borewell water) > 15.1 µSvy-1 (hand pump water) > 6.7 µSvy-1 (well water).

Machine learning based quantification of VOC contribution in surface ozone prediction.

The prediction of surface ozone is essential attributing to its impact on human and environmental health. Volatile organic compounds (VOCs) are crucial in driving ozone concentration; particularly in urban areas where VOC limited regimes are prominent. The limited measurements of VOCs, however, hinder assessing the VOC-ozone relationship. This work applies machine learning (ML) algorithms for temporal forecasting of surface ozone over a metropolitan city in India. The availability of continuous VOCs measurement data along with meteorology and other pollutants during 2014-2016 makes it possible to deduce the influence of various input parameters on surface ozone prediction. After evaluating the best ML model for ozone prediction, simulations were carried out using varied input combinations. The combination with isoprene, meteorology, NOx, and CO (Isop + MNC) was the best with RMSE 4.41 ppbv and MAPE 6.77%. A season-wise comparison of simulations having all data, only meteorological data and Isop + MNC as input showed that Isop + MNC simulation gives the best results during the summer season (RMSE: 5.86 ppbv, MAPE: 7.05%). This shows the increased ability of the model to capture ozone peaks (high ozone during summer) relatively better when isoprene data is used. The overall results highlight that using all available data doesn't necessarily give best prediction results; also critical thinking is essential when evaluating the model results.

COVID-19 lockdown: a boon in boosting the air quality of major Indian Metropolitan Cities.

ABSTRACT: The COVID-19 lockdown has not only helped in combating the community transmission of SARS-CoV-2 but also improved air quality in a very emphatic manner in most of the countries. In India, the first phase of COVID-19 lockdown came into force on March 25, 2020, which was later continued in the next phases. The purpose of this study was to investigate the result of lockdown on air quality of major metropolitan cities-Delhi, Mumbai, Kolkata, Chennai, Bengaluru, Hyderabad, Jaipur, and Lucknow-from March 25 to May 3, 2020. For this study, the concentration of six criteria air pollutants (PM2.5, PM10, CO, NO2, SO2, and O3) and air quality index during the COVID-19 lockdown period was compared with the same period of the previous year 2019. The results indicate a substantial improvement in air quality with a drastic decrease in the concentration of PM2.5, PM10, CO, and NO2, while there is a moderate reduction in SO2 and O3 concentration. During the lockdown period, the maximum reduction in the concentration of PM2.5, PM10, CO, NO2, SO2, and O3 was observed to be - 49% (Lucknow), - 57% (Delhi), - 75% (Mumbai), - 68% (Kolkata), - 48% (Mumbai), and - 29% (Hyderabad), respectively. The value of the air quality index (AQI) also dwindled significantly during the COVID-19 lockdown period. The maximum decline in AQI was observed - 52% in Bengaluru and Lucknow. The order of AQI was satisfactory > moderate > good > poor and the frequency order of prominent pollutants was O3 > PM10 > PM2.5 > CO > NO2 > SO2 during the lockdown period in all the aforementioned metropolitan cities.

Effect of an educational intervention on knowledge and attitude regarding pharmacovigilance and consumer pharmacovigilance among community pharmacists in Lalitpur district, Nepal.

BACKGROUND: Pharmacovigilance activities are in a developing stage in Nepal. ADR reporting is mainly confined to healthcare professionals working in institutions recognized as regional pharmacovigilance centers. Community pharmacists could play an important role in pharmacovigilance. This study was conducted among community pharmacists in Lalitpur district to examine their knowledge and attitude about pharmacovigilance before and after an educational intervention. METHODS: Knowledge and attitude was studied before, immediately after and 6 weeks following the intervention among 75 community pharmacists. Responses were analysed using descriptive and inferential statistics. A pretested questionnaire having twelve and nine statements for assessing knowledge and attitude were used. The overall scores were obtained by adding the 'knowledge' and 'attitude' scores and 'overall' scores were summarized using median and interquartile range. Wilcoxon signed-rank test for repeated samples was used to compare the differences between knowledge and attitude of the pharmacists before and after the educational program. RESULTS: Knowledge scores [median (interquartile range)] improved significantly between pre-test [39 (44-46)], post-test [44 (44-44)] and retention period of 6 weeks after the intervention [46 (43-46)]. Knowledge score improved immediately post-intervention among both males [44 (41-47)] and females [44 (43-45)] but the retention scores (after 6 weeks) were higher [46 (42-48)] among males. Attitude scores improved significantly among females [46 (44-48)]. The overall scores were higher among pharmacists from rural areas. CONCLUSION: Knowledge and attitude scores improved after the educational intervention. Further studies in other regions of the country are required. The national pharmacovigilance center should promote awareness about ADR reporting among community pharmacists.

Knowledge and Practice on Injection Safety among Primary Health Care Workers in Kaski District, Western Nepal.

BACKGROUND: Unsafe injection practice can transmit various blood borne infections. The aim of this study was to assess the knowledge and practice of injection safety among injection providers, to obtain information about disposal of injectable devices, and to compare the knowledge and practices of urban and rural injection providers. METHODS: The study was conducted with injection providers working at primary health care facilities within Kaski district, Nepal. Ninety-six health care workers from 69 primary health care facilities were studied and 132 injection events observed. A semi-structured checklist was used for observing injection practice and a questionnaire for the survey. Respondents were interviewed to complete the questionnaire and obtain possible explanations for certain observed behaviors. RESULTS: All injection providers knew of at least one pathogen transmitted through use/re-use of unsterile syringes. Proportion of injection providers naming hepatitis/jaundice as one of the diseases transmitted by unsafe injection practice was significantly higher in urban (75.6%) than in rural (39.2%) area. However, compared to urban respondents (13.3%), a significantly higher proportion of rural respondents (37.3%) named Hepatitis B specifically as one of the diseases transmitted. Median (inter-quartile range) number of therapeutic injection and injectable vaccine administered per day by the injection providers were 2 (1) and 1 (1), respectively. Two handed recapping by injection providers was significantly higher in urban area (33.3%) than in rural areas (21.6%). Most providers were not aware of the post exposure prophylaxis guideline. CONCLUSION: The knowledge of the injection providers about safe injection practice was acceptable. The use of safe injection practice by providers in urban and rural health care facilities was almost similar. The deficiencies noted in the practice must be addressed.

A recurred subungual glomus tumour of the thumb.

Glomus tumours are rare benign neoplasms arising from the glomus body, accounting for 1-5% of all soft-tissue tumours of the hand. The diagnosis of glomus tumour is frequently delayed, varying from 3 to 15 years. We present a case of a recurred glomus tumour of the thumb where symptoms persisted for a period of 6 years after an attempted surgical excision. The patient presented with classical symptoms of localised tenderness, cold sensitivity and excruciating pain on touch. Findings on radiograph, ultrasonography and contrast-enhanced MRI further supported the diagnosis. Complete surgical excision, the only recommended treatment, resulted in complete symptomatic relief to the patient. This case report highlights the importance of meticulous complete excision and clinical awareness of the disease among primary care physicians.

Injection practice in Kaski district, Western Nepal: a community perspective.

BACKGROUND: Previous studies have shown that unsafe injection practice is a major public health problem in Nepal but did not quantify the problem. The present community-based study was planned to: 1) quantify injection usage, 2) identify injection providers, 3) explore differences, if any, in injection usage and injection providers, and 4) study and compare people's knowledge and perception about injections between the urban and rural areas of Kaski district. METHODS: A descriptive, cross-sectional mixed-methods study was conducted from July to November 2012, using a questionnaire based survey and focus group discussions (FGDs). A semi-structured questionnaire advocated by the World Health Organization was modified and administered to household heads and injection receivers in selected households and the FGDs were conducted using a topic guide. The district was divided into urban and rural areas and 300 households from each area were selected. Twenty FGDs were held. RESULTS: In 218 households (36.33%) [99 in urban and 119 in rural] one or more members received at least one injection. During the three month recall period, 258 subjects (10.44%) reported receiving injection(s) with a median of two injections. The average number of injections per person per year was calculated to be 2.37. Health care workers (34.8%), staff of medical dispensaries (37.7%), physicians (25.2%), and traditional healers (2.3%) were consulted by the respondents for their basic health care needs and for injections. Compared to urban respondents, more rural respondents preferred injections for fever (p < 0.001). People preferred injections due to injections being perceived by them as being powerful, fast-acting, and longer lasting than oral pills. More than 82% of respondents were aware of, and named, at least one disease transmitted by using unsterile syringes during injection administration or when syringes are shared between people. CONCLUSIONS: Less preference for injections and high awareness about the association between injections and injection-borne infections among the general population is encouraging for safe injection practice. However, respondents were not aware of the importance of having qualified injection providers for safe injections and were receiving injections from unqualified personnel.

Comparative study of high tibial osteotomy using dynamic axial fixator and locked low-profile plate in medial osteoarthritis of knee.

PURPOSE: The purpose of this study was to evaluate the role of medial opening wedge high tibial osteotomy (HTO) in medial unicompartmental osteoarthritis (MCOA) of knee and to compare between the two methods of osteotomy using either dynamic axial fixator (DAF) or locking compression plate (LCP). METHODS: A total of 20 patients with medial osteoarthritis of knee were enrolled in this prospective study who were divided into two groups of 10 each. First group comprising of two males and eight females were treated by HTO using DAF. Second group comprising of five males and five females were treated by HTO using LCP. We assessed various radiological parameters including hip knee ankle angle (HKA), tibiofemoral angle (TFA), weight-bearing line on tibia, Insall Salvati index and tibial slope. Functional outcome of knee at final follow-up was assessed by Oxford knee score (OKS) and visual analogue scale. RESULTS: In first group, mean HKA angle changed from 187° to 178.30° (p = 0.006), mean TFA from 182.40° to 172° (p = 0.003), average position of weight-bearing line from 11.24 to 59.54 % (p = 0.004), and mean OKS 43.3-16.9 (p = 0.004). In second group, mean HKA angle changed from 186° to 178.80° (p = 0.004), mean TFA from 180.90° to 173.60° (p = 0.004), average position of weight-bearing line from 14 to 61.3 % (p = 0.004), and mean OKS 43.2-16.5 (p = 0.002). CONCLUSION: HTO is an established treatment for patients with symptomatic MCOA knee with significant improvement in the clinical and radiographic parameters. There is no significant difference between the two methods; however, external fixator has the complication of pin tract infections. LEVEL OF EVIDENCE: II.

Injection practices in Nepal: health policymakers' perceptions.

BACKGROUND: The unnecessary and unsafe use of injections is common in developing countries like Nepal. Policymakers have an important role in promoting rational and safe injection use. Hence, the present study was carried out to explore the perception of health policymakers regarding safe injection practice in Nepal. METHODS: An exploratory qualitative study design was used in this study. Key policymakers from both the central and regional level were selected using purposive sampling. A semi-structured questionnaire advocated by the World Health Organization (WHO) was used after modifying the context. Interviews were conducted to clarify doubts and obtain additional information. The data was analyzed manually using deductive content analysis technique. RESULTS: In total, eleven policymakers participated. All unanimously agreed that injection safety is a problem and seven participants reported that injections are overused. They shared the opinion that injections are administered by various providers, including formal and informal health providers, and also quacks. Almost half the respondents reported that the National Drug Policy discourages injection overuse, while others reported that the policy contains no provisions regarding injection overuse. Most policymakers stated that only single-use disposable injection equipment is used to provide injection, while others thought that sterilizable glass syringe is also used. More than half of the participants believed that the quality of injection equipment available in the Nepalese market is not regulated by any government institution. Almost two-third of the policymakers stated that syringes and needles are not reused, while the rest thought syringes might be reused without sterilization in some parts of the country. Almost half of the respondents stated that illegal commercialization of used syringes exists in Nepal. Almost all respondents thought that health care institutions have a waste management plan, while more than half of them opined that such plans are limited to tertiary care hospitals located in the capital. CONCLUSIONS: The result of this study revealed a divergence of views among policymakers, even among those in the same ministry. Though there has been some effort from the government to increase the safety of injection practices, greater efforts are required, especially with regard to standardization of policies and procedures related to injection practice.

Need for involving consumers in Nepal's pharmacovigilance system.

In Nepal, reporting of adverse drug reactions (ADRs) occurs on a voluntary basis by doctors, pharmacists, nurses, health assistants, and other healthcare professionals. The country's pharmacovigilance program is still in its infancy; it has limited coverage and underreporting is common. This major limitation could be reduced with consumer involvement. This report examines the necessity and benefits of consumer involvement in Nepal's existing pharmacovigilance program, reflecting on existing examples of consumer pharmacovigilance in different countries to highlight the necessity for such a framework in Nepal.

Pharmacy practice and injection use in community pharmacies in Pokhara city, Western Nepal.

BACKGROUND: Community pharmacies in Nepal serve as the first point of contact for the public with the health care system and provide many services, including administering injections. However, there is a general lack of documented information on pharmacy practice and injection use in these pharmacies. This study aims to provide information about pharmacy practice in terms of service and drug information sources, and injection use, including the disposal of used injection equipment. METHODS: A mixed method, cross-sectional study was conducted in 54 community pharmacies in Pokhara city. Data was collected using a pre-tested, semi-structured questionnaire, and also by the direct observation of pharmacy premises. Interviews with pharmacy supervisors (proprietors) were also conducted to obtain additional information about certain points. RESULTS: Interviews were carried out with 54 pharmacy supervisors/proprietors (47 males and 7 females) with a mean age and experience of 35.54 and 11.73 years, respectively. Approximately a half of the studied premises were operated by legally recognized pharmaceutical personnel, while the remainder was run by people who did not have the legal authority to operate pharmacies independently. About a quarter of pharmacies were providing services such as the administration of injections, wound dressing, and laboratory and consultation services in addition to medicine dispensing and counseling services. The 'Current Index of Medical Specialties' was the most commonly used source for drug information. Almost two-thirds of patients visiting the pharmacies were dispensed medicines without a prescription. Tetanus Toxoid, Depot-Medroxy Progesterone Acetate, and Diclofenac were the most commonly-used/administered injections. Most of the generated waste (including sharps) was disposed of in a municipal dump without adhering to the proper procedures for the disposal of hazardous waste. CONCLUSIONS: Community pharmacies in Pokhara offer a wide range of services including, but not limited to, drug dispensing, counseling, dressing of wounds, and administering injections. However, the lack of qualified staff and adequate infrastructure may be compromising the quality of the services offered. Therefore, the health authorities should take the necessary measures to upgrade the qualifications of the personnel and to improve the infrastructure for the sake of good pharmacy practice and the safer use of injections.

An educational intervention's effect on healthcare professionals' attitudes towards pharmacovigilance.

BACKGROUND: Pharmacovigilance concerns the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. Consumer pharmacovigilance is the involvement of consumers in adverse drug reaction (ADR) reporting. Assessing healthcare professionals' (HCPs) knowledge of and attitude towards pharmacovigilance and consumer pharmacovigilance is integral to strengthening adverse drug reaction reporting systems. AIMS: To study knowledge of and attitude towards pharmacovigilance and consumer pharmacovigilance among HCPs from KIST Medical College, Lalitpur, Nepal, and to plan an appropriate educational intervention to address deficiencies noted. METHOD: The study was conducted from February 2013 to December 2013 at KIST Medical College using a self-administered, pretested, structured questionnaire. The maximum possible scores for knowledge, attitude, and total were 100, 95, and 195, respectively. Baseline knowledge and attitude were studied. Two months after the questionnaire, an intervention that used a combination of methods about pharmacovigilance and consumer pharmacovigilance was undertaken. Knowledge and attitudes were studied immediately after the intervention. Scores before and after the intervention were compared using Wilcoxon signed-rank test. RESULTS: A total of 105 HCPs participated. The median (interquartile range) knowledge, attitude, and total scores before the intervention were 56 (7), 72 (9), and 127 (16), respectively. After the intervention the scores increased significantly to 72 (8), 75 (11.5), and 146 (16.5) (p<0.001), respectively. CONCLUSION: The intervention was effective in improving HCPs' knowledge of and attitude towards pharmacovigilance and consumer pharmacovigilance. More studies on this topic among HCPs at other institutions and in the community are required.

Strategies and challenges for safe injection practice in developing countries.

Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of "Safe Injection Global Network (SIGN)" was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice.