BACKGROUND: Many countries are implementing measures for social distancing to contain the spread of the coronavirus disease 2019 (COVID-19) pandemic. The Indian government also issued an order for complete lockdown of the country, with all the nonessential services, including most of the services for nonemergency health issues, being temporarily suspended. OBJECTIVES: This study aimed to understand the effect of pandemic lockdown on medical advice-seeking behavior and the medication practices of the non-COVID Indian patients confined to homes, who would have normally visited the outpatient departments (OPDs) for medical advice. MATERIALS And METHODS: It was a questionnaire-based, cross-sectional study conducted online during the lockdown period. The questions dealt with medical advice-related practices, self-medication, the sources of medical advice, and the need to visit emergency department. Evaluation of data was done as for descriptive studies. RESULTS: A total of 106 people (34%) out of the 312 participants had either old or new health problems. Ninety-six of such people (90.5%) tried to manage their sufferings by either continuing the drugs prescribed earlier or by making phone calls to doctors along with taking the help of home remedies, if needed. Ten (9.5%) of the symptomatic participants did not consult any doctor waiting for natural course of relief. None of the participants practiced self-medication of modern medicine therapy. Only one participant (of the total 312) took hydroxychloroquine as self-medication for assumed prophylactic therapy against the COVID-19 infection. CONCLUSION: Most of the people with medical conditions, confined at home due to national lockdown, are coping with their problems without any irrational self-medication with modern medicines or any misuse of prophylactic therapy against the COVID infection. This seemingly positive trend may also have been due to the strict enforcement of the lockdown rules by the law enforcement agencies.
TiO 2 anatase is considered to play a significant importance in energy and environmental research. However, for developing artificial photosynthesis with TiO 2 , the major drawback is its large bandgap of 3.2 eV. Several non-metals have been used experimentally for extending the TiO 2 photo-absorption to the visible region of the spectrum. It’s therefore of paramount importance to provide theoretical guidance to experiment about the kind of defects that are thermodynamically stable at a realistic condition (e.g. Temperature ( T ), oxygen partial pressure ( ), doping). However, disentangling the relative stability of different types of defects (viz. substitution, interstitial, etc.) as a function of charge state and realistic T , is quite challenging. We report here using state-of-the-art first-principles based methodologies, the stability and meta-stability of different non-metal dopants X (X = N, C, S, Se) at various charge states and realistic conditions. The ground state electronic structure is very accurately calculated via density functional theory with hybrid functionals, whereas the finite T and effects are captured by ab initio atomistic thermodynamics under harmonic approximations. On comparing the defect formation energies at a given T and (relevant to the experiment), we have found that Se interstitial defect (with two hole trapped) is energetically most favored in the p-type region, whereas N substitution (with one electron trapped) is the most abundant defect in the n-type region to provide visible region photo-absorption in TiO 2 . Our finding validates that the most stable defects in X doped TiO 2 are not the neutral defects but the charged defects. The extra stability of is carefully analyzed by comparing the individual effect of bond-making/breaking and the charge carrier trapping energies.
Epilepsy is the most common neurological disorder affecting approximately 50 million people worldwide. In India, overall prevalence of epilepsy is reported to be 5.59/1000 population. Antiepileptic drugs (AEDs) constitute the main-stay of treatment with a large number of AEDs available in the market. High incidence of adverse effects is a major limitation with AEDs. One of the major concerns is significant metabolic effects on the bone. However, little attention has been paid to this issue because most of the bone effects remain subclinical for a long time and may take years to manifest clinically. The main effects include hypocalcemia, hypophosphatemia, reduced serum levels of Vitamin D, increase in parathormone (PTH) levels, and alterations in bone turnover markers. The CYP450 enzyme-inducing AEDs such as phenytoin, phenobarbital, carbamazepine, and primidone are the most common AEDs associated with bone disorders while the data regarding the effect of valproate and newer AEDs such as lamotrigine, gabapentin, vigabatrin, levetiracetam, and topiramate on bone metabolism and bone density are scanty and controversial. Deficiency of Vitamin D is commonly described as a cause for the bone loss in epileptic patients while others being decreased absorption of calcium, increased PTH levels, and inhibition of calcitonin secretion, etc. However, there are no formal practical guidelines for the management of bone disease among those taking AEDs. Evidence-based strategies regarding monitoring, prevention, and treatment of bone diseases in patients on AED therapy are needed.
Background This study aimed to determine the impact of pulmonary complications on death after surgery both before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Methods This was a patient-level, comparative analysis of two, international prospective cohort studies: one before the pandemic (January–October 2019) and the second during the SARS-CoV-2 pandemic (local emergence of COVID-19 up to 19 April 2020). Both included patients undergoing elective resection of an intra-abdominal cancer with curative intent across five surgical oncology disciplines. Patient selection and rates of 30-day postoperative pulmonary complications were compared. The primary outcome was 30-day postoperative mortality. Mediation analysis using a natural-effects model was used to estimate the proportion of deaths during the pandemic attributable to SARS-CoV-2 infection. Results This study included 7402 patients from 50 countries; 3031 (40.9 per cent) underwent surgery before and 4371 (59.1 per cent) during the pandemic. Overall, 4.3 per cent (187 of 4371) developed postoperative SARS-CoV-2 in the pandemic cohort. The pulmonary complication rate was similar (7.1 per cent (216 of 3031) versus 6.3 per cent (274 of 4371); P = 0.158) but the mortality rate was significantly higher (0.7 per cent (20 of 3031) versus 2.0 per cent (87 of 4371); P < 0.001) among patients who had surgery during the pandemic. The adjusted odds of death were higher during than before the pandemic (odds ratio (OR) 2.72, 95 per cent c.i. 1.58 to 4.67; P < 0.001). In mediation analysis, 54.8 per cent of excess postoperative deaths during the pandemic were estimated to be attributable to SARS-CoV-2 (OR 1.73, 1.40 to 2.13; P < 0.001). Conclusion Although providers may have selected patients with a lower risk profile for surgery during the pandemic, this did not mitigate the likelihood of death through SARS-CoV-2 infection. Care providers must act urgently to protect surgical patients from SARS-CoV-2 infection.
For the clean and sustainable development, sequestration of carbon dioxide (CO2) through electrocatalytic reduction to produce high-value industrial precursors, such as CO, is a promising avenue.
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