Challenges in containing the burden of hepatitis B infection in dialysis and transplant patients in India

Aim: Whether or not completing the hepatitis B vaccination in patients who have undergone kidney transplantation in the middle of incomplete vaccination schedule leads to development of protective antibody titres is not known. This study was designed to determine whether the strategy of completing hepatitis B virus (HBV) vaccination after transplantation is efficacious. Methods: Sixty‐four end‐stage renal disease (ESRD) patients were screened for hepatitis B surface antigen (HBsAg), antibodies to hepatitis B surface antigen (anti‐HBs), hepatitis B e‐antigen (HBeAg) and HBV DNA. HBsAg negative patients received four doses of 40 µg recombinant HBV vaccine. Schedule was continued in after transplantation period if it was incomplete before transplant. Anti‐Hbs titres were evaluated at 1, 3, 6, 9 and 12 months. Results: Past HBV infection was noted in 12 patients: 10 by serology plus viraemia and two by viraemia alone. Of the 46 patients without current or past HBV infection who had received at least two doses of the vaccine before transplant, 17 each had received two and three doses and 12 had completed the schedule. Seventeen (37%) exhibited protective titres. Patients who had completed vaccination were more likely to have protective titres than those incompletely vaccinated (P = 0.02). Five patients responded to post‐transplant vaccination. Conclusion: Partially vaccinated patients do not mount an adequate antibody response despite continued vaccination in the post‐transplant period, whereas complete vaccination provides protection in 60%. The present study data highlights the need of administration of a full schedule of HBV vaccination before kidney transplantation. Nucleic acid‐based tests can identify occult HBV infection.     

Challenges in developing medicinal plant databases for sharing ethnopharmacological knowledge

Ethnopharmacological relevance

Major research contributions in ethnopharmacology have generated vast amount of data associated with medicinal plants. Computerized databases facilitate data management and analysis making coherent information available to researchers, planners and other users. Web-based databases also facilitate knowledge transmission and feed the circle of information exchange between the ethnopharmacological studies and public audience. However, despite the development of many medicinal plant databases, a lack of uniformity is still discernible. Therefore, it calls for defining a common standard to achieve the common objectives of ethnopharmacology.

Aim of the study

The aim of the study is to review the diversity of approaches in storing ethnopharmacological information in databases and to provide some minimal standards for these databases.

Materials and methods

Survey for articles on medicinal plant databases was done on the Internet by using selective keywords. Grey literatures and printed materials were also searched for information. Listed resources were critically analyzed for their approaches in content type, focus area and software technology.

Results

Necessity for rapid incorporation of traditional knowledge by compiling primary data has been felt. While citation collection is common approach for information compilation, it could not fully assimilate local literatures which reflect traditional knowledge. Need for defining standards for systematic evaluation, checking quality and authenticity of the data is felt. Databases focussing on thematic areas, viz., traditional medicine system, regional aspect, disease and phytochemical information are analyzed. Issues pertaining to data standard, data linking and unique identification need to be addressed in addition to general issues like lack of update and sustainability. In the background of the present study, suggestions have been made on some minimum standards for development of medicinal plant database.

Conclusion

In spite of variations in approaches, existence of many overlapping features indicates redundancy of resources and efforts. As the development of global data in a single database may not be possible in view of the culture-specific differences, efforts can be given to specific regional areas. Existing scenario calls for collaborative approach for defining a common standard in medicinal plant database for knowledge sharing and scientific advancement.     

Self care practices and psychological distress among diabetic patients in Manipur during COVID-19: A scenario from the North East

Background and aimUncontrolled diabetes has emerged as one of the major risk factors for mortality in patients with coronavirus disease (COVID-19). Physical inactivity, alterations in dietary habits, and inability to seek guidance from the physician are some of the contributing factors. This study aims to assess the self-care practices and psychological distress during the pandemic among diabetic patients visiting the institute’s out patient department.MethodA convenient sampling method was used to recruit subjects from a representative clinical sample using validated scales like the Summary of Diabetes Self-Care Activities (SDSCA) and Kessler Psychological Distress Scale (K10).ResultThe study enrolled a total of 108 subjects with the mean age being 56.3 years. The everyday healthy eating plan was followed by 76.85% (N = 83) subjects and daily physical activity for at least 30 min performed by 50% (54) subjects. Only 12.04% (13) subjects tested their blood sugar and 6.48% (7) respondents checked their feet daily. There was no significant difference found between the SDSCA and psychological distress based on socio-demographic variables.ConclusionParticipants in this study typically reported a good level of self-care behavior particularly for diet followed by exercise whereas the self-care behavior was not adequate for foot care and blood-glucose testing. People were not too anxious about COVID-19. This study highlighted the fact that people with diabetes should monitor their blood sugar levels more often along with their foot care.     

An Observational Study in Manipur State,India on Preventive Behavior Influenced by Social Media During the COVID-19 Pandemic Mediated by Cyberchondria and Information Overload

ObjectivesThe coronavirus disease 2019 (COVID-19) pandemic is a public health emergency posing unprecedented challenges for health authorities. Social media may serve as an effective platform to disseminate health-related information. This study aimed to assess the extent of social media use, its impact on preventive behavior, and negative health effects such as cyberchondria and information overload.MethodsA cross-sectional observational study was conducted between June 10, 2020 and August 9, 2020 among people visiting the outpatient department of the authors’ institution, and participants were also recruited during field visits for an awareness drive. Questions were developed on preventive behavior, and the Short Cyberchondria Scale and instruments dealing with information overload and perceived vulnerability were used.ResultsThe study recruited 767 participants with a mean age of about 45 years. Most of the participants (>90%) engaged in preventive behaviors, which were influenced by the extent of information received through social media platforms (β=3.297; p<0.001) and awareness of infection when a family member tested positive (β=29.082; p<0.001) or a neighbor tested positive (β=27.964; p<0.001). The majority (63.0%) of individuals often searched for COVID-19 related news on social media platforms. The mean±standard deviation scores for cyberchondria and information overload were 9.09±4.05 and 8.69±2.56, respectively. Significant and moderately strong correlations were found between cyberchondria, information overload, and perceived vulnerability to COVID-19.ConclusionsThis study provides evidence that the use of social media as an information-seeking platform altered preventive behavior. However, excessive and misleading information resulted in cyberchondria and information overload.     

Traditional uses of herbal vapour therapy in Manipur,North East India: An ethnobotanical survey

Ethnopharmacological relevance

Vapour-based medicines are an aspect of traditional medicine in North East India. However, no collective studies on this therapy in the region have been attempted. With the changing perception of traditional knowledge, documenting these herbal preparations and the subsequent development of baseline data for applications in further ethnopharmacological research are needed.

Aims of the study

To survey and document the plant species associated with vapour therapy in Manipur, North East India, and to evaluate these traditional practices.

Materials and methods

Semi-structured questionnaires were used to collect information from the Meitei community in the Imphal valley and the Jiribam area in Manipur. Traditional disease concepts were studied along with their corresponding medical terminologies. Plant samples collected from fields, healers' private collections and home gardens were identified. Evaluation of the ethnobotanical data was performed with a modified fidelity level index.

Results

In the study, 41 traditional disease complexes were treated by 13 different routes of administration using 48 mono-ingredient and 17 multi-ingredient compositions. Preparation methods included boiling in water (28%), burning the materials (48%), crushing the materials to release the aroma (21%) and slight heating of the materials (3%). Some of the mono-ingredient recipes reported in the study were observed to have similar uses in other parts of the world, whereas polyherbal remedies were found to be unique without any similar report.

Conclusion

Many compositions mentioned in the paper are still used by the Meitei community. Traditional healers follow their own criteria for selecting medicinal plants. Plants recorded in this ethnobotanical study can suggest methods for selecting and identifying potentially effective plants for future drug candidates. Scientific characterisation of the herbal remedies can contribute to the endorsement of traditional vapour-based therapies in the modern health care systems. Findings from these “new usage” reports of plants and unique combinations of polyherbal compositions indicate the importance of such documentation efforts.