Author: Vimarishi

Vaccine Development against COVID-19

A novel coronavirus (CoV) named ‘2019 novel coronavirus ’by the World Health Organization (WHO) is responsible of this outbreak of pneumonia that began at the mid of November 2019 near in Wuhan City, Hubei Province, China. The SARS-CoV-2 is a pathogenic virus. Coronaviruses are enveloped viruses with a large, single-stranded, positive-sense RNA genome, which are about 120 nanometers in diameter. They are vulnerable to mutation and recombination and are therefore highly diverse. There are about 40 different varieties which they mainly infect human and non-human mammals and birds. They reside in bats and wild birds, and will spread to other animals and hence to humans. The virus that causes COVID-19 is assumed to possess originated in bats then spread to snakes and pangolins and hence to humans, perhaps by contamination of meat from wild animals, as sold in China’s meat markets.
The corona-like appearance of coronaviruses is due to the presence of spike glycoproteins, or peplomers, which are necessary for the viruses to enter host cells. The spike has two subunits, one subunit is S1 which binds to a receptor on the surface of the host cell and the opposite subunit which is S2 fuses with the cell wall. The cell wall receptor for both SARS-CoV-1 and SARS-CoV-2 could even be a sort of angiotensin converting enzyme, ACE-2, different from the enzyme that’s inhibited by conventional ACE-1 inhibitors, like enalapril and ramipril.
Viral RNA can be detected by polymerase chain reaction which is sometimes referred to as RT-PCR or real time PCR. In this test, the virus’s single-stranded RNA is converted to its complementary DNA by reverse transcriptase; specific regions of the DNA are marked by primers, are then amplified. This is done by synthesizing new DNA strands from deoxy-nucleoside triphosphates using DNA polymerase.

COVID-19 DRUG DEVELOPMENT

COVID19 drug development is basically a research process to develop preventative therapeutic prescription drugs which may lower the severity of coronavirus disease 2019 (COVID19). Internationally, by November 2020, several hundred drug companies, biotechnology firms, university research groups, and health organizations are trying to develop over 500 potential therapies for COVID19 disease in various stages of preclinical or clinical research.
The World Health Organization (WHO), European Medicines Agency (EMA), US Food and Drug Administration (FDA), and therefore, the Chinese government and drug manufacturers were coordinating with academic and industry researchers to hurry development of vaccines, antiviral drugs, and post-infection therapies.
Drug development may be a multistep process, typically requiring five years to assure safety and assurance of the new compound. Several national regulatory agencies, like the EMA and the FDA, have approved procedures to expedite clinical testing. Chloroquine is an anti-malarial medication that is also used against some auto-immune diseases. Hydroxy-chloroquine is more commonly available than chloroquine in the United States. Although several countries initially used chloroquine or hydroxy-chloroquine for treatment of people hospitalised with COVID19, the drug has not been formally approved through clinical trials.

VACCINE DEVELOPMENT

A vaccine for a communicable and pathogenous disease which has never before been produced in several years, and also no vaccine exists for preventing a coronavirus infection in humans. After the coronavirus was detected, the genetic sequence of COVID‐19 was published on 11 January 2020, triggering an urgent international response towards organize for an epidemic and hasten development of a preventive vaccine.

In February 2020, the World Health Organization (WHO) said it didn’t expect a vaccine against severe acute respiratory syndrome coronavirus or the SARS-CoV-2 which is the causative virus, to become available in 18 months.
Their development had previously been considered as low priority because the coronaviruses that were circulating in humans caused relatively mild disease. Most coronaviruses encode only one large surface protein, the spike protein, which is responsible for receptor binding and membrane fusion. In the case of SARS-CoV-2 (and SARS-CoV), the spike protein binds to angiotensin- converting enzyme 2 (ACE2) on host cells and is then endocytosed. This step is followed by fusion of viral and endosomal membranes and release of the viral genome into the cytoplasm. Antibodies that bind to the spike protein, especially to its receptor-binding domain (RBD), prevent its attachment to the host cell and neutralize the virus. On the basis of this knowledge, and information gained from preclinical studies with SARS-CoV and MERS-CoV, the spike protein was identified as an antigenic target for the development of a vaccine against SARS-CoV-2 at a very early stage. It has been demonstrated that the spike protein is a strong target of CD4+ T cells, whereas fewer CD8+ T cells are induced by natural infection with SARS-CoV-2 in general. It is important to note that natural infection induces both mucosal intramuscularly or intradermally induce mainly IgG, and no secretory IgA. It is therefore possible that most vaccines currently in development induce disease-preventing or disease-attenuating immunity, but not necessarily sterilizing immunity.

This pandemic which is due the coronavirus requires a rapid and fast action in the field of vaccines and biology and in a short amount of time as the original vaccine making process for any disease requires at least 15 years for the whole procedure and testing trials antibody responses (secretory immunoglobulin A (IgA)) and systemic antibody responses (IgG). The upper respiratory tract is thought to be mainly protected by secretory IgA, whereas the lower respiratory tract is thought to be mainly protected by IgG. Vaccines that are administered and therefore, is a very tedious and lengthy process and work. As this disease requires a very fast process so the first clinical trial of a vaccine candidate for SARS-CoV-2 began in March 2020. Trials were designed in such a manner that clinical phases are overlapping and trial starts are staggered, with initial phase I/II trials followed by rapid progression to phase III trials after interim analysis of the phase I/II data. Currently, several manufacturers have already started the commercial production of vaccines at risk without any results from phase III trials. Although the licensure pathways are not yet completely clear, it is possible that reviews could be expedited and that vaccines could even be approved through an emergency use authorization. The FDA has released a guidance document for the development and licensure of SARS-CoV-2 vaccines, which as well as providing additional details states that an efficacy of at least 50% will be required. It is very important to point out that moving forward at financial risk is the main factor that has enabled the accelerated development of SARS-CoV-2 vaccine candidates, and no corners have been or should be cut in terms of safety evaluation.

Bioavailability of Nutrients

As with protein, the contents of other nutrients in foods determined by chemical or physical analysis may be quite misleading in terms of the nutrient status of a food. Apart from amount, what is important is whether the nutrient is in a form that can be utilized in metabolism; that is, whether the nutrient is bioavailable. For example, adding small iron pellets to cereals would increase their iron content, but the iron would not be very available to people eating the cereal and, therefore, be of little value.

Many factors influence a nutrient’s bioavailability, including the food’s digestibility and the nutrient’s absorbability from the intestinal tract, which are affected by nutrient binding to indigestible constituents and nutrient-nutrient interactions in food raw materials. Processing and cooking procedures also can influence nutrient bioavailability. Apart from the food itself, different animal species exhibit variations in bioavailability of specific nutrients from a particular food. The age, sex, physiological health, consumption of drugs, general nutritional status, combinations of foods eaten together, and other factors all influence the ability of an individual to make use of a particular nutrient.

Bioavailability of carbohydrates, proteins, fats, vitamins, and minerals may be in- creased or decreased since all nutrients are reactive and generally present in varying amounts in food systems. There are many examples of how food composition, processing, and storage affect nutrient bioavailability. One example is the essential mineral iron. Under practical conditions its bioavailability from foods may be only 1-10% of its total level determined by chemical analysis. The recommended dietary allowances for nutrients in the United States and other countries attempt to take bioavailability into account. However, the many factors influencing nutrient bioavailability and the difficulties inherent in meaningful evaluation procedures leave much research in this area still to be done.

Balanced Diet and Nutrients

A balanced diet is a diet that contains differing kinds of foods in certain quantities and proportions so that the requirement for calories, proteins, minerals, vitamins and alternative nutrients is adequate and a small provision is reserved for additional nutrients to endure the short length of leanness. In addition, a balanced diet ought to offer bioactive phyto-chemicals like dietary fibre, antioxidants and nutraceuticals that have positive health advantages.

A balanced diet should offer around 60-70% of total calories from carbohydrates, 10-12% from proteins and 20-25% of total calories from fat.

A balanced diet will not be the same for everyone. We’re all different and often, individuals will require different amounts and types of nutrients. What you need will depend on age, gender, lifestyle, health and the rate at which your body works. Eating a balanced diet is key in maintaining good health and keeping your body in optimum condition. A balanced diet doesn’t cut out food groups; it consists of a wide variety of foods to support your body and keep you energised, motivated and healthy. Most nutritionists recommend a diet that is balanced for anyone to remain fit and healthy. The exact meaning of a balanced diet, however, is not very clear in everybody’s mind. A balanced diet is not like a crash diet as it allows you to eat everything that an average adult should, but in optimum proportions. Moreover, to maintain a proper balance, you cannot indulge in only one type of food. This would result in you missing out on essential nutrition that comes from comprehensive meals. A ‘balanced diet’ is complete only when you have a variety of food from all food groups contributing to your nutrition intake.

Good nutritional habits and a balanced diet aren’t developed in one day, nor are they destroyed in one unbalanced meal. Healthful eating means a lifestyle of making choices and decisions, planning, and knowing how to make quick and wise choices when you haven’t planned. What you learn about eating in these first years on your own will help establish good dietary patterns for the rest of your life. Making the break from home cooking and becoming responsible for choosing the foods you eat is part of the challenge of becoming a mature and an independent adult. It is a challenge that should not be taken lightly. The nutritional habits you develop now will be difficult to change in the coming years when your body stops growing and your lifestyle may become more sedentary. Learning to make sensible choices from a confusing array of options is not easy, but the rewards are great. Eating nutritious and healthful food while maintaining your proper body weight will contribute to a better performance in the classroom, in the gym, and on the dance floor. You will feel and look your best. In contrast, a poor diet can lead to insidious health problems that can interfere with success in academic and social performance and may eventually mean confronting a serious long-term illness, such as heart disease or diabetes. Knowing how much and what to eat is important knowledge.

Ageing and Age-related Diseases

Age-related diseases are the leading cause of death worldwide, and they are also the leading source of concern for people concerned with global healthcare spending, both now and in the future. The CNS, vascular structures, joints, bones, the renal system, and other systems and tissues will be the focus of the special issue on age-related disease. The disorders must all be age-related, and the papers must seek to explain how the ageing process contributes to the pathology. Innovative articles that suggest basic interventions in the ageing process with either therapeutic potential or clinical trial results will be given high priority. Prospective publications may alternatively or in addition, address broader geriatric concerns, such as symptomatic care, diagnostic procedures, and funding for age-related disease treatment on a local, national, or global basis. Relevant dementias (such as Alzheimer’s, Parkinson’s, FTD, etc.), cardiovascular diseases (such as myocardial infarction, coronary artery disease, aneurysm, stroke, peripheral vascular disease, congestive heart failure, etc.), osteoarthritis, osteoporosis, renal failure, skin ageing, immunosenescence, or other age-related diseases may be among the specific age-related diseases.

Diabetes Mellitus

Diabetes involves the dysfunction of pancreatic ß-cells which leads to the development of diabetes. Aging of β cells in islets is mainly manifested as a decrease in the number of ß-cells and reduction in their secretion capacity. The mechanisms between islet cell failure in diabetes and aging are complex. The main interventions for diabetes include diet control, exercise, weight loss, and combination of hypoglycemic drugs.

Skin Ageing

Skin ageing is the overall part of the aging of the body and basically effects the appearance and makes body functioning difficult. This can lead to various diseases like anxiety, depression and self- abasement. Treatment for skin ageing mainly includes oral antioxidant drugs, topical anti-aging agents, and photoelectric and acoustic physical technology.

Alzheimer’s Disease

It is a neurodegenerative disease that occurs in old age and pre old age. It is basically brain aging. This disease involves nerve cell injury or apoptosis of brain nerve cells. Currently, drugs used in the clinical treatment of Alzheimer’s Disease are mainly noncompetitive N-methyl-D-aspartic acid receptor antagonists (such as memantine) and cholinesterase inhibitors (such as donepezil and galantamine).

The process of aging is universal but not uniform. Aging and age-related diseases pose a serious threat to human health and reduce the quality of life of elderly people. Awareness of age-related physiological changes, such as reduced acuity of vision and hearing, slow reaction time, and impaired balance, will prepare patients and caregivers to manage risks, make informed decisions, and perhaps prevent falls and medication adverse effects. The molecular basis of aging has various mechanisms and cells and different systems involved in it, which contribute to the process of aging and show the life span of a person and how healthy his life can be according to his inner systems. Stem cells have their own role to play and have a very important part in every single mechanism of aging. Basically, aging is a process which will happen no matter what the circumstances are and defines the life span of a person.

Cell based Therapy in Human Regenerative Therapy

CELL BASED THERAPY AND XENOGENEIC ACELLULAR NERVE MATRICES

Adipose cell transplantation is an option for reconstructing peripheral nerves. The cells may be administered systematically via intravenous, sub-cuticular or intramuscular routes as used for traditional drug therapy. When adipose derived stem cells (ADSC) have been introduced intravenously, they spread throughout the body and locate to damage tissue. In the context of traumatic brain injury, these cells spread via the reticuloendothelial system directly into the diseased brain tissue. The observed benefits of human ADSC injection were largely dependent on the recipient rat’s age. In the older rats, fewer cells transited though the spleen. This subsequently led to differences in cell distribution within injured parts of the rat’s brains. In other studies when ADSCs were administered via the intravenous route they were also shown to improve neuropathic pin in rats which had the ill effects of chronic pain stimulated.

CURRENT THERAPIES AND FUTURE DIRECTIONS

Organ and tissue loss through disease and injury motivate the development of therapies that can regenerate tissues and decrease reliance on transplantations. Regenerative medicine, an interdisciplinary field that applies engineering and life science principles to promote regeneration, can potentially restore diseased and injured tissues and whole organs. Since the inception of the field several decades ago, a number of regenerative medicine therapies, including those designed for wound healing and orthopedic applications, have received Food and Drug Administration (FDA) approval and are now commercially available. These therapies and other regenerative medicine approaches currently being studied in preclinical and clinical settings will be covered in this review. Regenerative medicine has the potential to heal or replace tissues and organs damaged by age, disease, or trauma, as well as to normalise congenital defects. Promising preclinical and clinical data to date support the possibility for treating both chronic diseases and acute insults, and for regenerative medicine to abet maladies occurring across a wide array of organ systems and contexts, including dermal wounds, cardiovascular diseases and traumas, treatments for certain types of cancer, and more. The current therapy of transplantation of intact organs and tissues to treat organ and tissue failures and loss suffers from limited donor supply and often severe immune complications, but these obstacles may potentially be bypassed through the use of regenerative medicine strategies.

Regenerative Medicine opened new avenues for curing patients with difficult to treat diseases and physically impaired tissues. Despite many successes, regenerative medicine is still unfamiliar to many scientists and clinicians. This poses a great limit, as tissue engineering and regenerative medicine could overcome the unsolvable problems of the current medical treatments. The creation and use of cloned pigs have made a significant contribution to various fields in basic and applied research for regenerative medicine such as for treatment for intractable diseases, stem cell therapy and organ or tissue transplantation. It is important to verify the findings obtained from the in vitro studies in a complex system of individual animals. The role of research that uses cloned pigs as a platform isn terms of producing findings truly useful for clinical application. The crucial point of this revolution is transforming the current numerous scientific discoveries into novel and viable therapies from bench and bedside. The unique benefits of animal modelling techniques will continue to be used in the future to promote experimental endeavours in this field of study.

Present Conditions: Bio-medical Waste Disposal

Biomedical waste poses various health and environmental hazards. Hence, it should be handled with the utmost care and disposed-off safely. Several lacunas exist within the management of biomedical waste in India, and the pandemic posed by the corona virus has made it even tougher. The sudden outbreak of the corona virus led to an exponential rise in the quantity of biomedical waste. Furthermore, the poor infrastructure and lack of human resources have aggravated this example. To combat this serious problem in a timely manner, the government has formulated various standard operating procedures and has amended the existing rules and guidelines. Corona viruses have caused large-scale pandemics, namely, severe acute respiratory syndrome coronavirus-1 (SARS-Cov-1) and the Middle East respiratory syndrome (MERS). A new outbreak in this family was added in November-December of 2019 as the novel corona virus disease 2019 (COVID-19) caused by a large group of highly diverse, enveloped, positive sense, and single-stranded RNA viruses, namely, SARS-CoV-2. Mass sampling with rapid tests, isolation of suspects/patients, use of personal protective measures, social distancing, and life-supporting treatments are known countermeasures to prevent fighting this fatal pandemic. Personal protective equipment (PPE), surgical (and protective) face masks, aprons/gowns, and nitrile gloves are essentially used to protect individuals from exposure to pathogens and contaminants. Traditionally, these protective measures have been predominantly used against pathogens in hospitals. However, COVID-19 has necessitated their usage in domestic isolation and individual protection, leading to a rapid accumulation of potentially infectious waste streams. The entire world is, therefore, facing an unprecedented challenge to fighting COVID-19 together with the myriad COVID-waste.

The composition of waste is greatly influenced by disposable plastic-based personal protective equipment (PPE) and single-use plastics by online shopping for most basic necessities. The use of PPEs and single-use plastics during the pandemic not only increased the quantity of medical waste but also altered the average density of the medical waste. Waste generation amid COVID-19, especially discarded PPEs and single-use plastics, has been an environmental and public health crisis around the world, particularly in countries with developing economies and those in transition. Safe solid waste management is already a matter of major concern in these countries where safe and sustainable practice is scarce and healthcare waste has not been adequately regulated. India is generating tonnes of hospital waste in just a few months, in which Maharastra is the highest contributor because it has the highest number of COVID-19 cases and hence the waste produced.
The bio waste is just dumped in the open at the airports. Perfect norms are not followed. This is leading to a serious increase in COVID-19 cases in India. The used PPE kits are dumped properly by following the norms or the rules and regulations given by the government, hence the increased cases of infection and deaths. These should be dumped after destroying them so that they can not be reused, which can also lead to the transmission of the infection. After that, these things should be perfectly dumped so that no further transmission can occur.

Generally, discarded healthcare waste and other forms of clinical waste are disposed of in a sanitary landfill or incinerated in the form of waste for energy recovery. However, in many developing countries, healthcare waste along with municipal solid waste is dumped in the open or in poorly managed landfills where the movements of waste pickers and livestock such as dogs, goats, and cows are often noticed. A few countries also apply advanced technology to treat their medical waste by steam sterilizing (autoclaving) or chemically disinfecting, but they are exceptional.
We should make some changes in medical waste disposal technology, as in the case of COVID-19. It is important to come up with something new. We normally use decentralization to centralization, from irregular to regular management, and from mostly incineration to non-incineration disposal technologies such as autoclave steam, dry heat, chemical disinfection, or microwave.
The treatment facilities for medical waste should be more automated and based on technology, with a minimum of workers involved. The goals of making automatic processes and the use of minimum workers for infectious waste are what we can do so that there are fewer risks and chances of transmission. Larger capacities of mobile facilities should be maintained, particularly during the pandemic, which may be vital for developing countries where medical waste disposal facilities are limited. The mobile facilities aren’t only convenient for emergency situations, but can also be used as a strategic backup capacity for a state in the future.

Management of Biomedical Waste Disposal

According to the latest guidelines for segregation and management of biomedical waste and its disposal is through colour coding:

  • Yellow Bag: it consists of the hospital wastes like the used dressings, bandages and cotton swabs with body fluids and blood, blood bags, human anatomical waste or the category 1 waste, body parts or organs.
  • Red Bag: it costs of all category 4 wastes which the sharp things used like needles, syringes, also consists of used or soiled gloves, IV tubes and these are later incinerated.
  • Cardboard box with blue marking: This consists of ampules, glass vials and other glass ware are discarded in cardboard boxes.
  • White puncture proof container: These are consisting of needles, sharps, blades and these are disposed in white translucent puncture proof container.
  • Black Bags: These are to be used for non-bio-medical waste. In a hospital setup, this includes stationary, vegetable and fruit peels, leftovers, packaging including that from medicines, disposable caps, disposable masks, disposable shoe-covers, disposable tea cups, cartons, sweeping dust, kitchen waste etc.
COLOUR CODINGTYPE OF CONTAINERWASTE CATEGORY
YellowPlastic bagCategory 1, 2, 3, 6
RedDisinfected container/ Plastic bagCategory 3, 6, 7
Blue/White translucentPlastic bag/ Puncture proof bagCategory 4, 7
BlackPlastic bagCategory 5, 9, 10 (only solid)

Bio-medical Waste Disposal

The goals of Bio-medical waste treatment are to cut back or eliminate the waste’s hazards, and frequently to form the waste unrecognisable. Treatment ought to render the waste safe for subsequent handling and disposal. There are many treatment ways which will accomplish these goals. These are some most commonly used disposal techniques:

  • Incineration: Most of the Biomedical waste is incinerated. It basically destroys the pathogens and sharps. Most of the materials become unrecognisable because they become as. Alternatives to this can be thermal treatment which results in pathogen destruction.
  • Autoclaving: Actoclaving is a techniques often used in laboratories mainly to sterilize the objects or materials used in laboratory to make sure it is free from any bacteria. It basically uses steam and pressure to sterilise the waste or reduce its microbiological load to a level at which it may be safely disposed of. Many healthcare facilities routinely use an autoclave to sterilize medical supplies. If the same autoclave is used to sterilize supplies and treat biomedical waste, administrative controls must be used to prevent the waste operations from contaminating the supplies. Effective administrative controls include operator training, strict procedures, and separate times and space for processing biomedical waste.
  • Microwaving: Microwave medical care may use for treatment of medical specialty wastes. Microwave irradiation may be a style of non-contact heating technologies for medical care. Microwave chemistry is predicated on economical heating of materials by microwave effects. Microwave medical care may be a recently developed technology that provides advantage over recent existing technologies of autoclaves as microwave based mostly medical care has less cycle time, power consumption and it needs least usage of water and consumables as compared to autoclaves.

REGULATION AND MANAGEMENT IN INDIA

The Bio-medical Waste (Management and Handling) Rules, 1998 and additional amendments were passed for the regulation of bio-medical waste management. Every state’s Pollution panel or Pollution management Committee are chargeable for implementing the new legislation. New laws have an effect on the distribution of medical waste by medical professionals into their correct recepticals.
In India, there area unit variety of various disposal ways, the case is purposeless and most area unit harmful instead of useful. If body fluids are present, the materials must be incinerated or place into autoclave. Though this can be the correct technique, most medical facilities fail to follow the laws. It’s typically found that medical specialty waste is drop into the ocean, wherever it eventually washes up on shore, or in landfills because of improper sorting or negligence once within the medical facility. Improper disposal will result in several diseases in animals furthermore as humans. For example, animals, like cows in Pondicherry, are consuming the infected waste and eventually, these infections may be transported to humans World Health Organization consume their meat or milk. Sizable amount of unregistered clinics and establishments additionally generate bio-medical waste that isn’t controlled.
The waste is not disposed accurately because most the people in the profession are not aware of the fact that these bio-medical the waste from the hospitals can transmit diseases and have different side effects on the environment as well.

Different Categories of Bio-medical Waste

Biomedical waste is defined as any waste, which is generated during the diagnosis, treatment or immunisation of human beings or animals, or in research activities pertaining thereto, or in the production or testing of biologicals.

There are almost 10 broad categories of biomedical waste and they have different ways of disposal as well. The categories of biomedical are disposed in different ways according to the needs so that it does not harm any living organism or human mainly.

CATEGORYWASTE CATEGORYTREATMENT/ DISPOSAL
1)Human Anatomical waste consisting of human tissues, organs and body parts.Deep burial or incineration
2)Animal waste which consists of animal tissues, organs, body parts, bleeding parts, fluid, blood, experimental animals used in research, discharge from hospitals.Deep burial or incineration
3)Microbiological and biotechnological waste which consists of wastes from laboratory cultures, stocks or specimens of microbes they maybe live or attenuated, human or animal cell culture used for research in laboratories, toxins, waste from production of biological products, devices used to transfer the cultures.Incineration, autoclaving, microwaving
4)Waste sharps include needles, syringes, scalpels, blades, glasses etc that may cause puncture or cuts. They consists of both used and unused.Disinfection which include chemical treatment, autoclaving, microwaving etc.
5)Discarded Medicines or cytotoxic drugs which include waste comprising of outdated, contaminated and discarded medicines.Destruction or drug disposal in landfills and incineration
6)Solid Waste (I) are the items which include items contaminated with blood and body fluids including cotton, dressings, solid plaster casts, lines, beddings and anything contaminated with blood.Autoclaving or incineration
7)Solid Waste (II) are the item or wastes generated from disposable items other than the waste sharps such as tubings, intracenous sets etc.Disinfection by chemical treatment, autoclaving, microwaving and shredding
8)Liquid Waste consisting of waste generated from laboratory and washing, cleaning, house-keeping and disinfecting activities.First disinfection by chemical treatment and then discharge into drains
9)Incineration Ash which is the ash from the incineration of any biomedical waste.Disposal in municipal landfill
10)Chemical Waste are the chemicals used in production of biologicals, chemicals used in disinfection as insecticides etc.Chemical discharge into drains for liquids and secured landfill for solids

Biomedical waste should be safely and efficiently identified, segregated, stored, transported and disposed after appropriate treatment. Its effective implementation in our community is of prime importance to protect public health and environment. With a growing population, biomedical waste is also growing in quantity in our country. Management of this waste is a rising concern in India. Segregation of Bio-Medical Waste at its origin is the key to the efficiency of waste management. Following regulations and scientifically managing Bio- Medical Waste is in the best interest of the public as well as the environment. It is really important to completely destroy the waste and it should be destroyed by following the norms so that it cannot transmit infection to anyone or harm anyone especially in present situation.

Bio-medical Waste: a Biohazard

Biohazard also known as biological hazard, is basically a biological substance that poses a threat to the health of living organisms, primarily humans. They include the micro- organisms, virus or toxins that may adversely have an effect on human health. A biohazard might even be a substance harmful to alternative animals. Biohazard and its symbol are usually used as a warning, in order that those probably exposed to the substances can grasp to require precautions. Sources of biological hazards include microorganism, viruses, insects, plants, birds, animals, and humans. These sources will cause a range of health effects starting from skin irritation and allergies to infections, cancer. Biohazards are the biological materials like plats, micro-organisms, or their by-products that pose as a threat to the other living organisms. It basically is the negative impact of biological pathogens of different levels and origins which cause harm to different spheres like medical, agricultural, domestic etc.

Biomedical waste is defined as any waste, which is generated during the diagnosis, treatment or immunisation of human beings or animals, or in research activities pertaining thereto, or in the production or testing of biologicals.

Medical care and hospitals are basic need for good life, well-being and health. But with this they generate a lot of waste which can be hazardous, toxic and lethal for humans and other living beings because it can be a main reason for transmission of diseases. Since beginning, the hospitals are known for the treatment of sick persons but we are unaware about the adverse effects of the garbage and filth generated by them on human body and environment. Now it is a well established fact that hospital waste is a potential health hazard to the health care workers, public and flora and fauna of the area. The medical waste contains infectious, biomedical as well as sharps like injections, knives and now there is a addition to the medical waste which are PPE kits which a doctor wears while treating a corona positive patient or there are used masks, used tissues, cottons etc. in todays conditions it is very important to dump the biomedical waste according to the norms so that it cannot transmit any kind of infection, especially for the waste related to corona virus because the cases are increasing day by day. If the waste is not properly treated or dispose or is allowed to get mixed with the municipal waste then it can surely transmit infection. The subject of biomedical waste management and handling has been assuming increasing significance for the past few years. The responsibility of medical administrators as regards proper handling and disposal of this category of waste has now become a statutory requirement. The rag pickers are typically worst affected, as a result of inadvertently or inadvertently, they rummage through all types of toxic material whereas attempting to salvage things that they’ll sell for recycle. At identical time, this sort of banned and unethical recycle are often very dangerous and even fatal. Diseases like Asiatic cholera, plague, T.B., infectious disease, AIDS (HIV), contagious disease etc. in either epidemic or perhaps endemic kind, create grave public health risks. And now in addition to these disease there is corona virus infection which is currently the reason for most deaths.

About the rules and Regulations the act passed by the Ministry of Environment and Forests in 1986 and notified the Bio Medical Waste (Management and Handling) Rules in July 1998, it is the duty of every “occupier”, i.e. a person who has the control over the institution or its premises, to take all steps to ensure that waste generated is handled without any adverse effect to human health and environment. The provisions are equally applicable to our service hospitals.
The quantity of biomedical waste generated per bed per day will vary depending upon the type of health problems, the type of care provided and the hospital waste management practices. It varies from 1 to 2 kg in developing countries to 4.5 kg in developed countries such as USA. 10 to 15% of the waste is infectious in developed countries whereas it varies from 45.5 to 50% in India, requiring special handling.

What is Bone Tissue Engineering?

Bone development involves the aggregation of mesenchymal stem cells into mesenchymal condensations, which is partly similar to tooth development but without the epithelial invagination. Bone has a high potential for endogenous self-repair.There are two types bone formation: intra-membranous and endochondral. In endochondral bone formation, the mesenchymal condensations first undergo chondrogenesis and then ossification to form cartilage and bone. During adulthood, bone possesses the intrinsic capacity for regeneration throughout life. In most bone injuries or fractures, the damaged bone tissue can be functionally regenerated by the local cells. However, when the fractures are serious such as large bone defects created by trauma, infection, tumour resection, and skeletal abnormalities enough that self-healing cannot repair, an adequate supply of stem cells such as bone marrow stem cells is required for efficient bone regeneration. Oral MSCs seem to be ideal candidates for bone regeneration. Due to the population ageing, human diseases with impaired bone regeneration are on the rise.

CURRENT STRATEGIES

Current strategies to facilitate one healing include various biomolecules, cellular therapies, biomaterials and different combinations of these. Animal models for testing novel regenerative therapies remain the gold standard in pre-clinical phases of drug discovery and development. For usage of animal models for human bone regeneration skeletal characteristics of the selected animal species should considered seriously; a suitable animal model should be studied which basically mimics the intended clinical indication; and all the cell based approaches should be specifically studied.

Pancreas Regeneration in Human Regenerative Therapy

Diabetes, a disease with 346 million sufferers worldwide, is a significant health and welfare problem that the modern society faces. The pancreas is made from two distinct components: the exocrine pancreas, a reservoir of digestive enzymes, and the endocrine islets the source of the vital metabolic hormone insulin. Human islets possess limited regenerative ability; loss of islet ß-cells in diseases such as type 1 diabetes requires therapeutic intervention.the leading strategy for restoration of ß-cell mass is through the generation and transplantation of new ß-cells derived from human pluripotent stem cells. Other approaches include stimulating endogenous ß-cell proliferation, reprogramming non ß-cells to ß like cells, and harvesting islets from genetically engineered animals. Together these approaches form genetically engineered animals. Together these approaches form a rich pipeline of therapeutic development for pancreatic regeneration.

Generation of rat pancreas in apancreatic mouse by blastocyst complementation.

At present, however, transplantation therapy has the problem of an acute shortage of donor organs or tissues. An innovative study has recently been conducted showing that it may be possible to induce pancreatic regeneration. There is a long history of investigations into pancreatic regeneration, going back nearly a century. The epidemic of diabetes in recent decades has spurred numerous studies on pancreas development, homeostasis, and regeneration. Animal studies have suggested that the exocrine pancreas possesses an intrinsic capacity for regeneration and thus can make a rapid and full recovery from exocrine diseases such as acute pancreatitis. By contrast, the endocrine islets have limited regenerative capacity in adults. Indeed, it remains unclear whether the adult human pancreas can spontaneously regenerate ß-cells in any physiologically meaningful way. Substantial ß-cell loss therefore results in permanent endocrine deficiency and irreversible diabetes. There is an increasing consensus that a regenerative medicine approach will be helpful, even essential, in treating certain forms of diabetes including T1D and possibly the subset of T2D in which there is substantial ß-cell loss.

In vivo xenogeneic pancreas generation system using apancreatic pigs.

What is Xenotransplantation?

Xenotransplantation is the transplantation of cells, tissue or other organs between phylogenetically different species. The process of grafting organs or tissues between members of different of different species. It is any procedure that involves the transplantation, implantation or infusion into a human recipient of either live cells, tissues or organs from a non human animal source or human body fluids, cells, tissues, or organs that have had ex-vivo contact with live non human animal cells, tissues or organs. The development of xenotransplantation is driven by the fact that the demand for human organs for clinical transplantation far exceeds the supply.

Currently main problem is the long waiting list, according to World Health Organization (WHO), more than 114,000 organs transplantation are performed every year worldwide, which is only the 10% of the actual need currently.

The main advantage of xenotransplant is that they would provide an easily available animal source with an unlimited supply of donor organs. Ethically, pigs are an acceptable option for an alternative organ source. However, this solution is immunologically less desirable than non human primates, due to genetic distance between pigs and humans. Pig xenotransplant in non human primates have progressed a great deal, and the first clinical trials of complete organ xenografts will likely involve patients with renal failure. These patients could be selected because they have a high degree of sanitisation, which prevents them from easily obtaining an allograft.

M PHASE in Mitosis

This is the most important and dramatic period of the cell cycle involving a major reorganisation of virtually all components of the cell cycle. And since the number of chromosomes in the parent and progeny cells is the same, it is also called as equational division. This has mainly consists of nuclear division in various stages (karyokinesis). This phase is complex and highly regulated and sequence of events are divided into phases. Karyokinesis involves following stages:

  • PROPHASE
  • METAPHASE 
  • ANAPHASE
  • TELOPHASE 
  • CYTOKINESIS

PROPHASE

Prophase which is the first stage of karyokinesis of mitosis follows the S and G2 phases of interphase. Prophase is marked by the initiation of condensation of chromosomal material. The chromosomal material becomes untangled during the process of chromatin condensation. The centrosome, which had undergone duplication during S phase of interphase, now begins to move towards opposite poles of the cell.︎︎︎ Chromosomal material condenses to form compact mitotic chromosomes. Chromosomes are seen to be composed of two chromatids attached together at the centromere. Centrosome which had undergone duplication during interphase, begins to move towards opposite poles of the cell. Each centrosome radiates out microtubules called asters. The two asters together with spindle fibres forms mitotic apparatus. Cells at the end of prophase, when viewed under the microscope, golgi complexes, endoplasmic reticulum, nucleolus and the nuclear envelope are not present.

METAPHASE

The complete disintegration of the nuclear envelope marks the start of the second phase of mitosis, and therefore the chromosomes are spread through the cytoplasm of the cell. By this stage, condensation of chromosomes is completed and they can be observed clearly under the microscope. At this stage, metaphase chromosome is made up of two sister chromatids, which are held together by the centromere. Small disc-shaped structures at the surface of the centromeres are called kinetochores. These structures serve as the sites of attachment of spindle fibres which are formed by the spindle fibres to the chromosomes that are moved into position at the centre of the cell. Hence, the metaphase is characterised by all the chromosomes coming to lie at the equator with one chromatid of each chromosome connected by its kinetochore to spindle fibres from one pole and its sister chromatid connected by its kinetochore to spindle fibres from the opposite pole. The plane of alignment of the chromosomes at metaphase is referred to as the metaphase plate.︎︎︎︎ main event Spindle fibres attach to kinetochores of chromosomes. Chromosomes are moved to spindle equator and get aligned along metaphase plate through spindle fibres to both poles.

Phases of Mitosis

ANAPHASE

At the onset of anaphase, each chromosome arranged at the metaphase plate is split simultaneously and the two daughter chromatids, now referred to as daughter chromosomes of the future daughter nuclei. They basically begin their migration towards the two opposite poles. As each chromosome moves away from the equatorial plate, the centromere of each chromosome remains directed towards the pole and hence at the leading edge, with the arms of the chromosome trailing behind. Anaphase stage is characterised by spli`ng of centrosome and separation of chromatids and chromatids move to opposite poles.

TELOPHASE

At the beginning of telophase which is the final stage of karyokinesis, the chromosomes that have reached their respective poles de-condense and lose their individuality as in they just get dissolved and are not in the shape of chromosomes anymore. The individual chromosomes can no longer be seen and each set of chromatin material tends to collect at each of the two poles. Chromosomes cluster at opposite spindle poles and their identity is lost as discrete elements. Nuclear envelope develops around the chromosome clusters at each pole forming two daughter nuclei. Nucleolus, golgi complex and Endoplasmic Reticulum now appears again.

CYTOKINESIS

Mitosis accomplishes not only the segregation of duplicated chromosomes into daughter nuclei which is called as karyokinesis, but the cell itself is divided into two daughter cells by the separation of cytoplasm called cytokinesis at the end of which cell division gets completed. In an animal cell, this is achieved by the appearance of a furrow in the plasma membrane. The furrow gradually deepens and ultimately joins in the centre dividing the cell cytoplasm into two. Plant cells are enclosed by a relatively inextensible cell wall. And they undergo cytokinesis by a different mechanism. In plant cells, wall formation starts in the centre of the cell and grows outward to meet the existing lateral walls. The formation of the new cell wall begins with the formation of a simple precursor, called the cell-plate that represents the middle lamella between the walls of two adjacent cells. At the time of cytoplasmic division, organelles like mitochondria and plastids get distributed between the two daughter cells. In some organisms karyokinesis is not followed by cytokinesis as a result of which multinucleate condition arises leading to the formation of syncytium.

SIGNIFICANCE OF MITOSIS

  • Mitosis or the equational division is usually restricted to the diploid cells only. However, in some lower plants and in some social insects haploid cells also divide by mitosis.
  • Mitosis usually results in the production of diploid daughter cells with identical genetic complement. The growth of multicellular organisms is due to mitosis.
  • Cell growth results in disturbing the ratio between the nucleus and the cytoplasm. It therefore becomes essential for the cell to divide to restore the nucleo-cytoplasmic ratio.
  • A very significant contribution of mitosis is cell repair. The cells of the upper layer of the epidermis, cells of the lining of the gut, and blood cells are being constantly replaced.
  • Mitotic divisions in the meristematic tissues – the apical and the lateral cambium, result in a continuous growth of plants throughout their life.

Introduction to ‘Interphase’ in Mitosis

Growth and reproduction are characteristics of cells and of all living organisms. All cells reproduce by dividing into two, with each parental cell giving rise to two daughter cells each time they divide. These newly formed daughter cells can themselves grow and divide, giving rise to a new cell population that is formed by the growth and division of a single parental cell and its progeny.

Cell division is very important process in all living organisms. The cell cycle is a process a cell will go through to replicate all of its material and divide itself from one cell into two identical cells. During the division of a cell, DNA replication and cell growth also take place. All these processes, i.e., cell division, DNA replication, and cell growth have to take place in a coordinated way to ensure correct division and formation of progeny cells containing intact genomes. The sequence of events by which a cell duplicates its genome, synthesises the other constituents of the cell and eventually divides into two daughter cells is termed cell cycle. Although cell growth in terms of cytoplasmic increase is a continuous process, DNA synthesis occurs only during one specific stage in the cell cycle. The replicated chromosomes (DNA) are then distributed to daughter nuclei by a complex series of events during cell division. These events are themselves under genetic control.

PHASES OF CELL CYCLE

To divide, a cell must complete several important tasks it must grow, copy its genetic material (DNA), and physically split into two daughter cells. Cells perform these tasks in an organized, predictable series of steps that make up the cell cycle. The cell cycle is a cycle, rather than a linear pathway, because at the end of each go-round, the two daughter cells can start the exact same process over again from the beginning. These cells divide in approximately every 24 hours and mostly the duration of cell cycle can vary from organism and also from cell type to cell type.

In eukaryotic cells or cells with nucleus, the stages of the cell cycle and divided into two major phases:

INTERPHASE

Interphase is a series of changes that takes place in a newly formed cell and its nucleus before it becomes capable of division again. It is also called preparatory phase or resting phase. It is the time during which the cell is preparing for division by undergoing both cell growth and DNA replication in an orderly manner. Typically interphase lasts for at least 91% of the total time required for the cell cycle.

Interphase proceeds in three stages, G1, S, and G2, followed by the cycle of mitosis and cytokinesis.

G1 PHASE

The first phase of the interphase is called the G1 phase or the Gap 1 phase. Also called as growth phase. The duration of G1 is highly variable, even among different cells of the same species. In this phase, the cell increases its supply of proteins, increases the number of organelles (such as mitochondria, ribosomes), and grows in size. The cells are metabolically ac/ve and con/nuously grows but does not replicate its DNA. The cells needs to con/nue cell cycle and enter S phase which is the step or the next phase of the interphase.

S PHASE

S phase or the synthesis phase marks the period during which DNA synthesis or the replication takes place. During this time the amount of DNA per cell doubles. It also duplicates a centrosome. The centrosome helps separate the DNA during Phase. However, there is no increase in the chromosome number. If the cell had diploid or 2n number of chromosomes at G1, even aTer Phase the number of chromosomes remains the same. Rates of RNA transcription and protein synthesis are very low during this phase.

G2 PHASE

It occurs after the DNA replication and is the period of protein synthesis and rapid cell growth to prepare the cell fo mitosis called as the second gap phase. During this phase the cell grows more, makes proteins and organelles and begins to recognise its contents in preparation for mitosis.

The G1, S and G2 phases together are known as the interphase. Here the the prefix inter means between, reflecting that interphase takes place between one mitotic phase or the M Phase and next.

QUIESCENT STAGE (G0)

Some cells in the adult animals do not appear to exhibit division (e.g., heart cells) and many other cells divide only occasionally, as needed to replace cells that have been lost because of injury or cell death. These cells that do not divide further exit G1 phase to enter an inactive stage called quiescent stage (G0) of the cell cycle. Cells in this stage remain metabolically active but no longer proliferate unless called on to do so depending on the requirement of the organism.

M PHASE

This is the most important and dramatic period of the cell cycle involving a major reorganisation of virtually all components of the cell cycle. And since the number of chromosomes in the parent and progeny cells is the same, it is also called as equational division. This has mainly consists of nuclear division in various stages (karyokinesis). This phase is complex and highly regulated and sequence of events are divided into phases. Karyokinesis involves following stages:

  • PROPHASE
  • METAPHASE 
  • ANAPHASE 
  • TELOPHASE
  • CYTOKINESIS