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Fulltext Assessment and valuation of health impacts of fine particulate matter during COVID-19 lockdown: a comprehensive study of tropical and sub tropical countries

Bherwani H, Kumar S, Musugu K, Nair M, Gautam S, Gupta A, et al.

Environ Sci Pollut Res Int, 2021 Aug;28(32):44522-44537.
PMID: 33852112 DOI: 10.1007/s11356-021-13813-w

A novel coronavirus disease (COVID-19) continues to challenge the whole world. The disease has claimed many fatalities as it has transcended from one country to another since it was first discovered in China in late 2019. To prevent further morbidity and mortality associated with COVID-19, most of the countries initiated a countrywide lockdown. While physical distancing and lockdowns helped in curbing the spread of this novel coronavirus, it led to massive economic losses for the nations. Positive impacts have been observed due to lockdown in terms of improved air quality of the nations. In the current research, ten tropical and subtropical countries have been analysed from multiple angles, including air pollution, assessment and valuation of health impacts and economic loss of countries during COVID-19 lockdown. Countries include Brazil, India, Iran, Kenya, Malaysia, Mexico, Pakistan, Peru, Sri Lanka, and Thailand. Validated Simplified Aerosol Retrieval Algorithm (SARA) binning model is used on data collated from moderate resolution imaging spectroradiometer (MODIS) for particulate matters with a diameter of less than 2.5 μm (PM2.5) for all the countries for the month of January to May 2019 and 2020. The concentration results of PM2.5 show that air pollution has drastically reduced in 2020 post lockdown for all countries. The highest average concentration obtained by converting aerosol optical depth (AOD) for 2020 is observed for Thailand as 121.9 μg/m3 and the lowest for Mexico as 36.27 μg/m3. As air pollution is found to decrease in the April and May months of 2020 for nearly all countries, they are compared with respective previous year values for the same duration to calculate the reduced health burden due to lockdown. The present study estimates that cumulative about 100.9 Billion US$ are saved due to reduced air pollution externalities, which are about 25% of the cumulative economic loss of 435.9 Billion US$.
Fulltext Gastric ulcer healing by chebulinic acid solid dispersion-loaded gastroretentive raft systems: preclinical evidence

Negi P, Gautam S, Sharma A, Rathore C, Sharma L, Upadhyay N, et al.

Ther Deliv, 2022 Feb;13(2):81-93.
PMID: 35075915 DOI: 10.4155/tde-2021-0062

Background: Chebulinic acid (CA), a component in Terminalia chebula, exhibits antiulcer activity, but has poor aqueous solubility. Raft-forming systems incorporating solid dispersions (SDs) of CA, were developed to overcome its poor biopharmaceutical properties and to prolong the gastric residence time for maximum activity. Methods: SDs were formulated by a solvent evaporation method using Eudragit EPO. Raft formulations consisted of sodium alginate as a polymer. Results: Release of CA in the dissolution medium was 40%, whereas SDs showed 95.45% release. The CA raft system (20 mg/kg) showed curative efficacy in an alcohol-induced gastric ulcer model and increased protection when compared with omeprazole (10 mg/kg) and CA suspension (20 mg/kg). Conclusion: These studies demonstrated SD raft systems to be a promising approach for antiulcer therapy by CA.
Subclinical Hypothyroidism and Clinical Outcomes After Percutaneous Coronary Intervention: A Meta-Analysis

Ang SP, Chia JE, Jaiswal V, Bandyopadhyay D, Iglesias J, Mohan GVK, et al.

Curr Probl Cardiol, 2023 Aug;48(8):101719.
PMID: 36967069 DOI: 10.1016/j.cpcardiol.2023.101719

While subclinical hypothyroidism (SCH) was reportedly associated with an increased risk of cardiovascular mortality, the relationship between SCH and clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) is uncertain. The aim of this study was to assess the association of SCH and cardiovascular outcomes in patients undergoing PCI. We searched PubMed, Embase, Scopus, and CENTRAL databases from its inception until April 1, 2022 for studies comparing the outcomes between SCH and euthyroid patients undergoing PCI. Outcomes of interest include cardiovascular mortality, all-cause mortality, myocardial infarction (MI), major adverse cardiovascular and cerebrovascular events (MACCE), repeat revascularization and heart failure. Outcomes were pooled using the DerSimonian and Laird random-effects model and reported as risk ratios (RR) and 95% confidence intervals (CI). A total of 7 studies involving 1132 patients with SCH and 11,753 euthyroid patients were included in the analysis. Compared with euthyroid patients, patients with SCH had significantly higher risk of cardiovascular mortality (RR 2.16, 95% CI: 1.38-3.38, P < 0.001), all-cause mortality (RR 1.68, 95% CI: 1.23-2.29, P = 0.001) and repeat revascularization (RR 1.96, 95% CI: 1.08-3.58, P = 0.03). However, there were no differences between both groups in terms of incidence of MI (RR 1.81, 95% CI: 0.97-3.37, P = 0.06), MACCE (RR 2.24, 95% CI: 0.55-9.08, P = 0.26) and heart failure (RR 5.38, 95% CI: 0.28-102.35, P = 0.26). Our analysis suggests among patients undergoing PCI, SCH was associated with increased risk of cardiovascular mortality, all-cause mortality and repeat revascularization compared to euthyroid patients.
Fulltext Vascular complications and outcomes following transcatheter aortic valve replacement in patients on chronic steroid therapy: a meta-analysis

Ang SP, Chia JE, Jaiswal V, Hanif M, Vadhera A, Gautam S, et al.

Int J Surg, 2024 Apr 01;110(4):2421-2429.
PMID: 38320107 DOI: 10.1097/JS9.0000000000001132

BACKGROUND: Chronic steroid (CS) therapy was reportedly linked to increased vascular complications following percutaneous coronary intervention. However, its association with vascular complications after transcatheter aortic valve replacement (TAVR) remained uncertain, with conflicting results being reported.
OBJECTIVE: The authors aimed to compare the rate of vascular complications and outcomes between patients with and without CS use after TAVR.
METHODS: The authors conducted a comprehensive literature search in PubMed, Embase, and Cochrane databases from their inception until 18th April 2022 for relevant studies. Endpoints were described according to Valve Academic Research Consortium-2 definitions. Effect sizes were pooled using DerSimonian and Laird random-effects model as risk ratio (RR) with 95% CI.
RESULTS: Five studies with 6136 patients undergoing TAVR were included in the analysis. The included studies were published between 2015 and 2022. The mean ages of patients in both study groups were similar, with the CS group averaging 80 years and the nonsteroid group averaging 82 years. Notably, a higher proportion of patients in the CS group were female (56%) compared to the nonsteroid group (54%). CS use was associated with a significantly higher risk of major vascular complications (12.5 vs. 6.7%, RR 2.32, 95% CI: 1.73-3.11, P <0.001), major bleeding (16.8 vs. 13.1%, RR 1.61, 95% CI: 1.27-2.05, P <0.001), and aortic annulus rupture (2.3 vs. 0.6%, RR 4.66, 95% CI: 1.67-13.01, P <0.001). There was no significant difference in terms of minor vascular complications (RR 1.43, 95% CI: 1.00-2.04, P =0.05), in-hospital mortality (2.3 vs. 1.4%, RR 1.86, 95% CI: 0.74-4.70, P =0.19), and 30-day mortality (2.9 vs. 3.1%, RR 1.14, 95% CI: 0.53-2.46, P =0.74) between both groups.
CONCLUSION: Our study showed that CS therapy is associated with increased major vascular complications, major bleeding, and annulus rupture following TAVR. Further large multicenter studies or randomized controlled trials are warranted to validate these findings.