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Experts suggest ways to take care of your mental health.

With the number of cases rising each day, near and dear ones getting affected, and amid lockdowns, stress and anxiety are at an all-time high in the second wave of Covid 19. “The second wave is severe not just because of the toll it’s taking due to the huge population being affected but also because it suddenly came when everything seemed to be returning to normal. Vaccine felt like a respite but there are millions yet to be vaccinated and people still haven’t recovered from financial and personal losses,” Dr Jyoti Kapoor, senior psychiatrist and founder, Manasthali.

In a recently released insight by Practo in March 2021, most discussed concerns of women in non-metro cities included depression, anxiety and panic attacks while most discussed concerns of women in metro cities were stress, obsessive-compulsive disorders, eating disorders, and mood disorders.

What is leading to mental health concerns?

According to the World Health Organization (WHO), “fear, worry, and stress are normal responses to perceived or real threats, and at times when we are faced with uncertainty or the unknown. So it is normal and understandable that people are experiencing fear in the context of the COVID-19 pandemic”.

Added to the fear of contracting the virus in a pandemic such as COVID-19 are the significant changes to our daily lives with our movements being restricted in support of efforts to contain and slow down the spread of the virus, as per WHO. Faced with new realities of working from home, temporary unemployment, home-schooling of children, and lack of physical contact with other family members, friends and colleagues, it is important that we look after not just physical health but mental health too.

In circumstances like these, how can people take care of their mental health? Here’s what mental health experts tell us.

Besides following Covid-appropriate behaviour, psychiatrist Dr Samir Parikh suggested that one must try and not “look into social media too much”. “Social support is the key – share and keep talking to people,” he said, while mentioning that one needs to keep a healthy lifestyle, have regular sleep, exercise, do yoga, do reading, listen to music and take multiple breaks.

The only way to manage stress in these times is to focus on living in the present, said Dr Kapoor.

*Avoid focusing on statistics that serve no purpose for the common man. All one needs to do is focus on their own self which means the same old stringent measures of wearing a mask and staying indoors.

Follow a disciplined routine. Discipline helps the brain to focus on the task at hand and not stray away into unnecessary negative thoughts.

*Pursue a creative activity. Even if work from home is taxing, find time to indulge in hobbies you enjoy. It takes away the stress of achieving results for work. The process itself induces happy chemicals.

*Exercise releases endorphins which are natural pain killers. It also gives a sense of accomplishment while keeping us physically fit and improving immunity.

*Adequate sleep and sleep-wake patterns allow for the balance of neurochemicals to be restored so the emotional exhaustion and burnout is low.

*Healthy diet is always important to improve physical and psychological stress tolerance.

*Connect with family and friends. Don’t get into the same old Corona-related speculations; talk about other things like sports, science, universe.

*Read whatever interests you, go beyond the newspaper; there is so much to choose from.

*Focus on all the things we still have. Sooner or later, things will change. We have a better understanding of diseases today than we ever had. Patience is a good virtue to learn today and forever.

*”Last but not least- be grateful. We will survive and in the process will also build a better world. So many things are changing for good,” said Dr Kapoor.

Finding it difficult to sleep?

According to a new survey from the American Academy of Sleep Medicine, a third of Americans are sleeping worse than they did before the pandemic. About 30 percent say they have difficulty falling asleep or staying asleep. One in five also say they’ve experienced more disturbing dreams during the pandemic. This so-called COVID-somnia” can be brought on by fears about the coronavirus, concern for our loved ones, economic worries, and limited social contact, said Dr Malik Merchant, consultant psychiatrist and psychotherapist, Wockhardt Hospital, Mumbai Central.

Some Factors that affect the amount and quality of sleep

-increased stress and anxiety

-an uptick in screen time

-lack of exercise

-increase in the use of tobacco and alcohol


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COVID-19 Impact On Health Supply Chain

Before the imposition of the strict lockdowns and the spread of COVID-19, the disruptions in China caused a ripple effect on the global supply chains. Emphasis has been laid on minimisation of costs and timely delivery of essential products.

In India, as the situation worsens due to the outbreak, we have seen disruptions in the logistics supply chain. There are several reasons attributed to the increase in demand and slowing of the supply. There are several workable solutions available to look into this situation. We should work towards promoting Indian markets and amend policies to help the local workforce lessen the inter-dependencies of imports on other countries. This will help in strengthening the logistics supply chain in India. This will create employment opportunities and increase the GDP growth.

Logistics is the backbone of an economy, as it ensures free flow of goods and services required for the functioning of industries and the economy. India’s logistics sector is rapidly evolving despite facing enormous challenges (PYMNTS, 2020). Inadequate logistics infrastructure has created several bottlenecks in the growth of the economy. The biggest challenge faced by the Indian industry today is the lack of integration of transport, distribution of warehouses, different regulations imposed at the national, state and district levels and trained and efficient workforce’s. This makes the sector unorganized. Today, we are facing an unprecedented crisis which has made us look into the vulnerabilities of our logistics supply chain.

The Chinese economy is the manufacturing powerhouse and is also known as the world’s factory. One can see its products everywhere, with the label ‘Made in China’. Therefore, China being the epicenter of COVID-19, it went under a lock down and extensive measures were put into action quite early, causing supply from the manufacturing facilities being reduced, affecting the exports from China and imports to the other countries. Before this pandemic, China used to produce half the world’s masks. However, as the infection rate in China increased, the systems of manufacturing came to a halt. Now that the infection rate has slowed in China, it has started exporting products to all over the world. The problem that remains is of the substandard products being shipped to countries worldwide.

As the COVID-19 pandemic continues to spread, it has exposed vulnerabilities of supply chains and logistics. It has disrupted health supply chains, affecting active pharmaceutical ingredients, shipping, procurement’s, finished healthcare products and more.

Logistics supply chain means much more than the movement of pharmaceuticals and other products between countries. It definitely deals with problems at the grassroots level, including the migration of labourers working in industrial units, ban on transportation activities, especially trucks, lack of cooperation between different administrations and transporters and couriers not functioning timely. All these factors cause delays and hamper the supply chain, causing issues in supplies of vaccines, hand sanitizers, testing kits, protective healthcare equipment (PPE), medicines, medical equipment, raw material and much more.

While things are still better in metro cities, the situation remains grim in the districts. Trucks carrying coal are not allowed to pass through borders, and the suspension of flight services has led to goods being stuck in different corners of the country. This has primarily affected chemists and eco-retailers in distributing products to the community.

Moreover, the World Health Organization reported that serious and escalating damage to the global supply of PPE, N95, sanitisers and testing kits is triggered by rising competition, panic purchasing, hoarding and abuse, which is placing lives at risk from the latest coronavirus and other infectious diseases. An approximate 89 million medical masks are required per month for combating COVID-19, based on WHO modelling. The number goes up to 76 million for examination gloves, while overseas demand for goggles is 1.6 million a month.

Many companies across the globe are working to make their supply chain leaner. Their emphasis on minimisation of costs and timely deliveries has left no room for adequate buffers and has led to a reduction in the inventory buffers. These situations have worsened the impact on the supply chains, exposing the fragility of logistics management.

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An Overview On Sanitary Napkins

The first disposable sanitary napkin, made of cotton and gauge, was put together in 1896. It was successfully commercialized in the United States of America in 1921. As the availability of the material shrank, there was a need to find a material that is easily available and cost-effective. Later, wood pulp was incorporated since it is an absorbent material from softwood.

The plastic revolution changed the entire nature of the sanitary napkin. Sanitary napkins began to be made of Super Absorbent Polymer(SAP) as an absorbent material, with Polypropylene(PP) for the back cover. This made it waterproof. The polypropylene top sheet kept it dry. Today’s sanitary napkins are almost entirely from a plastic material. Only a few are natural.

Potential problems of Sanitary napkins :

Hygiene risk: Improvisation led to introducing SAP to increase absorbency, they began to be made of polypropylene(PP) based perforated top sheet and polyethylene sheet as a barrier. This improved its functionality. These products seem innocuous but they may be laced with dioxins, petrochemicals, GMO (Genetically Modified Organisms), and fragrances. When these chemicals come in contact with sensitive skin, tissue may get irritated. Dioxins are carcinogenic in nature hence the risk of cancer increases even at very low levels of exposure. Additives such as fragrances, deodorants, absorbency agents, urea, and formaldehyde enhance the properties but can cause allergies and skin reactions.

Disposability: Polymers in sanitary pads are non-biodegradable materials. This may create many serious problems. Sanitary pads are made of SAP. When these pads are flushed, they block sewage lines as these chemicals absorb all the water in the sewage line. Disposed used sanitary pads cause occupational hazards for waste pickers who use their bare hands to sort out garbage. This is a health hazard. The common practice is to incinerate used sanitary pads. This releases dioxins and furans, creating an environmental hazard.

Affordability: In developing countries, the price of sanitary pads is often prohibitive for most of the population. About 70 percent of Indian women still cannot afford sanitary pads and use unhygienic rags. In a 2012 study on diffusion and adaptation of sanitary pads to the target group, it was found that working status, education, type of home, and monthly household incomes influence the usage of sanitary napkins. The reason behind its cost is the fact that most of the material used is imported from developed places. This ultimately increases the cost of the product.

Structure of sanitary napkins:

There are four functional components of a sanitary napkin: (i) fluid acquisition layer (ii) distribution component (iii) absorbent structure (iv) liquid impervious membrane.

(i) Fluid acquisition layer: A lot of R&D has been done to keep the top surface dry so that it does not cling to the body and fits comfortably. This layer is a perforated film that allows liquid to pass through it quickly into the absorbent structure and stays dry since the fluid is entrapped in the structure. It thus reduces the chance of leakage.

(ii) Distribution component: This component spreads out the fluid, especially in the longitudinal direction, for better utilization of the product. By spreading fluid, it increases the probability of more retention of fluid.

(iii) Absorbent structure: One of the main characteristics of sanitary pads is to absorb body fluid and retain it for a long period of time and avoid backflow under pressure.

(iv) Liquid impervious membrane: This is the last layer. It acts as a barrier to prevent fluid from leaking.

Performance characteristic of sanitary napkin:

Liquid flow through the interface among these three components (top layer, an absorbent layer, and barrier film) and mainly within the absorbent component is the key factor in deciding the performance of a sanitary napkin. To understand the working principle of sanitary napkins we have to consider the flow path of fluid through each layer of a sanitary pad.

As fluid comes vertically in contact with the first layer, it moves across the fluid acquisition layer to the absorbent layer without spreading in the facing layer. Once the fluid reaches the absorbent layer, it spreads and can be held without reversing flow direction.

The first problem in sanitary pads is the interface between the acquisition layer and the absorbent layer. The acquisition layer is mainly made up of hydrophobic fiber and the absorbent layer is composed of hydrophilic fiber so the fluid must get readily transferred from the acquisition layer to the absorbing medium. Transfer of fluid from one layer to another will fail if there is not enough intimate contact between the two layers. Any gap will alter the pattern of flow and liquid may spill and lead to failure of the product.

Almost all sanitary pads use fluffed cellulosic pulp as the core component of the absorbent material. This fluff is prepared by defibrillation of unopened compressed cellulosic boards. There is always a chance of some amount of unopened board which gives heterogeneity to the absorbent material. Therefore, uneven flow and retention of fluid will be different from the rest of the area.

Performance of sanitary pads can be evaluated on fluid retention capacity or the amount of fluid sustained after applying pressure. One factor which affects fluid retention is density. Modern commercial sanitary pads are made from super-absorbent fiber used in compressed and uncompressed form. Density significantly influences the absorption and stability of the product. A highly compressed fiber will expand on absorption whereas, in the case of lightly compressed fiber, it will collapse as a result of absorption. So compression of absorbent material is necessary to maintain its structural integrity.

Choice of raw material:

(i) Fluid transfer layer: The top layer is designed to transfer fluid from the top cover to the immediate secondary layer. An efficient sanitary pad should be dry for comfort. Traditional sanitary pads were of multilayer cellulosic material. Instead of dripping down, fluid tended to remain at or near the surface. This led to discomfort so one proposed solution has been to use thermoplastic fiber. It has been found that at least 20 percent of the fiber should be hydrophilic to provide sufficient capillary attraction to pull the fluid through the cover and provide a dry surface.

(ii) Acquisition and distributing layer: As the absorbent core cannot absorb fluid immediately, so this layer imbibes the fluid, drawing it away from the point of discharge, distributes it laterally, and holds it for the core to absorb. It is generally made up of thermally bonded or air bonded composite non-woven.

(iii) Absorbent layer: The absorbent core of the sanitary pad is generally made up of cellulosic pulp but there have been some changes in the composition. Nowadays, SAP is air-laid with pulp and used to increase absorbency. The position of this polymer is important as it may clog the pore of the structure and restrict absorption of fluid, so the SAP polymer is affixed to tissue and placed between the pulp and back sheet.

(iv) Barrier sheet: The back sheet is a fluid impermeable sheet that prevents leakage, generally made up of polyethylene.

Tests to evaluate performance:

Absorbency test:

This method determines the total absorption capacity of the material. According to the test standard ISO 5405-1980, a sample is laid on a flat level and transparent surface, so that the underside of the pad can be observed. The fluid is to be dripped, at the rate of 15ml per minute, so that 30 ml of the fluid maintained at a temperature of 2702C is poured onto the center of the sanitary pad from a height of approx. 1 to 2 mm. After the napkin has absorbed the full amount of fluid, the standard weight of 1 kg is put above the sample for a minute on the portion where the fluid is absorbed. After that, the back and sides of the pad are observed for fluid flowing up. The reading is recorded.

Fluid Retention capacity:

The measurement of fluid retention is determined by using the standard ASTM D 461. A sample of the pad is to be immersed in the fluid at room temperature for five minutes to completely wet it out. The fluid clogged sanitary napkin is weighted, dried, and reweighed. Fluid retention is calculated as a percentage of dry mass.

Liquid strike through the test:

A drop of test solution is allowed to fall on the sample and the time taken for the solution to transport from the upper layer of the napkin to the inner layers of the sample. This is measured by observing the drop closely so that the dull wet spot is seen on the wet area of the sample. All samples should be conditioned for 24 hours before the tests.

Sanitary pad manufacturers are more interested in increasing the performance of pads by using material derived from crude petroleum. This has negative environmental impacts and is a health hazard.

Designing a sanitary pad safe to health, biodegradable, sustainable, and affordable for lower-income class women has become a challenge. An alternative raw material has to be found to replace these synthetic fibers and polymers.

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Are Masks Safe?

Face masks are a simple way to help decrease coronavirus transmission and save lives. According to the Centers for Disease Control and Prevention, wearing a face mask in public places has been shown to reduce the spread of COVID-19, because those who are pre-symptomatic can spread the virus before showing symptoms. However, some masks are more effective than others.

How do the different types of masks work?

Medical masks

Also called surgical masks, these are loose-fitting disposable masks. They’re meant to protect the wearer from contact with droplets and sprays that may contain germs. A medical mask also filters out large particles in the air when the wearer breathes in.

To make medical masks more form-fitting, knot the ear loops where they attach to the mask. Then fold and tuck the unneeded material under the edges.

N95 masks

An N95 mask is a type of respirator. It offers more protection than a medical mask does because it filters out both large and small particles when the wearer inhales.

Because N95 masks have been in short supply, the CDC has said they should be reserved for health care providers. Health care providers must be trained and pass a fit test before using an N95 mask. Like surgical masks, N95 masks are intended to be disposable. However, researchers are testing ways to disinfect and reuse them.

Some N95 masks, and even some cloth masks, have valves that make them easier to breathe through. Unfortunately, these masks don’t filter the air the wearer breathes out. For this reason, they’ve been banned in some places.

Cloth masks

A cloth mask is intended to trap respiratory droplets that are released when the wearer talks, coughs, or sneezes. It also acts as a barrier to protect the wearer from inhaling droplets released by others.

The most effective cloths masks are made of multiple layers of tightly-woven fabric like cotton. A mask with layers will stop more droplets from getting through your mask or escaping from it.

Face masks with valves:

These masks may make it easier to breathe out, but as the wearer is doing so, they’re also exhaling their germs into the air around them. Increasingly more medical facilities around the country have banned the use of masks with valves. They do a good job protecting the wearer, but because of the one-way valves, they don’t offer much protection to the people around the wearer. If the wearer is contagious, either knowingly or unknowingly, they could still be spreading the virus to others around them. Since the main reason to wear a mask is to protect others, a simpler mask with a filter may be a better choice.

How to get the cost from your mask

The effectiveness of cloth and medical masks can be improved by ensuring that the masks are well fitted to the contours of your face to prevent leakage of air around the masks’ edges.

Masks should be snug over the nose, mouth, and chin, with no gaps. You should feel warm air coming through the front of the mask when you breathe out. You shouldn’t feel air coming out under the edges of the mask.

Masks that have a bendable nose strip help prevent air from leaking out of the top of the mask.

Some people choose to wear a disposable mask under their cloth mask. In that case, the cloth mask should press the edges of the disposable mask against the face. Don’t add layers if they make it hard to breathe or obstruct your vision.

Proper use, storage, and cleaning of masks also affect how well they protect you. Follow these steps for putting on and taking off your mask:

  • Wash or sanitize your hands before and after putting on your mask.
  • Place your mask over your mouth and nose and chin.
  • Tie it behind your head or use ear loops. Make sure it’s snug.
  • Don’t touch your mask while wearing it.
  • If you accidentally touch your mask, wash or sanitize your hands.
  • If your mask becomes wet or dirty, switch to a clean one. Put the used mask in a sealable bag until you can get rid of it or wash it.
  • Remove the mask by untying it or lifting off the ear loops without touching the front of the mask or your face.
  • Wash your hands immediately after removing your mask.
  • Regularly washcloth masks in the washing machine or by hand. (They can be washed along with another laundry.)

And don’t forget these precautions:

  • Don’t put masks on anyone who has trouble breathing or is unconscious or otherwise unable to remove the mask without help.
  • Don’t put masks on children under 2 years of age.
  • Don’t use face masks as a substitute for physical distancing.

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Why is PPE Essential?

Healthcare personnel delivers care directly or indirectly to patients infected with pandemic diseases like SARS (Severe Acute Respiratory Syndrome), AIDS (Acquired Immune Deficiency Syndrome), avian influenza (bird flu), H1N1 (swine flu), and multidrug-resistant tuberculosis.

They also prevent the further spread of these infectious diseases. It is necessary for healthcare personnel to wear Personal Protective Equipment (PPE) to limit morbidity and mortality of patients in their care, as well as themselves, their family members, and other members of the community to prevent a pandemic’s larger societal progression.

In the last few decades, the transmission mechanisms of pandemic infectious pathogens from a patient to healthcare personnel have been thoroughly investigated to develop PPE. Through these investigations, it has been found that infectious pathogens can be transferred to healthcare personnel through their respiratory organs and dermis via air and liquids (water, blood, etc.), and through mucus membranes (eyes, nose, etc). Thus, respiratory, dermal, and mucus membrane protection are essential for healthcare personnel.

Consequently, different types of PPE have been developed and made commercially. Commonly used PPE includes medical masks, respirators, gloves, gowns, and eye protectors. Some other types of PPE, such as face shields, are also occasionally used by healthcare personnel. Among these, respiratory (medical masks, respirators, etc.) and dermal (gloves, gowns, etc.) protective equipment are primarily textile-based and used regularly by healthcare personnel.

Why is PPE essential?

The use of PPE has recently been prominent in health care institutions such as hospitals, clinics, and clinical laboratories during this Pandemic.

When used correctly, PPE works as a barrier between infectious viruses and bacteria and the human body. They stop them from contaminating the skin, mouth, nose, or eyes (different mucous membranes). PPE has a major role to play in blocking the transmission of contaminants through blood, body fluids, or respiratory secretions.

PPE has definitely played a significant role in containing the Covid-19 Pandemic in most of the countries around the world.

The growing demand of PPE

Healthcare Personal Protective Equipment is witnessing a surge in demand amidst the COVID-19 pandemic across the globe as PPE for healthcare workers is crucial to fight against the novel coronavirus (COVID-19). Gloves, Face Shields, Goggles, Face Masks, Coveralls, Head Covers, and Boots are among some of the personal protective equipment with rising global demand.

The key factors which can play a major role to drive the market for the PPE Industry include increasing awareness about the importance of healthcare safety, safety preparedness at healthcare facilities, implementation of stringent safety norms, and emphasizing labor safety at the workplace.

PPE for Healthcare Sector

Different PPE is used for different situations in the healthcare sector from Head to Toe. Chemical Splash Goggles are used for optimum protection against biological splashes in hospitals. Disposable Workwear that does not allow penetration of any chemical or bio agent is used for protecting the body. Face Masks like N95 are suitable to fight against harmful air-borne pathogens, preventing them to enter the human body through the nose or mouth. Similarly, Face Shields are used to act as a barrier, protecting the eyes, nose, and mouth of the user.

There are some important aspects to consider while protecting the health and safety of doctors, nurses and other health care staff. First is to develop awareness on choosing the right PPE depending on a particular situation. Further, it is extremely important to acquire the right training on how to wear different PPE and making sure to understand the correct disposal and storage methods as per health institution guidelines. With any type of contaminated waste, there is always a possibility of cross-contamination, so any medical PPE has to be properly discarded and disposed of.

We are hopeful that while the world will beat this Pandemic with cohesive efforts, we shall never forget the lessons it has taught. Personal safety needs and requirements are going to be the top priority for everyone around the world.