Self-medication is the use of drugs to treat self-diagnosed ailments without the use of a formal prescription. Self-medication is defined by the World Health Organization as the use of medications to address self-diagnosed diseases or symptoms. Over-the-counter (OTC) pharmaceuticals are medications that can be sold without a prescription directly to the client in accordance with the laws of each nation. During the COVID-19 pandemic, an increasing tendency in the use of OTC and self-medication was seen, with the situation in India particularly deteriorating due to lax regulatory restrictions. This has resulted in a slew of problems, ranging from a lack of drugs to severe responses due to overdosage and drug-drug combinations. There is an urgent need for more tangible regulatory control over self-medication and OTC medications to safeguard the uninformed populace from harm.

The current coronavirus disease 2019 (COVID-19) pandemic is one example of the scores of zoonotic diseases responsible for various outbreaks resulting in the deaths of millions of people for centuries. The COVID-19 pandemic has broken the age-old healthcare infrastructure and led to utter chaos. In the shadow of this pandemic, other zoonotic infections like the nipah virus, monkeypox, and langya virus, to name a few, have been neglected. Hence, outbreaks caused by such zoonotic viruses are rising in their endemic areas, like the Indian subcontinent. The mortality and morbidity due to such zoonoses are greater than usual due to the shortage of healthcare professionals caused by the COVID-19 crisis. Due to the lack of vaccines and therapeutics directed against this viral infection, treatment of patients is limited to supportive management and prevention, making preparedness for these potential zoonotic viral outbreaks essential. This paper highlights some of these zoonotic infections, which perpetuated and wreaked havoc while the world was occupied with containing the COVID-19 pandemic.

Purpose: This systematic review endeavors to find an effective treatment protocol for subacute thyroiditis (SAT) to minimize side effects, recurrence and long-term hypothyroidism. Materials and Methods: We analyzed available original studies on treatment protocols for SAT. A thorough literature search was performed on the following online databases PubMed, Cochrane library nd Google Scholar using appropriate keywords for choosing relevant articles. Two reviewers assessed the methodological quality of selected articles independently using a critical appraisal instrument. The results were analyzed and synthesized qualitatively using the level of evidence method. Results: The literature search retrieved a total of 460 publications after abstract screening; out of which 36 articles met the inclusion criteria. After full text screening, 23 articles were further excluded as they were focusing on aspects of SAT other than management, the remaining 15 articles were investigated for both reliability and validity. Thirteen studies provided low-quality evidence, and two randomized control trials (RCT) provided a high quality of evidence. Steroid therapy was found to be the most effective for moderate to severe SAT and provided relief from acute symptoms but was found to not be a risk factor for recurrence. Low initial doses of steroid (15 mg) were preferred over high initial dosage (30– 40 mg). Furthermore, a look into the mode of steroid delivery (RCT) revealed that intrathyroidal steroid therapy can potentially become a safer and faster mode of therapy. The duration of tapering was found to be of significance as a short tapering period was linked with greater recurrence rates. Conclusion: Low initial doses of steroid along with an extended tapering period may help lower recurrence rates; also, intrathyroidal steroid injections are potentially a better alternative to oral prednisone (PSN) with regard to safety and speed of action. However, the evidence is of moderate quality and further investigation is required.

India is home to the most significant number of tuberculosis (TB) cases around the globe. The COVID-19 crisis has deeply perturbed most of the essential TB services in India. Regulating TB is difficult in a densely populated country like India due to latent TB infection in millions of Indians, which can reactivate at any point in the future. Due to the ongoing pandemic, healthcare workers have been diverted to activities implemented for effective COVID-19 management, leaving a meager workforce to help deal with TB management. Integrating TB and COVID-19 to augment India’s health outreach is the need of the hour to diminish the effect of the COVID-19 crisis on TB. Increasing overall testing capacity, active screening, implementation of strategies for easy identification of TB hotspots, and ensuring uninterrupted drug supply for treatment through heedful planning of local and regional distribution and transportation will especially help cater to the vulnerable population who are at a high risk of suffering from adverse outcomes of TB. Lessons learnt in the battle against COVID-19 can most definitely help in providing insights to fulfill the goal of eliminating TB from India.

Disease X is caused by pathogen X, an unknown infectious agent that can potentially trigger an epidemic or pandemic. Pathogen X might be any pathogen, including bacteria, viruses, parasites, fungi, and prions. WHO uses the term ‘Disease X’ for any new emerging disease caused by an unknown pathogen X. Disease X stands for any possible future pandemic in WHO’s shortlist of high-priority diseases. This review looks at the manifestations of the recent COVID-19 epidemic as the first Disease X to evaluate what has happened and to learn from what went wrong in India and worldwide. To this end, a summary is presented of response measures by governments, often lacking flows of information, discrepancies in the views of experts and decisions of policymakers, and undesirable variations in individual and collective behavior and their consequences. The elements of combating Disease X in a world with considerable inequalities in relevant knowledge, expertise, information, quality of governance, and financial possibilities are discussed. Based on this, recommendations are given for an innovative global pandemic preparedness system.

December 2019 marked the emergence of a new deadly strain of the coronavirus family which unleashed an unprecedented pandemic named the coronavirus disease 2019 outbreak (COVID-19) upending lives all over the world. We still do not have drugs or vaccines that specifically target this vile virus. Hence, the need to find alternative therapeutic options is to optimize recovery and reduce the viral load due to COVID-19. Convalescent plasma (CP) therapy is a potential therapeutic option being explored all over the world. In this study, we reviewed all relevant publications that mentioned the use of plasma therapy. Out of the 61 articles, eight publications specifically explored CP therapy in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients and were studied in detail during this review. The plasma collected from convalescent COVID-19 patients contains neutralising antibodies which show potential benefit in reducing viral load and accelerating viral clearance with negative reverse transcriptase polymerase chain reaction (RT-PCR) test reports. The concentration of neutralising antibodies also increased post CP therapy. Improvement in clinical symptoms like fever, cough and dyspnoea was also reported. Radiological findings before and after CP therapy showed reduced ground glass opacities and resorption of pneumonia in several SARS-CoV-2 patients. Laboratory parameters also showed improvement as lymphocyte counts increased, and markers of inflammation like C-reactive protein (CRP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) reduced after plasma therapy. There were no adverse reactions reported in any of the studies reviewed. However, potential adverse reactions cannot be ruled out like circulatory overload and anaphylaxis. Lack of large-scale clinical trials on CP therapy is a major shortcoming before this therapeutic modality starts being extensively used.