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The purposes of this chapter are threefold: to discuss the impact of home confinement due to the pandemic, to analyze the results of a social survey about the impact of the pandemic on the general public, and to present maps showing the spread of virus in Pakistan. Not only in Pakistan, but throughout the world, the outcomes of the pandemic were mainly related to psychological and health issues. Emergency situations in global policy, such as pandemics, impact both physical and mental health. A country like Pakistan, which was already fragile and struggling from deflation, was badly affected by the lockdown imposed by the pandemic outbreak. Home confinement during the lockdown period severely impacted the health and economic conditions of communities at large. The effect is discussed in detail in this chapter. In a similar vein, a community-based survey was conducted of 1043 people residing in different areas in Pakistan. The purpose of the survey was to check the behavioral concerns of people towards the pandemic and their safety behavior. The variables used were adapted from existing studies and questions and modified to address the issues in this survey. The last section of this chapter discusses, with GIS maps, how the virus spread throughout the country. The survey instrument provided a general understanding of safety concerns of the people. GIS maps at provincial levels were generated to depict the spread of virus during the peak times of the pandemic. The chapter provides a clear picture of the country during the pandemic times and serves as a reference to understand the social side of pandemic in the country. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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Background/Aim: Unpredicted social and economic consequences have resulted from the SARS-CoV-2 pandemic worldwide. Limited information is currently available addressing the COVID-19 infection impact on the RT-PCR Cycle threshold value trend, infection risk factors, impact on liver enzymes, etc. Method(s): From November 2020 to March 2021, a cross-sectional study was carried out in the Chemical Pathology also Molecular Biology divisions of the Pathology Department of Shalamar Hospital, Lahore. Result(s): Males had a higher risk of contracting SARS-CoV-2 infection than females about 51%. 36.5 percent of total infected people fell within the 20-40 age range. Significant factors that affect the severity of COVID-19 include age and underlying comorbidities. The majority of the patients (78.3%) reported fever, 50.4% had a cough, and 50.1% had myalgias. Low Ct value of RT-PCR may be asignificant predictor of illness severity and risk of mortality, with p values of 0.001 and 0.003, correspondingly. Disease severity was substantially associated with CRP, AST, ALT, and bilirubin indirect. It was observed that the Deritis ratio and CRP were highly associated with the risk of mortality. These markers can therefore be used to evaluate a patient's status as it progresses toward a severe disease, liver damage from treatment, and death risk. Conclusion(s): For doctors making patient management decisions, real-time PCR data and Ct values for SARS-CoV-2 may be useful. Age and comorbidities, among other risk variables, have been recognized as being associated with the likelihood of having a fatal illness. ALT, AST, Deritis ratio, and CRP are biochemical laboratory indicators that can be considered prognostic biomarkers for the development of severe disease and risk of mortality. Copyright © 2022 Authors. All rights reserved.
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The objective of this study is to examine the main constraints experienced in the online mode of education during this pandemic at higher education level in Pakistan. The COVID-19 pandemic credibly transformed the method of learning and teaching from face to face to online. In unexpected sudden septicity, universities in Pakistan have started online education without proper instructional provision and relevant experience. For this purpose, the data is collected from 750 students and teachers across all over the regions in Pakistan. The study has used partial least square structural equation modeling (PLS-SEM). The findings show that technological bottlenecks, institutional preparedness, and digital divide are significant challenges. The differences in perceptions of rural and urban areas are also very important referring to several policies implications, implementing information communication technology (ICT), friendly curriculums, enhancing online accessibility and infrastructure development. This study contributes to help universities for developing effective e-learning policies for students in the situation of COVID-19.
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BACKGROUND: Diagnosis with reverse transcriptase polymerase chain reaction (RT-PCR) test is a very important step for the control of the COVID-19 pandemic. The aim of this study is to compare the RT-PCR results of the samples taken directly from the viral transport medium (VTM) without extraction with the RT-PCR results of two different extraction methods, one automated and the other manual, in the diagnosis of COVID-19. METHODS: Among the respiratory tract samples sent to Sakarya Training and Research Hospital Microbiology Laboratory for COVID-PCR study, 20 negative and 43 positive samples with different cycle threshold (CT) values were included in the study. Both manual nucleic acid isolation with the vNAT isolation kit (Bioeksen, Turkey) and automatic nucleic acid isolation with the EZ1 Virus Mini Kit v2.0 in the isolation device were performed simulta-neously from the patient samples included in the study and the results were compared. RESULTS: The mean Ct values of the samples were found to be 21.58 using manual vNAT as the extraction method, 17.63 using the automated magnetic bead method, and 21.45 in PCR from direct VTM without extraction. When the automatic magnetic beads extraction method was taken as the reference method, the sensitivity of direct PCR was 97.3%, the specificity was 95%, the positive predictive value was 97.3%, and the negative predictive value was 95%. Phi coefficients were found to be 0.927 between vNAT and direct PCR, 1 between vNAT and EZ1, and 0.922 between direct PCR and EZ1. CONCLUSIONS: Direct PCR has advantages such as eliminating RNA extraction and purification steps, providing a shorter detection time, and using less labor and less consumables without reducing the diagnostic accuracy. It is thought that this method can help as a useful process management for the control of the epidemic in countries with limited resources.
Subject(s)
COVID-19 , Nucleic Acids , COVID-19/diagnosis , COVID-19 Testing , Humans , Pandemics , RNA , RNA, Viral/analysis , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2/genetics , Sensitivity and SpecificityABSTRACT
The SARS-CoV-2 has initiated in Wuhan city of China and then extend all around the world as a health emergency. It begins a new research area to produce potential drugs using data-driven approaches to identify potential therapies for the treatment of the virus. This is the time to develop specific antiviral drugs using molecular docking, quantum chemical approaches, and natural products. The protease inhibitors that constitute plant derivatives may become highly efficient to cure virus-prompted illnesses. A systematic study of isolated phytochemicals was executed then frontier molecular orbitals, docking score, molecular descriptors, and active sites were compared with favipiravir, dexamethasone, redeliver, and hydroxychloroquine which are being used against COVID19 nowadays. This is the first study on the phytochemicals of Daphne species to explore their anti-SARS-CoV-2 behavior by molecular docking and quantum chemical methods.
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Aim: To assess the main radiological feature of chest radiography for diagnosis and evaluation of COVID-19 patients. Methodology: A literature search was performed with the use of search engines. The following search engines provided us articles for this systematic review from until 27 February 2021: PubMed, NCBI, Medline, Medscape, and Google Scholar. We included only those articles in which CXR was performed on infected patients for the detection and evaluation of COVID-19. Results: out of eighty (80) articles, only twelve (12) were included in this review to assess the main radiological feature of chest radiography of COVID-19 patients. Patients who went for chest x-ray have shown following radiographic features with pooled percentages as mentioned GGO 32.38%, consolidation 35.15%, vascular congestion sign 7.92%, nodules 33.57% whereas pleural effusion accounts 19.36%, pneumothorax 18.55%, and lymphadenopathy was noted on 1.96%. Pooled Percentages of radiographic features of COVID-19 patients in right lung, left lung or both affected lungs were 21.32%, 5.77% and 47.78% respectively. This calculation is showing B/L lung involvement is more dominant as compare to right and left lung independently. Conclusion: Chest radiograph can be helpful modality in the diagnosis, evaluation and follow-up of SARS- CoV 2 pneumonia patients. Consolidation, GGO with peripheral distribution of lesion and bilateral pneumonia are most common findings of COVID-19 on chest X-ray. Chest x-ray are the baseline/first line approach for COVID-19 as it is easily available. Moreover, in late stages multiple radiological findings are quite helpful.
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Background: Coronavirus Disease-2019 (COVID-19) has appeared as a deadly pandemic affecting most of the countries across the world. The disease has caught humanity unprepared;therefore, there has been a lack of awareness about the causes, and transmission and mortality rates. It has also affected the overall socioeconomics from individual to worldwide levels. COVID-19 is an unprecedented and first-time challenge for Pakistan and a lockdown imposed by the Government of Pakistan has further devastated the economy of the country. This online survey was conducted to know the effects of the Covid-19 pandemic on the social life and economic status of the people of Pakistan. In this article, we mainly focused on teachers and students from different Universities of Pakistan for data generation because they can provide better information due to the use of modern technologies as a source of information. Methods: An online questionnaire survey covering 11 parameters including age, gender, employment status, mortality rate, education, marital status and, information about the pathogen responsible for the disease was filled by 1260 individuals from Pakistan. Results: The results obtained show that 56.6% of the responders were males,43.4% were females, 59.9% were unmarried, 37.7% were graduate students and, 48.7% unemployed. Most of the responders (55.6%) said that COVID-19 negatively affected the jobs of the people. We found (93%) of the responders with good knowledge about COVID-19. Conclusion: We conclude from the results that most of the responders were males, educated and they knew the pathogenic effect of the COVID-19 virus on humans. These results also show that the disease has drastically affected the economy and social life of the people of Pakistan.
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Introduction: Coronavirus Disease-19 (COVID-19) affected the health care system worldwide. The golden rules of fracture fixation and early mobilisation of patients was not strictly followed, because of fear of spread of the disease among the patients and health care workers. Early surgery and prompt postoperative ambulation improves outcomes for patients with hip fractures, but the morbidity and mortality were high in the patients who were operated upon, when having an active infection of COVID-19 virus. Aim: To study the short-term outcome of delayed fixation of hip fractures in coronavirus positive patient in terms of postoperative infection, union at the fracture, deep vein thrombosis and mortality. Materials and Methods: This was a prospective cohort study carried out at a tertiary care center in Kashmir, India from April 2020 to September 2020. Delayed surgery using different methods of fixation was performed in patients with hip fractures who had active COVID-19 infection. The patients were followed for a period of six months. Short term mortality and complications if any were recorded. Results were expressed in terms of frequency and percentages and analysed by Microsoft Excel 2016. Results: Among the 24 operated patients, males were 9 (37.5%) and females were 15 (62.5%). Of the total, 14 (58.33%) were intertrochanteric fractures, 6 (25%) were femoral neck and 4 (16.66%) were subtrochanteric fractures. Dynamic hip screw was used to treat 15 (62.5%) patients. Age ranged from 39 to 82 years mean age was 51.04 years. Majority of patients, 16 (66.66%) sustained hip fractures after a low velocity fall from standing height. Delay in surgery was 15 to 21 days (Average-18.25 days). Two elderly patients died after 14 weeks of follow-up due to causes else than respiratory failure. Three patients developed superficial infection which settled with oral antibiotics. No case of deep venous thrombosis, pulmonary thrombo embolism was observed in the present study. Conclusion: Despite the delay, the mortality rate in the early postoperative period was less. The present study findings suggest that hip fracture patients who present with COVID-19 infection can safely undergo delayed surgical intervention after appropriate medical optimisation.
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Coronavirus disease 2019 (SARS-CoV-2) is a pandemic effecting people worldwide. Number of cases are increasing with the passage of time. SARS-CoV-2 is causative agent of COVID-19 and belong to MRSA and SARS-CoV-1 family. Already approved antiviral drugs (hydroxychloroquine and chloroquine, Remdesivir and immunomodulators like LPV/r plus interferon beta) are considered for their antiviral activity against COVID-19 infection. Extensive research and in-vivo trials are required to validate their efficacy. These drugs also have some side effects. Vaccines are also being produced. Vaccine production is a time-consuming process and required hundreds of trials to be approved for treatment of disease. Nanobiotechnology is an emerging field of medicine. Nanoparticles are target specific, deliver drug safely, evade immune response and have antibacterial and antiviral properties. For treatment of COVID-19, different nanoparticles are being studied and indicated antiviral activity in-vitro. Iron oxide nanoparticles, sliver nanoparticles, decoy nanoparticles and glycyrrhizic acid nanoparticles are some nanoparticles being tested for their antiviral activity against COVID-19 infection. These nanoparticles deliver drug or vaccine to a specific site and improve the treatment outcomes. However, more projects and research should be channeled to validate the use of nanoparticles for COVID-19 treatment.
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Background: The whole world is facing one of the biggest health related disasters of the century. As a novel disease, Covid-19 has so many parameters yet to explore. Aim: To explore varied pattern of clinical presentation of COVID-19 in obstetric population in tertiary care hospital. Study design: Cross-sectional study. Methodology: This study with enrolled pregnant females (n=36) was carried out after ethical review committee s (ERC) approval at Department of Gynecology & Obstetrics, Sir Ganga Ram Hospital, Lahore-Pakistan over a period of 3 months in 2020. Data was analyzed by SPSS software, version-20. Presenting symptoms of subjects were presented as frequency and percentage. Results: Total 36 patients were selected. Twenty four (66.66%) patients were symptomatic while the rest 12 (33.33%) patients were asymptomatic. Conclusion: We concluded that clinical presentation of COVID-19 pregnant patients is similar as in rest of the world and it is also same as in general population.
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Aim: To assess the knowledge of medical students to differentiate between the features of Corona virus and Common cold Influenza virus. Methodology: A cross-sectional study was conducted on undergraduate medical students (MBBS) from both private and public institutes across Punjab, Pakistan between 20th April 2020 to 1st June2020. This was done using a validated, structured online questionnaire which was based on WHO recommendations and facts, assessing knowledge of both Corona and Influenza. A total of 253 medical students were chosen after random sampling, who had completed the survey. Results: Median age was 22 years and a total of 56.5% participants were female and 43.5%male.Overall, more than 90% of the respondents correctly answered the questions related to COVID-19 and the knowledge score revealed that above 90% had good knowledge about Coronavirus.73.5% being aware of the virus type(RNA),95.7% knew the transmission route,86.6% were familiar with the incubation period and more than 90% acquainted with the symptoms of COVID-19. Knowledge level for Influenza was moderate with only 55.7% of the participants accurately answering related questions. Majority of the students used social media as source of information. Conclusion: The undergraduate medical students of Punjab showed good knowledge of COVID-19. However, there is a lack of comprehensive knowledge of Influenza Virus. Thus, there is an inadequate knowledge base to differentiate it from Corona virus. This is alarming in the light of the current pandemic and therefore there is a need for immediate action to improve learning for future doctors for becoming a better health provider. © 2020 Lahore Medical And Dental College. All rights reserved.