The state of health in Pakistan and its provinces and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding health trends and estimating the burden of disease at the national and subnational levels helps policy makers track progress and identify disparities in overall health performance. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides comprehensive estimates for Pakistan. Comparison of health indicators since 1990 provides valuable insights about Pakistan's ability to strengthen its health-care system, reduce inequalities, improve female and child health outcomes, achieve universal health coverage, and meet the UN Sustainable Development Goals. We present estimates of the burden of disease, injuries, and risk factors for Pakistan provinces and territories from 1990 to 2019 based on GBD 2019 to improve health and health outcomes in the country. Methods We used methods and data inputs from GBD 2019 to estimate socio-demographic index, total fertility rate, cause-specific deaths, years of life lost, years lived with disability, disability-adjusted life-years, healthy life expectancy, and risk factors for 286 causes of death and 369 causes of non-fatal health loss in Pakistan and its four provinces and three territories from 1990 to 2019. To generate estimates for Pakistan at the national and subnational levels, we used 68 location-years of data to estimate Pakistan-specific demographic indicators, 316 location-years of data for Pakistan-specific causes of death, 579 location-years of data for Pakistan-specific non-fatal outcomes, 296 location-years of data for Pakistan-specific risk factors, and 3089 location-years of data for Pakistan-specific covariates. Findings Life expectancy for both sexes in Pakistan increased nationally from 61 center dot 1 (95% uncertainty interval [UI] 60 center dot 0-62 center dot 1) years in 1990 to 65 center dot 9 (63 center dot 8-67 center dot 8) years in 2019;however, these gains were not uniform across the provinces and federal territories. Pakistan saw a narrowing of the difference in healthy life expectancy between the sexes from 1990 to 2019, as health gains for women occurred at faster rates than for men. For women, life expectancy increased by 8 center dot 2% (95% UI 6middot3-13middot8) between 1990 and 2019, whereas the male life expectancy increased by 7 center dot 6% (3 center dot 5-11 center dot 8). Neonatal disorders, followed by ischaemic heart disease, stroke, diarrhoeal diseases, and lower respiratory infections were the leading causes of all-age premature mortality in 2019. Child and maternal malnutrition, air pollution, high systolic blood pressure, dietary risks, and tobacco consumption were the leading all-age risk factors for death and disability-adjusted life-years at the national level in 2019. Five non-communicable diseases-ischaemic heart disease, stroke, congenital defects, cirrhosis, and chronic kidney disease-were among the ten leading causes of years of life lost in Pakistan. Burden varied by socio-demographic index. Notably, Balochistan and Khyber Pakhtunkhwa had the lowest observed gains in life expectancy. Dietary iron deficiency was the leading cause of years lived with disability for both men and women in 1990 and 2019. Low birthweight and short gestation and particulate matter pollution were the leading contributors to overall disease burden in both 1990 and 2019 despite moderate improvements, with a 23 center dot 5% (95% UI 3 center dot 8-39 center dot 2) and 27 center dot 6% (14 center dot 3-38 center dot 6) reduction in age-standardised attributable DALY rates during the study period. Interpretation Our study shows that progress has been made on reducing Pakistan's disease burden since 1990, but geographical, age, and sex disparities persist. Equitable investment in the health system, as well as the prioritisation of high-impact policy interventions and programmes, are needed to save lives and improve health outcomes. Pakistan is facing several domestic and foreign challenges-the Taliban's return to power in Afghanistan, political turmoil, catastrophic flooding, the COVID-19 pandemic-that will shape the trajectory of the country's health and development. Pakistan must address the burden of infectious disease and curb rising rates of non-communicable diseases. Prioritising these three areas will enhance Pakistan's ability to achieve universal health coverage, meet its Sustainable Development Goals, and improve the overall health outcomes.

COVID-19: Impact, Diagnosis, Management and Phytoremediation

COVID-19, or SARS-CoV-2, is an extremely deadly virus that is responsible for over half a million deaths of people in the world. This virus originated in China in December 2019 and rapidly spread worldwide in 2-3 months, and affected every part of the world. Its life-threatening nature forced governments in all countries to take emergency steps of lockdown that affected the entire world's education, health, social and economic aspects. Due to the implementation of these emergencies, the population is facing psychological, social and financial problems. Additionally, this pandemic has significantly influenced the health care systems as all the resources from governments of all countries were directed to invest funds to discover new diagnostic tests and manage COVID-19 infection. The impact of the COVID-19 pandemic on the education and social life of the population is described in this article. Additionally, the diagnosis, management, and phytoremedia-tion to control the spread of COVID-19 and traditional medicinal plants' role in managing its mild symptoms have been discussed.Copyright © 2023 Bentham Science Publishers.

An Overview of the Treatment Contributions Measured Globally for the COVID-19 Outbreak

Background: SARS CoV2 is a newly emerged animal beta coronavirus that causes respiratory illness. This infection has affected 212 countries to date and has been declared a pandemic by the World Health Organization. Due to the high transmission rate and lack of availability of any approved anti-viral drug, the formulation of a specific anti-viral therapy has now become a global emergency. Genomic studies have revealed a 79% identity of SARS CoV2 with SARS CoV and 50% identity with MERS CoV, which has given a clue point to test the drugs that were efficient against previously encoun-tered beta coronaviruses. For this purpose, several clinical trials based on the knowledge of existing drugs are moving ahead. These therapies include chloroquine and hydroxychloroquine, remdesivir, cor-ticosteroids therapy, favipiravir, ribavirin, lopinavir/ritonavir, anti-cytokine therapy, and convalescent sera. Aim of the study: The purpose of this review is to give a pointer of contributions conducted globally, including strategies utilized for treatments, the pattern of dosage, adverse reactions, and effective outcomes from different drugs. Methodology: Literature has been retrieved from PubMed, PubMed Central, ResearchGate, ScienceDi-rect, and Google Scholar, using a combination of keywords for extensive information. Conclusion(s): Among all the drug options, Remdesivir and the use of Convalescent Sera have been con-sidered as the safest options for treatment against COVID-19. Data from the ongoing clinical trials will be required for the formulation of a specific and approved anti-viral drug,.Copyright © 2021 Bentham Science Publishers.

Dark tetrad personality during COVID-19: An overview of psycho-somatic therapies for managing mental health response

The recent empirical data represented the unprecedented opportunity to understand how threatful situations affect people adaptive and mal-adaptive behaviour and diverse ways to cope with the situation. In particular, the people with existing mental health issues such as dark tetrad personality found to be higher in forming an unhealthy relationship on cyber as well as real life during COVID-19. The current paper provides an interesting but alarming picture of how people with dark tetrad personality trait formed relationships with others during COVID-19. Also, the current paper highlights the significance of psycho-somatic therapies in managing their mental health response during COVID-19. Copyright © Medicinska naklada - Zagreb, Croatia

Improving Coronavirus (COVID-19) Diagnosis Using Deep Transfer Learning

Background: Coronavirus disease (COVID-19) is an infectious dis- ease caused by a new virus. Exponential growth is not only threatening lives, but also impacting businesses and disrupting travel around the world. Aim: The aim of this work is to develop an efficient diagnosis of COVID-19 disease by differentiating it from viral pneumonia, bacterial pneumonia, and healthy cases using deep learning techniques. Method: In this work, we have used pre-trained knowledge to improve the diagnostic performance using transfer learning techniques and compared the performance of different CNN architectures. Results: Evaluation results using K-fold (10) showed that we have achieved state-of-the-art performance with overall accuracy of 98.75% on the perspective of CT and X-ray cases as a whole. Conclusion: Quantitative evaluation showed high accuracy for automatic diagnosis of COVID-19. Pre-trained deep learning models developed in this study could be used for early screening of coronavirus;however, it calls for extensive need to CT or X-rays dataset to develop a reliable application. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Practices, attitudes and knowledge of covid-19 among the university students of lcwu, Lahore

The primary goal of this study was to analyze COVID-19-related knowledge, attitudes, and practices among Lahore College for Women University students (LCWU). Methods: A cross-sectional study was carried out among LCWU students. Data was collected using a self-administered questionnaire and processed using a Google Form. The data was analyzed statistically. Results: The total number of responses received was 114. According to our research, 98 percent of respondents were familiar with COVID-19, with 51.8 percent receiving information via social media. 68.4 percent thought the virus was contagious, 95.60 percent thought it was spread by respiratory droplets, and 24.8 percent thought the elderly and children were at risk. 93.9 percent of participants were aware of social/physical distancing and believed that it could help to prevent infection, 95.5 percent believed that cough and fever could be signs and symptoms of COVID-19, and 106 (93 percent) claimed that staying at home could help to prevent the disease from spreading. Conclusion: It was observed that the majority of individuals were aware of COVID-19, with 90% of the population knowing about it. There is an ever-increasing need for COVID-19 knowledge among the local populace. It will assist in the prevention of COVID-19 transfer with minimal secondary transmission. Extensive survey studies are needed to offer supporting evidence in the development and implementation of public health policies related to the COVID-19 pandemic. It would help to regulate and stop the spread of COVID-19 across the country. © Pakistan Academy of Sciences.

A rare manifestation of COVID-19 in the abdomen: Acute pancreatitis

Introduction: Coronavirus, a novel menace, is exacting terrible human toll and mass death till date. It was thought that COVID-19 primarily affects the respiratory system, but recent studies have reported gastrointestinal manifestations as well. However, the incidence of acute pancreatitis in the setting of COVID-19 is a rising debate due to unknown mechanisms, especially in the absence of any precipitating factors for pancreatitis Case Description/Methods: An otherwise healthy 30-year-old female presented to the emergency department with pain in the lower abdomen radiating to the back, fever, cough, vomiting, diarrhea, and sore throat for the past seven to ten days. Her initial examination revealed a temperature of 100°F, a pulse rate of 85 beats /minute, blood pressure of 110/70 mmHg, respiratory rate of 20 breaths/minute, and oxygen saturation of 94% on room air. Her swab result for SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) came positive. Laboratory testing revealed a rise in serum lipase and serum lipase level. Her ultrasonography (USG) of the abdomen was suggestive of fatty liver changes (hyperechoic parenchymal echogenicity) and no gallstones. She was managed conservatively with intravenous fluid, analgesics and antibiotics for bacterial infection. Absence of any predisposing factor for pancreatitis in the setting of COVID led to the diagnosis of acute pancreatitis induced by COVID-19. Her contrast-enhanced computed tomography (CECT) of the abdomen also confirmed our suspicion. Discussion: The rationale behind the development of acute pancreatitis in the presence of COVID- 19 infection, with no past medical history and precipitating risk factor for pancreatitis, is suggestive of COVID-19 as a triggering factor. This case highlights the importance of pancreatic enzyme monitoring if patients have abdominal complications and without further delay, proper management can be set up if diagnosed early. Future complications such as chronic pancreatitis and pseudocyst formation can also be prevented if timely diagnosed. (Figure Presented) .

COVID-19 and SARS-CoV-2: Everything we know so far - A comprehensive review

Coronavirus disease-2019 (COVID-19) emerged as a unique type of pneumonia outbreak in the Wuhan city of China in 2019 and spread to all its provinces in a matter of days and then to every continent of the world except Antarctica within 3-4 month. This paper aims to comprehensively consolidate the available information about COVID-19 and present all the possible information about this disease in form of a single paper to readers. Unparalleled research and exhaustive studies of everything about the disease and its causative virus, i.e., severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are underway since its emergence. The genome sequence of the virus was made available within a record short time by China, making possible immediate study of its structure and characteristics. The routes of transmission of the disease, signs and symptoms, incubation period, pathogenesis, and pathophysiology have been extensively studied and presented in an organized way in this review paper. The number of confirmed cases and case fatality and mortality rates are updated regularly. The different diagnostic mechanisms have been characterized. Testing and management criteria and protocols have been adopted. Extensive efforts are underway for finding a treatment of the disease and developing a vaccine against it. A number of vaccines are available even in markets in different countries. More and more ways of personal protection, prevention, and mitigation of the disease are being explored and shared. While the outbreak has been declared as pandemic, the response of scientists was timely and enormous;thousands of publications about various aspects and impact of the diseases and its causative virus are there on the World Health Organization database and many more studies are underway. The purpose of writing this review article is to provide a comprehensive summary of the major aspects and important scientific findings so far, about COVID-19 and SARS-CoV-2, in a single article for ready reference. © 2021 Sumaira Naz et al., published by De Gruyter.

Knowledge, attitude, practice and perceived barriers among healthcare workers regarding COVID-19: a cross-sectional survey from Pakistan.

A self-administered validated (Cronbach's alpha=0.077) questionnaire was used to assess knowledge, attitude and practice among healthcare workers (HCWs) in Pakistan regarding coronavirus disease 2019 (COVID-19). Findings showed that HCWs have good knowledge (93.2%, N=386), a positive attitude [mean 8.43 (standard deviation 1.78)] and good practice (88.7%, N=367) regarding COVID-19. HCWs perceived that limited infection control material (50.7%, N=210) and poor knowledge regarding transmission (40.6%, N=168) were the major barriers to infection control. Regression analysis indicated that pharmacists were more likely to demonstrate good practice than other HCWs (odds ratio 2.247, 95% confidence interval 1.11-4.55, P=0.025). This study found that HCWs in Pakistan have good knowledge, but there are gaps in specific aspects of knowledge and practice that warrant attention.