Time series analysis and short-term forecasting of monkeypox outbreak trends in the 10 major affected countries.

BACKGROUND: Considering the rapidly spreading monkeypox outbreak, WHO has declared a global health emergency. Still in the category of being endemic, the monkeypox disease shares numerous clinical characters with smallpox. This study focuses on determining the most effective combination of autoregressive integrated moving average model to encapsulate time dependent flow behaviour of the virus with short run prediction. METHODS: This study includes the data of confirmed reported cases and cumulative cases from eight most burdened countries across the globe, over the span of May 18, 2022, to December 31, 2022. The data was assembled from the website of Our World in Data and it involves countries such as United States, Brazil, Spain, France, Colombia, Mexico, Peru, United Kingdom, Germany and Canada. The job of modelling and short-term forecasting is facilitated by the employment of autoregressive integrated moving average. The legitimacy of the estimated models is argued by offering numerous model performance indices such as, root mean square error, mean absolute error and mean absolute prediction error. RESULTS: The best fit models were deduced for each country by using the data of confirmed reported cases of monkeypox infections. Based on diverse set of performance evaluation criteria, the best fit models were then employed to provide forecasting of next twenty days. Our results indicate that the USA is expected to be the hardest-hit country, with an average of 58 cases per day with 95% confidence interval of (00-400). The second most burdened country remained Brazil with expected average cases of 23 (00-130). The outlook is not much better for Spain and France, with average forecasts of 52 (00-241) and 24 (00-121), respectively. CONCLUSION: This research provides profile of ten most severely hit countries by monkeypox transmission around the world and thus assists in epidemiological management. The prediction trends indicate that the confirmed cases in the USA may exceed than other contemporaries. Based on the findings of this study, it remains plausible to recommend that more robust health surveillance strategy is required to control the transmission flow of the virus especially in USA.

Risk factors and outcomes in patients with severe Necrotizing fasciitis admitted to surgical intensive Care unit: a retrospective cohort study from pakistan.

Background: Necrotizing fasciitis (NF) is a debilitating condition that has high mortality and morbidity even in specialized centres. This study aims to determine risk factors in our local population and identify variables that contribute to mortality in the necrotizing fasciitis patients treated in the surgical intensive care unit of a tertiary care hospital. Methods: This retrospective cross-sectional study included 39 patients admitted to the surgical ICU from January 1, 2015 to June 30, 2019. They were analyzed for comorbidities, symptoms at presentation, predisposing factors, location of the infection, microbiological analysis and mortality. Results: There were 27 (69.2%) males and 12 (30.8%) females while the age was distributed as 47.44±15 years. Pain was the most frequently reported symptom (89.7%), followed by swelling (79.5%) and tenderness (77%). Significant predisposing factors included trauma in 14 (35.9%) and Intramuscular injections (IM) in 10 (25.6%) patients. On univariate and multiple logistic regression, patients with chronic kidney disease (AOR:1.27, 95% CI: 0-691.22) and ischemic heart (AOR: 1.55, 95% CI: 0.02-153.26) disease had higher odds of mortality than those with no comorbidity. The overall mortality was 12/39 (30.8%). Conclusion: Intramuscular injections without aseptic measures in our local population are a significant predisposing risk factor for severe necrotizing fasciitis. High laboratory risk Indicators for necrotizing fasciitis and acute physiology and chronic health evaluation II scores at admission were associated with increased mortality.

Status of Research and Development Within Dental Institutes of Pakistan.

Health sector institutes of Pakistan can play a pivotal part in improving the status of health sciences. This can be achieved by facilitating research and innovation facilities. It is a need of the day to emphasize academicians and institutional administrations to take keen interest in this regard. Knowledge of the present research and development conditions within higher education institutions may help in policy development and fund allocations at the required levels. Therefore, the objective of this study is to evaluate the status of research and development within dental Institutes of Pakistan. A 30 itemed questionnaire was e mailed/posted to all institutional heads of all registered and recognized dental institutes of Pakistan. Response rate was 62% showing lack of administrational interest. Insufficient infrastructure, inadequate research planning, execution and intellectual property management was recorded. It can be concluded that higher education dental institutions of Pakistan are in need of deeper administrational and educational input to gear up the progress of health sector in this direction.

Successful treatment of refractory Gastric Antral Vascular Ectasia (GAVE) in a cirrhotic patient with transcatheter arterial embolisation in a tertiary care facility in Pakistan: A case report.

Gastric antral vascular ectasia (GAVE) is a rare but important cause of upper gastrointestinal bleeding that may present with refractory anaemia or overt gastrointestinal bleeding requiring multiple admissions and resuscitation. Although endoscopic therapies are considered first line treatment for the management of refractory gastric antral vascular ectasia, angiographic embolisation of the culprit vessel(s) may emerge as an effective and safe treatment modality in the near future. Here, we present the case of a middle-aged gentleman with refractory gastric antral vascular ectasia, who was not responding to repeated sessions of Argon Plasma Coagulation (APC) and was successfully treated with trans-catheter arterial embolisation of gastro-duodenal artery.