Assessing the role of quarantine and isolation as control strategies for COVID-19 outbreak: A case study.

Life style of people almost in every country has been changed with arrival of corona virus. Under the drastic influence of the virus, mathematicians, statisticians, epidemiologists, microbiologists, environmentalists, health providers, and government officials started searching for strategies including mathematical modeling, lock-down, face masks, isolation, quarantine, and social distancing. With quarantine and isolation being the most effective tools, we have formulated a new nonlinear deterministic model based upon ordinary differential equations containing six compartments (susceptible S ( t ) , exposed E ( t ) , quarantined Q ( t ) , infected I ( t ) , isolated J ( t ) and recovered R ( t ) ). The model is found to have positively invariant region whereas equilibrium points of the model are investigated for their local stability with respect to the basic reproductive number R 0 . The computed value of R 0 = 1.31 proves endemic level of the epidemic. Using nonlinear least-squares method and real prevalence of COVID-19 cases in Pakistan, best parameters are obtained and their sensitivity is analyzed. Various simulations are presented to appreciate quarantined and isolated strategies if applied sensibly.

Assessing the adherence of obstetricians towards postpartum diabetes screening guidelines: a pre- and post-intervention study at secondary care hospital in Karachi, Pakistan.

OBJECTIVE: To assess the adherence level of obstetricians towards postpartum diabetes screening guidelines. METHODS: The quasi-experimental pre- and post-intervention study was conducted from May 2014 to April 2015 at Aga Khan Hospital for Women-Karimabad, Karachi, and comprised all obstetricians practicing at the time. All the booked women with gestational diabetes delivered in the 6 months before refresher lecture (group 1) and those delivering in the 6 months following the intervention (group 2) were included. Data was analysed using SPSS 19. RESULTS: Of the 550 cases, 275(50%) each were in groups 1 and 2. All pregnant women had live-birth. The intervention made it thrice likely (95% confidence interval: 7.83) that a physician advised postpartum oral glucose tolerance test. Caesarean section increased the chances of getting test advice almost 4 times (95% confidence interval: 1.70, 9.10) compared to women who delivered vaginally. Women managed on insulin with / without metformin were 4 times likely to being advised the test compared to women managed on diet (confidence interval: 1.00, 17.09). Full-time employees advised 7 times more than the visiting obstetricians (confidence inter val: 1.33, 35.16). CONCLUSIONS: It is time for more strategic planning regarding patient education the benefits of detection of abnormal glucose tolerance in early postpartum period.

Tubo-omental ectopic pregnancy.

Tubo-omental pregnancy is a very rare form of ectopic pregnancy. Here we present a case of tubo-omental pregnancy diagnosed at surgical exploration. A 26-year-old woman presented with abdominal discomfort, nausea and vomiting. There was ectopic pregnancy with viable foetus in the right adnexa and haemoperitonium. Laparotomy was performed and on exploration tubo-omental pregnancy was found attached to fimbria at one side and omentum at the other. Fimriaectomy and partial omentectomy was performed. The patient had a successful post-operative recovery.

NON-INVASIVE MONITORING OF FOETAL ANAEMIA IN KELL SENSITIZED PREGNANCY.

We report a case of Kell sensitized pregnancy with good neonatal outcome. Anti-K antibodies were detected in maternal serum in early pregnancy as a part of routine antibody screening test. The middle cerebral artery doppler monitoring and serial titers were carried out to screen for foetal anaemia. Despite of rising antibody titers, serial middle cerebral artery doppler was normal and did not showed foetal anaemia. The pregnancy was carried out till term and patient delivered at 37 weeks of pregnancy with no evidence of foetal anaemia. This case underlines the need of general screening on rare antibodies in all pregnant women and that non-invasive monitoring of foetal anaemia can be done with anti-k titers and middle cerebral artery Doppler.

Occurrence of fungal microbial contamination in drinking water of megacity of Karachi (Pakistan) and their physico-chemical control.

The water quality in Karachi (Pakistan) is uncertain due to the occurrence of fungi and other microorganisms. A total of twenty-five water samples were collected from public places, educational institutes, hospitals, water supply systems and surface water of the canal of Karachi (Pakistan). The different fungal species including Acremonium sp., Alternaria alternata, Aspergillus flavus, A. fumigatus, A. sulphureus, Cladosporium sp., Fusarium sp., Clonostachys (Gliocladium) sp., Macrophomina phaseolina, Mucor racemosus, Paecilomyces sp. Penicillium chrysogenum, P. citrinum, P. commune, P. expansum, Rhizoctonia sp. and Stachybotrys sp. were isolated from these drinking water samples. However, the bacteria, microalgae and some other microorganisms were present in low concentrations. The reason for fungi infection and production of mycotoxicity depends upon various factors and the availability of their nutrients in filtration plants. The major threats to human health are fungal mycotoxicity which is responsible for carcinogenic and other lethal diseases. Mostly, the genus Aspergillus was dominated and isolated with a maximum of 88-98% of occurrence in the different samples of drinking water by the direct plate-spread method. For the control of fungi, various Physico-chemical coagulation treatments were used, but Potassium alum, clay pot, and hot water treatment disinfected effectively 69-70% removal of the fungi and its spore or mycelia from the water. In addition, it is concluded that drinking water purifications such as chlorination, filtration and lime did not eliminate thermophilic fungal spores or mycelia including Penicillium, Paecilomyces and Mucor from the water.

Ethnopharmacological uses of fauna among the people of central Punjab, Pakistan.

Introduction: The utilization of fauna and fauna-based byproducts in ethnomedicinal usages has been a longstanding human activity, practiced across various cultures worldwide. This study focuses on investigating the utilization of animal-based traditional medicine by the people of Pakistan, specifically in the Gujranwala area. Methods: Data collection took place from January to September 2019 through interviews with local communities. Ethnomedicinal applications of animal products were analyzed using several indices, including Relative Frequency of Citation (RFC), Relative Popularity Level (RPL), Folk Use Value (FL), and Relative Occurrence Percentage (ROP). Results: The study identified the use of different body parts of 54 species of animals in treating various diseases and health issues. These include but are not limited to skin infections, sexual problems, pain management (e.g., in the backbone and joints), eyesight issues, immunity enhancement, cold, weakness, burns, smallpox, wounds, poisoning, muscular pain, arthritis, diabetes, fever, epilepsy, allergies, asthma, herpes, ear pain, paralysis, cough, swelling, cancer, bronchitis, girls' maturity, and stomach-related problems. Certain species of fauna were noted by informers with high "frequency of citation" (FC), ranging from 1 to 77. For instance, the black cobra was the most frequently cited animal for eyesight issues (FC = 77), followed by the domestic rabbit for burn treatment (FC = 67), and the Indus Valley spiny-tailed ground lizard for sexual problems (FC = 66). Passer domesticus and Gallus gallus were noted to have the highest ROP value of 99. Discussion: The findings of this study provide valuable preliminary insights for the conservation of fauna in the Gujranwala region of Punjab, Pakistan. Additionally, screening these animals for medicinally active compounds could potentially lead to the development of novel animal-based medications, contributing to both traditional medicine preservation and modern pharmaceutical advancements.

Mathematical analysis for a new nonlinear measles epidemiological system using real incidence data from Pakistan.

Modeling of infectious diseases is essential to comprehend dynamic behavior for the transmission of an epidemic. This research study consists of a newly proposed mathematical system for transmission dynamics of the measles epidemic. The measles system is based upon mass action principle wherein human population is divided into five mutually disjoint compartments: susceptible S(t)-vaccinated V(t)-exposed E(t)-infectious I(t)-recovered R(t). Using real measles cases reported from January 2019 to October 2019 in Pakistan, the system has been validated. Two unique equilibria called measles-free and endemic (measles-present) are shown to be locally asymptotically stable for basic reproductive number R 0 < 1 and R 0 > 1 , respectively. While using Lyapunov functions, the equilibria are found to be globally asymptotically stable under the former conditions on R 0 . However, backward bifurcation shows coexistence of stable endemic equilibrium with a stable measles-free equilibrium for R 0 < 1 . A strategy for measles control based on herd immunity is presented. The forward sensitivity indices for R 0 are also computed with respect to the estimated and fitted biological parameters. Finally, numerical simulations exhibit dynamical behavior of the measles system under influence of its parameters which further suggest improvement in both the vaccine efficacy and its coverage rate for substantial reduction in the measles epidemic.