COVID-19 outbreak: a predictive mathematical study incorporating shedding effect.

In this paper, a modified SEIR epidemic model incorporating shedding effect is proposed to analyze transmission dynamics of the COVID-19 virus among different individuals' classes. The direct impact of pathogen concentration over susceptible populations through the shedding of COVID-19 virus into the environment is investigated. Moreover, the threshold value of shedding parameters is computed which gives information about their significance in decreasing the impact of the disease. The basic reproduction number ( R 0 ) is calculated using the next-generation matrix method, taking shedding as a new infection. In the absence of disease, the condition for the equilibrium point to be locally and globally asymptotically stable with R 0 < 1 are established. It has been shown that the unique endemic equilibrium point is globally asymptotically stable under the condition R 0 > 1 . Bifurcation theory and center manifold theorem imply that the system exhibit backward bifurcation at R 0 = 1 . The sensitivity indices of R 0 are computed to investigate the robustness of model parameters. The numerical simulation is demonstrated to illustrate the results.

Correlation and Comparison of Epicardial Adipose Tissue with Sagittal Abdominal Diameter and Other Anthropometric and Biochemical Variables of Metabolic syndrome.

OBJECTIVE: 1) To determine relation of epicardial adipose tissue (EAT) thickness with sagittal abdominal diameter (SAD) and other anthropometric measurements in metabolic syndrome (MetS). 2) To determine relation of epicardial adipose tissue with biochemical variables of metabolic syndrome. METHODS: Cases were recruited from the patients attending OPD in New Medical College Hospital, Govt. Medical College, Kota, Rajasthan, India between March 2015 to February 2016. Informed consent was obtained from all participants after taking permission from hospital ethical committee. Patients were categorized as cases and controls according to IDF criteria for MetS. We obtained receiver operating characteristic (ROC) curve of EAT for determination of cut-off values. RESULTS: Epicardial adipose tissue thickness had significant positive correlation with fasting blood sugar (r = 0.49), sagittal abdominal diameter(r = 0.48), body mass index (r = 0.47), LDL cholesterol(r = 0.34), waist circumference (r = 0.33), waist hip ratio (r = 0.32), triglycerides (r= 0.31) and total cholesterol (r = 0.29). Epicardial adipose tissue thickness had significant negative correlation to HDL cholesterol (r = -0.34). EAT thickness (cm) was greater in metabolic syndrome cases (0.515 ± 0.07 vs 0.338 ± 0.06; p < 0.0001). Optimal cut off of EAT in metabolic syndrome is 0.425 cm according to ROC curve at which test is 96% sensitive and 83 % specific. CONCLUSIONS: EAT has shown good correlation with SAD and other anthropometric measurements as well as biochemical parameters of metabolic syndrome. Optimal cut off value of EAT to predict metabolic syndrome is 0.425 cm. FBS and Triglycerides are more closely associated with EAT. HDL Cholesterol is better correlated to SAD while LDL cholesterol is best correlated to WC.

Acute Scrotal Edema: An Atypical Manifestation of Dengue.

Acute scrotal edema associated with dengue fever is a rare and self limiting condition resolving in a few days without any complication or sequelae. We report two cases of dengue fever in father and son which presented simultaneously with acute scrotal edema.

A Prospective Study on Utility of Exercise Treadmill Test in Type 2 Diabetes Mellitus Patients.

OBJECTIVE: Primary objective of this study was to access utility of exercise treadmill test in type-2 diabetes mellitus patients for detecting silent myocardial ischaemia and associated risk factors. METHODS: 75 DM-2 cases were enrolled in study of any age attending medical OPD. All cases were gone through detailed history and TMT procedure. RESULTS: There is higher prevalence of SMI in DM-2 patients. TMT positivity for inducible ischaemia in DM-2 patients were associated with increasing age, male sex, higher BMI, hypertension, smoking, alcoholism, microalbuminuria, macroalbuminuria and dyslipidemia. Duration of diabetes increases the development of CAD in diabetic patients. TMT is a safe procedure with no complication. CONCLUSIONS: For detection of silent myocardial ischaemia in diabetic patients TMT has a significant role. Prevalence of silent myocardial ischaemia in DM-2 patients is 37.3%. There is significant correlation between risk factors of CVD and evidence of ischaemia on TMT in diabetic patients. Duration of diabetic state has a strong correlation for inducible ischaemia on TMT. It may be a safer, cheaper, reliable and easily available non-invasive screening tool for earlier detection of CAD in diabetic patients.