RESUMEN
BACKGROUND/OBJECTIVES: There is some evidence in the literature of under-testing of COVID-19 cases in Pakistan. This study aims to explore COVID-19 testing trends and the factors affecting them in a lower middle-income country for future infectious disease policy-making and intervention strategies. METHODOLOGY: The study was conducted as a serial cross-sectional study during the three major peaks from March 2020 to June 2021 on 1616 participants in Punjab, Pakistan. This is the first study to explore COVID-19 testing trends in association with flu-like symptoms (FLS) and the factors affecting all three major waves in Pakistan. RESULTS: The results show that in all three waves, only 18.8% reported COVID-19 tested despite that 86.7% thought they had already had COVID-19, with 51.3% reporting having FLS and 35.6% with exposure to FLS from their families and 19.8% of positive testing rate among their family members. Out of the survey participants, 66% received vaccination, and over 80% had their eligible family members immunized. Fear of contracting COVID-19 was 69.7% in all three waves. Factors positively associated with the uptake of testing were the age group of 31-40 years with an adjusted odds ratio of 3.27 (95% confidence interval (CI): 2.09-5.12) for the second wave and an adjusted odds ratio of 13.75 (95% CI: 9.43-20.01) for the third wave and traveling abroad with odds of 3.08 times when the reference was inland traveling. The adjusted odds ratio to test for FLS was 1.62 (95% CI: 1.21-2.16). CONCLUSION: In this study, there is convincing evidence of COVID-19 under-testing and thus under-reporting. This study also suggests that fear-based interventions may be counterproductive; however, economic factors such as education, employment, and traveling are significant in guiding the behavior for infectious disease prevention and management.
RESUMEN
OBJECTIVE: To assess literature related to the various aspects of dental pulp tissue engineering, its myriad protocols, inclusive of adjuvant surgeries, and to summarise the testing methodologies of pulp vitality. METHODS: The multidisciplinary systematic review was conducted at the Army Medical College, Rawalpindi, the National University of Medical Sciences, Rawalpindi, and HITEC Dental College, Taxilla, Pakistan, and comprised literature search on PubMed, Scopus, MEDLINE, Cochrane and Science Direct databases related to articles about 'revitalisation', 'revascularisation', 'dental pulp' and 'regeneration' published from January 2017 to January 2020. RESULTS: Of the 5,986 articles found through search, 14(0.23%) studies were selected; 8(57.1%) clinical trials, 1(7.1%) case series, and 5(35.7%) case reports with platelet concentrates. All the studies (100%) had observed standard clinical treatment procedures for canal disinfection. Current strategies of pulpal regeneration reported commendable success. Histological analysis of clinical trials is essential to ensure confirmatory evidence of quality of revitalisation. CONCLUSIONS: The assessment of the impact of oral factors and a long-term follow up are required to produce a definitive understanding of the phenomenon.