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1.
Pestic Biochem Physiol ; 172: 104750, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33518043

RESUMEN

Over use of organophosphate pesticides including Chlorpyrifos (CPF) has led to contamination of soil and water resources, resulting in serious health problems in humans along with other non-target organisms. The current study was aimed to investigate Chlorpyrifos as well as 3, 5, 6-Trichloro-2-pyridinol (TCP) biodegradation tendency of bacterial strain Bacillus thuringiensis MB497 isolated from wheat/cotton fields of Dera Saleemabad, Mianwali, Pakistan, having a history of heavy Organophosphate pesticides application. HPLC analysis revealed almost 99% degradation of the spiked CPF (200 mg L-1) in M-9 broth, soil slurry and soil microcosm by MB497 after 9 days of incubation. Strain MB497 was also able to degrade and transform TCP (28 mg L-1), up to 90.57% after 72 h of incubation in M-9 broth. A novel compound Di-isopropyl methanephosphonate along with known products of 3, 5, 6-Trichloro-2-pyridinol (TCP), Diethyl thiophospsphate and Phosphorothioic acid were detected as metabolites of CPF by GCMS analysis. Three novel metabolites of TCP (p-Propyl phenol, 2-Ethoxy-4, 4, 5, 5-tetramethyloxazoline and 3-(2, 4, 5-Trichlorophenoxy)-1-propyne) were identified after 72 h. Based on these metabolites, new/amended metabolic pathways for CPF and TCP degradation in these bacteria has been suggested.


Asunto(s)
Bacillus thuringiensis , Cloropirifos , Insecticidas , Biodegradación Ambiental , Pakistán , Piridonas
3.
BMC Oral Health ; 21(1): 59, 2021 02 10.
Artículo en Inglés | MEDLINE | ID: mdl-33568128

RESUMEN

BACKGROUND: The COVID-19 outbreak which developed into a public health crisis has raised concerns regarding infection control among health care workers particularly dentists all over the world. The aim of this survey was to assess awareness, fear and compliance with practice modification according to CDC guidelines during COVID-19 pandemic among Pakistani dentists. METHODS: A cross-sectional study was conducted using an online survey questionnaire. The questionnaire was designed on Google Forms and was distributed among all seven regions of Pakistan through social media and WhatsApp after carrying out the reliability analysis. Statistical analysis was performed using SPSS 20.0. Question wise analysis using frequencies and percentages was done. Pearson correlation and Kruskal Wallis test was applied to check association of awareness level with qualification and workplace setting. RESULTS: A total of 313 dentists participated and submitted the form online from all regions of Pakistan. The response rate was quite satisfactory as Pakistan was under an official lockdown and most of the hospitals/clinics were either closed or operating with minimum staff. Most of the dentists were well aware of the CDC guidelines. However, 75% of the dentists were afraid of getting infected and 88% of them were anxious while providing treatment. Sixty-eight percent of them were avoiding aerosol generating procedures and only 28% were using rubber dam isolation. Regional analysis was also done and areas of poor compliance were identified. Only 38.5% dentists in Balochistan were using N95 masks and none of the dentists (0%) were using rubber dam isolation. A large number of dentists (80.9%) were afraid and wanted to close their dental practice in Khyber Pakhtunkhwa. Furthermore, a positive correlation was seen between the designation and awareness level (p = 0.01). Similarly, significant correlation (p = 0.03) was seen between qualification and workplace setting. CONCLUSION: The results of the study can help devise strategies to ensure adherence with infection control guidelines in regions with poor compliance. Initiation of awareness programs to help overcome fear and train the faculty and staff in the targeted areas would greatly contribute towards reducing the spread of infection and thus lowering the healthcare burden in a third world country like Pakistan.


Asunto(s)
Pandemias , Estudios Transversales , Odontólogos , Conocimientos, Actitudes y Práctica en Salud , Humanos , Pakistán/epidemiología , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
4.
J Pak Med Assoc ; 71(Suppl 1)(1): S18-S22, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33582717

RESUMEN

OBJECTIVE: To assess the impact of coronavirus disease on surgical training. Methods: The cross-sectional study was conducted at the General Surgery Department of Liaquat National Hospital, Karachi, from August 2019 to May 2020, and comprised surgical trainees from year 1 to 4. The subjects were interviewed and inquired about their opinion regarding the impact of coronavirus disease on their training. Data was prospectively collected in two equal phases of 5 months each, separating the phases on the basis of the application of preventive measures and changes relating to coronavirus disease. Data of cases from log books was divided into major and minor cases. RESULTS: Of the 24 surgical trainees available, 18(75%) participated; 12(66.6%) females and 6(33.3%) males. There was a significant difference between the two phases, with the number of surgical case going down drastically in the second phase (p=0.005), affecting the training process. CONCLUSIONS: Considering the ongoing pandemic, it may be worthwhile to look into the possibility of increasing the duration of training.


Asunto(s)
Cirugía General , Internado y Residencia/estadística & datos numéricos , Cirujanos/educación , Cirujanos/estadística & datos numéricos , Estudios Transversales , Femenino , Cirugía General/educación , Cirugía General/organización & administración , Cirugía General/estadística & datos numéricos , Humanos , Masculino , Pakistán
5.
J Coll Physicians Surg Pak ; 31(1): 14-20, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33546527

RESUMEN

OBJECTIVE:   To identify utility of chest computed tomography severity score (CT-SS) as an additional tool to COVID-19 pneumonia imaging classification in assessing severity of COVID-19. STUDY DESIGN: Descriptive analytical study Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, (AFIRI) Rawalpindi, from April 2020 to June 2020. METHODOLOGY: Five hundred suspected COVID-19 cases referred for high resolution computed tomography - chest were included in the study. Cases were categorised by radiological findings using COVID-19 pneumonia imaging classification, proposed in the radiological society of North America expert consensus statement on reporting chest CT findings related to COVID-19. CT-SS was calculated for all scans. Patients were clinically classified according to disease severity as per 'Diagnosis And Treatment Program of Pneumonia of New Coronavirus Infection' recommended by China's National Health Commission. The relationships between radiological findings, CT-SS, and clinical severity were explored. RESULTS: Based on the radiological findings, 298 cases were graded as typical, 34 as indeterminate, 15 as atypical, and 153 as negative for pneumonia. The apical and posterior basal segments of lower lobes were most commonly involved. The CT-SS showed higher values in patients of severe group as compared to those in moderate group (p < 0.05). CT-SS threshold for recognising severe COVID-19 was 18.5 (area under curve, 0.960), with 84.3% sensitivity and 92.5% specificity. CONCLUSION: In coherence with COVID-19 pneumonia imaging classification, CT-SS may provide a comprehensive and objective assessment of COVID-19 severity. Key Words: COVID-19, COVID-19 pneumonia, CT-SS, High resolution computed tomography.


Asunto(s)
Pulmón/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Tórax/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Pruebas Diagnósticas de Rutina , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Pakistán , Radiografía Torácica/métodos , Atención Terciaria de Salud , Adulto Joven
6.
Trials ; 22(1): 127, 2021 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-33568226

RESUMEN

OBJECTIVES: The objective of the study is to measure the efficacy of ionic-iodine polymer complex [1] for clinical and radiological improvement in coronavirus disease 2019 (COVID-19) patients. TRIAL DESIGN: The trial will be closed label, randomized and placebo-controlled with a 1:1:1:1 allocation ratio and superiority framework. PARTICIPANTS: All PCR confirmed COVID-19 adult patients including non-pregnant females, with mild to moderate disease, will be enrolled from Shaikh Zayed Post-Graduate Medical Complex, Ali Clinic and Doctors Lounge in Lahore (Pakistan). Patients with any pre-existing chronic illness will be excluded from the study. INTERVENTION AND COMPARATOR: In this multi-armed study ionic-iodine polymer complex with 200 mg of elemental iodine will be given using three formulations to evaluate efficacy. Patients will be receiving either encapsulated iodine complex of 200 mg (arm A), iodine complex syrup form 40 ml (arm B), iodine complex throat spray of 2 puffs (arm C) or empty capsule (arm D) as placebo; all three times a day. All the 4 arms will be receiving standard care as per version 3.0 of the clinical management guidelines for COVID-19 established by the Ministry of National Health Services of Pakistan. MAIN OUTCOMES: Primary outcomes will be viral clearance with radiological and clinical improvement. SARS-CoV-2 RT-PCR and HRCT chest scans will be done on the admission day and then after every fourth day for 12 days or till the symptoms are resolved. RT-PCR will only be shown as positive or negative while HRCT chest scoring will be done depending on the area and severity of lung involvement [2]. Time taken for the alleviation of symptoms will be calculated by the number of days the patient remained symptomatic. 30-day mortality will be considered as a secondary outcome. RANDOMISATION: Stratification for initial COVID-19 status (or days from initial symptoms as a proxy), age groups, gender, baseline severity of symptoms and co-morbidities will be used to ensure that the study arms remain balanced in size for the 1:1:1:1 allocation ratio. Randomization will be done using the lottery method. As patients are being admitted at different times, they will be recruited after obtaining their voluntary written informed consent following all standard protocols of the infection, control and disinfection. BLINDING (MASKING): This is a quadruple (participants, care providers, investigators and outcomes assessors) blinded study where only the study's Primary Investigator will have information about the arms and their interventions. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): 200 patients will be randomized into four groups with three experimental and one placebo arm. TRIAL STATUS: Protocol Version Number is 2.3 and it is approved from IRB Shaikh Zayed Hospital with ID SZMC/IRB/Internal0056/2020 on July 14th, 2020. The recruitment is in progress. It was started on July 30, 2020, and the estimated end date for the trial is August 15, 2021. TRIAL REGISTRATION: Clinical Trial has been retrospectively registered on www.clinicaltrials.gov with registration ID NCT04473261 dated July 16, 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). With the intention of expediting dissemination of this trial, the conventional formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines.


Asunto(s)
/tratamiento farmacológico , Compuestos de Yodo/administración & dosificación , Polímeros/administración & dosificación , Índice de Severidad de la Enfermedad , Adulto , /mortalidad , Cápsulas , Femenino , Humanos , Masculino , Vaporizadores Orales , Pakistán/epidemiología , Admisión del Paciente , Ensayos Clínicos Controlados Aleatorios como Asunto , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Resultado del Tratamiento
7.
J Pak Med Assoc ; 71(Suppl 1)(1): S83-S88, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33582729

RESUMEN

The coronovirus disease-2019 pandemic has severely impacted surgical education and training in Pakistan and worldwide, causing problems, such as risk of infection, limited hands-on training, examination delays, and trainee redeployment to non-surgical specialties. The current review was planned to describe innovative strategies adopted by surgical training programmes worldwide in order to suggest comprehensive recommendations at the level of the College of Physicians and Surgeons Pakistan and individual institutions to counter the challenges presented by the pandemic in Pakistan. The innovative use of technology, including open-access online educational portals, virtual educational activities and simulation-based learning, can help reform education delivery during the pandemic. Hospitals' implementation of "shift schedules" for rotations helps continue training while minimising risks. Moreover, examination boards and residency programmes must appropriately tailor their eligibility criteria and assessment processes to the current situation. Lastly, it is vital to safeguard trainees' mental wellness during the pandemic and after by ensuring readily available professional psychological support when needed.


Asunto(s)
Educación de Postgrado en Medicina/métodos , Cirugía General/educación , Cirujanos/educación , Países en Desarrollo , Educación a Distancia , Humanos , Internado y Residencia , Pakistán , Pandemias
9.
Braz J Biol ; 81(4): 940-953, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33605364

RESUMEN

Nowadays food borne illness is most common in people due to their epidemic nature. These diseases affect the human digestive system through bacteria, viruses and parasites. The agents of illness are transmitted in our body through various types of food items, water and uncooked. Pathogens show drastic changes in immunosuppressant people. This review gives general insights to harmful microbial life. Pakistan is a developed country and because of its improper food management, a lot of gastrointestinal problems are noted in many patients. Bacteria are most common agents to spread diarrhoea, villi infection, constipation and dysenteric disease in human and induce the rejection of organ transplant. Enhancement of their lifestyle, properly cooked food should be used and to overcome the outbreak of the diseases.


Asunto(s)
Enfermedades Transmitidas por los Alimentos , Bacterias , Diarrea , Enfermedades Transmitidas por los Alimentos/epidemiología , Humanos , Pakistán/epidemiología
10.
BMC Public Health ; 21(1): 21, 2021 01 05.
Artículo en Inglés | MEDLINE | ID: mdl-33402145

RESUMEN

BACKGROUND: The Novel Coronavirus Disease (COVID-19) has created havoc globally as countries worldwide struggle to combat this pandemic. Since prevention and social isolation are known to be the only ways to prevent the spread of COVID-19, this has created challenges among the lower-middle income countries (LMIC) including Pakistan, as it battles between an under-resourced healthcare, an economic shutdown, and widespread myths and misconceptions. Therefore, a study was conducted to evaluate the knowledge, attitude and perceptions regarding COVID-19 as public understanding is vital to help facilitate the control of this outbreak. METHODS: A pre-validated online questionnaire was distributed among the general population of Pakistan from 1st to 12th June 2020. Descriptive statistics were analyzed using SPSS v25. Adequate knowledge was assigned as a score of > 4 (range: 0-8) and good perception as a score of > 3 (range: 0-5). Chi-square test was used to determine the significance of difference in knowledge and perception of COVID-19 with socio-demographic characteristics. Logistic regression analysis was run to identify factors associated with adequate knowledge and perception. P < 0.05 was considered as significant. RESULTS: A total of 1200 respondents participated in this study with a wide range of age groups and education. Majority of the respondents had adequate knowledge (93.3%) with a mean score of 6.59 ± 1.35, and good perception (85.6%) with a mean score of 4.29 ± 0.82. Significant differences in knowledge and perception were observed among genders, age groups, education and between students and employees in the healthcare and non-healthcare department. A multivariate analysis revealed a higher educational status and female gender to be significant predictors of adequate knowledge and perception. CONCLUSIONS: Albeit the surge of COVID-19 cases in Pakistan, the participants demonstrated an overall adequate knowledge and good perception towards COVID-19. There is a need to follow the preventive protocols and dissemination of correct information through conducting educational interventions that target safe health practices and provide appropriate information on this infection.


Asunto(s)
/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pakistán/epidemiología , Encuestas y Cuestionarios , Adulto Joven
11.
PLoS One ; 16(1): e0244886, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33400723

RESUMEN

INTRODUCTION: While chest x-rays (CXRs) represent a cost-effective imaging modality for developing countries like Pakistan, their utility for the prognostication of COVID-19 has been minimally explored. Thus, we describe the frequency and distribution of CXR findings, and their association with clinical outcomes of patients with COVID-19. METHODS: All adult (≥ 18 years) patients presenting between 28th February-31st May to the emergency department of a tertiary care hospital in Pakistan, who were COVID-19 positive on RT-PCR with CXR done on presentation, were included. A CXR Severity Score (CXR-SS) of 0-8 was used to quantify the extent of pulmonary infection on CXR, with a score of 0 being negative and 1-8 being positive. The patients' initial CXR-SS and their highest CXR-SS over the hospital course were used for analysis, with cut-offs of 0-4 and 5-8 being used to assess association with clinical outcomes. RESULTS: A total of 150 patients, with 76.7% males and mean age 56.1 years, were included in this study. Initial CXR was positive in 80% of patients, and 30.7% of patients had an initial CXR-SS between 5-8. The mortality rate was 16.7% and 30.6% patients underwent ICU admission with intubation (ICU-Int). On multivariable analysis, initial CXR-SS (1.355 [1.136-1.616]) and highest CXR-SS (1.390 [1.143-1.690]) were predictors of ICU-Int, and ICU-Int was independently associated with both initial CXR-SS 5-8 (2.532 [1.109-5.782]) and highest CXR-SS 5-8 (3.386 [1.405-8.159]). Lastly, age (1.060 [1.009-1.113]), initial CXR-SS (1.278 [1.010-1.617]) and ICU-Int (5.047 [1.731-14.710]), were found to be independent predictors of mortality in our patients. CONCLUSION: In a resource-constrained country like Pakistan, CXRs may have valuable prognostic utility in predicting ICU admission and mortality. Additional research with larger patient samples is needed to further explore the association of CXR findings with clinical outcomes.


Asunto(s)
/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Radiografía Torácica/métodos , Adulto , Anciano , /mortalidad , Servicio de Urgencia en Hospital , Femenino , Hospitalización , Humanos , Tiempo de Internación , Pulmón/patología , Masculino , Persona de Mediana Edad , Pakistán/epidemiología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Centros de Atención Terciaria
12.
PLoS One ; 16(1): e0244853, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33411791

RESUMEN

BACKGROUND: Cytokine release syndrome (CRS) plays a pivotal role in the pathophysiology and progression of Coronavirus disease-2019 (COVID-19). Therapeutic plasma exchange (TPE) by removing the pathogenic cytokines is hypothesized to dampen CRS. OBJECTIVE: To evaluate the outcomes of the patients with COVID-19 having CRS being treated with TPE compared to controls on the standard of care. METHODOLOGY: Retrospective propensity score-matched analysis in a single centre from 1st April to 31st July 2020. We retrospectively analyzed data of 280 hospitalized patients developing CRS initially. PSM was used to minimize bias from non-randomized treatment assignment. Using PSM 1:1, 90 patients were selected and assigned to 2 equal groups. Forced matching was done for disease severity, routine standard care and advanced supportive care. Many other Co-variates were matched. Primary outcome was 28 days overall survival. Secondary outcomes were duration of hospitalization, CRS resolution time and timing of viral clearance on Polymerase chain reaction testing. RESULTS: After PS-matching, the selected cohort had a median age of 60 years (range 32-73 in TPE, 37-75 in controls), p = 0.325 and all were males. Median symptoms duration was 7 days (range 3-22 days' TPE and 3-20 days controls), p = 0.266. Disease severity in both groups was 6 (6.6%) moderate, 40 (44.4%) severe and 44 (49%) critical. Overall, 28-day survival was significantly superior in the TPE group (91.1%), 95% CI 78.33-97.76; as compared to PS-matched controls (61.5%), 95% CI 51.29-78.76 (log rank 0.002), p<0.001. Median duration of hospitalization was significantly reduced in the TPE treated group (10 days vs 15 days) (p< 0.01). CRS resolution time was also significantly reduced in the TPE group (6 days vs. 12 days) (p< 0.001). In 71 patients who underwent TPE, the mortality was 0 (n = 43) if TPE was done within the first 12 days of illness while it was 17.9% (deaths 5, n = 28 who received it after 12th day (p = 0.0045). CONCLUSION: An earlier use of TPE was associated with improved overall survival, early CRS resolution and time to discharge compared to SOC for COVID-19 triggered CRS in this selected cohort of PS-matched male patients from one major hospital in Pakistan.


Asunto(s)
/complicaciones , Síndrome de Liberación de Citoquinas/terapia , Intercambio Plasmático , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pakistán , Puntaje de Propensión , Estudios Retrospectivos , Índice de Severidad de la Enfermedad
13.
Arch Environ Contam Toxicol ; 80(1): 41-54, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33386942

RESUMEN

The focus of the present study was to assess the quality of different drinking water sources, impacts of poor water quality on human health, and to apportion pollution source(s) of the district Bajaur, Pakistan. Drinking water samples (n = 331) were randomly collected from springs, hand pumps, open wells, and tube wells and analyzed for physicochemical parameters including toxic elements, and bacteriological contamination (i.e., Escherichia coli). Furthermore, a questionnaire survey was conducted to record the cases of waterborne diseases in the study area. The results showed that total suspended solids and bacteriological contamination exceeded the permissible limits of the WHO in all four of the water sources. Among the potentially toxic elements, Cd, Pb, and Mn were above the permissible limits of the WHO in some samples. The hazard index for spring water was found to exceed the toxicity level (i.e., HI > 1) set by US EPA for both adults and children, while the sources from hand pumps, open wells, and tube wells were within the safe limit. The order for the overall safety level for water quality in the study area was tube wells > open wells > hand pumps > springs. The pollution source apportionment statistics revealed that both geogenic and anthropogenic activities are the sources of drinking water contamination. The results of the questionnaire survey indicated that reports of waterborne diseases were highest in respondents who took their drinking water from springs, whereas reports of diseases were moderate in respondents taking their water from open wells and hand pumps and lowest in respondents taking their water from tube wells. Based on the findings of the study, the tube well source of water is recommended for drinking water purposes.


Asunto(s)
Agua Potable/normas , Microbiología del Agua/normas , Contaminantes Químicos del Agua/análisis , Contaminación del Agua/análisis , Calidad del Agua/normas , Abastecimiento de Agua/normas , Adulto , Niño , Agua Potable/química , Agua Potable/microbiología , Humanos , Pakistán , Distribución Aleatoria , Medición de Riesgo , Abastecimiento de Agua/métodos , Abastecimiento de Agua/estadística & datos numéricos
14.
Arch Environ Contam Toxicol ; 80(1): 1-10, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33386943

RESUMEN

Groundwater contamination is a global problem that has a significant impact on human health and ecological services. Studies reported in this special issue focus on contaminants in groundwater of geogenic and anthropogenic origin distributed over a wide geographic range, with contributions from researchers studying groundwater contamination in India, China, Pakistan, Turkey, Ethiopia, and Nigeria. Thus, this special issue reports on the latest research conducted in the eastern hemisphere on the sources and scale of groundwater contamination and the consequences for human health and the environment, as well as technologies for removing selected contaminants from groundwater. In this article, the state of the science on groundwater contamination is reviewed, and the papers published in this special issue are summarized in terms of their contributions to the literature. Finally, some key issues for advancing research on groundwater contamination are proposed.


Asunto(s)
Monitoreo del Ambiente/métodos , Agua Subterránea/química , Contaminantes Químicos del Agua/análisis , China , Humanos , India , Nigeria , Pakistán , Turquia
15.
BMJ Glob Health ; 6(1)2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33495285

RESUMEN

The COVID-19 epidemic is the latest evidence of critical gaps in our collective ability to monitor country-level preparedness for health emergencies. The global frameworks that exist to strengthen core public health capacities lack coverage of several preparedness domains and do not provide mechanisms to interface with local intelligence. We designed and piloted a process, in collaboration with three National Public Health Institutes (NPHIs) in Ethiopia, Nigeria and Pakistan, to identify potential preparedness indicators that exist in a myriad of frameworks and tools in varying local institutions. Following a desk-based systematic search and expert consultations, indicators were extracted from existing national and subnational health security-relevant frameworks and prioritised in a multi-stakeholder two-round Delphi process. Eighty-six indicators in Ethiopia, 87 indicators in Nigeria and 51 indicators in Pakistan were assessed to be valid, relevant and feasible. From these, 14-16 indicators were prioritised in each of the three countries for consideration in monitoring and evaluation tools. Priority indicators consistently included private sector metrics, subnational capacities, availability and capacity for electronic surveillance, measures of timeliness for routine reporting, data quality scores and data related to internally displaced persons and returnees. NPHIs play an increasingly central role in health security and must have access to data needed to identify and respond rapidly to public health threats. Collecting and collating local sources of information may prove essential to addressing gaps; it is a necessary step towards improving preparedness and strengthening international health regulations compliance.


Asunto(s)
Control de Enfermedades Transmisibles , Vigilancia en Salud Pública , /epidemiología , Control de Enfermedades Transmisibles/legislación & jurisprudencia , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/normas , Etiopía , Política de Salud , Humanos , Nigeria , Pakistán
16.
PLoS One ; 16(1): e0245343, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33444381

RESUMEN

OBJECTIVE: To evaluate the utility of teleconsultation in the provision of eye care services during the COVID-19 lockdown. Disparities in the consultation burden of sub-specialities and socio-demographic differences in teleconsultation utilization were also assessed. METHODS: Al-Shifa Trust Eye Hospital Rawalpindi began audio and video teleconsultation using broadband telecommunication services during the lockdown. Patients' and consultations' data gathered during the first three weeks after the commencement of this programme were compared with data from the four weeks prior to lockdown. The weekly consultation ratio and overall consultation burden of sub-specialities were measured. Chi-Square tests of association determined the relationship between different variables (socioeconomic status and consultation characteristics) and consultation modality (on-site vs online). RESULTS: In total, 17507 on-site consultations (4377/week) were conducted compared to 1431 teleconsultations (477/week), which maintained 10.89% of the weekly pre-lockdown eye care services. The post-lockdown teleconsultation programme saw a relatively higher percentage of service utility among female (47.09% vs 44.71%), younger-age (31.33±19.45 vs 41.25±23.32 years) and higher-socioeconomic-status (32.21% vs 0.30%) patients compared to pre-lockdown on-site consultations. The most common indication for teleconsultation was red-eye (16.70%). While cornea and glaucoma clinics maintained most of the pre-lockdown services (30.42% and 29% respectively), the highest dropout was seen in optometric and vitreoretinal services supporting only 5.54% and 8.28% of pre-lockdown services, respectively. CONCLUSION: Digital initiatives could partially maintain eye care services during the lockdown. Focused strategies to improve teleconsultation utilization are required during the pandemic and beyond.


Asunto(s)
/epidemiología , Oftalmopatías/diagnóstico , Oftalmopatías/terapia , Consulta Remota/métodos , Adolescente , Adulto , Anciano , Países en Desarrollo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pakistán/epidemiología , Pandemias , Cuarentena , Consulta Remota/estadística & datos numéricos , /aislamiento & purificación
17.
J Environ Manage ; 281: 111895, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33385903

RESUMEN

In peri-urban areas, waste water is used to irrigate orchards due to scarcity of fresh water which increases heavy metals contents in soils, leaves and fruits. Due to excessive waste water irrigations, heavy metals enter into the food chain, which eventually causes metabolic disorders in humans. The present study was envisaged to investigate the effects of canal, tubewell and sewage water on the quality of mango fruits and heavy metals accumulation in soils, leaves and fruits. Leaf and fruit samples from an un-grafted (Desi mango) and six commercial cultivars of mango (Anwar Rataul, Aman Dusehri, Sufaid Chaunsa, Samar Bahisht Chaunsa, Kala Chaunsa and Anwar Rataul Late) grafted on Desi mango were collected from different mango orchards located in peri-urban areas of Multan (Pakistan) and analyzed for some physico-chemical attributes and heavy metals contents. Soil samples were also taken from these orchards irrigated with different water sources to assess the soils' heavy metals status. A significant variation was observed among the mango cultivars for their physico-chemical attributes. Sewage water irrigation improved total soluble solids (TSS), titratable acidity, ascorbic acid content, total phenolics, total carotenoids, total flavonoids and antioxidant activity of mango fruits. However, it did not affect fruit weight and shelf life. Among the heavy metals, copper and nickel contents were found in greater amounts in soils, leaves and fruits of sewage water irrigated orchards than canal and tubewell water irrigated ones. However, zinc and cadmium were not detected in any soil, water, leaf or fruit sample. The interaction among the sources of irrigation and the mango cultivars was significant for copper accumulation in different soil layers, copper and nickel accumulation in leaves of different mango cultivars, and fruit weight, titratable acidity, ascorbic acid content, total flavonoids and shelf life of mango fruits.


Asunto(s)
Mangifera , Metales Pesados , Contaminantes del Suelo , Frutas/química , Humanos , Metales Pesados/análisis , Pakistán , Contaminantes del Suelo/análisis , Agua
18.
Arch Virol ; 166(2): 581-586, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33416997

RESUMEN

An advanced detection assay is important for clinical diagnosis of human immunodeficiency virus (HIV) infection in asymptomatic individuals. The first step in timely treatment and management of the infection is the early detection of HIV. In this study, we determined the prevalence of HIV in Islamabad for the first time using a chemiluminescent microparticle immunoassay (CMIA), which is an advanced serological diagnostic technique. A total of 3659 samples were obtained from the general public in Islamabad, Pakistan, and 85 of them were found to be positive for HIV infection (2.32% prevalence). Of the positive subjects, 78.82% (67/85) were male, 10.6% (9/85) were female, and 10.6% (9/85) were of unidentified gender. The results revealed a significant relationship between age groups and HIV status. The age group of 21- to 30-year-olds was found to have the highest rate of HIV infection, and the rate of HIV infection in males was higher than in females.


Asunto(s)
Infecciones por VIH/virología , VIH/inmunología , Inmunoensayo/métodos , Mediciones Luminiscentes/métodos , Tamizaje Masivo/métodos , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Pakistán , Prevalencia , Adulto Joven
19.
Artículo en Inglés | MEDLINE | ID: mdl-33494178

RESUMEN

Social distancing has manifold effects and is used as a non-pharmacological measure to respond to pandemic situations such as the novel coronavirus (COVID-19), especially in the absence of vaccines and other useful antiviral drugs. Governments around the globe have adopted and implemented a series of social distancing strategies. The efficacy of various policies and their comparative influence on mechanisms led by public actions and adoptions have not been examined. The differences in types and effective dates of various social distancing policies in various provinces/territories of Pakistan constitute a pure ground to examine the causal effects of each COVID-19 policy. Using the location trends and population movement data released by Google, a quasi-experimental method was used to measure the impact of the government's various social distancing policies on the people's existence at home and their outside social mobility. Based on the magnitude and importance of policy influences, this research ranked six social distancing policies whose influence exceeded the effect of voluntary behavior. Our research outcomes describe that the trend of staying at home was firmly pushed by state-wide home order rather than necessary business closings and policies that were associated with public gathering restrictions. Strong government policies have a strong causal effect on reducing social interactions.


Asunto(s)
/prevención & control , Política de Salud , Humanos , Pakistán
20.
Ecotoxicol Environ Saf ; 208: 111685, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33396017

RESUMEN

The wastewater utilization for irrigation purposes is common practice in peri-urban areas located in vicinity of developed cities. This water contains elements like chromium (Cr), nickel (Ni), cadmium (Cd) and nitrate (NO3-N) that poses health risk when exposed to human. In this study effect of wastewater irrigation from Chakara wastewater plant, Faisalabad on growth of wheat and health risks was assessed. Pot experiment was conducted at Institute of Soil and Environmental, University of Agriculture, Faisalabad using different concentration of wastewater as treatment 100% tap water, 25% wastewater + 75% tap water, 50% wastewater + 50% tap water, 75% wastewater + 25% tap water, 100% wastewater. The results indicated that the wastewater irrigation negatively effects the plant growth and physiological parameters. The minimum plant height, grain weight, spike length, osmotic potential and SPAD values were recorded 50.33 cm, 1.47 g plant-1, 7.00 cm, 423 and 38.91 respectively in 100% wastewater irrigation. The risk quotient (RQ TEs) for each toxic element and cumulative risk index (RI TEs) values were calculated. The cadmium risk quotient (Cd RQ) for adults was on margin and value was >1 for in 75% wastewater + 25% tap water and 100% wastewater irrigation, while the RQ for Ni and Cr was <1. Maximum RI TEs values calculated in 100% wastewater irrigation 0.424 and 0.294 for children and adults respectively. Hence it was concluded that wastewater irrigation significantly increased the accumulation rate of metals and nitrate in wheat and cause potential health risks for children and adults.


Asunto(s)
Riego Agrícola/métodos , Bioacumulación/efectos de los fármacos , Metales Pesados/toxicidad , Nitratos/toxicidad , Contaminantes del Suelo/toxicidad , Triticum/efectos de los fármacos , Aguas Residuales/química , Adulto , Cadmio/análisis , Cadmio/toxicidad , Niño , Cromo/análisis , Cromo/toxicidad , Ciudades , Grano Comestible/química , Humanos , Metales Pesados/análisis , Modelos Teóricos , Níquel/análisis , Níquel/toxicidad , Nitratos/análisis , Pakistán , Medición de Riesgo , Suelo/química , Contaminantes del Suelo/análisis , Triticum/crecimiento & desarrollo , Triticum/metabolismo , Aguas Residuales/análisis
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