Public health in Global South: effect of environmental pollutant PM2.5 on the incidence and mortality of SARS-CoV-2 in Karachi, Lahore, and Islamabad.

OBJECTIVE: Environmental pollution has undoubtedly been established as a planetary, intergenerational, and existential threat to global human health and safety. Environmental pollution is adversely affecting the world, mainly the countries where human health is not a priority aspect, and this has been exacerbated due to the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and pandemic is known as "COVID pandemic". This study investigates the association of environmental pollutants, particulate matter (PM2.5), with SARS-CoV-2 daily cases and deaths in Karachi, Lahore, and Islamabad, Pakistan, presenting the perspectives from the Global South. MATERIALS AND METHODS: The day-to-day PM2.5 levels were recorded from the metrological website, Real-Time Air Quality Index-AQI. The corresponding data on the COVID cases and deaths in Karachi, Lahore, and Islamabad were obtained from August 1, 2020, to September 30, 2021, from the Health Ministry and National Command Operations Centre Pakistan. RESULTS: The mean values for PM2.5 in Karachi were 110.4±46.2; in Lahore 174.0±83.2; and in Islamabad 107.1±40.0. The COVID-19 mean daily cases in Karachi were 538.9±446.6; Lahore 398.3±403.1; and Islamabad 212.2±187.6; and mean daily deaths in Karachi were 9.2±8.3; Lahore 9.3±9.7; and Islamabad 1.8±1.8. The results further depicted that the SARS-CoV-2 cases were 2.86 times higher in Karachi and 1.4 times higher in Lahore than in Islamabad. Similarly, the SARS-CoV-2 deaths were 3.6 and 2.8 times higher in Karachi and Lahore, respectively, compared to Islamabad. CONCLUSIONS: The findings claim that cases and deaths augmented significantly along with PM2.5 levels. These empirical estimates demonstrate an association between PM2.5 and SARS-CoV-2 daily cases and deaths in the cities of the Global South. These findings can contribute to policy-making decisions about addressing air pollutants and climate concerns in developing countries and create an urgency to develop a strategy for minimizing environmental pollution. This study can also steer the actions needed to address the environmental problems in developing countries to improve public health and safety.

Effect of heat and humidity on the incidence and mortality due to COVID-19 pandemic in European countries.

OBJECTIVE: The weather allied conditions have an impact on air, water, soil, food, ecosystem, feelings, behaviors, and pattern of health and disease. The present study aims to investigate the impact of heat and humidity on the daily basis incidence and mortality due to COVID-19 pandemic in European countries. MATERIALS AND METHODS: We selected 10 European countries, Russia, United Kingdom, Spain, Italy, Germany, Turkey, France, Belgium, Netherlands and Belarus. This region has a relatively low temperature and high humidity, and has homogenous European ethnicity with almost similar socioeconomic culture and health care system. The data on COVID-19 pandemic including daily new cases and new deaths were recorded from World Health Organization (WHO). The information on daily temperature and humidity was obtained from world climate web "Time and Date". The daily cases, deaths, temperature and humidity were recorded from the date of appearance of first case of "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" in the European region, from Jan 27, 2020 to July 17, 2020. RESULTS: In 10 European countries, (Russia, United Kingdom, Spain, Italy, Germany, Turkey, France, Belgium, Netherlands and Belarus), the daily basis mean temperature from Jan 27, 2020 to July 17, 2020 was 17.07±0.18°C, and humidity was 54.78±0.47%. The overall results revealed a significant inverse correlation between humidity and the number of cases (r= -0.134, p<0.001) and deaths (r= -0.126, p<0.001). Moreover, an increase in temperature was linked with an increase in the number of cases (r=0.062, p=0.013) and deaths (r=0.118, p<0.001). The regression analysis results further revealed that with an increase of 1% humidity the number of cases (ß = -15.90, p<0.001) and deaths (ß=-1.56, p<0.001) reduced significantly. Whereas, with an increase of 1°C in temperature the number of cases (ß = 20.65, p<0.001) and deaths (ß = 3.71, p<0.001) increased significantly. CONCLUSIONS: Increase in relative humidity was associated with a decrease in the number of daily cases and deaths, however, a rise in temperature was allied with an upsurge in the number of daily cases and daily deaths due to COVID-19 pandemic in European countries. The study findings on weather events and COVID-19 pandemic have an impact at European regional levels to project the incidence and mortality trends with regional weather events to enhance public health readiness and assist in planning to fight against this pandemic situation.

Climate and COVID-19 pandemic: effect of heat and humidity on the incidence and mortality in world's top ten hottest and top ten coldest countries.

OBJECTIVE: The COVID-19 pandemic has caused a global public health crisis with social, psychological and long-lasting economical damages. Weather-related dynamics have an impact on the pattern of human health and disease. The present study aimed to investigate the impact of heat and humidity on daily basis incidence and mortality due to COVID-19 pandemic in ten of the world's hottest countries compared to ten of the coldest ones. MATERIALS AND METHODS: Worldwide, we selected 20 countries; 10 hottest countries with the highest temperatures and 10 coldest countries with the lowest temperature. The selection of the countries was based on the daily basis mean temperature from the date of appearance of the initial cases of COVID-19, Dec 29, 2019 to May 12, 2020. In the world's 10 hottest countries, the mean temperature was (26.31±1.51) and humidity (44.67±4.97). However, in the world's 10 coldest countries the mean temperature was (6.19±1.61) and humidity (57.26±2.35). The data on the global outbreak of COVID-19, daily new cases and deaths were recorded from World Health Organization, and daily information on temperature and humidity was obtained from metrological web "Time and Date". RESULTS: In countries with high temperatures and low humidity, the mean daily cases incidence were (407.12±24.33); cumulative cases (9094.34±708.29); and cumulative deaths (452.84±43.30) were significantly low compared to countries with low temperatures and high humidity: daily cases (1876.72±207.37); cumulative cases (44232.38±5875.11); and cumulative deaths (2008.29±310.13). Moreover, COVID-19 cases and deaths per million population were significantly low in countries with high temperatures (cases 711.23, and deaths 16.27) compared to countries with low temperatures (cases 1685.99; and deaths 86.40). Furthermore, in hottest countries, a 1% increase in humidity reduced number of cases and deaths by (ß = -5.40, p<0.001) and (ß = -0.187, p=0.004) respectively. A similar trend was seen with a 1°C increase in temperature, reducing the number of deaths by (ß = -1.35. p<0.001). CONCLUSIONS: The results revealed a significant decrease in incidence of daily cases and deaths in countries with high temperatures and low humidity (warmest countries), compared to those countries with low temperatures and high humidity (coldest countries). The findings could be of interest to the policymakers and the health officials on the epidemiological trends of COVID-19 pandemic and weather changes.

Acute tonsillitis complicated by retropharyngeal and thyroid abscess infected with de-repressed beta lactamase Citrobacter mutans.

An unusual presentation of acute tonsillitis complicated by retropharyngeal and thyroid abscess is reported. Spontaneous rupture of retropharyngeal abscess resulted in necrotic fistulae between the pharyngeal wall and the retropharyngeal space.

Clinical value of anaerobic blood culture: a retrospective analysis of positive patient episodes.

AIM: To investigate the clinical value of anaerobic blood culture. METHODS: Blood culture bottles (n = 25,185) submitted for culture over a two year period were reviewed. RESULTS: The bottles yielded 1992 positive patient episodes, a positive rate of 14.4/1000 hospital admissions. Significantly more isolations were obtained from aerobic than from anaerobic bottles. Twelve of the 38 anaerobic episodes were detected in aerobic bottles. Clinical management was influenced in one of 24 patients whose cultures yielded anaerobes from anaerobic bottles only. For a further six patients it was unlikely that the result had any effect on clinical management. CONCLUSIONS: If aerobic bottles were substituted for the anaerobic bottles, detection of positive patient episodes would increase by at least 6%. A higher yield would be achieved by using two aerobic bottles for routine culture and using anaerobic bottles only for patients where anaerobic culture may influence clinical management.