Dynamics of the optimality control of transmission of infectious disease: a sensitivity analysis.

Over the course of history global population has witnessed deterioration of unprecedented scale caused by infectious transmission. The necessity to mitigate the infectious flow requires the launch of a well-directed and inclusive set of efforts. Motivated by the urge for continuous improvement in existing schemes, this article aims at the encapsulation of the dynamics of the spread of infectious diseases. The objectives are served by the launch of the infectious disease model. Moreover, an optimal control strategy is introduced to ensure the incorporation of the most feasible health interventions to reduce the number of infected individuals. The outcomes of the research are facilitated by stratifying the population into five compartments that are susceptible class, acute infected class, chronic infected class, recovered class, and vaccinated class. The optimal control strategy is formulated by incorporating specific control variables namely, awareness about medication, isolation, ventilation, vaccination rates, and quarantine level. The developed model is validated by proving the pivotal delicacies such as positivity, invariant region, reproduction number, stability, and sensitivity analysis. The legitimacy of the proposed model is delineated through the detailed sensitivity analysis along with the documentation of local and global features in a comprehensive manner. The maximum sensitivity index parameters are disease transmission and people moved from acute stages into chronic stages whose value is (0.439, 1) increase in parameter by 10 percent would increase the threshold quantity by (4.39, 1). Under the condition of a stable system, we witnessed an inverse relationship between susceptible class and time. Moreover, to assist the gain of the fundamental aim of this research, we take the control variables as time-dependent and obtain the optimal control strategy to minimize infected populations and to maximize the recovered population, simultaneously. The objectives are attained by the employment of the Pontryagin maximum principle. Furthermore, the efficacy of the usual health interventions such as quarantine, face mask usage, and hand sanitation are also noticed. The effectiveness of the suggested control plan is explained by using numerical evaluation. The advantages of the new strategy are highlighted in the article.

An exact solution approach to warm inflation using Tsallis and Barrow holographic dark energy entropy within Rastall gravity.

This paper studies the phenomena of warm inflation in a modified cosmological scenario within Rastall gravity. In this context, we modify the standard Friedmann equations using recently proposed Tsallis and Barrow holographic dark energy entropies, alternatively. For both entropies, the exact solutions including the inflaton field, potential required to produce inflation and the scale factor are obtained under slow-roll approximation for low- and high-dissipative regimes. We obtain exponentially growing scale factors for both dark energy models. To confront the theoretical predictions of these models with recent observational data, we calculate the slow-roll parameters, number of e-folds, scalar spectral index, running of scalar spectral index and the tensor-to-scalar ratio for both extremes of dissipation. The Planck bounds on inflationary trajectories are being used to constraint the free parameters. The results are interesting and physically viable up to 2 σ level.

A quadruple blinded placebo controlled randomised trial to evaluate the effectiveness of an Iodine complex for patients with mild to moderate COVID-19 in Pakistan (I-COVID-PK): A structured summary of a study protocol for a randomised controlled trial.

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.

Quality of life of students of a private medical college.

OBJECTIVE: To determine the quality of life of students of a private medical college in Karachi in Pakistan. METHODS: This cross sectional study was conducted among 217 medical students of Liaquat College of Medicine and Dentistry, Karachi from June 2017 to March 2018. Students were selected by a stratified sampling method and the World Health Organization Quality of Life BREF Instruments (WHO QOL-BREF) was used for the above-mentioned study. Statistical analysis was performed using SPSS (Statistical Package for Social Sciences) version 21 and Analysis of variance (ANOVA). Independent t-test was used as p <0.05 significant. RESULTS: A total of 250 questionnaires were distributed among 2nd year, 3rd year, 4th year and final year students and the response rate was 86.8%. Among them 48.5% (n=105) students were male and 51.5% (n=112) students were female, while 9.2% (n=20) students were currently ill and the other 90.8% (n=197) were healthy. CONCLUSION: Medical education influences the quality of life (QOL) of students adversely. Social relationships and environmental domain were satisfactory in private medical institutes whereas physical and psychological progress was low due to academic load which requires improvement either by physical activities such as fitness classes or other extra-curricular activities.