COVID-19 household transmissibility remains unclear in Pakistan. To understand the dynamics of Severe Acute Respiratory Syndrome Coronavirus disease epidemiology, this study estimated Secondary ...Attack Rate (SAR) among household and close contacts of index cases in Pakistan using a statistical transmission model.
A retrospective cohort study was conducted using an inclusive contact tracing dataset from the provinces of Punjab and Khyber-Pakhtunkhwa to estimate SAR. We considered the probability of an infected person transmitting the infection to close contacts regardless of residential addresses. This means that close contacts were identified irrespective of their relationship with the index case. We assessed demographic determinants of COVID-19 infectivity and transmissibility. For this purpose based on evolving evidence, and as CDC recommends fully vaccinated people get tested 5-7 days after close contact with a person with suspected or confirmed COVID-19. Therefore we followed the same procedure in the close contacts for secondary infection.
During the study period from 15th May 2020 to 15th Jan 2021, a total of 339 (33.9%) index cases were studied from 1000 cases initially notified. Among close contact groups (n = 739), households were identified with an assumed mean incubation period of 8.2+4.3 days and a maximum incubation period of 15 days. SAR estimated here is among the household contacts. 117 secondary cases from 739 household contacts, with SAR 11.1% (95% CI 9.0-13.6). All together (240) SAR achieved was 32.48% (95% CI; 29.12-37.87) for symptomatic and confirmed cases. The potential risk factors for SAR identified here included; old age group (>45 years of age), male (gender), household members >5, and residency in urban areas and for index cases high age group. Overall local reproductive number (R) based on the observed household contact frequencies for index/primary cases was 0.9 (95% CI 0.47-1.21) in Khyber Pakhtunkhwa and 1.3 (95% CI 0.73-1.56) in Punjab.
SAR estimated here was high especially in the second phase of the COVID-19 pandemic in Pakistan. The results highlight the need to adopt rigorous preventive measures to cut the chain of viral transmission and prevent another wave of COVID-19.
Pakistan has second highest burden of hepatitis C virus (HCV) infected patients in the World. Little is known about the molecular epidemiology and risk factors for prevailing HCV genotypes in ...Pakistan. Considering this a multicenter cross-sectional study was conducted at 23different viral hepatitis control and prevention centers. A total of 175,897 patients were registered and screened for HCV, out of which 73,180 (41.6%) were found positive on Architect screening test. The screened positive patients were sequentially tested on RT-PCR; where 41,241 (56.35%) were detected positive. Molecular characterization results showed genotype 3 (73.9%) as the most prevalent type, followed by genotype 1 (9.7%), and genotype 4 (0.3%) was isolated for the first time in Pakistan. On regression analysis; risk factors associated with genotype 3 and 1 included; age group of 30–50 years, rural residence, exposure to >10 injections, barber shaving, circumcision by barbers, and low literacy rate. Phylogenetic analysis based on genotypes identified in this study and sequences isolated from Pakistan in last 10 years demonstrated that genotype 3 and 1 are endemic locally in Punjab province. The high prevalence rate of HCV is a threat for a generalized epidemic and genetic recombination with such variability of genotypes identified here is an alarming condition. More focused attention and resources should be spent in awareness of the population to prevent the spread of HCV among high risk population.
•its the first study in Pakistan reporting HCV genotype 4 in a large cohort.•sequence analysis and genotyping is carried out on a large sample size.•this study reports an emerging pattern of HCV endemic highlighting the threat of epidemic in the country.
Depression is defined as a psychiatric disorder characterized by depressed mood, lack of concentration, diminished energy, disturbed sleep, and low self-esteem. Depression is more prevalent in ...HIV/AIDS patients than the general population. There is no published study available that reveals the present status of depression among HIV patients in Pakistan. As such, the present study was conducted to determine the prevalence and associated factors of depression among HIV/AIDS patients attending the HIV clinic of Jinnah Hospital, Lahore, Pakistan.
A hospital-based cross-sectional study was carried out from February to March 2019 in Lahore. Data were collected from 158 HIV/AIDS patients using a pretested, standardized, structured interviewer-administered questionnaire. Nonprobability convenience sampling was used to recruit the study participants. Depression was evaluated using the Patient Health Questionnaire. SPSS version 23 was used to analyze the data. Binary logistic regression models were used to determine the various factors associated with depression. AORs with 95% CIs were used to assess the magnitude of associations between depression and associated factors.
The mean age of the study participants was 35.03 years±9.123. Prevalence of depression among HIV/AIDS patients was 32.2%. Living in a rural area (AOR 5.60, 95% CI 2.20, 14.15), fear of stigma and discrimination (AOR 3.505, 95% CI 1.364, 9.008), having worked abroad (AOR 3.017, 95% CI 1.134, 8.031), and history of substance abuse (AOR 4.147, 95% CI 1.673, 10.28) were significantly associated with depression.
The prevalence of depression among HIV/AIDS patients is very high in Pakistan. Therefore, it is suggested that guidelines formulated to screen and treat depression among HIV patients.
The assessment of disease pattern and burden in a defined population based on the symptomatology as well as the organic presentation is quite fruitful.Objectives: This study was designed to determine ...demographic characteristics and disease patterns related to different organ systems presenting at first tier of primary healthcare system. Methods: A cross-sectional study was conducted using Basic Health Unit’s (BHU) Outdoor Patient Department (OPD) database retrospectively in order to determine the age, gender and organ system wise distribution of various diseases. Secondary data was collected from standard OPD register in which all patients that presented in the outpatient department of the facility during a period of 6 months from 1st January, 2017 to 30th June, 2017 were included and no patient was excluded. Results: Out of total 2357 patients, 1024 (43.4%) were males and 1333 (56.6%) were females. Most of the patients 1057 (44.8%) belonged to the age group of 15-49 years whereas only 96 (4.1%) were less than one year old. About 2204 patients (93.5%) presented for the first time to the BHU and 153 patients (6.5%) were follow-up patients. Majority of patients 735 (31.2%) presented with symptoms of respiratory system. Certainsystems were more involved in females than males like musculoskeletal system (257 v/s 113), respiratory system (377 v/s 358) and especially the genitourinary system (50 v/s 5). Conclusions: Addressing and treating the diseases presenting at this basic level (BHU) can prove to be very useful in reducing patient load at the level of tertiary care and teaching hospitals.
ABSTRACT Objective: To determine the association of Paranasal Sinus Abnormalities with Primary Acquired Nasolacrimal Duct Obstruction (PANDO). Study Design: Comparative Cross-sectional Study. Place ...and Duration of Study: Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi Pakistan, from Jul 2021 to Feb 2022. Methodology: A total of 90 patients were included in the study. 40 were part of the control Group while 50 formed the Study Group. Patients presenting with Nasolacrimal Duct Obstruction and Sinonasal Abnormalities were included in the study. All Data Analysis was performed using statistical package for social sciences (SPSS) 23.0 software (SPSS inc., Chicago, IL, USA). Results: The Mean age of control group was 50.0±8.3 years while the mean age of patients in the NLDO group was 53.8±6.5 years. 32(64%) had right sided NLDO while 18(36%) had left sided NLDO. No statistically significant association was found between PANDO and Sino-nasal abnormalities such as Concha Bullosa, Chronic Sinusitis, Turbinate Hypertrophy and Septal Deviation (p=0.05). Conclusion: No Association was found between Sino-nasal pathologies and their potential role in the development of PANDO. Further researches are needed on this topic especially ones exploring gender predilection and ethnicity to ascertain with certainty the potential relation of PANDO with paranasal pathologies.
Cornea plana (CP) is a rare ocular condition existing in two distinct clinical and hereditary forms: a milder, autosomal dominant type I and a more severe, autosomal recessive type II. The condition ...is more commonly found in Finnish, Saudi, and Czech families. We report three brothers from a consanguineous marriage that presented with complaints of decreased vision of varying degrees. All three of them have blue, thick, and hazy corneas with shallow anterior chamber depths. The additional features of CP type II were seen in the older two brothers including arcus lipoids, ill-demarcated limbus, and an accommodative squint. They were managed by the correction of refractive errors through spectacles and detailed counseling with follow-up visits to look for progressive complications. The management is mainly centered around optically or surgically correcting the developmental anomalies. This is complimented with proper genetic counseling and regular follow-up visits to look for and manage complications. There are, however, novel therapies that can be considered in these patients including corneal transplants or corneal stromal stem cellular therapies.
Axenfeld-Rieger syndrome (ARS) is a rare autosomal dominant condition characterized by the dysgenesis of the anterior segment along with some systemic abnormalities such as dental and facial bone ...defects. Its incidence is thought to be 1 in 200,000. Treatment is predominantly the management of glaucoma and is mostly medical but can be surgical in refractory cases. Here, we describe the case of a 35-year-old female patient who presented with co-existing vernal keratoconjunctivitis and ARS. The treatment was more challenging as we had to manage two conditions simultaneously.
This study used laser-assisted chemical bath synthesis (LACBS) as a simple, catalyst-free hydrothermal approach to synthesize pure and Al-doped ZnO nanostructures. Under the influence of a blue ...laser, the photocatalytic degradation of methylene blue has been studied (444.5 nm of wavelength and 8000 lx of light intensity). For the first time, LACBS produced numerous doping concentrations (2, 4, and 6%) using a continuous blue laser (power is 7 W and wavelength is 444.5 nm). X-ray diffraction (XRD), scanning electron microscopy (FE-SEM), and UV–vis spectrophotometry were used to verify the structural and optical properties of the prepared nanostructures. It has been demonstrated that ZnO:Al (6%) nanosheets have a significant role in the rapid photodegradation caused by blue laser irradiation. The efficiency for methylene blue degradation varies from 85.9, 86.3, and 99.4 to 99.7% for the pure and ZnO:Al (2, 4, and 6%), respectively. This improved photocatalytic activity is attributed to the increased catalytic activity and surface area of Al-doped ZnO. Using UV–visible spectroscopy, the photocatalytic efficiency was determined from the absorption spectra. The photocatalytic activity is increased due to a combination of the Al-plasmonic effect and ZnO surface imperfections that enable the separation of photogenerated electron–hole pairs and shift the absorption edge of the hybrid nanostructure toward the visible spectrum region. Effective visible light absorption and improved dye degradation efficiency are caused by band-edge tuning in ZnO:Al nanostructured.
Thermoelectric materials have potential applications in energy conversion and waste heat recovery. Thermoelectric materials with non-stoichiometric composition may exhibit improved thermoelectric ...properties compared to the stoichiometric composition material. Bi2Te3 is one of the best-known thermoelectric materials having optimum performance near room temperature. In the present study, non-stoichiometric bismuth telluride (Bi2±x Te3), x = (0, 0.01, 0.02, 0.03), was synthesized using the co-precipitate method to create imperfections and strains in the crystal structure of the material. The crystal structure of the synthesized bismuth telluride revealed significant changes in the c direction when examined using X-ray diffraction (XRD). Scanning electron microscopy (SEM) revealed the formation of micro-particles. Energy dispersive spectroscopy (EDX) also confirmed the non-stoichiometric elemental composition of Bi and Te rich bismuth telluride. Thermogravimetric analysis (TGA) was performed in a non-inert environment, and an oxidation temperature of 685 K was recorded in non-stoichiometric samples. The post-oxidation of stoichiometric and non-stoichiometric Bi Rich and Te Rich bismuth tellurides was also confirmed by XRD and TGA comparison. The thermal conductivity was reduced by the imperfections and defects for all non-stoichiometric compositions, and a zT value of 0.54 at 420 K was obtained in the Tellurium Rich bismuth telluride, which is about a 12% improvement compared to the pure sample.
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