Physical and Psychological Impacts on COVID-19 Hospitalized Patients of 3rd Wave

Background: COVID shelters and many emergency centers were established as a countermeasure to control this pandemic that hit the word by the end of 2019. Due to unavailability of medical care, along with physical health issues, these patients suffer with mental health related issues. Aims: This study aimed to explore the both, physical and psychological impacts upon the patients diagnosed with COVID-19 and admitted in intensive care units of hospitals of Pakistan during the third wave. Methods: This cross-sectional survey was performed during the peak time of COVID-19 for the duration of two months i.e. April & May 2021. After getting ethical approval from Shifa International Hopsital (Ref# 070-021), permission was sorted from public and private hospitals of Pakistan. 183 conscious patients diagnosed with COVID and currently admitted in intensive care units were randomly selected from hospitals of Islamabad and Rawalpindi. Written consent was taken from patients and their caregivers after they were briefed regarding the importance of the study. PHQ-15 was used to assess somatic symptoms related to COVID-19 whereas DASS-21 was used to assess level of depression, anxiety and stress among patients. Results: Of 183 hospitalized patients of COVID-19 in intensive care units, 170 (92.9%) participants showed mild to severe level of somatic symptoms on PHQ-15. Shortness of breath, feeling hearth race, back pain, stomach pain, low energy and sleeping difficulties were the most common somatic complaints reported by patients. The statistics of DASS-21 showed that 51 (27.86%) participants had mild to severe level of depression, 74 (40.4%) had mild to profound level of anxiety and 96 (52.45%) reported mild to profound level of stress. Conclusion: This study portrayed a better understanding and confirms the physical and psychological impacts upon hospitalized COVID-19 patients, therefore highlighting the need of both physical and mental health interventions to minimize these impacts

Randomized controlled trial of standard versus double dose cotrimoxazole for childhood pneumonia in Pakistan

Objective: Increasing concern over bacterial resistance to cotrimoxazole, which is recommended by WHO as a first-line drug for treating non-severe pneumonia, led to the suggestion that this might not be optimal therapy. However, changing to alternative antimicrobial agents, such as amoxicillin, is costly. We compared the clinical efficacy of twice-daily cotrimoxazole in standard versus double dosage for treating non-severe pneumonia in children.Methods: A randomized controlled multicentre trial was implemented in seven hospital outpatient departments and two community health programmes. A total of 1143 children aged 2-59 months with non-severe pneumonia were randomly allocated to receive 4 mg trimethoprim plus 20 mg sulfamethoxazole/kg of body weight or 8 mg trimethoprim plus 40 mg sulfamethoxazole/kg of body weight orally twice-daily for 5 days Treatment failure occurred when a child required a change of therapy, died or was lost to follow-up. Children required a change of therapy if their condition worsened (they developed chest indrawing or danger signs) or if at 48 hours after enrollment, their clinical condition was the same (defined as having a respiratory rate that was 5 breaths/minute higher or lower than at the time of enrollment).Findings: The results of 1134 children were analysed: 578 were assigned to the standard dose of cotrimoxazole and 556 to the double dose. Treatment failed in 112 children (19.4%) in the standard group and 118 (21.2%) in the double-dose group (relative risk 1.10; 95% confidence interval = 0.87-1.37). Using multivariate analysis we found that treatment was more likely to fail in children who were not given the medicine correctly (P = 0.001), in those younger than 12 months (P = 0.004), those who had used antibiotics previously (P = 0.002), those whose respiratory rate was \u3e or =20 breaths/minute above the age-specific cut-off point (P = 0.006), and those from urban areas (P = 0.042).Conclusion: Both standard and double strength cotrimoxazole were equally effective in treating non-severe pneumonia. Close follow-up of patients is essential to prevent worsening of disease. Definitions of clinical failure need to be more specific. Surveillance in both rural and urban areas is essential in the development of treatment policies that are based on clinical outcomes

Wood-derived biochar influences nutrient use efficiency of heavy metals in spinach (spinacia oleracea) under groundwater and wastewater irrigation

Present study analysed the influence of slow-pyrolyzed wood-derived biochar on growth performance and heavy metal accumulation in the leaves of spinach grown under groundwater and wastewater irrigation. Biochar was applied in soil as 5% (~30 t·ha−1) and 10% (~60 t·ha−1) amendment. According to results, plant biomass was significantly higher under wastewater than groundwater irrigation. Biochar amendment increased significantly the aboveground plant biomass and root biomass and promoted water use efficiency (WUE). Under groundwater irrigation, biochar amendment at 10% application rate, increased the leaf area index (P < 0.05), while amendment of biochar at all application rates significantly reduced leaf area index under wastewater irrigation (P < 0.05). Application of biochar also reduced accumulation of rhizosphere soil around roots under wastewater irrigation, indicating less exudate production in the rhizosphere of plants. Biochar significantly reduced the concentration of copper (Cu) in under wastewater irrigation. Biochar increased the nutrient use efficiency (NUE) of plants for zinc (Zn) and Cu under wastewater irrigation

Improving community case management of diarrhoea and pneumonia in district Badin, Pakistan through a cluster randomised study--the NIGRAAN trial protocol

BACKGROUND: Diarrhoea and pneumonia contribute 30% of deaths in children under 5 in Pakistan. Pakistan\u27s Lady Health Workers Programme (LHW-P) covers about 60% of the population but has had little impact in reducing morbidity and mortality related to these major childhood killers. An external evaluation of the LHW-P suggests that lack of supportive supervision of LHWs by lady health supervisors (LHSs) is a key determinant of this problem. Project NIGRAAN aims to improve knowledge and skills of LHWs and community caregivers through supervisory strategies employed by LHSs. Ultimately, community casemanagement (CCM) of childhood pneumonia and diarrhoea will improve. METHODS/DESIGN: NIGRAAN is a cluster-randomised trial in District Badin, Pakistan. There are approximately 1100 LHWs supervised by 36 LHSs in Badin. For this study, each LHS serves as a cluster. All LHSs working permanently in Badin who regularly conduct and report field visits are eligible. Thirty-four LHSs have been allocated to either intervention or control arms in a ratio of 1:1 through computer-generated simple randomisation technique. Five LHWs from each LHSs are also randomly picked. All 34 LHSs and 170 LHWs will be actively monitored. The intervention consists of training to build LHS knowledge and skills, clinical mentorship and written feedback to LHWs. Pre- and post-intervention assessments of LHSs, LHWs and community caregivers will be conducted via focus group discussions, in-depth interviews, knowledge assessment questionnaires, skill assessment scorecards and household surveys. Primary outcome is improvement in CCM practices of childhood diarrhoea and pneumonia and will be assessed at the cluster level. DISCUSSION: NIGRAAN takes a novel approach to implementation research and explores whether training of LHSs in supervisory skills results in improving the CCM practices of childhood diarrhoea and pneumonia. No significant harm to participants is anticipated. The enablers and barriers towards improved CCM would provide recommendations to policymakers for scale up of this intervention nationally and regionally

Impact of rangeland enclosure and seasonal grazing on protected and unprotected rangelands in Chakwal region, Pakistan

Scrub rangelands support livestock grazing and provide ecosystem services to their inhabitants. The present study was conducted in Chakwal, an important tract of the Pothwar Plateau, which sustains herds of small domestic and nomadic ruminants. Urbanization and uncontrolled grazing practices have reduced rangeland productivity and increased soil erosion and resulted in poor land conditions. This study assessed the influence of two years of rangeland protection on aboveground vegetation biomass and the chemical composition of plants and aimed to determine the influence of seasonal grazing on the live-weight gain of small ewes. Using the line intercept method, vegetation data from protected and unprotected plots in 2015 and 2016 were collected at two sites, Dhulli and Begal. Vegetation cover was assessed from images using VegMeasure. Results showed that protected study sites displayed higher vegetation biomass (834 and 690 kg ha-1) compared to the unprotected study site (477 and 326 kg ha-1) during April and August of both years. In the seasonal grazing trial, the experimental ewes that grazed on protected rangelands showed higher live-weight gain (33–63 g day-1) compared to live weight of ewes (17–21 g day-1) that grazed on unprotected rangelands during the experimental period of 127 days at both sites. The results suggest that the Chakwal rangeland has tremendous potential to improve vegetation productivity but modern livestock management and seasonal grazing practices are needed to improve carrying capacity and livestock productivity

Measurement of the cross-section of high transverse momentum vector bosons reconstructed as single jets and studies of jet substructure in pp collisions at √s = 7 TeV with the ATLAS detector

This paper presents a measurement of the cross-section for high transverse momentum W and Z bosons produced in pp collisions and decaying to all-hadronic final states. The data used in the analysis were recorded by the ATLAS detector at the CERN Large Hadron Collider at a centre-of-mass energy of √s = 7 TeV;{\rm Te}{\rm V}$and correspond to an integrated luminosity of$4.6\;{\rm f}{{{\rm b}}^{-1}}$. The measurement is performed by reconstructing the boosted W or Z bosons in single jets. The reconstructed jet mass is used to identify the W and Z bosons, and a jet substructure method based on energy cluster information in the jet centre-of-mass frame is used to suppress the large multi-jet background. The cross-section for events with a hadronically decaying W or Z boson, with transverse momentum${{p}_{{\rm T}}}\gt 320\;{\rm Ge}{\rm V}$and pseudorapidity$|\eta |\lt 1.9$, is measured to be${{\sigma }_{W+Z}}=8.5\pm 1.7$ pb and is compared to next-to-leading-order calculations. The selected events are further used to study jet grooming techniques

Observation of associated near-side and away-side long-range correlations in √sNN=5.02 TeV proton-lead collisions with the ATLAS detector

Two-particle correlations in relative azimuthal angle (Δϕ) and pseudorapidity (Δη) are measured in √sNN=5.02  TeV p+Pb collisions using the ATLAS detector at the LHC. The measurements are performed using approximately 1  μb-1 of data as a function of transverse momentum (pT) and the transverse energy (ΣETPb) summed over 3.1<η<4.9 in the direction of the Pb beam. The correlation function, constructed from charged particles, exhibits a long-range (2<|Δη|<5) “near-side” (Δϕ∼0) correlation that grows rapidly with increasing ΣETPb. A long-range “away-side” (Δϕ∼π) correlation, obtained by subtracting the expected contributions from recoiling dijets and other sources estimated using events with small ΣETPb, is found to match the near-side correlation in magnitude, shape (in Δη and Δϕ) and ΣETPb dependence. The resultant Δϕ correlation is approximately symmetric about π/2, and is consistent with a dominant cos⁡2Δϕ modulation for all ΣETPb ranges and particle pT

Search for direct production of charginos and neutralinos in events with three leptons and missing transverse momentum in √s = 7 TeV pp collisions with the ATLAS detector

A search for the direct production of charginos and neutralinos in final states with three electrons or muons and missing transverse momentum is presented. The analysis is based on 4.7 fb−1 of proton–proton collision data delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with Standard Model expectations in three signal regions that are either depleted or enriched in Z-boson decays. Upper limits at 95% confidence level are set in R-parity conserving phenomenological minimal supersymmetric models and in simplified models, significantly extending previous results

Measurement of χ c1 and χ c2 production with s√ = 7 TeV pp collisions at ATLAS

The prompt and non-prompt production cross-sections for the χ c1 and χ c2 charmonium states are measured in pp collisions at s√ = 7 TeV with the ATLAS detector at the LHC using 4.5 fb−1 of integrated luminosity. The χ c states are reconstructed through the radiative decay χ c → J/ψγ (with J/ψ → μ + μ −) where photons are reconstructed from γ → e + e − conversions. The production rate of the χ c2 state relative to the χ c1 state is measured for prompt and non-prompt χ c as a function of J/ψ transverse momentum. The prompt χ c cross-sections are combined with existing measurements of prompt J/ψ production to derive the fraction of prompt J/ψ produced in feed-down from χ c decays. The fractions of χ c1 and χ c2 produced in b-hadron decays are also measured

Measurements of fiducial and differential cross sections for Higgs boson production in the diphoton decay channel at s√=8 TeV with ATLAS

Measurements of fiducial and differential cross sections are presented for Higgs boson production in proton-proton collisions at a centre-of-mass energy of s√=8 TeV. The analysis is performed in the H → γγ decay channel using 20.3 fb−1 of data recorded by the ATLAS experiment at the CERN Large Hadron Collider. The signal is extracted using a fit to the diphoton invariant mass spectrum assuming that the width of the resonance is much smaller than the experimental resolution. The signal yields are corrected for the effects of detector inefficiency and resolution. The pp → H → γγ fiducial cross section is measured to be 43.2 ±9.4(stat.) − 2.9 + 3.2 (syst.) ±1.2(lumi)fb for a Higgs boson of mass 125.4GeV decaying to two isolated photons that have transverse momentum greater than 35% and 25% of the diphoton invariant mass and each with absolute pseudorapidity less than 2.37. Four additional fiducial cross sections and two cross-section limits are presented in phase space regions that test the theoretical modelling of different Higgs boson production mechanisms, or are sensitive to physics beyond the Standard Model. Differential cross sections are also presented, as a function of variables related to the diphoton kinematics and the jet activity produced in the Higgs boson events. The observed spectra are statistically limited but broadly in line with the theoretical expectations