COVID-19 infection during pregnancy - maternal and perinatal outcomes: a tertiary care centre study

Background: With the exponential increase in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) worldwide, an increasing proportion of pregnant women are now infected during their pregnancy. The knowledge gained from previous human coronavirus outbreaks suggests that pregnant women and their fetuses are particularly susceptible to poor outcomes. The aim of this study was to summarize the maternal and perinatal outcomes of pregnant women infected with COVID-19 during their pregnancy.Methods: Eligibility criteria included pregnant women positive for COVID-19 as detected by real-time polymerase chain reaction (PCR) or dual fluorescence PCR-confirmed SARS-CoV-2 infection.Results: A total of 38 pregnant women positive for COVID-19 as confirmed by RT-PCR, were included in the study. 21% cases had preterm deliveries and LSCS was the preferred mode of delivery in 23 of 38 i.e., 60.5% cases. There was a tendency for low Apgar score at birth, higher rates of fetal distress, meconium, NICU admissions. There was one IUD and one neonatal death. The treatment patterns of COVID-19 infection among pregnant women during their pregnancy or following delivery was mostly supportive in the form of oxygen and antibiotic therapy.Conclusions: Although the majority of mothers were discharged without any major complications, severe maternal morbidity as a result of COVID-19 and perinatal deaths were reported. Vertical transmission of the COVID-19 could not be ruled out. Pregnant infected women had different symptoms, and they were given mostly supportive treatments than the general infected population. Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection are warranted

Cholestasis of pregnancy: effects on maternal and fetal outcome

Background: Intrahepatic cholestasis of pregnancy (ICP) typically occurs in late pregnancy affecting 1.5-2% pregnancies. Limited data is available regarding its fetal and maternal implications. This study aims to assess the impact of ICP on maternal and fetal outcome.Methods: A total 200 patients with pruritus in later half of pregnancy were studied over a period of 18 months out of which 135 were diagnosed as ICP. Clinical and biochemical parameters like serum aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total protein, and gamma glutamyl transferase was recorded. Maternal and fetal outcome was noted in the form of LSCS rate, preterm births, fetal distress and neonatal ICU admissions.Results: In this study, most common symptom was pruritus. Most of cases had onset of symptoms between 32-36 weeks. High LSCS rates were seen among cases. Intrapartum complications viz. meconium staining of amniotic fluid (57.8%), preterm delivery (11.9%), fetal distress (42.2%) were significantly higher in study population and there was high incidence of NICU admissions (49. 6% neonates) among cases mostly due to meconium aspiration and prematurity.Conclusions: ICP increases maternal morbidity and is associated with adverse perinatal outcome viz. increased risk of fetal distress, preterm births and sudden IUD at term as evidenced in this study. A timely intervention at 37-38 weeks will reduce the adverse outcomes

CASTLEMAN DISEASE: A GREAT MIMICKER OF METASTASES IN RADIOIODINE REFRACTORY THYROID CANCER

A 27-year-old male underwent total thyroidectomy for thyroid swelling. Histopathology showed papillary thyroid carcinoma [T3 - 6.0 cm] with extra-thyroidal extension. The patient was treated with 150 mCi radioactive iodine(RAI) as adjuvant ablative therapy. Radioiodine refractory disease was identified 1-year post-RAI therapy with elevated thyroglobulin levels and negative I-131 whole body scan. F-18 FDG positron emission tomography/computedtomography scan showed activity in the right thyroid bed and multilevel right cervical nodes. Right-sided modified neck dissection was done, which showed Castleman disease (hyaline vascular type) in right cervical nodes. The most probable cause of elevated tumour markers was found out to be 0.6 cm right thyroid bed nodule on follow-up ultrasonography. Our patient also had coexistent conditions as; osteopoikilosis and Hepatitis C along with thyroid carcinoma.Key words: Castleman disease, lymph node, radioiodine, thyroid cance

DETERMINANTS OF MANUFACTURED GOODS EXPORTED FROM PAKISTAN:

This study determined the impact of foreign direct investment (FDI) along with other factors on exports of manufactured goods in Pakistan. The study employed time series data from 1990 to 2010. We applied ARDL approach to estimate the determinants of manufactured goods exported from Pakistan. Results showed that FDI, agriculture value added and technology have positive and significant impact on manufactured exports of Pakistan, while real effective exchange rate showed in negative and significant impact on manufactured exports from Pakistan. So, better environment for attracting FDI, investing in agriculture, value addition and introducing the latest technology in the country would further improve the exports of manufactured goods from the country

Epidemiology of prediabetes and prehypertension-progression, regression and interaction

Background: The major portion of the non-communicable diseases is formed by cardiovascular diseases. The two major modifiable risk factors are hypertension and diabetes. The probable CVD risk with pre-hypertension and pre-diabetes, to some extent, is dependent on whether pre-HTN leads to hypertension and pre-DM leads to diabetes. Our aim was to study: the progression of prehypertension and prediabetes to overt hypertension and diabetes or to normal status, and the association of pre-obesity and obesity with prehypertension and prediabetes. Methods: A total of 1200 patients equally distributed among three groups were studied for progression or regression. Group A included 400 patients of pre-hypertension, and group B included 400 patients of pre-diabetes and group C included 400 patients of pre-diabetes and pre-hypertension. Results: Among the 400 studied patients with prediabetes 31 (7.8%) progressed to diabetes and only 9 (2.3%) progressed to hypertension over a period of two years. Patients with both prehypertension and prediabetes had a higher risk of progression to hypertension and diabetes (3% to hypertension and 15.5% to diabetes). Males were more prone to develop both pre-hypertension and pre-diabetes mellitus and progression. Obesity increased the risk of progression to hypertension and diabetes significantly. Conclusions: The screening of people for pre-diabetes mellitus and pre-hypertension should be carried out at mass levels so as to diagnose them at an early stage and hence, their progression can be either halted or modified

Peranan Penyederhana Jarak Kuasa Terhadap Hubungan Kepercayaan Organisasi Dan Perilaku Mendiamkan Diri Dan Bersuara Pekerja (Relationship between Organizational Trust, Employee Voice and Silence Behaviour: The Moderator Effect of Power Distance)

Kajian lepas mendapati faktor organisasi dan budaya yang diamalkan mempunyai pengaruh terhadap perilaku mendiamkan diri dan bersuara dalam kalangan pekerja. Walau bagaimanapun, kajian berkaitan dengan perilaku dan berdiam diri ini lebih banyak dijalankan di Barat, yang mempunyai dimensi budaya yang berbeza. Justeru, dapatan kajian di Barat mungkin tidak dapat diaplikasikan sepenuhnya dalam konteks Asia. Oleh itu, kajian ini bertujuan untuk mengkaji hubungan antara kepercayaan organisasi (percaya terhadap organisasi, percaya terhadap ketua, percaya terhadap penyelia) dengan perilaku mendiamkan diri dan bersuara dalam kalangan pekerja. Turut dikaji ialah dimensi budaya, jarak kuasa sebagai penyederhana untuk hubungan kepercayaan organisasi dan perilaku mendiamkan diri dan bersuara oleh pekerja. Kaedah kuantitatif digunakan dalam kajian ini. Kajian ini melibatkan sebanyak 111 orang responden daripada industri pembuatan yang dianalisa menggunakan IBM SPSS versi 22.0 dan SmartPls 3.0. Hasil kajian mendapati jarak kuasa hanya mengukuhkan hubungan antara kepercayaan organisasi dengan perilaku bersuara serta hubungan percaya terhadap ketua dan penyelia berbanding perilaku mendiamkan diri dalam kalangan pekerja. Oleh itu, penekanan dalam isu kepercayaan organisasi perlulah diberikan perhatian kerana mampu mempengaruhi tingkah laku individu di tempat kerja

Quantitative assessment on remote code execution vulnerability in web apps

With the exponential increasing use of online tools, applications that are being made for day to day purpose by small and large industries, the threat of exploitation is also increasing. Remote Code Execution (RCE) is one of the top most critical and serious web applications vulnerability of this era and one of the major concerns among cyber threats ,which can exploit web servers through their functionalities and using their scripts/files. RCE is an application layer vulnerability caused by careless coding practice which leads to a huge security breach that may bring unwanted resource loss or damages. Attacker may execute malicious code and take complete control of the targeted system with the privileges of an authentic user with this vulnerability. Attackers can attempt to advance their privileges after gaining access to the system. Remote Code Execution can lead to a full compromise of the vulnerable web application as well as the web server. This chapter highlights the concern and risk needed to put under consideration caused by RCE vulnerability of a system. Moreover, this study and its findings will help application developers and its stakeholders to understand the risk of data compromise and unauthorized access of the system. Around 1011 web applications were taken under consideration and experiment was done by following manual double blinded penetration testing strategy. The experiments shows that more than 12% web application were found vulnerable with RCE. This study also explicitly listed down the critical factors of Remote Code Execution vulnerability and improper input handling. The experimental results are promising to motivate developers to focus on security enhancement through proper and safe input handling

Doe guided chitosan based nano-ophthalmic preparation against fungal keratitis

A recent upsurge in ocular infections is a pointer towards an enhanced prevalence of ophthalmic disorders, posing challenges for researchers globally. The caveats of conventional therapeutics demand a specifically designed Ocular Drug Delivery System (ODDS) and hence the primary objective of the present work is a fabrication of a Design of Expert (DoE) guided Chitosan based Antifungal loaded Nanoparticles (CANs), as a locoregionally effective eye formulation/drops for fungal keratitis therapy. The purported formulation was prepared using High-Pressure Homogenisation technique and was critically characterized on various parameters to check their suitability as an ODDS. The optimized formulation has fruitfully yielded irregularly spherical particles in up to a size of 200 nm and a Poly-dispersity Index (PDI) of less than 0.2 nm. The optimised formulation has further showcased a high mucoadhesion capacity thereby, suggesting the greater retention of CANs on the mucous membrane of an eye with low ocular irritancy as highlighted using HET-CAM (Hen's Egg Chorioallantoic Membrane) test. The in-vitro drug release study across a dialysis membrane has indicated both diffusion as swelling controlled release pattern for an optimized formulation. The ex-vivo corneal permeation study on goat corneal tissues using a Franz-Diffusion cell also has indicated a steady increase in the permeation of drug with time for an optimized formulation. Further, the optimised formulation was found to be non-irritant and ocular safe in ex-vivo transcorneal toxicity studies on goat corneal tissues. In conclusion, the designing of a proposed nanosized formulation, offers a promising step towards the management of external ocular diseases with a positive attributes of high patient compliance, controlled drug delivery, prolonged drug precorneal residence time and enhanced ocular bioavailability. The optimized CANs could be further exploited as a potential ODDS

Attitude and perception towards vaccination against poliomyelitis in Peshawar, Pakistan

OBJECTIVE: This research aimed to quantitatively assess the general public's awareness, attitude and perception of polio and its vaccination in Peshawar KPK, Pakistan. METHODS: We conducted a survey-based study to understand the surge in polio cases from 2015 to 2019 in the Peshawar city of the Khyber Pakhtunkhwa (KPK), Pakistan. A pre-tested questionnaire-based study was conducted in 2019 to assess the attitude and general perception of residents of Peshawar KPK towards polio vaccination. RESULTS: Out of 241 country-wide polio cases, 63 (26.1%) polio cases were reported in Peshawar city from 2015–2019. The questionnaire revealed that individuals between 18–30 years of age had sufficient knowledge (65.1%) about polio. Male and female participants had equal awareness (~ 43%). Participants with higher education (45.9%), those with better financial status (49.5%), individuals with children < 5 years of age (46.4%), and those who had experience of a polio patient (63.1%) had better knowledge. Participants inhabiting the central city were better aware (50.5%) of polio than individuals living in the outskirts. CONCLUSION: The data indicated that poor knowledge and negative attitudes of people towards polio vaccination are the main causes of the polio eradication program's failure. Moreover, religious beliefs, unchecked migration between the Pak-Afghan border, and lack of knowledge about polio vaccination are identified as critical barriers to polio eradication

Environmental study on water quality of Mayur River with reference to suitability for irrigation

ABSTRACT The farmers residing in the western fringe of Khulna city in Bangladesh use the sewage-fed water of the Mayur River for irrigation as good quality surface water is not available as well as higher cost in groundwater irrigation. The present study was undertaken to evaluate the suitability of this river water for irrigation during the hot summer months (March to May) since this period is more sensitive to crop agriculture in the study area. A total of 30 water samples, 10 in each month from 10 stations, were collected and analyzed for pH, EC, TDS, major cations (Na, K, Ca, Mg) and anions (Cl, HCO 3 , NO 3 , PO 4 , SO 4 ), Chemical data were used for calculation of SAR, Na%, RSC, PI, KI and MR for better understanding the suitability of river water for irrigation use. Wilcox diagram and USSL diagram were also adopted in the present study to verify the suitability of river water quality for irrigation. The results revealed that water of the Mayur River was alkaline in nature like major world rivers. Sodium was the most dominant cation throughout the sampling period, whereas sulfate was the most dominat anion in March and May, and chloride in April. The river water was found to be safe for irrigation with respect to pH and PI. However, some usual and calculated parameters like EC, TDS, hardness, alkalinity, chloride, sulfate, nitrate, sodium, Na%, SAR, KI, MR and Ca/Mg restricted the Mayr River water for use in irrigation. The RSC values indicated the water to be safe during April and May and permissible to severe in March. The USSL and Wilcox diagrams indicated high salinity in the water with high sodium being unsuitable for irrigation. The findings call for an immediate management plan to protect this invaluable resource