Transmission Dynamics Model of Coronavirus COVID-19 for the Outbreak in Most Affected Countries of the World

The wide spread of coronavirus (COVID-19) has threatened millions of lives and damaged the economy worldwide. Due to the severity and damage caused by the disease, it is very important to fore-tell the epidemic lifetime in order to take timely actions. Unfortunately, the lack of accurate information and unavailability of large amount of data at this stage make the task more difficult. In this paper, we used the available data from the mostly affected countries by COVID-19, (China, Iran, South Korea and Italy) and fit this with the SEIR type model in order to estimate the basic reproduction number R_0. We also discussed the development trend of the disease. Our model is quite accurate in predicting the current pattern of the infected population. We also performed sensitivity analysis on all the parameters used that are affecting the value of R0

The role of microvascular endothelial dysfunction and genetics on severity and progression of primary open angle glaucoma in Malays

There is lack of knowledge of clinical presentation and risk factor for primary open angle glaucoma (POAG) in Malays. Identification of the risk factors for severity and progression of POAG in Malays is important to strategies prevention of blindness and effective management. This study was conducted to determine the severity and progression of POAG in Malay patients and to determine the role of microvascular endothelial function and genetics in progression and severity of POAG. A cross-sectional study was conducted involving 215 Malay (114 POAG patients and 101 controls) subjects. Progression was determined based on Humphrey visual field analysis (HVF) of 114 POAG patients using combination criteria of Advanced Glaucoma Intervention Study (AGIS) scoring and Hodapp, Parish and Anderson classification. Severity of POAG was based on modified AGIS scoring of HVF. Microvascular endothelial function was assessed using Laser Doppler Fluximetry (LDF) with the process of acetylcholine (ACh) and sodium nitroprusside iontophoresis. Venesection was also conducted. High purity genomic DNA was extracted. Microarray Human Omni Express-12 platform was used to identify genetic markers. rs1392912 and rs1660029 from KALRN gene, and rs1210977of COL9A1 gene were identified as potential markers for progression and microvascularendothelial function. These single nucleotide polymorphisms (SNPs) were then subjected to DNA sequencing. After the mean 4.1(3.0) years of follow up, 35 patients showed evidence of visual field progression. Based on HVF at recruitment, 55 patients were mild, 29 moderate and 30 severe POAG. There was significant reduction of microvascular endothelial function in POAG patients compared to control (p<0.001)). ACh and sodium nitroprusside response was significantly reduced in severe POAG (p<0.001). There was significant reduction of microvascular endothelial function in patients who showed visual field progression (p<0.001). The risk of progression is 4.8 folds (95% CI 1.52, 14.86) in patients with rs1392912GA and 5.8folds (95% CI 1.85, 18.61) in patients with rs1660029AG. However, there was no association betweenrs1210977 of COL9A1 and microvascular endothelial function of Malay patients with POAG The progression rate of POAG in Malay patients was 8.5 patients/year. Microvascular endothelial function play a role in progression and severity of POAG in Malays. rs1392912GA and rs1660029AG of KALRN gene are potential genetic markers for progression of glaucoma. Perhaps, improvement in microvascular endothelial function and early detection of patients with genetic variations of KALRN gene may retard the progression of POAG in Malays

Optimal Control Analysis of Ebola Disease with Control Strategies of Quarantine and Vaccination

The 2014 Ebola epidemic is the largest in history, affecting multiple countries in West Africa. Some isolated cases were also observed in other regions of the world

Analysis of a Mathematical Model of Emerging Infectious Disease Leading to Amphibian Decline

We formulate a three-dimensional deterministic model of amphibian larvae population to investigate the cause of extinction due to the infectious disease. The larvae population of the model is subdivided into two classes, exposed and unexposed, depending on their vulnerability to disease. Reproduction ratio ℛ0 has been calculated and we have shown that if ℛ01, we discussed different scenarios under which an infected population can survive or be eliminated using stability and persistence analysis. Finally, we also used Hopf bifurcation analysis to study the stability of periodic solutions

Frequency of Surgical Impactions of Mandibular Third Molar in Orthodontic Patients with Different Antegonial Notching

Background: Few studies have been reported so far on the frequency of lower third molar impactions in patients with different morphological characteristics. Our aim in this study was to find out the frequency of impacted lower third molars in orthodontic patients with different antegonial notch depths. Material and Methods: This cross-sectional research was conducted at Orthodontics Department of Dental Section, Faisalabad Medical University, Faisalabad, and de’Montmorency College of Dentistry, Lahore, Pakistan from June 2017 to June 2019. A total of 60 orthopantomograms (OPGs) of patients with impacted lower third molars were included. The depth of antegonial notch was calculated on all the selected OPGs by measuring distance between the deepest area of the notch cavity and the tangent on the inferior border of the mandible. The patients with depth of antegonial notch of 1 mm or less were labeled as having shallow antegonial notch, while those with 3 mm or more were considered as having deep antegonial notch. Percentages and mean + SD were calculated for different variables. Depth of antegonial notching was compared between genders using ANOVA with P-value &lt;0.5 considered as significant. Results: Of 60 orthodontic patients, there was an equal number of male and female patients (n=30). The average age of the patients was 25.5±4 years. Overall frequency of impactions was similar in both the genders and frequency of impacted lower third molars was found to be greater in patients with deeper antegonial notches. Conclusion: Mandibular third molar impactions were most frequent in orthodontic patients with deep antegonial notche

SURVEY BASE STUDY ON CURRENT TREND OF TREATMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN KARACHI

Objective: Community-acquired pneumonia (CAP) is a potentially serious infection that results in various general physicians (GP) visits and hospital admission every year. The prime objective of this research was to find the current trend of treatment of community-acquired pneumonia in Karachi.Methods: It was a prospective survey conducted in all districts of Karachi. A Questionnaire was filled by distinctive specialities of doctors in an outpatient setting in Karachi. A preliminary test questionnaire was used to collect the data directly from distinctive specialities of doctors in outpatient setting in Karachi. Total 500 doctors were selected from distinct districts of Karachi with convenient random sampling.Results: Majority (33.8%) of the respondents recommended complete blood count and chest x-ray for diagnosis of community-acquired pneumonia in an outpatient setting. Most (76%) of the respondents recommended nebulization for the management of community-acquired pneumonia in an outpatient setting. 31% and 25.4% of the physicians recommended clarithromycin as 1st line antibiotic therapy in adults and children for the management of a community-acquired pneumonia patients in outpatient setting.55.6% of the physicians recommended two-week duration of antibiotic therapy for the management of CAP in outpatient setting.Conclusion: This is clearly indicated by this study that deviation from the standard guideline is observed in the management of community-acquired pneumonia in Karachi. These deviations from the highly recommended guideline can results excess cost and inappropriateness of the management of the disease of community-acquired pneumonia. There is a need that the physician should take a decision of therapy according to the standard guidelines for the treatment of CAP in an outpatient setting.Â

Mandibular Third Molars and Lower Anterior Crowding: Comparison of Opinions of Oral-Maxillofacial Surgeons and Orthodontists

Objective: To compare the opinion of orthodontists and oral-maxillofacial surgeons on relation between erupting mandibular third molars and lower incisal crowding.Patients and Methods: This descriptive study involved 100 Pakistani clinicians (50 orthodontists, 50 oral-maxillofacial surgeons) to answer online questionnaire regarding their opinions on link between erupting Mandibular Third Molars along with their extraction opinion with reference to development and prevention of lower incisal crowding. Data was analyzed using SPSS version 21.0. Pearson's chi-square test was applied and statistical significance was defined at &lt;=0.05.Results: Statistically insignificant differences were found between oral-maxillofacial surgeons and orthodontists regarding question of erupting mandibular third molars in causing lower incisal crowding. Similarly, statistically insignificant differences between oral-maxillofacial surgeons and orthodontists were found regarding question of recommending preventive extraction of mandibular third molars for developing lower incisal crowding.Conclusion: No opinion differences were observed between Pakistani oral surgeons and orthodontists, regarding the link of lower third molar as a cause of lower incisal crowding

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020