An Explication of Pandemic Public Health Emergency, Coronavirus Disease 2019 (COVID-19): A Review

In December 2019 a series of acute atypical respiratory disease occurred in Wuhan, China. The first clusters of cases were identified in association with the South China Seafood Market. In subsequent investigations it was found to be a novel coronavirus. It is suggested to have zoonotic origin. On December 31st 2019, China notified the outbreak to the World Health Organization. During the New Year, the massive migration of Chinese fuelled the epidemic. Cases in other provinces of China and other countries (South Korea, Thailand and Japan in quick succession) were reported in people who were returning from Wuhan. On 11 February, on the basis of existing rules on taxonomy the virus was names as SARS-CoV-2. SARS-CoV-2 belongs to the family of coronaviruses. It is a positive-sense single-stranded RNA (+ssRNA) virus. It has a single linear RNA segment. On the same day WHO announced the new name for the disease i.e. Coronavirus disease 2019 (COVID-19). The WHO and the US Centers for Disease Control and Prevention (CDC) say it is primarily spread directly due to close contact between people through small droplets produced during coughing, sneezing or talking within a range of about 1-3 meters. It may even transmit through indirect contact via fomites. While there are concerns it may spread by feces, this risk is believed to be low. Soon, the number of cases started increasing exponentially and on March 12, 2020 WHO announced COVID-19 a pandemic. COVID-19 has been impacting a large number of people worldwide, being reported in approximately 200 countries and territories. It was identified that Angiotensin converting enzyme 2 (ACE2) act as a functional receptor for SARS-CoV-2. The pathophysiology of COVID-19 follows sex differences, age differences, race differences in as well as underlying disease conditions i.e. comorbidities aggravated the severity of this disease.  The most common symptoms being reported are fever, dry cough or chest tightness, and dyspnoea. It is now widely recognized that respiratory symptoms of COVID-19 are extremely heterogeneous, ranging from minimal symptoms to significant hypoxia with ARDS. Diagnosis is done with the help of history, clinical signs and serological testing. Real-time reverse transcription polymerase chain reaction (rRT-PCR) is considered the standard method of testing. Several have been tested in clinical trials but none of them have been proven to be a definite therapy yet. The evolution of the current outbreak has seen extraordinary measures put in place to control transmission, including the ‘shut-down’ and ‘quarantine’. Researchers are trying to develop a vaccine against SARS-CoV-2 but at present, no vaccine is available. One should strictly follow all the preventive measures as directed by WHO and CDC and along with this, one should boost up its natural immunity to lessen the chances of getting infection

Neural ring homomorphism preserves mandatory sets required for open convexity

It has been studied by Curto et al. (SIAM J. on App. Alg. and Geom., 1(1) : 222 \unicode{x2013} 238, 2017) that a neural code that has an open convex realization does not have any local obstruction relative to the neural code. Further, a neural code $\mathcal{C}$ has no local obstructions if and only if it contains the set of mandatory codewords, $\mathcal{C}_{\min}(\Delta),$ which depends only on the simplicial complex $\Delta=\Delta(\mathcal{C})$. Thus if $\mathcal{C} \not \supseteq \mathcal{C}_{\min}(\Delta)$, then $\mathcal{C}$ cannot be open convex. However, the problem of constructing $\mathcal{C}_{\min}(\Delta)$ for any given code $\mathcal{C}$ is undecidable. There is yet another way to capture the local obstructions via the homological mandatory set, $\mathcal{M}_H(\Delta).$ The significance of $\mathcal{M}_H(\Delta)$ for a given code $\mathcal{C}$ is that $\mathcal{M}_H(\Delta) \subseteq \mathcal{C}_{\min}(\Delta)$ and so $\mathcal{C}$ will have local obstructions if $\mathcal{C}\not\supseteq\mathcal{M}_H(\Delta).$ In this paper we study the affect on the sets $\mathcal{C}_{\min}(\Delta)$ and $\mathcal{M}_H(\Delta)$ under the action of various surjective elementary code maps. Further, we study the relationship between Stanley-Reisner rings of the simplicial complexes associated with neural codes of the elementary code maps. Moreover, using this relationship, we give an alternative proof to show that $\mathcal{M}_H(\Delta)$ is preserved under the elementary code maps

A prospective study of acceptability, safety and demographic profile for post placental intrauterine contraceptive device

Background: The objective of this study was to study the acceptance rate, safety, demographic profile and complication of post placental intrauterine contraceptive device (PPIUCD).Methods: Study was prospective, interventional study, held in department of Obstetrics and Gynaecology at authors tertiary care centre.  Number of participants was 280. Counselling about family planning was done in antenatal OPD and indoor ward. Total duration of study was 18 months. Selection of participants done based on selection criteria. Participants who accepted postplacental   intrauterine contraceptive device as method of contraception followed up to 6 weeks postnatal for complication related to PPIUCD.Results: Authors noted that acceptance rate of PPIUCD was 13.6% and main reason for acceptance was its long acting reversible nature and main reason for denial was ‘do not want contraception immediately’. In present study there was statistically significant association between parity and birth order. However, literacy, urban locality and employment had positive influence over acceptance.  If good technique of insertion will be used than expulsion rate will also reduce as seen in present study i.e. expulsion rate only 2.6 %.Conclusions: Post placental intrauterine contraceptive device is one of the best long acting reversible contraceptive methods. It does not affect breast milk production. Woman does not need extra visit to clinic for contraception and she is ensured that she has adequate contraception before getting discharge from hospital. PPIUCD provide adequate birth spacing between two children which reduces maternal and child morbidity

Audit on maternal mortality in a tertiary care centre in India of 6 years, a retrospective analysis

Background: This study is carried out on 382 cases of maternal deaths from July 2010 to June 2016 at the department of obstetrics and gynaecology of tertiary centre to evaluate causes and risk factor associated with maternal deaths.Methods: Retrospective analysis of all maternal deaths occurred in department of obstetrics and gynaecology of tertiary care hospital from July 2010 to June 2016.Results: The MMR in the study period was 915/100000 live births. Maximum no. of maternal death 42.7% were in age group of 21-25 years, majority of them residing in urban area. 117 patients referred from sub-district/district hospital. 76.4% patients were registered. 60% maternal deaths were seen in postnatal period. In present study majority of maternal deaths 60% were due to indirect cause while 40% patients died due to direct cause. Major causes of maternal deaths were hypertensive disorder 12%, obstetric haemorrhage 11% tuberculosis 11%, hepatitis E 8% and pregnancy related infections 5.6%.Conclusions: High maternal mortality can be due to the fact that the study was conducted in tertiary care referral centre. Referral of moribund cases from rural, sub-district, district and peripheral hospital to our institute have inflated this mortality ratio. All of these being preventable causes of death can be avoided by improving standard of obstetric care, increasing number of health professionals, upgradation of healthcare facilities at first referral units and by making better health policies