A Case Report Of COVID-19 Re-Infection

Spectrum of coronavirus disease continues to unfold as time passes. It has created health and economic crisis all over the world. Being a new virus, means less information on behavior and a lot to learn for its immunity. It was assumed initially that reinfection was less likely. Once exposed, we will develop antibodies and will be safe. But now we have a case of Covid-19 reinfection, depicting that despite of exposure and having IgG Antibody titer, reinfection occurred within 6 months. &nbsp

Evaluating motor performance with the Bruininks-Oseretsky test of motor proficiency in impoverished Pakistani children

Objective: To evaluate the sensitivity of the modified Brief Form of Bruininks Oseretsky Test in identifying motor differences secondary to malnutrition and poverty.Methods: This longitudinal cohort study was conducted at Nowshero Feroze, Sindh from 2013 to 2014 and comprised data drawn from children who participated in a randomised controlled trial, that assessed responsive stimulation and nutrition interventions in the first two years of life. Outcome measures included motor development assessed using Brief Form of Bruininks Oseretsky Test, child anthropometry and household economic and demographic information. Data was analysed using SPSS 15 and STATA 12.Results: Of the 1058 children, 570(53%) were boys. Moderate-severe stunting was reported in 171(16.12%) subjects, while moderate-severe underweight was reported in 117(11.1%). Also, 591(56%) subjects belonged to poor families, 343(32%) had illiterate mothers, and 392(37%) were food-insecure. Malnutrition, socio-economic status and maternal literacy were significantly associated with a 6-item motor composite of the Brief Form of Bruininks Oseretsky Test (p\u3c0.05).Conclusions: The 6-item motor composite of the Brief Form of Bruininks Oseretsky Test was found to be a reliable tool to measure motor performance in Pakistani pre-school children

Frequency of colistin and fosfomycin resistance in carbapenem-resistant Enterobacteriaceae from a tertiary care hospital in Karachi

Introduction: Management of infections with carbapenem-resistant Enterobacteriaceae (CRE) is challenging. In recent times, agents such as colistin and fosfomycin have been used in combination with other antibiotics to treat such infections. In this study, we aim to seek frequency of colistin and fosfomycin resistance in CRE from Pakistan. Methods: This study was conducted at clinical laboratories, Aga Khan University Hospital. In total, 251 CRE were included in the study. Colistin minimum inhibitory concentrations (MICs) were performed using broth microdilution (BMD) method and VITEK 2 system, whereas fosfomycin susceptibility was performed using Kirby-Bauer method. MIC50 and MIC90 were calculated for colistin and agreement between VITEK and BMD was also calculated. Results: Out of 251 strains colistin MIC of ≥4 g/mL was seen in 40 (15.9%). Of these strains 20 (50%) were Klebsiella pneumoniae. Colistin MIC50 and MIC90 were found to be 0.5 and 16 g/mL, respectively. BMD and VITEK 2 showed 100% categorical agreement. Essential agreement was 88.5% with kappa score 0.733 indicating strong agreement between VITEK and BMD. 31 out of 251 (12.3%) CREs were resistant to fosfomycin. Conculsion: Study shows frequency of colistin and fosfomycin resistance to be 15.9% and 12.3%, respectively. In countries where rate of CREs is high, emerging resistance against these last resort antibiotics is alarming as it leaves clinicians with almost no options to manage such multidrug resistant and extensively drug resistant infections

Discrepancy between PCR based SARS-CoV-2 tests suggests the need to re-evaluate diagnostic assays

Objective: We investigated the discrepancy between clinical and PCR-based diagnosis of COVID-19. We compared results of ten patients with mild to severe COVID-19. Respiratory samples from all cases were tested on the Roche SARS-CoV-2 (Cobas) assay, Filmarray RP2.1 (bioMereiux) and TaqPath™ COVID19 (Thermofisher) PCR assays.Results: Laboratory records of ten patients with mild to severe COVID-19 were examined. Initially, respiratory samples from the patients were tested as negative on the SARS-CoV-2 Roche® assay. Further investigation using the BIOFIRE® Filmarray RP2.1 assay identified SARS-CoV-2 as the pathogen in all ten cases. To investigate possible discrepancies between PCR assays, additional testing was conducted using the TaqPath™ COVID19 PCR. Eight of ten samples were positive for SARS-CoV-2 on the TaqPath assay. Further, Spike gene target failures (SGTF) were identified in three of these eight cases. Discrepancy between the three PCR assays could be due to variation in PCR efficiencies of the amplification reactions or, variation at primer binding sites. Strains with SGTF indicate the presence of new SARS-CoV-2 variant strains. Regular modification of gene targets in diagnostic assays may be necessary to maintain robustness and accuracy of SARS-CoV-2 diagnostic assays to avoid reduced case detection, under-surveillance, and missed opportunities for control

Global variation of COVID-19 mortality rates in the initial phase

Objective: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused devastation in over 200 countries. Italy, Spain, and the United States (US) were most severely affected by the first wave of the pandemic. The reasons why some countries were more strongly affected than others remain unknown. We identified the most-affected and less-affected countries and states and explored environmental, host, and infrastructure risk factors that may explain differences in the SARS-CoV-2 mortality burden.Methods: We identified the top 10 countries/US states with the highest deaths per population until May 2020. For each of these 10 case countries/states, we identified 6 control countries/states with a similar population size and at least 3 times fewer deaths per population. We extracted data for 30 risk factors from publicly available, trusted sources. We compared case and control countries/states using the non-parametric Wilcoxon rank-sum test, and conducted a secondary cluster analysis to explore the relationship between the number of cases per population and the number of deaths per population using a scalable EM (expectation-maximization) clustering algorithm.Results: Statistically significant differences were found in 16 of 30 investigated risk factors, the most important of which were temperature, neonatal and under-5 mortality rates, the percentage of under-5 deaths due to acute respiratory infections (ARIs) and diarrhea, and tuberculosis incidence (p \u3c 0.05).Conclusion: Countries with a higher burden of baseline pediatric mortality rates, higher pediatric mortality from preventable diseases like diarrhea and ARI, and higher tuberculosis incidence had lower rates of coronavirus disease 2019-associated mortality, supporting the hygiene hypothesis

Comparison of radiation therapy alone and concurrent chemoradiation therapy for in operable cervical cancer

Objectives: Concurrent chemoradiation therapy (CCRT) is the standard treatment for inoperable cervical cancer. The purpose of this study was to compare the outcomes of CCRT with cisplatin and radiotherapy (RT) for inoperable cervical cancer. Methods: From January 2O12 to June 2012, 60 female patients with FIGO stage IIB to IVA were enrolled in this randomized phase III trial to compare radiotherapy (RT) alone with chemo radiotherapy (RT 5 Fraction in a week and Cinplatin 40 mg weekly). External beam radiation therapy was delivered using a telecobalt-60 unit. This was followed by 21 Gy of intracavitary brachytherapy. Results: In total, 30 patients were recruited: RT alone (30) and CCRT (30). The age of patients ranged from 26-65 years. There was statistically significant (p value < 0.037) complete response (70.00%) CCRT group vs 43.30% RT group) in CCRT group. Conclusion: CCRT was seen to have better efficacy for patients with inoperable cervical cancer than RT alone.

Effects of autologous stem cell therapy for fertility enhancement among women with premature ovarian insufficiency

Background: Premature ovarian insufficiency (POI) is a condition where the ovary loses its normal reproductive potential earlier than 40 years, compromising fertility. There is no treatment for POI, only ovum or embryo donation. Autologous stem cell ovarian transplant (ASCOT) may be a procedure that creates new eggs in the ovaries of women with POI. The aim of the study was to find out the efficacy of ASCOT in patients suffering from POI. Methods: A total of 50 patients were included according to inclusion and exclusion criteria in this prospective observational study. POI was confirmed with low levels of anti-mullerian hormone (AMH) (<0.5 ng/dl), high level of follicle stimulating hormone (FSH) >25 ng/ml, and or a low number of antral follicle count (AFC) (<3 in each ovary). Results: Results showed that after stem cell therapy, mean AMH values increased by 0.48±0.306 and mean FSH values increased by 2.73±3.98 but the difference was not statistically significant. AFC values significantly decreased by 1.33±0.625 at 1st post-stem-cell cycle. During the second cycle, AMH and AFC increased by 0.110±0.051 and 4.63±1.49, respectively, and FSH decreased by 7.4±2.78. In third cycle, AMH & FSH was significantly increased by 0.820±0.44 & 4.120±0.470 and FSH has been decreased by 2.150±3.625. The increase in AMH & AFC was statistically significant, and the decrease in FSH was not statistically significant compared to baseline values. Conclusions: The study showed that autologous stem cell therapy can have a significant effect on women’s ovarian function and fertility. It showed that ASCOT can increase AMH and AFC, and decrease FSH in patients with POI, with a total pregnancy rate of 4% after the third cycle follow-up

GIS-Based Solutions for Monitoring and Controlling COVID-19 in ASHGHAL Construction Projects: Improving Construction Sector Resilience

Early in 2020, doctors around the globe identified the virus responsible for Coronavirus disease 2019 (COVID-19). Rapidly spreading, the virus reached every continent. As part of its efforts to prepare for the FIFA World Cup in 2022 and Qatar National Vision 2030, the Public Works Authority (Ashghal), the State of Qatar, is on a fast-track mission to implement major infrastructure projects to revamp roads and sewer networks. Managing the human workforce on construction project sites becomes a significant challenge considering the pandemic. Large infrastructure projects are always characterized by many workers interacting in proximity at the work site. Immediately at the pandemic's beginning, management was instructed to leverage technology to empower decision-makers with COVID-19 monitoring tools across all the infrastructure construction projects. Thus, the Engineering Services Department created an ArcGIS Dashboard for engineers, contractors, and higher management to track the construction projects' COVID-19 status. Maps and data are combined in ArcGIS Dashboards to highlight significant patterns and measures. This paper explores the workflow established with direct communication and a submission system from the contractors and project managers to help collect and monitor critical health parameters of workers to prevent the propagation of COVID-19 infection. The study concluded that implementing a GIS safety dashboard for workers can help reduce the risk of project shutdowns due to novel Coronaviruses and provide an effective tool for organizations to improve occupational health and safety standards at worksites