# ent

id: cord-017731-xzfo5jjq
type: GGP
entity:
  Clostridium botulinum mainly type E Tavakoli and Imani Fooladi 2011 The processing is insufficient to kill the


id: cord-030959-olcz7g19
type: EVENT
entity:
  the International Academic Seminar on Industrial Cooperation and Construction of Industrial Zones CPEC Peking University Beijing


id: cord-307697-ds4uw7y1
type: GGP
entity:
  Cureus DOI 10 7759 cureus 8550 sha a4fc42e77bc46a2d1d30e0e8005c34883cea0c85 doc_id 307697 cord_uid ds4uw7y1 Background The coronavirus


id: cord-285223-07o9irev
type: ORG
entity:
  Food Safety Guidance for Food Businesses Review of the Clinical Characteristics of Coronavirus Disease


id: cord-268149-narre5e7
type: CELL_LINE
entity:
  Zegie Peninsula Northwestern Ethiopia Ethnoveterinary remedies of diseases among milk yielding animals in Kathua Ethnoveterinary plants


id: cord-268149-narre5e7
type: ORG
entity:
  the Department of Botany Shaheed Benazir Bhuto University Sheringal District Dir Upper Khyber Pakhtunkhwa Pakistan Species


id: cord-268149-narre5e7
type: ORG
entity:
  biocontainment Institute of Medicine Microbial Threats to Health Emergence Detection and Response Medicinal


id: cord-268149-narre5e7
type: CHEMICAL
entity:
  camaldulensis Ficus carica Melia azedarach Morus indica Morus nigra Olea ferruginea Pinus roxburghii Quercus baloot and Rumex hastatus


id: cord-268149-narre5e7
type: CHEMICAL
entity:
  Acacia modesta Wall Allium cepa L Allium sativum L B rapa Calotropis procera Aiton Dryand Cannabis sativa L Chenopodium album L C longa F vulgare Juglans regia L Nicotiana tabacum L Peganum harmala L Quercus oblongata D Don Trachyspermum ammi L


id: cord-292293-tko186lh
type: ORG
entity:
  COVID 19 Health Advisory Platform by Ministry of National Health Services Regulations and Coordination Characteristics of Households and Respondents Pakistan Demographic and Health Survey


# bib

id: cord-005129-2e6b5tm2
author: Chaudhry, Mamoona
date: 2016-10-20
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7088531/
doi: 10.1007/s11250-016-1159-6
title:
  Prospective study of avian influenza H9 infection in commercial poultry farms of Punjab Province and Islamabad Capital Territory, Pakistan

abstract:
  A prospective study was conducted from November 2013 to February 2014 to estimate the spatial clustering; cumulative incidence and risk factors associated with avian influenza (AI) subtype H9 infection on commercial poultry farms of Pakistan. A total of 400 farms were enrolled and followed during the study period. Among these, 109 farms submitted samples suspected for AI to the laboratory, and only 47 farms were confirmed positive by hemagglutinin inhibition (HI) test. Data was collected from these 109 farms about their demography, management, and biosecurity practices. The cumulative incidence of H9N2 was 11.75 % (95 % confidence interval (CI) 8.76–15.23). The highest number of cases (40.42 %) was reported in January. One most likely cluster (p = 0.009, radius = 4.61 km) occurred in the Kasur district. Multivariable logistic regression analyses showed that the presence of wild birds on the farms (odds ratio (OR) = 16.18; 95 % CI 3.94–66.45) was independently associated with H9N2 infection. Cleaning of cages before delivery on farm (OR = 0.16; 95 % CI = 0.06–0.47), presence of a footbath at the entrance of farm (OR = 0.24; 95 % CI 0.08–0.79), and changing of gloves (OR = 0.33; 95 % CI 0.11–0.99) were protective factors against H9N2 infection. Reducing the exposure to risk factors and adapting biosecurity measures may reduce the risk of AI H9N2 infection on commercial poultry farms in Pakistan.


id: cord-017731-xzfo5jjq
title: Foodborne Disease in the Middle East
author: Todd, Ewen C. D.
date: 2016-11-25
txt: ./txt/cord-017731-xzfo5jjq.txt
cache: ./cache/cord-017731-xzfo5jjq.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7122377/
doi: 10.1007/978-3-319-48920-9_17
summary:
  Food safety is a concern worldwide and according to the World Health Organization, developing countries are probably more at risk of foodborne illness because many of these, including those in the Middle East, have limited disease surveillance and prevention and control strategies. Like many other parts of the developing world, foodborne disease surveillance is limited and outbreaks are most often reported through the Press but with insufficient detail to determine the etiological agents and the factors contributing to the outbreaks, leading to speculation to the cause by those interested or responsible for food prevention and control. Thus, the main foodborne disease issues are with homemade, restaurant and street food, where isolated claims of illness are followed up by inspections and possible punitive action by public health agencies responsible for food safety.

abstract:
  Food safety is a concern worldwide and according to the World Health Organization, developing countries are probably more at risk of foodborne illness because many of these, including those in the Middle East, have limited disease surveillance and prevention and control strategies. Specifically, the Middle East and North Africa (MENA) region has the third highest estimated burden of foodborne diseases per population, after the African and South-East Asia regions. However, it is difficult to determine what the burden is since little is published in peer-reviewed journals or government reports for public access. This chapter reviews 16 autonomous nations, namely, Afghanistan, Bahrain, Egypt, Iran, Iraq, Israel, Palestine, Kuwait, Lebanon, Oman, Pakistan, Qatar, Saudi Arabia (KSA), Syrian Arab Republic (Syria), United Arab Emirates (UAE) and Yemen. Countries range in size from Bahrain with 1.8 million inhabitants to Pakistan with a population of 184 million. Agriculture and local food production is much influenced by water availability for irrigation. Water shortages are most severe in the Gulf countries which rely on aquifers, desalination, and recycled waste water for most of their water supplies. This means that most food is imported which is expensive if not subsidized through petrodollars. This impacts food security which is a particular concern in countries under conflict, particularly, Syria, Yemen and Iraq. Gastrointestinal infections are frequent in this region from Salmonella Typhi and other Salmonella spp., Shigella spp., Campylobacter jejuni and C. coli, rotavirus, hepatitis A virus, parasites, and more rarely from Aeromonas, Yersinia enterocolitica, Brucella spp., and Middle East Respiratory Syndrome coronavirus (MERS-CoV). Reports indicate that children are the most susceptible and that many isolates are multidrug resistant. Chemical contamination of water supplies and crops are probably more of a concern than published reports indicate, because of widespread indiscriminate use of fertilizers, antibiotics, and pesticides, coupled with increased industrial pollution affecting the water supplies. Like many other parts of the developing world, foodborne disease surveillance is limited and outbreaks are most often reported through the Press but with insufficient detail to determine the etiological agents and the factors contributing to the outbreaks, leading to speculation to the cause by those interested or responsible for food prevention and control. However, there are some well investigated outbreaks in the region that have those details, and reveal where the shortcomings of both the establishments and the inspection systems have been. Where the causative agents are known, the kinds of pathogens are generally similar to those found in the West, e.g., Salmonella, but many outbreaks seem to have short incubation periods that point to a toxin of some kind of chemical or biological origin, but these are almost never identified. Because of sectarian warfare, residents and refugees have been given food that has made them sick and solders? have been deliberately poisoned. Research has been focused on microbial contamination of locally-sold foodstuffs and manager and employee knowledge of food safety and hygienic conditions in food preparation establishments. An innovative pilot project in Qatar is to use seawater and sunlight for raising crops through the Sahara Forest Project. All countries have some kind of food establishment inspection system, but they tend to be punitive if faults are found in management or employees on the premises rather than being used for their education for improving food safety. Restaurants may be closed down and owners and employees fined for often unspecified infringements. However, some food control agents are moving towards employee training through seminars and courses before problems occur, which is a good disease prevention strategy. Unfortunately, many of the food handlers are from Asian countries with languages other than Arabic and English, which makes effective food safety communication and training difficult. Tourists visiting popular resorts in Turkey and Egypt have suffered from foodborne illnesses, usually of unknown origin but poor hygienic conditions are blamed with law suits following, and the adverse publicity affects the long-term viability of some of these resorts. Food exports, important for local economies, have occasionally been contaminated resulting in recalls and sometimes illnesses and deaths, notably fenugreek seeds from Egypt (E. coli O104:H4), pomegranate arils from Turkey (hepatitis A virus), and tahini from Lebanon (Salmonella). Overall, in recent decades, the Middle East has made strides towards improving food safety for both residents and foreign visitors or ex-pat workers. However, within the countries there are large discrepancies in the extent of effective public health oversight including food safety and food security. Currently, almost all of the countries are involved to a greater or lesser extent in the civil wars in Syria and Yemen, or are affected through political tensions and strife in Egypt, Iraq, Iran, Israel, Palestine, Lebanon and Turkey. In addition, the current overproduction of oil on a world-wide scale has led to a rapid decrease in revenues to most Gulf states. All this points to a severe setback, and an uncertain foreseeable future for improvements in obtaining both sufficient and safe food for residents in this region.


id: cord-025667-ta7n2u31
title: Medical Journal Publishing: Continued struggle is essential to Achieve and maintain standards
author: Jawaid, Shaukat Ali
date: 2020
txt: ./txt/cord-025667-ta7n2u31.txt
cache: ./cache/cord-025667-ta7n2u31.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260890/
doi: 10.12669/pjms.36.4.2685
abstract: nan
summary:
  Over the years the number of submissions from China, Iran has drastically reduced simply because we are more careful, selected only good quality manuscripts besides encouraging the authors to publish their manuscripts in their local journals. A further analysis of submission from Pakistan revealed that maximum number of manuscripts was submitted from Karachi followed by Lahore, Peshawar and Rawalpindi despite the fact that a large number of medical journals are also published from these cities but it is also a fact that more research work is also undertaken in these cities for various reasons. Since the objective of the Journal and its Editorial team is not just to accept, reject and publish papers but also teach and train the authors, Editorial team of Pakistan Journal of Medical Sciences has been actively participating in organizing as well as facilitating workshop on Scientific Writing, Peer Review and training courses on Journal publishing not only in Pakistan but in the EMRO region as well.


id: cord-030959-olcz7g19
title: China–Pakistan Economic Cooperation: The Case of Special Economic Zones (SEZs)
author: Hussain, Ejaz
date: 2020-08-28
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7453185/
doi: 10.1007/s40647-020-00292-5
abstract:
  This article attempts to underscore the extraordinary significance of Special Economic Zones (SEZs) in the industrialization and economic growth of Pakistan as well as the development and consolidation of China–Pakistan Economic Corridor (CPEC)—which is a core component of the Belt and Road Initiative (BRI). Though Pakistan has previously experimented with SEZs, its scale, outreach and impact on the country’s economy and society remained very limited. Thus, the proposed SEZs under the CPEC offer new opportunities for mutual economic cooperation, investment, human resource development, sustained industrialization and, above all, the consolidation of CPEC. Nevertheless, there are several challenges ranging from structural issues to security problems that the proposed SEZs, in particular, and CPEC, in general, face. The article, thus, provides a comprehensive set of strategies to convert challenges into capabilities.


id: cord-034495-gvtv8o96
author: Hussain, Kashif
date: 2020-11-02
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7604651/
doi: 10.1186/s40545-020-00277-5
title:
  Pharmacy services during COVID-19 pandemic: experience from a tertiary care teaching hospital in Pakistan

abstract:
  The coronavirus disease 19 (COVID-19) is rapidly spreading across the world. Pharmacy services play a vital role in public health in preventing and containing the COVID-19 pandemic. All over the world, especially in the developed countries pharmacists have responded smartly and speedily for public health, such as establishing professional protective and service guidance for pharmacy staff and services, creating and updating drug formularies, addressing the issues of drug shortages, providing public education for prevention and management of infection, contributing in drug evaluation and clinical trials. In this commentary, we review the exclusive demands from pharmacy services in Pakistan during coronavirus disease 2019 pandemic and sharing the responses of our hospital pharmacy to these demands and needs with the international pharmacy community, especially of the low and middle-income countries like Pakistan.


id: cord-117800-jzokod4q
author: Umer, Hamza
date: 2020-06-04
url: https://arxiv.org/pdf/2006.02987v1.pdf
doi: nan
title:
  Evaluating the Effectiveness of Regional Lockdown Policies in the Containment of Covid-19: Evidence from Pakistan

abstract:
  To slow down the spread of Covid-19, administrative regions within Pakistan imposed complete and partial lockdown restrictions on socio-economic activities, religious congregations, and human movement. Here we examine the impact of regional lockdown strategies on Covid-19 outcomes. After conducting econometric analyses (Regression Discontinuity and Negative Binomial Regressions) on official data from the National Institute of Health (NIH) Pakistan, we find that the strategies did not lead to a similar level of Covid-19 caseload (positive cases and deaths) in all regions. In terms of reduction in the overall caseload (positive cases and deaths), compared to no lockdown, complete and partial lockdown appeared to be effective in four regions: Balochistan, Gilgit Baltistan (GT), Islamabad Capital Territory (ICT), and Azad Jammu and Kashmir (AJK). Contrarily, complete and partial lockdowns did not appear to be effective in containing the virus in the three largest provinces of Punjab, Sindh, and Khyber Pakhtunkhwa (KPK). The observed regional heterogeneity in the effectiveness of lockdowns advocates for a careful use of lockdown strategies based on the demographic, social, and economic factors.


id: cord-221652-rsxw0q0e
title: Effect of Lockdown on the spread of COVID-19 in Pakistan
author: Farooq, Fizza
date: 2020-05-18
url: https://arxiv.org/pdf/2005.09422v1.pdf
doi: nan
abstract:
  A novel coronavirus originated from Wuhan, China in late December 2019 has now affected almost all countries worldwide. Pakistan reported its first case in late February. The country went to lockdown after three weeks since the first case, when the total number of cases were over 880. Pakistan imposed a lockdown for more than a month which slowed the spread of COVID 19 effectively, however in late April relaxation in lockdown was allowed by the government in stages to lift the strain on the economy. In this study, the data has been analyzed from daily situation reports by the National Institute of Health Pakistan and the effects of initial strict lockdown and later smart lockdown have been studied. Our analysis showed a 13.14 Percentage increase in cases before lockdown which drops down to 6.55 percent during the lockdown. It proved the effectiveness of lockdown. However, the Percentage Increase in case grows up to 7.24 during a smart lockdown. If it continues to rise in this manner, Pakistan may need to enter again into a strict second lockdown.


id: cord-255376-nqq5ieyg
title: COVID‐19: A threat to educated Muslim women's negotiated identity in Pakistan
author: Safdar, Muhammad
date: 2020-05-08
url: https://doi.org/10.1111/gwao.12457
doi: 10.1111/gwao.12457
abstract:
  This study attempts to explore how the lockdown/containment measures taken by the government during the COVID‐19 pandemic have threatened educated Muslim women's negotiated identity regarding wifehood and motherhood in urban Pakistan and how they struggle to reposition to reconstruct it. Through semi‐structured interviews, making an in‐depth comparative study of three differently situated cases (Muslim women), this study argues that the abnormal situation that has ensued from the pandemic has reinforced the vulnerability of women's nascent negotiated identity by landing them in a space where they are supposed by the normative structures to step back to carrying out their traditional responsibilities as ‘good’ wife and mother during the crisis. It has found that the pandemic has similarity in its impacts for the women in their familial lives, despite their being variously situated and resistive, due to the general religio‐culturally defined patriarchal social behaviour of the place (Pakistan) toward women and lack of action on the part of the state for implementing its laws of women's empowerment.


id: cord-256676-b7p92sb1
title: Estimation of the Final Size of the COVID-19 Epidemic in Pakistan
author: Syed, Faiza
date: 2020-04-06
url: https://doi.org/10.1101/2020.04.01.20050369
doi: 10.1101/2020.04.01.20050369
abstract:
  The COVID-19 infections in Pakistan are spreading at an exponential rate and a point may soon be reached where rigorous prevention measures would need to be adopted. Mathematical models can help define the scale of an epidemic and the rate at which an infection can spread in a community. We used an SIR model to predict the magnitude of the COVID-19 epidemic in Pakistan and compared the numbers with the reported cases on the national database. Our results indicate that Pakistan could hit peak number of infectious cases on May 26th, 2020 and by June 24th, 2020, 90% of the population will have become infected with the virus if policy interventions seeking to curb this infection are not adopted aggressively.


id: cord-258126-8ityzjjh
author: Mamun, Mohammed A.
date: 2020-05-11
url: https://api.elsevier.com/content/article/pii/S0889159120308618
doi: 10.1016/j.bbi.2020.05.028
title:
  COVID-19 suicides in Pakistan, dying off not COVID-19 fear but poverty? – The forthcoming economic challenges for a developing country

abstract:
  • Suicide increment during and afterwards a pandemic is highly common. • This study reports COVID-19 suicide cases in Pakistan for the first time. • Most of the suicides occur due to lockdown-related economic recession. • Fear of infection is the second suicide contributing factor. • Lockdown-related unemployment aggravates the life-threatening situation.


id: cord-258879-dueab356
title: Psychological impact of COVID-19 pandemic on postgraduate trainees: a cross-sectional survey
author: Imran, Nazish
date: 2020-08-25
url: https://www.ncbi.nlm.nih.gov/pubmed/32843485/
doi: 10.1136/postgradmedj-2020-138364
abstract:
  BACKGROUND: The present study aimed to evaluate psychological impact of COVID-19 outbreak on postgraduate trainees in Pakistan by quantifying the symptoms of depression, anxiety and acute stress disorder and by analysing potential risk factors associated with these symptoms. METHODS: Following Institutional Review Board approval, a cross-sectional study was conducted among 10,178 postgraduate trainees following COVID-19 outbreak through e-log system of College of Physicians and Surgeons of Pakistan. The nine-item Patient Health Questionnaire, seven-item Generalised Anxiety Disorder scale and Stanford Acute Stress Reaction Questionnaire were used to collect data. Statistical analyses were conducted using SPSS.26. Descriptive statistics, Mann-Whitney U test, the χ(2) test and logistic regression analysis were performed. The significance level was set at α=0.05. RESULTS: The prevalence of depressive symptoms, generalised anxiety disorder and acute stress disorder were 26.4%, 22.6% and 4.4%, respectively. Female postgraduate trainees, senior trainees and front-line workers reported experiencing more anxiety, depression and acute stress symptoms (p value<0.001). Logistic regression showed that being a front-line and senior staff member and female was associated with higher risk of experiencing symptoms of depression, anxiety and acute stress. CONCLUSIONS: Our study findings raise concerns about the psychological well-being of postgraduate trainees during the acute COVID-19 outbreak in Pakistan. It is necessary to employ strategies to minimise the psychological distress and provide adequate psychosocial support for postgraduate trainees during crisis situation such as COVID-19 pandemic.


id: cord-260583-n20y2zep
title: COVID‐19 and Salmonella Typhi co‐epidemics in Pakistan: A real problem
author: Haqqi, Aleena
date: 2020-07-15
url: https://www.ncbi.nlm.nih.gov/pubmed/32648942/
doi: 10.1002/jmv.26293
abstract:
  Recent articles have pointed the impact of co-epidemics/co-infections of COVID-19 and other infectious diseases on an already overburdened healthcare infrastructure 1, 2 . With the present toll of COVID-19 cases reaching beyond 10,922,324 infected cases and claiming 523,011 lives 3 . This article is protected by copyright. All rights reserved.


id: cord-265575-gcaj3p0f
title: Increasing and declining of COVID-19 cases puzzling the health experts in Pakistan
author: Shah, Pir Tariq
date: 2020-10-17
url: https://doi.org/10.1016/j.nmni.2020.100791
doi: 10.1016/j.nmni.2020.100791
abstract:
  Although the comprehensive social measures had been engaged, COVID-19 cases remained increasing until mid-July in Pakistan, which was followed by unexplained declining. Therefore, those countermeasures need to be re-examined to find out the loopholes or defects in implementing policies in order to eventually win the war against COVID-19.


id: cord-265996-97xxpe8m
author: Din, M.
date: 2020-10-13
url: https://doi.org/10.1016/j.puhe.2020.09.004
doi: 10.1016/j.puhe.2020.09.004
abstract: nan
title:
  Delays in polio vaccination programs due to COVID-19 in Pakistan: a major threat to Pakistan's long war against polio virus


id: cord-267791-v10eh408
author: Chughtai, Abrar Ahmad
date: 2019-02-07
url: https://api.elsevier.com/content/article/pii/S1876034119300668
doi: 10.1016/j.jiph.2019.01.064
title:
  Use of personal protective equipment to protect against respiratory infections in Pakistan: A systematic review

abstract:
  Like other low-income countries, limited data are available on the use of personal protective equipment (PPE) in Pakistan. We conducted a systematic review of studies on PPE use for respiratory infections in healthcare settings in Pakistan. MEDLINE, Embase and Goggle Scholar were searched for clinical, epidemiological and laboratory-based studies in English, and 13 studies were included; all were observational/cross-sectional studies. The studies examined PPE use in hospital (n = 7), dental (n = 4) or laboratory (n = 2) settings. Policies and practices on PPE use were inconsistent. Face masks and gloves were the most commonly used PPE to protect from respiratory and other infections. PPE was not available in many facilities and its use was limited to high-risk situations. Compliance with PPE use was low among healthcare workers, and reuse of PPE was reported. Clear policies on the use of PPE and available PPE are needed to avoid inappropriate practices that could result in the spread of infection. Large, multimethod studies are recommended on PPE use to inform national infection-control guidelines.


id: cord-268149-narre5e7
author: Aziz, Muhammad Abdul
date: 2018-01-29
txt: ./txt/cord-268149-narre5e7.txt
cache: ./cache/cord-268149-narre5e7.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/s13002-018-0212-0
doi: 10.1186/s13002-018-0212-0
summary:
  title: Traditional uses of medicinal plants used by Indigenous communities for veterinary practices at Bajaur Agency, Pakistan Most widely used medicinal plants with maximum use reports (URs) were Visnaga daucoides Gaertn., Foeniculum vulgare Mill., Solanum virginianum L., Withania somnifera (L.) Dunal, Glycyrrhiza glabra L., and Curcuma longa L. It has been recognized that plants have the capacity to combat several types of diseases ethnoveterinary medicines, a term generally used for folk skills, beliefs, knowledge, practices, methods related to animals'' health, and cure of various ailments in the rural areas [1] . Indigenous people of the study area are rich in traditional knowledge on veterinary medicines, which may be due to their close observation on domestic animals being considered as an important part of traditional lifestyle. Medicinal plants with high URs strengthen the concept that such species are more significant to the local population and useful in sharing the traditional knowledge with one another in the area.

title:
  Traditional uses of medicinal plants used by Indigenous communities for veterinary practices at Bajaur Agency, Pakistan

abstract:
  BACKGROUND: The pastoral lifestyle of Indigenous communities of Bajaur Agency is bringing them close to natural remedies for treating their domestic animals. Several studies have been conducted across the globe describing the importance of traditional knowledge in veterinary care. Therefore, this study was planned with the aim to record knowledge on ethnoveterinary practices from the remote areas and share sit with other communities through published literature. METHODS: Data was gathered from community members through semi-structured interviews and analyzed through informant consensus factor (Fic) to evaluate the consent of current ethnoveterinary practices among the local people. RESULTS: In total, 73 medicinal plants were recorded under the ethnoveterinary practices. Most widely used medicinal plants with maximum use reports (URs) were Visnaga daucoides Gaertn., Foeniculum vulgare Mill., Solanum virginianum L., Withania somnifera (L.) Dunal, Glycyrrhiza glabra L., and Curcuma longa L. New medicinal values were found with confidential level of citations for species including Heracleum candicans and Glycerhiza glabra. Family Apiaceae was the utmost family with high number (7 species) of medicinal plants. Maximum number of medicinal plants (32) was used for gastric problems. High Fic was recorded for dermatological (0.97) followed by reproductive (0.93) and gastrointestinal disorders (0.92). The main route of remedies administration was oral. CONCLUSIONS: Current study revealed that the study area has sufficient knowledge on ethnoveterinary medicinal plants. This knowledge is in the custody of nomadic grazers, herders, and aged community members. Plants with new medicinal uses need to be validated phytochemically and pharmacologically for the development of new alternative drugs for veterinary purposes.


id: cord-275445-d3i12m3l
author: Hashmi, Madiha
date: 2020-08-21
url: https://www.sciencedirect.com/science/article/pii/S0883944120306638?v=s5
doi: 10.1016/j.jcrc.2020.08.017
title:
  A national survey of critical care services in hospitals accredited for training in a lower-middle income country: Pakistan

abstract:
  PURPOSE: To describe the extent and variation of critical care services in Pakistan. MATERIALS AND METHODS: A cross-sectional survey was conducted in all intensive care units (ICUs) recognised for postgraduate training to determine administration, infrastructure, equipment, staffing, and training. RESULTS: There were 151 hospitals recognised for training, providing 2166 ICU beds and 1473 ventilators. Regional distribution of ICU beds per 100,000 population ranged from 1.0 in Sindh to none in Gilgit Baltistan (median 0.7). A senior clinician trained in critical care was available in 19 (12.1%) of units. One to one nurse to bed ratio during the day was available in 84 (53.5%) of units, dropping to 75 (47.8%) at night. Availability of 1:1 nursing also varied between provinces, ranging from 56.5% in Punjab compared to 0% in Azad Jamu Kashmir. Similarly there was disparity in availability of ventilators between provinces. All ICUs had basic infrastructure (electricity, running water, piped oxygen) and basic equipment (electronic monitoring and infusion pumps). CONCLUSION: Pakistan, a lower middle-income country, has an established network of critical care facilities with access to basic equipment, but inequalities in its distribution. Investment in critical care training for doctors and nurses is needed.


id: cord-275897-j9cwlzxu
title: New Horizons: COVID-19 and the Burden of Neuropsychiatric Illness in Pakistan
author: Hashmi, Ali M.
date: 2020-05-17
url: https://www.ncbi.nlm.nih.gov/pubmed/32582322/
doi: 10.12669/pjms.36.covid19-s4.2792
abstract:
  This manuscript reviews the current state of knowledge about the burden of mental illness and assesses the impact of COVID-19 illness on mental health in Pakistan. For this we analyzed secondary data obtained from the Institute of Health Metrics and Evaluation. The Global Burden of Disease (GBD) study draws from a wide range of data sources to quantify global and regional effects of a disease. We also did a literature search on the effects of COVID-19 illness on mental health and the psychosocial effects of COVID-19 and other Corona virus related illnesses such as SARS-CoV and MERS-CoV. Data from the studies obtained was utilized to extrapolate the anticipated effects of COVID-19 illness on healthcare workers, COVID-19 patients and the general public in Pakistan. Mental illness poses a significant challenge to Pakistan’s under resourced health care system. COVID-19 has the potential to strain Pakistan’s healthcare system to the breaking point. So far, the general morbidity from COVID-19 illness in Pakistan has been low compared to other countries but this could change in the coming weeks and months. Hidden within this crisis are also some opportunities for both healthcare and education.


id: cord-278145-3tfcxbfz
author: Ahmed, Sibtain
date: 2020-06-06
txt: ./txt/cord-278145-3tfcxbfz.txt
cache: ./cache/cord-278145-3tfcxbfz.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32551102/
doi: 10.1016/j.amsu.2020.06.004
summary:
  title: Challenges amid COVID-19 times Review of the changing practices in a clinical chemistry laboratory from a developing country To ensure such continuity of services, the aim of this review is to highlight the challenges faced by a Clinical https://doi.org/10.1016/j.amsu.2020.06.004 Received 6 May 2020; Received in revised form 1 June 2020; Accepted 1 June 2020 Chemistry laboratory in a developing country amid the COVID-19 crisis, the challenges, implementing changes and the lessons learnt. â�¢ Post pandemic world with the anticipated overwhelming financial crisis, will require major resource allocation decisions for inventory management and prioritizing needs for new developments and projects. With the current state of local spread in the country and amid the high chances of contracting COVID-19, it is inevitable that the clinical laboratories take drastic measures and succumb to acceptable alternate plans for ensuring the safety and interests of its valuable employs alongside continuousness of provision of diagnostic services for better health outcomes, in times of the pandemic.

title:
  Challenges amid COVID-19 times - Review of the changing practices in a clinical chemistry laboratory from a developing country

abstract:
  Corona Virus Disease 2019 (COVID-19) pandemic is the defining global health crisis of our time. Compared with its neighbors China and Iran, which were rated as epi-centers of the outbreak, Pakistan has lower standards of health care, unstable economy and dearth of financial resources to tackle the outbreak. Like other institutes and industries in the country, clinical laboratories were succumbed to a variety of challenges. This article is based on the experience and adapted workflow measures from the Clinical Chemistry laboratory at the Aga Khan University Hospital (AKUH), Karachi, which serves as a national referral center with its widespread network of satellite laboratories and phlebotomy centers across the country. It highlights the challenges faced and the appropriate responses to ensure the provision of diagnostic facilities during the COVID-19 outbreak. Furthermore, the lessons acquired and necessary preparations for the post crisis situation are also incorporated.


id: cord-279395-qfb06csa
title: Is Pakistan prepared for the COVID‐19 epidemic? A questionnaire‐based survey
author: Khan, Samea
date: 2020-04-10
url: https://doi.org/10.1002/jmv.25814
doi: 10.1002/jmv.25814
abstract:
  COVID‐19 is a pandemic that began in China in December 2019. World health organization (WHO) has expressed fears that Pakistan might emerge as the next epicenter of this pandemic. We hypothesize that at present the Pakistani masses are not prepared to face any threat of a looming epidemic. The main aim of this study was to evaluate the basic knowledge of educational and health care workers (HCWs) regarding COVID‐19, its control, and prevention. Knowledge about origin, symptoms, and spread of viral infection was assessed. In this cross‐sectional survey, a self‐designed questionnaire was distributed among 302 HCWs including physicians (10.9%), nurses (1.32%), lab staff (1.65%), and academic individuals including faculty and students (86.42%) of different organizations. Results were analyzed using the χ (2) test. Obtained results validate our null hypothesis that Pakistani masses are not well aware of the COVID‐19 and strategies for the prevention and control of infection. The study concluded that individuals belonging to the front‐line workers and high literacy groups are not prepared for the alarming situation in the country. Effectual implementation of infection control programs should be practiced, and it depends on awareness, training, and cooperation of individuals.


id: cord-279405-1d6gznls
title: Dengue Fever and COVID‐19 Co‐Infection; A Threat to Public Health for Co‐epidemic in Pakistan
author: Butt, Muhammad Hammad
date: 2020-08-27
txt: ./txt/cord-279405-1d6gznls.txt
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extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32852782/
doi: 10.1002/jmv.26464
summary:
  geographical spread of COVID-19 and more involvement of adults, there have been increasing reports of co-infections with various other infectious diseases. During the on-going pandemic where health authorities are primarily engaged to contain the infection, any other infectious disease outbreak will hinder the manoeuvres combating COVID-19 and will create the diagnostic challenges for healthcare professionals. Recently, National Institute of Health (NIH) in Pakistan issued ''High Alert'' for dengue viral infection (DVI) as monsoon season (July -December) is considered a vulnerable period for dengue spread [2] . Keeping in view the fragile healthcare system and economic turmoil in Pakistan, dengue outbreak will pose serious challenges for which country is not This article is protected by copyright. In Thailand, a patient who presented with petechial rashes was treated as dengue case but declared as co-infected with COVID-19 following advanced clinical diagnosis [6] . Patients presenting to healthcare professionals with fever, rash, headache and respiratory problems must be subjected to DVI and COVID-19 diagnosis.

abstract:
  The rapid expansion of COVID‐19 has caused around 16 million confirmed cases with approximately 0.65 million deaths worldwide. Recently with the geographical spread of COVID‐19 and more involvement of adults, there have been increasing reports of co‐infections with various other infectious diseases. This article is protected by copyright. All rights reserved.


id: cord-280050-fktc778q
author: Tahir, Shumaila
date: 2020-06-17
url: https://www.ncbi.nlm.nih.gov/pubmed/32699679/
doi: 10.7759/cureus.8679
title:
  Epidemiological and Clinical Features of SARS-CoV-2: A Retrospective Study from East Karachi, Pakistan

abstract:
  Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread to almost every country on the globe, and each country is reporting the symptomatic presentation of their patients to give better insight into the various clinical presentations of SARS-CoV-2. However, the epidemiological literature from Pakistan is scanty. Methods We retrospectively analyzed data from 412 patients who were residents of East Karachi and tested positive for SARS-CoV-2 between February 26 to April 24, 2020. Patients' demographics, symptoms, travel and contact history, and outcomes were recorded. All statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 22 (IBM SPSS Statistics for Windows, IBM Corp, Armonk, NY). Results Most of the patients were male (64.6%), the majority (43.3%) belonging to the 21- to 40-year age group. Most of the patients (65.5%) were residents of Gulshan Iqbal. A total of 15.8% of the patients were admitted to the hospital, and 3.9% of patients expired. The three most common presenting symptoms were fever (74.8%), cough (60.4%), and flu (35.5%). The majority of patients (89.3%) gave a history of contact with SARS-CoV-2 patients. Conclusion The number of SARS-CoV-2 cases is rapidly increasing in Karachi, Pakistan. There is a need to educate the population about the most common sign and symptoms of the virus so that individuals can identify these symptoms and get themselves tested. The concerned authorities should devise an adequate and effective plan to flatten the infectivity curve.


id: cord-285223-07o9irev
author: Malik, Usman Rashid
date: 2020-09-02
txt: ./txt/cord-285223-07o9irev.txt
cache: ./cache/cord-285223-07o9irev.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32887410/
doi: 10.3390/ijerph17176395
summary:
  title: Knowledge, Attitude, and Practices of Healthcare Professionals on COVID-19 and Risk Assessment to Prevent the Epidemic Spread: A Multicenter Cross-Sectional Study from Punjab, Pakistan A 39-itemed questionnaire based on the World Health Organization (WHO)COVID-19 risk assessment tool was shared with healthcare professionals in three purposively selected key divisions of Punjab province. Avoiding cross-infection from patients along with effective care delivery can be achieved if the healthcare professionals, including physicians, pharmacists, nurses, and other medical staff, have sufficient knowledge, a positive attitude, and better practices about COVID-19. A recent study reported the deficiencies in the awareness and preparedness of medical professionals regarding COVID-19 in Pakistan and demonstrated that frontline health workers were not well-prepared to prevent and control the infection [14] . A cross-sectional study to examine the knowledge, attitude, practices, and risk assessment of HCPs regarding coronavirus and its associated disease (COVID-19) was conducted.

title:
  Knowledge, Attitude, and Practices of Healthcare Professionals on COVID-19 and Risk Assessment to Prevent the Epidemic Spread: A Multicenter Cross-Sectional Study from Punjab, Pakistan

abstract:
  In the current outbreak of novel coronavirus (COVID-19), healthcare professionals (HCPs) have a primary role in combating the epidemic threat. HCPs are at high risk of not only contracting the infection but also spreading it unknowingly. It is of utmost importance to evaluate their knowledge, attitudes, and practices (KAP) and the ability to assess the risks associated with the outbreak. A cross-sectional online survey involving physicians, pharmacists, and nurses was conducted. A 39-itemed questionnaire based on the World Health Organization (WHO)COVID-19 risk assessment tool was shared with healthcare professionals in three purposively selected key divisions of Punjab province. Out of 500 healthcare professionals, 385 responded to the survey. The majority (70%) were aged 22–29 years; 144 (37.4%) physicians, 113 (29.4%) nurses, and 128 (33.2%) pharmacists completed the survey. Overall, 94.8% of healthcare professionals scored adequately (>14) for COVID-19-related knowledge; 97.9% displayed an optimistic attitude (>42) and 94.5% had an adequate practice score (>28). Kruskal–Wallis and Jonckheere–Terpstra tests showed significant differences (p < 0.05) in KAP and risk assessment scores among groups; physicians and nurses scored higher as compared to pharmacists. Further research and follow-up investigations on disaster management and risk assessment can help policy-makers better tackle future epidemics.


id: cord-290952-tbsccwgx
author: Ullah, Saif
date: 2020-07-03
txt: ./txt/cord-290952-tbsccwgx.txt
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extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0960077920304720
doi: 10.1016/j.chaos.2020.110075
summary:
  In this paper, we develop a mathematical model to explore the transmission dynamics and possible control of the COVID-19 pandemic in Pakistan, one of the Asian countries with a high burden of disease with more than 100,000 confirmed infected cases so far. In this paper, we develop a mathematical model to explore the transmission dynamics and possible control of the COVID-19 pandemic in Pakistan, one of the Asian countries with a high burden of disease with more than 100,000 confirmed infected cases so far. The effect of low (or mild), moderate, and comparatively strict control interventions like social-distancing, quarantine rate, (or contact-tracing of suspected people) and hospitalization (or self-isolation) of testing positive COVID-19 cases are shown graphically. The effect of low (or mild), moderate, and comparatively strict control interventions like social-distancing, quarantine rate, (or contact-tracing of suspected people) and hospitalization (or self-isolation) of testing positive COVID-19 cases are shown graphically.

title:
  Modeling the impact of non-pharmaceutical interventions on the dynamics of novel coronavirus with optimal control analysis with a case study

abstract:
  Coronavirus disease (COVID-19) is the biggest public health challenge the world is facing in recent days. Since there is no effective vaccine and treatment for this virus, therefore, the only way to mitigate this infection is the implementation of non-pharmaceutical interventions such as social-distancing, community lockdown, quarantine, hospitalization or self-isolation and contact-tracing. In this paper, we develop a mathematical model to explore the transmission dynamics and possible control of the COVID-19 pandemic in Pakistan, one of the Asian countries with a high burden of disease with more than 100,000 confirmed infected cases so far. Initially, a mathematical model without optimal control is formulated and some of the basic necessary analysis of the model, including stability results of the disease-free equilibrium is presented. It is found that the model is stable around the disease-free equilibrium both locally and globally when the basic reproduction number is less than unity. Despite the basic analysis of the model, we further consider the confirmed infected COVID-19 cases documented in Pakistan from March 1 till May 28, 2020 and estimate the model parameters using the least square fitting tools from statistics and probability theory. The results show that the model output is in good agreement with the reported COVID-19 infected cases. The approximate value of the basic reproductive number based on the estimated parameters is [Formula: see text]. The effect of low (or mild), moderate, and comparatively strict control interventions like social-distancing, quarantine rate, (or contact-tracing of suspected people) and hospitalization (or self-isolation) of testing positive COVID-19 cases are shown graphically. It is observed that the most effective strategy to minimize the disease burden is the implementation of maintaining a strict social-distancing and contact-tracing to quarantine the exposed people. Furthermore, we carried out the global sensitivity analysis of the most crucial parameter known as the basic reproduction number using the Latin Hypercube Sampling (LHS) and the partial rank correlation coefficient (PRCC) techniques. The proposed model is then reformulated by adding the time-dependent control variables u(1)(t) for quarantine and u(2)(t) for the hospitalization interventions and present the necessary optimality conditions using the optimal control theory and Pontryagin’s maximum principle. Finally, the impact of constant and optimal control interventions on infected individuals is compared graphically.


id: cord-292293-tko186lh
author: Javed, W.
date: 2020-08-14
txt: ./txt/cord-292293-tko186lh.txt
cache: ./cache/cord-292293-tko186lh.txt
extension: .txt
mime: text/plain
url: http://medrxiv.org/cgi/content/short/2020.08.13.20173914v1?rss=1
doi: 10.1101/2020.08.13.20173914
summary:
  These findings have been extrapolated to the rest of the urban, adult, working population of Pakistan, and as of 6th July, 2020, 4.11 million people in Pakistan have been infected with COVID-19, which is 17.7 times higher than the current number of 231,818 symptom-based PCR cases reported by the government which exclude asymptomatic cases. 2 Although literature indicates that asymptomatic infections within a population may be many folds higher than the number of PCR reported cases, 3, 4 large-scale, sero-prevalence studies within low-risk populations have not yet been conducted in Pakistan. Getz Pharma conducted a 100% census sero-prevalence study on a sample of 24,210 individuals using the IgG/IgM Test Kit (Colloidal gold) with follow-up and sequential testing after every 15-20 days. This is the first of its kind, large scale census conducted on the general, urban population of Pakistan, which indicates the total number of COVID-19 positive cases is 17.7 times higher than symptom-based PCR reported figures.

title:
  Sero-prevalence findings from metropoles in Pakistan: implications for assessing COVID-19 prevalence and case-fatality within a dense, urban working population

abstract:
  Population-level serologic testing has demonstrated groundbreaking results in monitoring the prevalence and case-fatality of COVID-19 within a population. In Pakistan, Getz Pharma conducted a sero-prevalence survey on a sample of 24,210 individuals using the IgG/IgM Test Kit (Colloidal gold) with follow-up and sequential testing after every 15-20 days on a sub-sample. This is the first of its kind, large scale census conducted on a dense, urban, working population in Pakistan. The study results reveal that from 24,210 individuals screened, 17.5% tested positive, with 7% IgM positive, 6.0% IgG positive and 4.5% combined IgM and IgG positive. These findings have been extrapolated to the rest of the urban, adult, working population of Pakistan, and as of 6th July, 2020, 4.11 million people in Pakistan have been infected with COVID-19, which is 17.7 times higher than the current number of 231,818 symptom-based PCR cases reported by the government which exclude asymptomatic cases.


id: cord-296363-qgoxlqoq
author: Khan, Yusra Habib
date: 2020-06-22
url: https://doi.org/10.4269/ajtmh.20-0654
doi: 10.4269/ajtmh.20-0654
title:
  Threat of COVID-19 Vaccine Hesitancy in Pakistan: The Need for Measures to Neutralize Misleading Narratives

abstract:
  Immediately after declaring COVID-19 as a pandemic, numerous wild conspiracy theories sprouted through social media. Pakistan is quite vulnerable to such conspiracy narratives and has experienced failures of polio vaccination programs because of such claims. Recently, two well-known political figures raised conspiracy theories against COVID-19 vaccines in Pakistan, stating that COVID-19 is a grand illusion and a conspiracy against Muslim countries. This theory is much discussed in the local community, supporting COVID-19 vaccine hesitancy. We urge healthcare authorities in Pakistan to take necessary measures against such claims before they penetrate to the general community. Anti-vaccine movements could undermine efforts to end the COVID-19 pandemic. We believe that ethical and responsible behavior of mass media, a careful advisory from the Pakistan Electronic Media Regulatory Authority, stern measures from healthcare authorities, effective maneuvers to increase public awareness on COVID-19, vigorous analysis of information by data or communications scientists, and publication of counter opinions from health professionals against such theories will go a long way in neutralizing such misleading claims. Because Pakistan is experiencing a large burden of disease, with a sharp rise in confirmed cases, immediate action is of paramount importance to eradicate any potential barriers to a future COVID-19 vaccination program.


id: cord-302497-5tydrrz1
title: Pharmacists at the frontline beating the COVID-19 pandemic
author: Bukhari, Nadia
date: 2020-04-20
url: https://doi.org/10.1186/s40545-020-00210-w
doi: 10.1186/s40545-020-00210-w
abstract:
  As the lockdowns are being observed all over the globe and the national level pharmacy professionals are performing frontline roles, this editorial highlights the role of pharmacists in the COVID − 19 pandemic. Pharmacists globally are providing services amidst pandemic, including TRIAGE services, seeing patients and reducing the patients’ burden on health care facilities such as hospitals and GP practices. Pharmacists are also working to providing home deliveries, as well as dealing with the increasing number of patients coming through to pharmacies with the other ailments. Pharmacy associations have issued their guidelines and in this editorial, several global examples of pharmacists’ role in the COVID 19 are being discussed. Pakistan is used as a country case study in this editorial. The editorial also elaborates how pharmacists in the UK and Pakistan have teamed up together to compile 10-steps protection guidelines for the pharmacy teams in Pakistan in English and Urdu language. This 10-point guidance educates community pharmacies for safety and standard operation as the number of patients in the country continues to rise. These guidelines are endorsed by the government and private bodies. These can be adopted and adapted by any country; keeping in view their laws and regulations.


id: cord-302842-idbmh1uo
title: Association between meteorological indicators and COVID-19 pandemic in Pakistan
author: Raza, Ali
date: 2020-10-14
txt: ./txt/cord-302842-idbmh1uo.txt
cache: ./cache/cord-302842-idbmh1uo.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33052566/
doi: 10.1007/s11356-020-11203-2
summary:
  This study was designed to investigate the impact of meteorological indicators (temperature, rainfall, and humidity) on total COVID-19 cases in Pakistan, its provinces, and administrative units from March 10, 2020, to August 25, 2020. The contribution of this study is (a) it first time examined the relationship between meteorological indicators and COVID-19 in Pakistan, (b) it first time examined the relationship between meteorological indicators and COVID-19 in four provinces and three administrative units in Pakistan, and (c) it used the generalized models to investigate the impact of average temperature, rainfall, and humidity on COVID-19 cases. A higher correlation coefficient was observed between temperature (minimum, maximum, and Fig. 11 Humidity in provinces and administrative areas Environ Sci Pollut Res average) and COVID-19 cases for all provinces and administrative units (Punjab, Sindh, Baluchistan, Khyber Pakhtunkhwa, Islamabad Capital Territory, Gilgit-Baltistan, and Azad Jammu and Kashmir).

abstract:
  This study was designed to investigate the impact of meteorological indicators (temperature, rainfall, and humidity) on total COVID-19 cases in Pakistan, its provinces, and administrative units from March 10, 2020, to August 25, 2020. The correlation analysis showed that COVID-19 cases and temperature showed a positive correlation. It implies that the increase in COVID-19 cases was reported due to an increase in the temperature in Pakistan, its provinces, and administrative units. The generalized Poisson regression showed that the rise in the expected log count of COVID-19 cases was 0.024 times for a 1 °C rise in the average temperature in Pakistan. Second, the correlation between rainfall and COVID-19 cases was negative in Pakistan. However, the regression coefficient between the expected log count of COVID-19 cases and rainfall was insignificant in Pakistan. Third, the correlation between humidity and the total COVID-19 cases was negative, which implies that the increase in humidity is beneficial to stop the transmission of COVID-19 in Pakistan, its provinces, and administrative units. The reduction in the expected log count of COVID-19 cases was 0.008 times for a 1% increase in the humidity per day in Pakistan. However, humidity and COVID-19 cases were positively correlated in Sindh province. It is required to create awareness among the general population, and the government should include the causes, symptoms, and precautions in the educational syllabus. Moreover, people should adopt the habit of hand wash, social distancing, personal hygiene, mask-wearing, and the use of hand sanitizers to control the COVID-19.


id: cord-303102-ap1dzbp9
title: It is time to control the worst: testing COVID-19 outbreak, energy consumption and CO(2) emission
author: Iqbal, Sajid
date: 2020-11-12
txt: ./txt/cord-303102-ap1dzbp9.txt
cache: ./cache/cord-303102-ap1dzbp9.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33184786/
doi: 10.1007/s11356-020-11462-z
summary:
  While, due to COVID-19 outbreak, several health issues have been raised and such issues are becoming serious days by day, more specifically in frugal economies like Pakistan, this impact is very critical, and now, an economic shock is being perceived; lockdown is being extended continuously; and by the effect of lockdown fuel consumption, CO 2 emission, energy demand and supply declined and market mechanism is altered very speedily. By the fact, the COVID-19 outbreak affected the energy sector of the world as a whole, and eventually, the demand graph of oil supplies have become bearish; oil market prices faced a decline; and big economies like the USA are bidding the oil-free of cost (Malamud and Núñez 2020) . We contributed in literature by presenting a novel study on the COVID-19 effect on carbon emission and energy consumption in modern time when the world is finding the solution for each and every sector and each and every aspect to make it sustainable.

abstract:
  During the COVID-19 outbreak, managing energy consumption and CO(2) emission remained a serious problem. The previous literature rarely solved this real-time issue, and there is a lack of public research proposing an effective way forward on it. However, the study examines the impact of the COVID-19 outbreak on energy consumption and CO(2) emission. The design of the study is quantitative, and the data is acquired from different online databases. The model of the study is inferred by using panel unit root test and ARDL test. The robustness of study findings was checked through panel quantile regression. The findings highlighted that the COVID-19 outbreak is negatively significant with energy consumption and CO(2) emission. The study suggested revising the energy consumption patterns by developing and implementing the national action plan for energy consumption and environmental protection. The study also contributed in knowledge by suggesting the novel insight into CO(2) emission and energy consumption patterns during COVID-19 pandemic and recommended to consider renewable energy transition methods as an opportunity for the society. For a more effective management of energy consumption and environmental pollution, country-specific measures are suggested to be taken, and the national government should support the concerned public departments, ministries and private organizations on it. To the best of our study, this is one of the pioneer studies studying this novel link and suggesting the way forward on recent topicality.


id: cord-305146-iprzeigk
author: Chughtai, Abrar Ahmad
date: 2020-03-04
txt: ./txt/cord-305146-iprzeigk.txt
cache: ./cache/cord-305146-iprzeigk.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jiph.2020.02.032
doi: 10.1016/j.jiph.2020.02.032
summary:
  We conducted a systematic review of studies on PPE use for respiratory infections in healthcare settings in Pakistan. Face masks (or medical masks) and respirators are the most commonly used PPE to protect from influenza and other respiratory infection in healthcare settings. The aim of this study was to examine the use of PPE for respiratory infections in healthcare settings in Pakistan. Studies where PPE was examined for general infection control were also included, given respiratory protective equipment (face masks and/or respirators) was mentioned. Two studies examined the guidelines and current practices on the use of face masks/respirators for influenza, tuberculosis and SARS in Pakistan [21, 22] . Medical masks were generally used to protect from influenza, tuberculosis and other respiratory infections, while the use of respirators was limited to high-risk situations [21, 22] .

title:
  Use of personal protective equipment to protect against respiratory infections in Pakistan: A systematic review

abstract:
  Like other low-income countries, limited data are available on the use of personal protective equipment (PPE) in Pakistan. We conducted a systematic review of studies on PPE use for respiratory infections in healthcare settings in Pakistan. MEDLINE, Embase and Goggle Scholar were searched for clinical, epidemiological and laboratory-based studies in English, and 13 studies were included; all were observational/cross-sectional studies. The studies examined PPE use in hospital (n = 7), dental (n = 4) or laboratory (n = 2) settings. Policies and practices on PPE use were inconsistent. Face masks and gloves were the most commonly used PPE to protect from respiratory and other infections. PPE was not available in many facilities and its use was limited to high-risk situations. Compliance with PPE use was low among healthcare workers, and reuse of PPE was reported. Clear policies on the use of PPE and available PPE are needed to avoid inappropriate practices that could result in the spread of infection. Large, multimethod studies are recommended on PPE use to inform national infection-control guidelines.


id: cord-307697-ds4uw7y1
author: Ahmed, Jawad
date: 2020-06-10
txt: ./txt/cord-307697-ds4uw7y1.txt
cache: ./cache/cord-307697-ds4uw7y1.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.7759/cureus.8550
doi: 10.7759/cureus.8550
summary:
  Whereas, doctors in Pakistan reported to have poor availability of PPE with only 37.4% having access to masks/N95 respirator, 34.5% to gloves, 13.8% to face-shields or goggles, and 12.9% to full-suit/gown. Whereas, doctors in Pakistan reported to have poor availability of PPE with only 37.4% having access to masks/N95 respirator, 34.5% to gloves, 13.8% to face-shields or goggles, and 12.9% to full-suit/gown. In contrast, doctors in Pakistan reported to have poor availability of PPE with only 37.4% (n = 130) having access to masks/N95 respirator, 34.5% (n = 120) to gloves, 13.8% (n = 48) to face-shields or goggles, and 12.9% (n = 44) to full-suit/gown. In our study, 73% of doctors from Pakistan and 58.4% from the US reported that HCWs in their hospitals had been infected with COVID-19. To conclude, there is a shortage of PPE in hospitals of the US and Pakistan due to COVID-19 and doctors are feeling scared working without adequate protection in the pandemic situation.

title:
  Availability of Personal Protective Equipment (PPE) Among US and Pakistani Doctors in COVID-19 Pandemic

abstract:
  Background The coronavirus disease (COVID-19) pandemic has put an excessive strain on healthcare systems across the globe, causing a shortage of personal protective equipment (PPE). PPE is a precious commodity for health personnel to protect them against infections. We investigated the availability of PPE among doctors in the United States (US) and Pakistan. Methods A cross-sectional study, including doctors from the US and Pakistan, was carried out from April 8 to May 5, 2020. An online self-administered questionnaire was distributed to doctors working in hospitals in the US and Pakistan after a small pilot study. All analysis was done using Statistical Package for Social Science (SPSS) version 23.0 (IBM Corp., Armonk, NY). Results After informed consent, 574 doctors (60.6% from Pakistan and 39.4% from the US) were included in the analysis. The majority of the participants were females (53.3%), and the mean age of the participants was 35.3 ± 10.3 years. Most doctors (47.7%) were from medicine and allied fields. Among the participants, 87.6% of doctors from the US reported having access to masks/N95 respirators, 79.6% to gloves, 77.9% to face-shields or goggles, and 50.4% to full-suit/gown. Whereas, doctors in Pakistan reported to have poor availability of PPE with only 37.4% having access to masks/N95 respirator, 34.5% to gloves, 13.8% to face-shields or goggles, and 12.9% to full-suit/gown. The reuse of PPE was reported by 80.5% and 60.3% physicians from the US and Pakistan, respectively. More doctors from Pakistan (50.6%) reported that they had been forced to work without PPE compared to doctors in the US (7.1%). Conclusion There is a lack of different forms of PPE in the US and Pakistan. Doctors from both countries reported that they had been forced to work without PPE. Compared to the US, more doctors from Pakistan reported having faced discrimination in receiving PPE.


id: cord-308556-xi2un0kc
author: Saadat, S.
date: 2020-09-02
url: http://medrxiv.org/cgi/content/short/2020.09.01.20182642v1?rss=1
doi: 10.1101/2020.09.01.20182642
title:
  Covid-19 SEIDRD Modelling for Pakistan with implementation of seasonality, healthcare capacity and behavioral risk reduction

abstract:
  Introduction: December 2019 saw the origins of a new Pandemic which would soon spread to the farthest places of the planet. Several efforts of modelling of the geo-temporal transmissibility of the virus have been undertaken, but none describes the incorporation of effect of seasonality, contact density, primary care and ICU bed capacity and behavioural risk reduction measures such as lockdowns into the simulation modeling for Pakistan. We use above variables to create a close to real data curve function for the active cases of covid-19 in Pakistan. Objective: The objective of this study was to create a new computational epidemiological model for Pakistan by implementing symptomatology, healthcare capacity and behavioural risk reduction mathematically to predict of Covid-19 case trends and effects of changes in community characteristics and policy measures. Methods: We used a modified version of SEIR model called SEIDRD (Susceptible - Exposed Latent - Diagnosed as Mild or severe - Recovered - Deaths). This was developed using Vensim PLE software version 8.0. This model also incorporated the seasonal and capacity variables for Pakistan and was adjusted for behavioural risk reduction measures such as lockdowns. Results: The SEIDRD model was able to closely replicate the active covid-19 cases curve function for Pakistan until now. It was able to show that given current trends, though the number of active cases are dropping, if the smart lockdown measures were to end, the cases are expected to show a rise from 28th August 2020 onwards reaching a second peak around 28th September 2020. It was also seen that increasing the ICU bed capacity in Pakistan from 4000 to 40000 will not make a significant difference in active case number. Another simulation for a vaccination schedule of 100000 vaccines per day was created which showed a decrease in covid cases in a slow manner over a period of months rather than days. Conclusion: This study attempts to successfully model the active covid-19 cases curve function of Pakistan and mathematically models the effect of seasonality, contact density, ICU bed availability and Lockdown measures. We were able to show the effectiveness of smart lockdowns and were also to predict that in case of no smart lockdowns, Pakistan can see a rise in active case number starting from 28th of August 2020.


id: cord-310293-0s7l0l4k
author: Salman, Saima
date: 2020-05-17
url: https://www.ncbi.nlm.nih.gov/pubmed/32582328/
doi: 10.12669/pjms.36.covid19-s4.2803
title:
  Inter-hospital communication and transfer practices during COVID-19 Pandemic in Karachi, Pakistan. A brief overview

abstract:
  OBJECTIVE: To discuss the referral mechanisms established for safe and expeditious inter-facility transfer of COVID 19 positive patients to ensure their referrals through establishing proper communication channels. METHODS: Mobile phone and WhatsApp based groups, administrated by The Indus Hospital were established in April 2020. Through detailed reports and frequent communication, factors like bed and ventilator availability across these facilities are shared. Weekly reports through zoom meetings updating the key stake holders, discussion of problems faced and planning for the week ahead are also done. RESULT: The establishment of these groups has been successful in ensuring referral to and from The Indus Hospital to various healthcare facilities across Karachi using appropriate ambulance services. CONCLUSION: The development of referral mechanisms is the need of the day that has been highlighted through the COVID 19 pandemic. It is our hope that these mechanisms are sustained after the pandemic and result in improvement in patient outcome through proper referrals.


id: cord-315059-l6guql8q
author: Mubarak, Naeem
date: 2020-04-30
txt: ./txt/cord-315059-l6guql8q.txt
cache: ./cache/cord-315059-l6guql8q.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ijid.2020.04.067
doi: 10.1016/j.ijid.2020.04.067
abstract: nan
summary:
  title: Corona and Clergy: The missing link for an effective social distancing in Pakistan. To begin with, more than half of the COVID-19 cases in Malaysia received virus 11 in a congregation of 16000 believers from 30 countries. Pakistan''s case is of concern due to a fragile healthcare system, poor hygiene practices, 20 limited access to healthcare, and steep rise in the number of local cases in a population bigger 21 than Italy and Iran combined. Evidence supports the substantial impact of social distancing as 22 a viable practice to contain the spread of the virus. In Pakistan, the practice of social distancing 24 Email: naeem.mubarak@lmdc.edu.pk Tel: 00-92-42-37392215 Muslim world, and cancelled Umrah (pilgrimage). for Pakistan to implement social distancing in the holy month of Ramadan (26 th April) when 46 influx in mosques increases many-fold for daily prayers and Tarawih (an additional prayer in 47 Email: naeem.mubarak@lmdc.edu.pk Tel: 00-92-42-37392215 79 80 COVID-19: Pakistan to allow mosques prayers in 70

title:
  Corona and Clergy: The missing link for an effective social distancing in Pakistan. Time for some unpopular decisions


id: cord-318390-uuz37610
author: Saleem, Tayyaba
date: 2020-09-25
txt: ./txt/cord-318390-uuz37610.txt
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extension: .txt
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url: https://doi.org/10.1016/j.yebeh.2020.107476
doi: 10.1016/j.yebeh.2020.107476
summary:
  The current pandemic of coronavirus disease 2019 (COVID-19) that led to an unprecedented crisis with significant health, social, and economic repercussions presented more serious concerns for those living with some chronic conditions such as epilepsy. The current study, which holds 77% of the respondents from rural areas and 23% from urban settings, showed that partial measures of lockdown taken to stop or slow the spread of COVID-19 resulted in adverse economic and health outcomes in the said population including cancelation of follow-up visits, worsening of seizures, job loss, burden of antiepileptic drugs (AEDs) costs, and discontinuation of medicines. The present study was aimed to find out the impact of COVID-19 containment measures on the management strategy of low literate caregivers of patients living in resource-limited areas of Pakistan, one of the active hotspots of the pandemic.

title:
  COVID-19 containment and its unrestrained impact on epilepsy management in resource-limited areas of Pakistan

abstract:
  The current pandemic of coronavirus disease 2019 (COVID-19) that led to an unprecedented crisis with significant health, social, and economic repercussions presented more serious concerns for those living with some chronic conditions such as epilepsy. This study was aimed to find out impact of the COVID-19 pandemic on management of epilepsy. A cross-sectional study was conducted through telephone interviews, targeting 213 caregivers of pediatric patients with epilepsy, belonging to underserved areas of Faisalabad, Punjab, Pakistan. A simple questionnaire was designed to record the responses of participants relevant to the direct and indirect effects of COVID-19 pandemic and their knowledge about possible ways that can be accessed for the management of epilepsy during an ongoing pandemic. The current study, which holds 77% of the respondents from rural areas and 23% from urban settings, showed that partial measures of lockdown taken to stop or slow the spread of COVID-19 resulted in adverse economic and health outcomes in the said population including cancelation of follow-up visits, worsening of seizures, job loss, burden of antiepileptic drugs (AEDs) costs, and discontinuation of medicines. Furthermore, knowledge about alternative ways to access health facilities was found very poor among caregivers. Income sources of poor people disrupted by lockdown can lead to unintentional nonadherence to medication, which is a clear picture of inequitable distribution of resources. This study highlights the major issues faced by the caregivers during this ongoing pandemic of COVID-19.


id: cord-337155-e4gn4fo1
author: Ullah, Atta
date: 2020-08-31
txt: ./txt/cord-337155-e4gn4fo1.txt
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mime: text/plain
url: https://api.elsevier.com/content/article/pii/S240584402031584X
doi: 10.1016/j.heliyon.2020.e04741
summary:
  The study aimed to analyse the role of the capital structure in the financial performance of 90 textile firms listed in Pakistan Stock Exchange (PSX) during the period 2008–2017. The results indicate that the capital structure debt to equity variable has a negative and significant relationship with financial performance while the asset turnover ratio and firm performance showed a negative and statistically insignificant relationship. The current study thus contributes to the existing literature by highlighting the firm-specific factors that affect the performance of the textile sector firms that are listed on the Pakistan Stock Exchange (PSX) concerning capital structure choices. The relationship of firms'' financing choice based on the capital structure, export growth, taxation, and financial performance (ROE) is a new variable in this particular study based on the textile sector. The current study aimed to highlight the relationship between the determinants of the capital structure and its impact on firm financial performance in the textile sector of Pakistan.

title:
  The nexus between capital structure, firm-specific factors, macroeconomic factors and financial performance in the textile sector of Pakistan

abstract:
  The study aimed to analyse the role of the capital structure in the financial performance of 90 textile firms listed in Pakistan Stock Exchange (PSX) during the period 2008–2017. The dependent variable was return on equity as a proxy for financial performance. The independent variables were the debt to equity, total debt to total assets, asset turnover ratios, sales growth, taxation, and export growth, while the firm size was taken as a control variable. The panel regression estimation technique was employed for analysis purposes, and both cross-sectional and time-series data were collected for this study. This study used the random-effect regression estimation model based on the Hausman diagnostic test statistics. The results indicate that the capital structure debt to equity variable has a negative and significant relationship with financial performance while the asset turnover ratio and firm performance showed a negative and statistically insignificant relationship. Export growth and sales growth have a considerable positive connection with financial performance; however, firm size has a negative and significant impact on firm performance, in favour of our alternative research hypothesis. The remaining variables include tax payable and the total debt to total assets ratio, which have an insignificant connection with financial performance (ROE) and validate the agency theory. With better corporate governance by putting more pressure on managers or increasing managerial ownership, institutional investors can reduce the capital, leverage risk and the overall firm capital cost that help to improve the firm's financial performance and economic stability.


id: cord-348521-ai7d634u
author: Atif, Muhammad
date: 2020-06-15
url: https://www.ncbi.nlm.nih.gov/pubmed/32547769/
doi: 10.1186/s40545-020-00240-4
title:
  COVID-19 and community pharmacy services in Pakistan: challenges, barriers and solution for progress

abstract:
  In the wake of atrocious rise in COVID-19 cases, developed countries are leveraging a range of community pharmacy services with the goal of improving access to essential medication and healthcare services. While in the developing nations, including Pakistan, pharmacists are unable to perform COVID-19 containment roles in community, since presence of pharmacists at community pharmacy settings and delivery of pharmacy services have historically been plagued by shortcomings at various levels. In this document, we identified these shortcomings which need to be resolved on many fronts. Broadly, a number of intertwined government related, public related, academic curricula and pharmacist related, and drug retailers’ related factors refrain community pharmacists from performing and facilitating Pakistan’s fragile public and healthcare system in the midst of COVID-19 pandemic. Government led multifaceted approaches are urgently needed to strengthen this unrecognized domain and thereby effectively combat COVID-19 by utilizing community pharmacy services, as evidenced in the developed world. [Note: Part of this article is published in Pakistan Observer Newspaper; dated 17 May 2020).


