The risk of cutaneous mucormycosis associated with COVID-19: A perspective from Pakistan

Assessing the older population acceptance of healthcare wearable in a developing Country: an extended PMT model

Wearable healthcare devices (HWDs) got prominence, especially during the COVID-19 pandemic. Aiming to know the proliferation of the HWDS, this study tries to evaluate the intentions of the old-age population to use the devices. To this end, the protection motivation theory (PMT) coupled with health information accuracy, perceived novelty, perceived ease of use, hedonic motivation, health anxiety, and health consciousness were investigated as predictors of HWDs among senior Pakistani citizens. A total of 310 participants who knew how the smartwatches could be used as a health monitoring device, were surveyed to empirically test the model. The required data were then analyzed using structural equation modeling. The findings reveal that the protective, utilitarian, and personal attributes of HWDs play a significant role in choosing the HWDs. While addressing their healthcare issues, senior citizens are highly receptive to perceived usefulness, accurate information accuracy, self-efficacy, perceived severity, health consciousness, and perceived vulnerability during COVID-19. These factors have a positive impact on their willingness to use HWDs. The study educates healthcare management and users to focus on the determining factors that can enhance the use of HWDs.

Poliovirus returns to Pakistan: A rising concern

Poliomyelitis is a completely preventable but deadly virus causing paralysis in children and in some cases, death. Pakistan is one of the only two countries where polio is still prevalent despite relentless vaccination drives. In the past two months, four cases of polio have been documented in children no older than two years, condemning them to a life of disability. This commentary explores the reasons for the recent spike in polio cases and what measures can be taken to limit the spread of the disease, especially in high-risk areas where vaccine hesitancy poses a major problem. Unless drastic measures are taken by the healthcare sector, polio will continue to be a burden on the country's economy and countless more children will fall victim to the disease.

Monkeypox virus: A future scourge to the Pakistani Healthcare system

Monkeypox is a rare viral infection that is mostly concentrated in the regions of Central and West Africa. During the last couple of weeks, reports of confirmed monkeypox cases in non-endemic countries such as the United Kingdom have alerted health authorities in Pakistan as well. Keeping in mind the devastating effects of the recent COVID-19 pandemic on the healthcare system of Pakistan, a subsequent monkeypox outbreak can be catastrophic. During the COVID-19 outbreak, the lack of financial resources and manpower exposed the vulnerability of the country's healthcare system. Therefore, it is imperative that relevant health authorities proactively work towards educating the public regarding effective precautionary measures that can keep them safe in the event of a monkeypox outbreak.

The minimal COVID-19 vaccination coverage and efficacy to compensate for a potential increase of transmission contacts, and increased transmission probability of the emerging strains

Background

Mass immunization is a potentially effective approach to finally control the local outbreak and global spread of the COVID-19 pandemic. However, it can also lead to undesirable outcomes if mass vaccination results in increased transmission of effective contacts and relaxation of other public health interventions due to the perceived immunity from the vaccine.

Methods

We designed a mathematical model of COVID-19 transmission dynamics that takes into consideration the epidemiological status, public health intervention status (quarantined/isolated), immunity status of the population, and strain variations. Comparing the control reproduction numbers and the final epidemic sizes (attack rate) in the cases with and without vaccination, we quantified some key factors determining when vaccination in the population is beneficial for preventing and controlling future outbreaks.

Results

Our analyses predicted that there is a critical (minimal) vaccine efficacy rate (or a critical quarantine rate) below which the control reproduction number with vaccination is higher than that without vaccination, and the final attack rate in the population is also higher with the vaccination. We also predicted the worst case scenario occurs when a high vaccine coverage rate is achieved for a vaccine with a lower efficacy rate and when the vaccines increase the transmission efficient contacts.

Conclusions

The analyses show that an immunization program with a vaccine efficacy rate below the predicted critical values will not be as effective as simply investing in the contact tracing/quarantine/isolation implementation. We reached similar conclusions by considering the final epidemic size (or attack rates). This research then highlights the importance of monitoring the impact on transmissibility and vaccine efficacy of emerging strains.

Polio amidst COVID-19 in Pakistan: Ongoing efforts, challenges, and recommendations

Poliomyelitis is a crippling viral disease caused by poliovirus, a positive‐stranded RNA virus that is a serotype of Enterovirus C. Pakistan remains one of the countries in the world where poliomyelitis is still prevalent, posing an obstacle to global poliomyelitis eradication. With the commencement of the COVID‐19 pandemic, polio eradication campaigns have proven less feasible, resulting in an increase in polio cases across the country. Pakistan's healthcare system and socio‐economic framework are incapable of dealing with two deadly viruses at the same time. As a result, effective measures for combating the destruction caused by the spread of the poliovirus are required.

Pakistan remains one of the nations in the world where poliomyelitis is still prevalent.

The number of polio cases in Pakistan has increased due to the disruption in vaccination procedures caused by the COVID‐19‐induced lockdown.

Aside from Polio, the COVID‐19 pandemic has resulted in an increase in the number of other infectious diseases.

The country still has the potential to eradicate polio from its soil if effective tactics, mass awareness, and public compliance are implemented.

The simultaneous crises of dengue and COVID-19 in Pakistan: a double hazard for the country's debilitated healthcare system

Dengue fever is an arthropod-borne viral illness caused by four dengue virus serotypes (DENV 1-4), spread by Aedes mosquitos. Common symptoms of dengue include high peak temperature, headache, myalgia, and malaise following infection, with a rash emerging after 3 to 4 days. More than half of the world's population lives in dengue-endemic areas. Every year, around 100 million dengue cases are reported, with Southeast Asia comprising the majority. Nearly every day, there is a breakout of dengue infections in many areas of Pakistan, in addition to the ongoing COVID-19 pandemic. As a result, combating the dual burden of dengue and COVID-19 is difficult for the nation's healthcare system. Misdiagnosis owing to overlapping symptoms with COVID-19, overburdening of the healthcare system, and a lack of appropriate vaccination are some of the obstacles for dengue infection management. The government of Pakistan is pursuing a variety of measures to combat dengue fever outbreaks, including, The Pakistan Red Crescent Society was asked by the Department of Malaria Control Program to aid in promoting awareness and organizing clean-up campaigns in polluted regions and stagnant water for vector control.

Tuberculosis amidst COVID-19 in Pakistan: a massive threat of overlapping crises for the fragile healthcare systems

Mycobacterium tuberculosis is the cause of tuberculosis (TB), a granulomatous illness that mostly affects the lungs. Pakistan is one of the eight nations that accounts for two-thirds of all new cases of developing TB. TB has long been an endemic disease in Pakistan. According to the World Health Organization (WHO) estimates, the nation has over 500 000 incident TB infections per year, with a rising number of drug-resistant cases. Recently, the coexistence of COVID-19 and TB in Pakistan has provided doctors with a problem. Fever or chills, cough, shortness of breath or difficulty breathing are all signs of COVID-19. After SARS-CoV-2 infection, cough might persist for weeks or months and it is frequently accompanied by persistent tiredness, cognitive impairment, dyspnoea or pain – a group of long-term consequences known as post-COVID syndrome or protracted COVID. Coughing with mucus or blood, and coughing that continues over 2 months are indications of TB. The same clinical presentation features make it difficult for healthcare personnel to effectively evaluate the illness and prevent the spread of these fatal diseases. Pakistan lacks the necessary healthcare resources to tackle two contagious diseases at the same time. To counteract the sudden increase in TB cases, appropriate management and effective policies must be implemented. Thus, in order to prevent the spread of these infectious diseases, it is critical to recognise and address the problems that the healthcare sector faces, as well as to create an atmosphere in which the healthcare sector can function at its full potential.

COVID-19 associated pulmonary aspergillosis (CAPA): An added potential burden on India's pre-existing fungal superinfection

The ongoing pandemic that initiated in Wuhan, China, has been an international public health emergency since January 2020. India has been battling a brutal COVID-19's second wave since April 2021. The healthcare system was struggling with a substantial increase in COVID-19 cases when the lack of necessary resources further aroused a major setback. Opportunistic fungal infections, specifically mucormycosis and candidiasis have become a pressing matter of concern. Recent cases of aspergillosis have also heightened public alarm. Hence, call for an immediate response to this public health crisis is the need of the hour by establishing countrywide surveillance, diagnostic, and management system, as well as public awareness to alleviate the burden of COVID-19 and fungal infections in India.

Secondary Cutaneous Mucormycosis Post-COVID-19: Case Series from a Tertiary Center

Background

Mucormycosis is an angioinvasive mucorales fungal infection. Cutaneous type formed 10.5% of cases in India in precovid-19 era. Glucocorticoid-induced immunosuppression and hyperglycemia, reusable oxygen humidifiers in COVID-19 therapy, and preexisting uncontrolled diabetes mellitus contribute to post-COVID-19 mucormycosis. However, for post-COVID-19 cutaneous mucormycosis, sufficient data is not available.

Aim

To study factors related to post-COVID-19 cutaneous mucormycosis.

Methodology

Clinical and investigation details of six patients admitted in tertiary center with post-COVID-19 cutaneous mucormycosis.

Results

Among six patients, three were males and three females; all in 45-60 years age group from districts under tertiary center. Site of eschar was face (four) and lips (two). All six were positive for COVID-19 10-12 days prior to admission for mucormycosis. All had intravenous steroids and supportive humidified oxygen therapy for minimum 1 week under COVID-19 treatment. They presented to emergency with ophthalmic/ENT complaints; subsequently, they developed cutaneous manifestations within 2-3 days. All six had diabetes mellitus, with above 400 mg/dL sugar levels at admission.

Conclusion

This study's findings correlated with various studies across the country and elsewhere. Preexisting diabetes mellitus and steroid therapy for COVID-19 increase the risk of mucormycosis. Caution for early diagnosis, maintaining blood glucose levels, and judicious use of steroids for treatment of COVID-19 are indicated.