An Overview of the Treatment Options Used for the Management of COVID-19 in Pakistan: Retrospective Observational Study

BackgroundSince the first reports of COVID-19 infection, the foremost requirement has been to identify a treatment regimen that not only fights the causative agent but also controls the associated complications of the infection. Due to the time-consuming process of drug discovery, physicians have used readily available drugs and therapies for treatment of infections to minimize the death toll.ObjectiveThe aim of this study is to provide a snapshot analysis of the major drugs used in a cohort of 1562 Pakistani patients during the period from May to July 2020, when the first wave of COVID-19 peaked in Pakistan.MethodsA retrospective observational study was performed to provide an overview of the major drugs used in a cohort of 1562 patients with COVID-19 admitted to the four major tertiary-care hospitals in the Rawalpindi-Islamabad region of Pakistan during the peak of the first wave of COVID-19 in the country (May-July 2020).ResultsAntibiotics were the most common choice out of all the therapies employed, and they were used as first line of treatment for COVID-19. Azithromycin was the most prescribed drug for treatment. No monthly trend was observed in the choice of antibiotics, and these drugs appeared to be a random but favored choice throughout the months of the study. It was also noted that even antibiotics used for multidrug resistant infections were prescribed irrespective of the severity or progression of the infection. The results of the analysis are alarming, as this approach may lead to antibiotic resistance and complications in immunocompromised patients with COVID-19. A total of 1562 patients (1064 male, 68.1%, and 498 female, 31.9%) with a mean age of 47.35 years (SD 17.03) were included in the study. The highest frequency of patient hospitalizations occurred in June (846/1562, 54.2%).ConclusionsGuidelines for a targeted treatment regime are needed to control related complications and to limit the misuse of antibiotics in the management of COVID-19.     

Resistance to new chemical insecticides in the house fly, Musca domestica L., from dairies in Punjab, Pakistan

The house fly, Musca domestica L., is one of the major pests in dairy operations that has developed resistance to a number of insecticides with different modes of action. Adult house fly populations from six dairies in Punjab, Pakistan were evaluated for resistance to insecticides with novel modes of action (abamectin, emamectin benzoate, fipronil, imidacloprid, indoxacarb, and spinosad). Significant levels of resistance to most of the insecticides tested were observed in the present study. For avermectins at LC₅₀ level, the resistance ratios were in the range of 38.40 to 94.44-fold for abamectin and 13.16 to 36.30-fold for emamectin benzoate. Fipronil LC₅₀ resistance ratios exceeded 10-fold in three house fly populations, while all the populations had >10-fold resistance ratios for imidacloprid. Indoxacarb and spinosad had the lowest resistance ratios that ranged from 3.02 to 7.12-fold for indoxacarb and 2.91 to 9.0-fold for spinosad. As the resistance to fipronil, indoxacarb, and spinosad are emerging, therefore these chemicals should be used cautiously in management programs to retain the efficacy for longer times.     

Improving short-term sun safety practices among adolescent survivors of childhood cancer: a randomized controlled efficacy trial

Introduction  

Skin cancer is one of the most common secondary neoplasms among childhood cancer survivors. However, little evidence exists for effective interventions to promote sun safety behaviors within this population.     

The effect of foot orthoses on joint moment asymmetry in male children with flexible flat feet

Introduction

It has been widely postulated that structural and functional misalignments of the foot, such as flat foot, may cause mechanical deviations of the lower limb during walking. The aim of this study was to investigate the effect of foot orthoses on lower extremity joint moment asymmetry during the stance phase of walking in children with asymptomatic flexible flat feet.