COVID-19 Pandemic and Maternal Perspectives

Aim Coronavirus (COVID-19) pandemic has affected perinatal women worldwide. Our study aimed to describe the opinions of perinatal women about COVID-19 related knowledge, attitude, and practices. Methods Pregnant and Postnatal women (n=223) were included and those who did not consent, and less than 16 weeks' gestation, were excluded. SPSS version 26 was used for descriptive statistics. Results Most of the women had good knowledge about COVID 19 regarding its nature, transmission, & symptoms. Their information sources were news (139/206=67.5%) and the internet (85/206=41%). Women understood the uncertainty around its effect on pregnancy; as it is a novel infection. A substantial number of women were concerned (130/206=63%), upset by social isolation (86/206=42%), negatively impacted by the visitor restrictions in hospital (154/206=75%), and faced COVID-19 related reduced household finances (97/206=47%). Most of them used hand washing (201/206=98%) & social distancing (191/206=93%) as preventive measures. They reported compromised contact with General Physician (GP) service as compared to the hospital service (85/206=41% Vs 31/206=15% respectively) during the pandemic. Conclusions The main challenges of the COVID-19 pandemic for perinatal women are the jeopardized GP & hospital services & psychological distress. It is imperative to incorporate telemedicine & virtual visits to tackle the burden of the COVID-19 pandemic. Perinatal women, are particularly vulnerable to the psychological impacts of the COVID-19 pandemic & societal lockdown, thus necessitating holistic interventions.

Efficacy of biorational insecticides against Bemisia tabaci (Genn.) and their selectivity for its parasitoid Encarsia formosa Gahan on Bt cotton

The toxicity of seven biorational insecticides [five insect growth regulators (Buprofezin, Fenoxycarb, Pyriproxyfen, Methoxyfenozide, and Tebufenozide) and two oil-extracts of neem and bitter gourd seeds] against Bemisia tabaci and their selectivity for its parasitoid, Encarsia formosa were evaluated in laboratory and field conditions for 2 years (2018-2019) in Pakistan. Toxicity results demonstrate that Pyriproxyfen, Buprofezin, and Fenoxycarb proved to be effective (80-91% mortality and 66.3-84.2% population-reduction) against B. tabaci followed by Methoxyfenozide, Tebufenozide (50-75% mortality and 47.8-52.4% population-reduction), and then oil-extracts of neem and bitter gourd (25-50% mortality and 36.5-39.8% population-reduction) in the laboratory [72 h post-application exposure interval (PAEI)] and field trails (168 h PAEI), respectively. All tested biorationals, except Methoxyfenozide [(slightly-harmful/Class-II), i.e., causing mortality of parasitoids between a range of 25-50%] and Tebufenozide [(moderately-harmful/Class-III), i.e., causing mortality of parasitoids between the ranges of 51-75%], proved harmless/Class-I biorationals at PAEI of 7-days in the field (parasitism-reduction < 25%) and 3-days in the lab (effect < 30%). In laboratory bioassays, exposure of parasitized-pseudopupae and adult-parasitoids to neem and bitter gourd oils demonstrated that these compounds proved harmless/Class-I biorationals (< 30% mortality). Alternatively, Pyriproxyfen, Buprofezin, Fenoxycarb, Methoxyfenozide, and Tebufenozide were slightly-harmful biorationals (30-79% mortality) against the respective stages of E. formosa. We conclude that most of the tested biorationals proved harmless or slightly harmful to E. formosa, except tebufenozide after PAEI of 7-days (168 h) in the field and, therefore, may be used strategically in Integrated Pest Management (IPM) of B. tabaci.

Day-case local anaesthetic radiofrequency thermal ablation of benign prostatic hyperplasia: a four-year follow-up

OBJECTIVE

This study reports long-term (median 4 years) clinical effectiveness, safety and patient acceptance of transurethral ablation prostatectomy (TURAPY) for symptomatic benign prostatic enlargement (BPE) using a radiofrequency technique.

MATERIAL AND METHODS

25 men were treated as day-case procedures under local anaesthesia for 1 h. The age range was 55-88 years (mean age 65.5 years) and all were suffering from symptomatic BPE with urinary flow rates of 12 ml/s or less. The treatment was carried out with a computer-based device using a special heating element mounted on a Foley-like catheter for prostatic ablation and the temperatures were monitored continuously in the prostatic region, sphincteric area and rectum for safety purposes.

RESULTS

TURAPY was carried out in all patients with temperatures ranging from 70 to 82 degrees C depending on the tolerance of the patient. The post-treatment mortality was nil and only 19 patients complained of mild dysuria, passing of some debris and/or minor bleeding on voiding which settled spontaneously in 2-3 weeks, except in two patients who had proven urinary infection requiring antibiotic therapy. At 4 years the International Prostate Symptom Score (I-PSS) improved from a mean value of 16.0 to 7.2 (p < 0.01) with quality-of-life score falling from 4 to 1.9 (p < 0.05); mean flow rate increased from 8.5 to 11.7 ml/s and mean residual volume decreased from 185.04 to 52.8 ml (p < 0.05). Post-treatment pressure flow studies in 14 patients showed normal pressure voiding in one, with four being in an equivocal range, but the rest were obstructed. Prostate ultrasound scanning before and after treatment in 15 patients showed a mean reduction of volume of 16.7 ml suggesting cavitation of prostate following TURAPY.

CONCLUSIONS

TURAPY provides lasting subjective but modest objective benefits in symptomatic BPE patients. It is worthy of consideration in elderly patients, or in those who are unfit for surgery or who do not wish to undergo surgery. It is a safe procedure with little transient morbidity but no mortality.

Limited effectiveness of home drinking water purification efforts in Karachi, Pakistan

OBJECTIVE

In many developing-country urban areas, municipally supplied water is not microbiologically safe. This study evaluated drinking water quality and effect of home water purification efforts in Karachi, Pakistan.

METHODS

Members of 300 households, including 100 households who used the Aga Khan University Hospital Laboratory and 200 of their neighbors were interviewed. In 293 consenting households, structured observations were performed and drinking water was analyzed for the presence of coliforms, using the multiple tube fermentation technique.

RESULTS

Although 193 of the 293 households (66%) reported using some method to purify their drinking water, including 169 (58%) who boiled their water, only 48 (16%) of the drinking water samples were free of coliforms. Although a combination of boiling and filtering was the most effective method of purification, only 38% of samples that had been boiled and filtered were free of coliforms.

CONCLUSIONS

Further refinements and evaluations of home-based efforts to purify and store water are needed.

Relationship of fetal macrosomia to a 75g glucose challenge test in nondiabetic pregnant women

We determined in nondiabetic women, the relationship of plasma glucose values obtained 2 hours after a 75 g oral glucose challenge test (GCT) at 16-20 weeks' gestation, with the incidence of macrosomia in term deliveries (37-41 weeks' gestation). From 1988-1990, in a systematic screening programme data collected prospectively from 1,331 women were analysed retrospectively. Women with gestational diabetes or impaired glucose tolerance (n = 53) were excluded. The rest (n = 1,278) had no evidence of glucose intolerance including 1,215 women with normal plasma glucose by GCT (< 7.8 mmol/L 2 hours after 75 g oral glucose load) and 63 women with abnormal GCT but not abnormal value at a glucose tolerance test. The GCT values were divided into 5 groups: Group A (< 4.5 mmol/L), B (4.5-5.5 mmol/L), C (5.6-6.6 mmol/L), D (6.7-7.7 mmol/L) and E (> 7.8 mmol/L). The variables studied were age, parity, gestational age at delivery and incidence of macrosomia. Using > 4 kg birth-weight as the definition of macrosomia, the incidence increased from 1.2% to 9.5% with increasing plasma glucose values in the GCT from Group A (> 4.5 mmol/L) to E (> 7.8 mmol/L). Similar trends of increasing incidences from 7.2% to 15.8% and 2.9% to 9.5% were noted when 90th and 95th birth-weight percentiles, respectively were used as definitions of macrosomia. The test of linear trend in this association was significant (p < 0.01). These results were not influenced by parity or gestational age at delivery.(ABSTRACT TRUNCATED AT 250 WORDS)