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Friday, July 3, 2020

New trial suggests revision for global pneumonia treatment guidelines

By Abdul Qadir Qureshi
(Pakistan News & Features Services)

A new study by researchers at Aga Khan University (AKU), Karachi, has highlighted the need to improve ways to diagnose and treat pneumonia, a leading cause of death in children under five around the world. 

The Pakistan-based study, RETAPP, is the world’s largest community-based assessment of the use or withholding of antibiotics in children with mild pneumonia. Pneumonia is a lung disease caused by viral or bacterial infections. It is especially common in low and middle income countries like Pakistan where malnutrition is prevalent and vaccine coverage is low. 

There are currently different views on the use of antibiotics for treating the diseases. While global guidelines recommend the use of antibiotics, two leading infectious diseases societies in North America, the Pediatric Infectious Diseases Society and the American Society of Tropical Medicine & Hygiene, advise against the use of antibiotics in young children with mild pneumonia. 

The Pakistan-based trial followed over 4,000 children and found that antibiotics needed to be given to 44 children diagnosed with mild pneumonia, under global guidelines, in order to prevent a single child from deteriorating. This raises the risk of antibiotic resistance among children who are not suffering from pneumonia. 

The researchers noted that one of the primary symptoms to diagnose mild pneumonia in children as fast breathing is not specific to pneumonia and can be seen with other illnesses such as fever and dehydration. This often leads to misdiagnosis or misclassification of the illness leading to antibiotics being used in too many cases.

“Resistance to commonly used antibiotics is a growing concern among infectious disease specialists and other physicians. Our findings lend weight to global efforts to reduce the unnecessary use of antibiotics by highlighting that we are yet to understand the symptoms of pneumonia,” Dr Fyezah Jehan, the study’s lead investigator and a specialist in paediatric infectious diseases at AKU,” noted. 

The researchers also stressed the need to reconsider prevailing thresholds of breaths per minute required to qualify for a pneumonia diagnosis, in order to better identify children who need antibiotics. They added that other factors such as fever and wheezing can also help recognise children at risk of worsening symptoms of pneumonia. 

The study by researchers at the AKU, Uppsala University and the Bill and Melinda Gates Foundation has been published in the New England Journal of Medicine, NEJM, the most highly cited medical journal in the world. 

Other health researchers writing in an associated commentary in the NJEM said: “These important trials conducted by Jehan et al. and Ginsburg et al. have contributed to our current knowledge, yet many gaps remain in our understanding of the appropriate management of pneumonia and deserve greater attention.” 

The study’s objectives are aligned with targets under Sustainable Development Goal 3 that call for efforts to reduce preventable deaths in children under the age of 5 from infectious diseases such as pneumonia. An international data safety and monitoring board oversaw the study. Rigorous safety procedures were put in place throughout the trial to protect children from harm. 

The co-authors on the paper include Dr Imran Nisar, Salima Kerai, Dr Benazir Balouch, Najeeb Rahman, Nick Brown, Arjumand Rizvi, Yasir Shafiq and Dr Anita Zaidi.

Mirpur University's renovated library facilitating 3,000 students


By Masood Sattar Khan
(Pakistan News & Features Services)

The Azad Jammu and Kashmir (AJK) President, Sardar Masood Khan, has expressed determination to turn the public sector universities of the liberated territory into hubs of modern knowledge.

"It is our passion to transform AJK universities into centres of excellence. Our students should be prepared to serve not only AJK and Pakistan but all over the world," he stressed. 

He expressed these views while addressing the participants at the inauguration ceremony of the administration block and central library at the Jarikas Campus of Mirpur University of Science and Technology (MUST) in Mirpur on July 2. 

The event was attended among others by the Executive Director of the Higher Education Commission (HEC), Dr Fateh Mohammad Marri, the AJK Minister for Power Development Organization, Chaudhry Rukhsar Ahmed, former Minister Chaudhry Mohammad Saeed, Vice Chancellor Prof Dr Maqsood Ahmed, and former Vice Chancellor, Prof Dr Habib ur Rehman.

The President said that the AJK has the most literate population of all of Pakistan and now this human resource was stepping into the realms of advanced technological and cutting edge disciplines like cloud computing, blockchain and nano technology. 

“We can easily become a growth engine and economic hub of Pakistan if our students are imparted with such disciplines,” he stated while appreciating the university administration for establishing a business incubator centre and holding job fairs, 

He hoped that the AJK universities will prepare their students to compete with their peers on the regional and global levels to tackle the ever-changing job market. 

“Academic excellence is not confined to one region and we should strive to compete with institutions in the region and international level,” he added. 

He directed the management and faculty to impart quality education of science and technology, business and research to the young generation so that they could not only demonstrate their skills in Pakistan and Azad Kashmir but also raise the image of their motherland on a global level. 

The AJK President unveiled the plaque of the admin block of the city campus and inaugurated central library, student services centre and the mosques built at a cost of 158 million rupees. 

Masood Khan, who is also the chancellor of MUST, commended the university administration for establishing a modern central library, mosque and the cafeteria within the shortest possible time, and directed to reserve a portion of the facility for an e-library to provide online facility of the library to the non-resident students. 

Earlier in his welcome address, Vice Chancellor MUST, Prof Dr Maqsood Ahmed, informed that the library was facilitating book reading for 3,000 students as it possessed two big multimedia sections, workshop rooms and study rooms at the complex. 

He also disclosed that international relations, physics and history have been initiated at Palandri campus while faculty of health and medical sciences including the department of pharmacy, physiotherapy and medical lab technology had been introduced at the city Campus of MUST.

Coronavirus Update: Infection rate rises again

By Mukhtar Alam
(Pakistan News & Features Services)

Sindh’s rate of daily COVID-19 infections was again on the rise as the health authorities confirmed 2,430 new cases on July 2, with 31 related deaths, compared 2,139 new infections and 29 deaths registered on July 1.

Overall, the provincial tally of infections soared to 89,225, with a total 1,437 deaths on July 12. During a period from June 26 to July 2, Sindh generated an average 2,008 cases of coronavirus infections and 37 deaths daily. 

Keen observers attributed the rise in the infection rate to increased testing of suspected samples but expressed concerns over the deaths, saying both the hospitals and the provincial health hierarchy should take the issue as a challenge. “Four months were enough to understand the dynamics of the lethal virus.” 

In the meantime, according to an official study, the number of samples taken for COVID-19 test was 4,072 on June 19, which gradually dropped to 1,890 on June 28. In view of the poor sampling and testing, as per an official source, the director general of the Sindh health services had asked 24 district health officers, including three of Karachi districts, on June 28 to explain their position for showing disappointing performance on their part. 

There were a few districts which showed zero number of sample collection, the source revealed.

In a letter to Sindh health secretary on June 28, the provincial health director general had submitted names of nine district health officers of grade 19s and 20s, saying he was under directions to request initiation of disciplinary proceedings against them. 

According to the daily COVID-19 summary issued by the Sindh health department on July 2 evening, Karachi districts collectively registered 1,700 new cases during the last 24 hours, followed by Hyderabad (89), Dadu 58), Ghotki (55), Thatta (51), Benazirabad (48), Tando Allahyar (47), Larkana (47), Naushero Feroze (41), Tando Mohammad Khan (37), Sukkur (37), Khairpur (37), Shikarpur (35), Sujawal (30), Matiari (21), Badin (18), Jacobabad (16), Jamshoro (19), Sanghar (15), Umerkot (13), Mirpurkhas (11), Tharparkar (2), Kambar Shahdadkot (1) and Kashmore (1).

Of the 31 COVID-19 deaths that occurred in Sindh during the last 24 hours ending at 9 am July 2, as many as 29 were reported from Karachi, including 20 men and 9 women. The deceased men were aged 35 to 94 years while women were in the age brackets of 55 to 75. In addition, a woman of 65 lost her life at Hyderabad, while a man, aged 77, died at Dadu.

As per the official report, 49,926 patients have recovered from the disease so far, while number of samples taken so far for COVID tests stood at 471,023.