Short-term adverse effects of COVID-19 vaccines after the first, second, and booster doses: a cross-sectional survey from Punjab, Pakistan, and the implications

ABSTRACT Background: Safety and efficacy concerns regarding coronavirus disease 2019 (COVID-19) vaccines are common among the public and have a negative impact on their uptake. We aimed to report the adverse effects currently associated with the vaccine in Pakistan to build confidence among the population for its adoption. Methods: A cross-sectional study was conducted in five districts of the Punjab province of Pakistan between January and March 2022. The participants were recruited using convenience sampling. All data were analyzed using SPSS 22. Results: We recruited 1622 people with the majority aged between 25-45 years. Of these, 51% were female, including 27 pregnant women and 42 lactating mothers. Most participants had received the Sinopharm (62.6%) or Sinovac (17.8%) vaccines. The incidences of at least one side effect after the first (N = 1622), second (N = 1484), and booster doses (N = 219) of the COVID-19 vaccine were 16.5%, 20.1%, and 32%, respectively. Inflammation/erythema at the injection site, pain at the injection site, fever, and bone/muscle pain were common side effects of vaccination. No significant differences were observed in the adverse effect scores between all demographic variables except for pregnancy (P = 0.012) after the initial dose. No significant association was observed between any variable and the side effect scores of the second and booster doses of the vaccine. Conclusions: Our study showed a 16-32% prevalence of self-reported side effects after the first, second, and booster COVID-19 vaccinations. Most adverse effects were mild and transient, indicating the safety of different COVID-19 vaccines.

Surveillance report on endemic measles in district Bannu

Objective: The objective of the current study was to report the surveillance of endemic measles in district Bannu and its peripheries

Study Design: Observational / descriptive study

Place and Duration of Study: The study was conducted in Women and Children Teaching Hospital Bannu and various BHUs and dispensaries of countryside's of the district from Jan, 2016 to March, 2016

Materials and Methods: Patients up to 16 years old were screened for febrile rash illnesses at women and children teaching hospital district Bannu and BHUs/dispensaries. Active measles cases were classified as measles, measles with eye and mouth complications, or severe complicated measles using IMCI criteria.16 most critical patient's blood samples were sent to CMH hospital laboratory Peshawar, KPK for further confirmation where test was done by ELISA technique utilizing IgM antibodies

Results: Results showed that male children were highly infected than female. Children from 1-3 years were most affected, followed by children with 1 to 12 months. Least no of cases were reported in children from 4-8 years. Bannu city surrounded areas like mammashkhel, shiekhan, surrani were more affected from measles outbreak while nearby areas are at constant threat

Conclusion: It is concluded that the peripheries were more affected from measles outbreak while nearby areas are at constant threat. In light of our findings, it can be stated that proper steps should be taken by government and non- government organization to control the situation in affected areas and to prevent the nearby areas specially the city from the current outbreak

Frequency of hypodontia in a tertiary care hospital of Karachi

To compare frequency of missing teeth in samples of population from Karachi. Cross-sectional study. This study was conducted in Department of Orthodontics, Karachi Medical and Dental College from October 2011 to October 2012. During the study period, 465 panoramic radiographs were evaluated and according to exclusion and inclusion criteria 309 panoramic radiographs were selected, out of which 109 [35.27%] were males and 200 [64.73%] were females. The patients were 12-25 years old. Data were collected and entered into the SPSS software [version 18; Chicago] to calculate frequencies, percentages and mean +/- SD. 02 males were found with hypodontia [1.83%] while 10 females were found with hypodontia [5%]. Few teeth like maxillary central incisors, 1[st] premolar and 1[st] molar in both arches show no congenital absence. A total of 17 teeth, [males = 3, females = 14] in 12 patients were congenitally missing. The most common congenitally missing teeth were maxillary left 2 incisor 23.52% followed by mandible left 2 pre-molar 17.64%. By early detection of missing teeth, alternative treatment modalities can be planned and minimize the complications of CMT. In this study it has been observed that among the population of Karachi threshold for agenesis of maxillary left 2nd incisors is the most commonly missing, followed by mandibular 2[nd] premolars

Comparison of the frequency of metabolic syndrome among diabetic and non-diabetic outpatients of a tertiary care public sector hospital in Karachi

To compare the frequency of Metabolic Syndrome among diabetic and non-diabetic out-patients of a tertiary care hospital with increased waist circumference. This cross-sectional study was conducted in Medical unit-II of Abbasi Shaheed Hospital, Karachi from September 2008 to January 2009. A total of 100 patients i.e. 50 diabetics and 50 nondiabetics were selected by non-probability, purposive sampling technique. After taking the informed consent, patients of age 30-50 years with waist circumference >102 cm in males and >88 cm in females non-diabetic and diabetic for three years were inducted in the study from out-patient department, while patients having ischaemic heart diseases, nephrotic syndrome and gestational diabetes were excluded. Blood sample was taken for lipid profile and blood glucose after 12 hours of fasting. Waist circumference in straight standing position was measured. Relevant information including age, sex, waist circumference, fasting blood glucose, lipid levels and diagnosis of Metabolic Syndrome were recorded on proforma by a physician and analyzed through SPSS-15. Among diabetics, 62% were males and 38% were females while in non-diabetics, 58% were males and 42% were females. Hundred percent diabetic patients had dyslipidaemia compared to 88% non-diabetics. Among diabetics, 88% were hypertensive while 34% non-diabetics were hypertensive. Sixty percent of diabetics and 28% of non-diabetics had metabolic syndrome [p = 0.001]. There was a significantly high proportion of Metabolic Syndrome with increased waist circumference in diabetic patients

Gerd symptoms and body mass index: a study in outpatients of Abbasi Shaheed hospital

This study aimed to determine the association between GERD [Gastro-Esophageal Reflux Disease] symptoms and Body Mass Index [BMI] in the outpatients of Abbasi Shaheed Hospital, Karachi. A comparative cross-sectional study was conducted in Abbasi Shaheed Hospital, Karachi from December 2008 to March 2009. By convenient sampling method, 200 outpatients who met the inclusion criteria were enrolled in the study, visiting the hospital with symptoms of epigastric pain, nausea, vomiting, acid regurgitation, heart burn, burping, belching, and feeling of wind. A questionnaire was filled, which contained patient's demographic profile, information on the frequency of all GERD symptoms and severity of main GERD symptoms. History of smoking, alcohol, drugs or any illness were also inquired and noted. Statistical analysis was done by SPSS version 16. Among 200 outpatients, 65% were females and 35% were male. Mean age was 38.4 years. Nausea was complained in 87%, epigastric pain in 66%, acid regurgitation in 66% and heart burning in 64% of patients. The frequency of heartburn and acid regurgitation was seen once a week in 39% and 45% of patients respectively while severity of heartburn and acid regurgitation was found 25% and 33% of patients respectively and there relation with body mass index were found insignificant. Co-relation of body mass index was not associated with symptoms of gastro-esophageal reflux disease i.e.: nausea [p=0.06], epigastric pain [p=0.658], acid regurgitation [p=0.935], heart burn [0.525]. Our study concludes that in our setting, the symptoms of GERD occur independently of body mass index. It seems that high BMI plays a more important role to cause symptoms of GERD among western population but not in Asian populations. However, further studies in Asian communities are also required in this regard

Risk of hypoxia during flexible upper GI endoscopy in unsedated patients of a tertiary care public sector hospital in Karachi, Pakistan

To measure the changes in oxygen saturation using pulse oximetry during flexible upper gastrointestinal endoscopy in unsedated patients. This is an observational study conducted on 356 patients undergoing unsedated upper gastrointestinal Endoscopy, during April 2009 to January 2010. Complete demographic data, systemic history, smoking history, laboratory evaluation and American Society of Anesthesiologists Physical Status [ASA-PS] were recorded in all patients. Patients with severe systemic disease [ASA-PS III-VI], those who needed emergency endoscopy and with anemia of hemoglobin <8gm/dl were excluded from the study. Out of 356 patients 186 [52.2%] were male and 170 [47%.8] were female. All the patients tolerated the procedure well at the start and at the end and had no oxygen desaturation. At mid of the procedure 21 [5.9%] patients showed mild oxygen desaturation and 4 [1.1%] showed moderate oxygen desaturation while 331 [93%] showed no oxygen desaturation. No patient at any stage showed severe oxygen desaturation. Relationship of smoking, co-morbidity and clinical signs with mid procedure oxygen saturation is insignificant in both genders. It is concluded that mild to moderate hypoxia is some what common during therapeutic endoscopic procedure and of no serious consequence. However, severe hypoxia is not recorded in our study. The unsedated gastrointestinal endoscopy is a safe procedure for the diagnostic purpose, as it does not produce hypoxia during this; therefore pulse oximetry is not a precondition in patients undergoing unsedated diagnostic endoscopy without severe systemic disease. We recommend monitoring through pulse oximetry in patients with age greater than 45 years and procedure longer than 8 minutes

Prevalence of sub-types and severity of red-green color vision deficiency in medical students of Karachi

The study aims to find out the prevalence of sub-types and severity of red-green color vision deficiency in medical students of Karachi. It was a cross sectional study conducted on the students of Karachi Medical and Dental College and Dow University of Health Sciences. With Convenient sampling, 550 healthy medical students [185 males and 365 females] were tested by using pseudo-isochromatic plates of 24-plates Ishihara chart. The data is presented in the form of numbers and percentages. 10 [5.4%] out of 185 males while only 01 [0.26%] out of 365 females were found to have red-green color vision deficiency. In males, 03 [1.62%] were Protans and 07 [3.78%] were Deutans. Protanomaly was detected in 01[0.54%], protanopia in 02 [1.08%], deuteranomaly in 02 [1.08%], deuteranopia in 05 [2.70%]. In females, the only case found was deuteranopia, 01 [0.26%]. By conducting screening for all medical students for diagnosing and detecting the sub-types and severity of CVD and provision of adaptive strategies and behavioral support will help them to deal with the potential difficulties, which could be overcome by awareness, self-training and effort. Moreover it is strictly advisable to avoid certain subspecialties as a career of choice

Frequency of ante-partum depression in public and private sector

To find out the frequency of ante-partum depression in public and private sector. The study was conducted at Abbassi Shaheed Hospital, Nazimabad [Government sector], Liaquat National Hospital, Stadium road [Private sector] and Aga Khan Maternity Hospital, Karim-a-bad [Private sector]. A sample of one hundred and fifty [150] subjects was selected. The survey was conducted by self administered questionnaire comprising of questions regarding Depression, Gynecological, Obstetrical, Medical, History Of Daily Interest, Emotional, Physical and Mental symptoms. All patients were made to fill one more questionnaire that is H.A.D. [Hamilton Anxiety Depression] scale of Abbasi Shaheed Hospital [Department of Psychiatric Medicine]. After selection of subjects from the Hospital, their verbal consent was taken. They were asked questions and the questionnaire was filled after translating it to them in Urdu. The result of the study showed that in Aga Khan Maternity Hospital, 4 [13.3%] out of 30 cases were in severe depression, In Abbasi Shaheed Hospital 23 [41.8%] out of 55 cases were in severe depression whereas in Liaquat National Hospital 14 [21.5%] cases were in severe depression. It also showed that 32.7% were diagnosed as mild depressive patient, while the ratio of moderate, severe and no depression is 17.3%, 28% and 22% respectively. It was found that a great proportion of pregnant ladies attending either public/private sector hospital experienced mild to severe depression. Females with severe depression were more prone to be belonging to low socio-economic group. Further more our research showed that ratio of depression was high among maternal age group of 18-28 years as compared to older age group. The study showed that depression was common among primi-para. It was also seen that house wives were more depressed during pregnancy as compared to working women