Knowledge, attitudes and practices towards COVID-19 among populations of Islamabad and Rawalpindi during lockdown: A cross-sectional survey

In Pakistan, the first confirmed case of COVID-19 was reported on 26 February 2020, having the travel history from Iran. Islamabad and Rawalpindi have also been affected by COVID-19 epidemic. On 23 March 2020, the Government of Pakistan has declared smart lockdown all over the country including Islamabad and Rawalpindi. The aim of the study was to identify the status of the knowledge, attitudes and practices regarding COVID-19 among the general population of the twin cities (Islamabad and Rawalpindi) in Pakistan during the COVID-19 outbreak. A cross-sectional web-based survey was conducted from 5 to 19 May 2020, the week during smart lockdown in Islamabad and Rawalpindi. Demographic characteristics were compared with independent-samples t-test, one-way, or Chi-square test. Multivariable linear regression analysis was used to identify factors associated with low knowledge score. Data analyses were conducted with SPSS version 21.0. A total of 1,282 participants completed the questionnaire. Among this final sample, the average age was 30.65 years. Among the survey respondents, 680 (53%) were women, 1096 (86%) held a bachelor's degree or above, 634 (50%) were engaged with the government and private sector and 606 (47%) were married. The overall correct rate of knowledge was 70%. The majority of the respondents agreed that COVID-19 will finally be successfully controlled (59%). Most of the participants had not visited any crowded place (74%) and 95% responded that they have reduced their outdoor activities. In response to precaution measures, 86% stated that they would isolate themselves if they ever felt a fever or cough. The study findings suggest that residents of the two cities have reasonable levels of knowledge on COVID-19. However, it is necessary to launch health education and awareness campaigns to improve the knowledge and practices about COVID-19, to control its transmission. © 2022 The Author(s).

Factors associated with noncompliance of COVID-19 guidelines recommended by Government of Pakistan for international travelers arriving at Islamabad International Airport, 1st June to 30th July 2021

Introduction: Since the start of pandemic new variants have been evolving and moving from one country to another either by air travel or ground crossings. Objective: To find out factors associated with noncompliance of recommended guidelines by international passengers so that we can improve the arrangements at airports where required, improve future preparedness, and give recommendations to concerned authorities for improvement in enforcing guidelines. Methodology: A cross-sectional study was carried out at Islamabad International Airport during the months of June and July 2021. The study population included international arriving passengers aged 12 years and above. Questions were asked about following guidelines before boarding, on board, and after disembarkation. Twenty questions were asked to assess compliance level. A median cut off value was set for assessment of noncompliance. Results: The male to female ratio was 1:1. The age range was 12 – 75 years. The odds of noncompliance to guidelines were higher in females compared to males. The results revealed a significant association between region of arrival of respondents and noncompliance. Passengers arriving from Afghanistan, the UK and the USA were more likely to be noncompliant to guidelines (p-value = 0.00). There was a significant association between occupation of participants and noncompliance. Housewives and retired were more likely to be noncompliant (p-value = 0.00). A significant association was observed between vaccinated people and noncompliance. Conclusion: Travelers arriving from some specific countries were noncompliant to guidelines. Vaccinated were most noncompliant which indicates still we need to work on awareness and need legislations, fines, or travel restrictions for noncompliant travellers. © 2022 The Author(s).

Assessing Medical Student Competency in the Teleneurology Examination

Background: The CoVid-19 pandemic prompted U.S. medical schools to increasingly implement telemedicine curriculum in undergraduate medical education. The neurological exam is wellsuited to the virtual doctor's visit, which has been demonstrated by telestroke for many years. However, there are few established protocols for assessing medical students' proficiency at performing a telemedicine exam. Studies show that students view formal telemedicine training as valuable to their medical education. Design/Methods: We recruited voluntary third-year medical students from University of New Mexico School of Medicine. We developed an innovative scorecard to yield a “neurologicalexam-score” (NES). Students were assigned a patient on which both in-person and teleneurological examination was performed yielding a “Student in-person NES” and “Student teleneurology NES”. Students were randomly assigned to perform an in-person exam or the teleneurological exam first. A neurology faculty or resident also performed an in-person examination on the patient yielding a “Faculty/Resident NES,” our “gold standard”. We compared the [Faculty/Resident NES minus Student in-person NES] score to [Faculty/Resident NES minus Student teleneurology NES] score using a one-tailed t-test, where p <.05 is considered statistically significant. Results: Twenty-nine students participated in the study. Ten were excluded for incomplete examinations and/or lack of neurology faculty NES. Comparing students' in-person exam to teleneurological exam, we found no significant difference between students' scores (mean= -0.5, p=.21). In addition, both “student in-person NES” and “student teleneurology NES” significantly differed compared to neurology faculty/resident's NES scores (mean= 2.3, p<.0001 and mean= 1.8, p<.0001 respectively). Conclusions: Students performed similarly on a teleneurological examination compared to inperson neurological examination. The study was limited by low-power and was limited to a single class. Our study shows potential in incorporating a telemedicine curriculum within the third-year clerkships and supports developing a teleneurology curriculum in an objective manner.

Association between covid-19 and anxiety among married and unmarried health workers

Aim: To explore the level of anxiety among married and unmarried health workers in Pakistan Method: This crossectional survey was conducted to explore the level of anxiety among married and unmarried health workers in Pakistan. After receiving the approval of the study from the institutional ethical review committee, data was collected online google forms from the entire Pakistan. . 592 dully filled forms were included in the study. Gender and marital status were taken as demographic variables. A Chi-square test was used to explore the difference in anxiety levels among married and unmarried health workers. Results: The results of the chi-square test revealed that there was a significant difference found between the level of anxiety among married, unmarried, and divorced health workers (X2=21.514, P001). Conclusion: Mild level of anxiety was observed in unmarried health workers (73.9%), Moderate level of anxiety was observed in married health care workers (60.2%). A severe level of anxiety was also observed among married health workers (57.6%) due to COVID-19.

Reinfection or relapse of COVID-19 in health care workers; case series of 2 patients from Pakistan.

During an ongoing pandemic of severe acute respiratory syndrome coronavirus 2, main question which has arisen in everyone's mind is about the immune response that may protect from reinfection. Coronaviruses are known for short-term immunity. Their ability of mutations enables them to escape host immunity, thus increasing chances of reinfection. Here we report two cases of reinfection among health care workers who presented with symptoms of COVID-19 disease, after 3 months of first infectious course. Such documentations are necessary for epidemiological purposes and also to monitor response of virus on re-exposure.

COVID-19 and the Clinical Phase of the Medical Doctorate Curriculum in Oman: Challenges and the way forward.

COVID-19 has gripped the world with lightning speed. Since the onset of the pandemic, activity throughout the world came to a grinding halt. However, business had to continue and people have to learn to live with the virus while the pandemic continues to rage. Medical education is no exception and may even deserve special mention, as it prepares frontline workers against the endemics of tomorrow. We discuss here the journey of medical education at the College of Medicine and Health Sciences at Sultan Qaboos University, Muscat, Oman, as the pandemic struck the world and Oman. This work suggests a roadmap for changes, discusses challenges and proposes measures to mitigate the effects of COVID-19 on medical schools.

Decontamination and Reuse of N95 Masks: A Narrative Review.

BACKGROUND: The COVID-19 pandemic has presented an unprecedented strain on healthcare supplies. Currently there is a global shortage of personal protective equipment (PPE), especially N95 masks. In order to safeguard healthcare personnel in this critical time and to mitigate shortages of N95 respirators, reuse of N95 respirators has to be considered. METHODS: Using PubMed and Science Direct, a literature search was conducted to find and synthesize relevant literature on decontamination of N95 respirators for their subsequent reuse. Peer-reviewed publications related to methods of decontamination from January 2007 to April 2020 in the English language are included in this narrative review. Bibliographies of articles for relevant literature were also scrutinized. Findings. A total of 19 studies are included in this narrative review. The appraised methods include ultraviolet germicidal irradiation (UVGI), moist heat incubation (MHI), ethylene oxide (EtO), hydrogen peroxide vapor (HPV), microwave steam bags (MSB), microwave-generated steam (MGS), dry microwave oven irradiation, hydrogen peroxide gas plasma (HPGP), dry heat, liquid hydrogen peroxide, and bleach and alcohol. CONCLUSION: In light of the COVID-19 pandemic, reuse of N95 respirators, although suboptimal, can be considered. Evidence reveals that UVGI, MHI, and HPV are amongst the safest and efficacious methods for decontamination of N95 masks. More research is needed to establish the safety and effectiveness of MGS, MSB, dry heat, EtO, liquid hydrogen peroxide, and HPGP. Alcohol, microwave irradiation, and bleach are not recommended because they damage N95 respirators.