ABSTRACT
Covid immunization commenced on 2nd Feb 2021 in Pakistan and as of 7th Sep 2021, over 84 million vaccine doses were administered in Pakistan, of which 72% procured by the government, 22% received through Covax and 6% were donated. The vaccines rolled out nationally included: Sinopharm, Sinovac and CanSinoBIO (China), AstraZeneca (UK), Moderna and Pfizer (USA), Sputnik (Russia), and PakVac (China/Pakistan). About half of the eligible population in Pakistan (63 m) had received at least one dose of Covid vaccine as of Sep 2021. Pakistan National Pharmacovigilance Centre (PNPC) in coordination with WHO, MHRA and Uppsala Monitoring Centre (UMC) established pharmacovigilance centers across Pakistan. The Covid vaccine AEFIs in Pakistan were mainly reported via NIMS (National Immunization Management System), COVIM (Covid-19 Vaccine Inventory Management System), 1166 freephone helpline and MedSafety. There have been 39,291 ADRs reported as of 30th Sept 2021, where most reported after the first dose (n = 27,108) and within 24-72 h of immunization (n = 27,591). Fever or shivering accounted for most AEFI (35%) followed by injection-site pain or redness (28%), headache (26%), nausea/vomiting (4%), and diarrhoea (3%). 24 serious AEFIs were also reported and investigated in detail by the National AEFI review committee. The rate of AEFIs reports ranged from 0.27 to 0.79 per 1000 for various Covid vaccines in Pakistan that was significantly lower than the rates in UK (~4 per 1000), primarily atrributed to underreporting of cases in Pakistan. Finally, Covid vaccines were well tolerated and no significant cause for concern was flagged up in Pakistan's Covid vaccine surveillance system concluding overall benefits outweighed risks.Copyright © 2022
ABSTRACT
Pakistan has reported a substantial number of COVID-19 cases since 2020. A multicenter observational study was conducted to identify the pattern of SARS-CoV-2 infection, transmission, and treatment in patients admitted to seven low to middle-income district hospitals in the Province of Punjab, Pakistan from March to June 2020. A total of 102 patients were recruited. 57 patients tested positive and 45 developed moderate-severe COVID-19 disease. About 67% of the patients in March-April and 93% in May-June have contracted the disease from the local transmission. The mean number of symptoms in SARS-CoV-2 positive patients was significantly higher than suspected patients (6.46 vs 5.04, p=0.003). The number of deaths was low (n=8) with 86% recovery rate. Mild COVID patients received acetaminophen (n=102), azithromycin (n=8), and hydroxychloroquine (n=4) in addition to standard medical care. The treatment provided to moderate-severe cases included acetaminophen (45/45), azithromycin (45/45), Ivermectin (14/45) and corticosteroids (13/45). The mean number of antimicrobials was significantly higher in moderate-severe patients than mild cases (1.80 vs 1.12, p=0.001). Low number of deaths with a high recovery rate was reported. Diabetes was the most common comorbid condition followed by hypertension. Many antimicrobials were prescribed in both mild and moderate-severe cases that require careful review.
ABSTRACT
Aim: To determine the role of vitamin D in the management of COVID-19 patients regarding morbidity and mortality. Study Design: Prospective/Observational Place and Duration: Departments of Medicine & Pulmonology, Allama Iqbal Memorial Teaching Hospital, Sialkot and Department of Medicine, Sughra Shafi Medical Complex Narowal from 1st November 2020 to 30th April 2020. Methodology: One hundred and sixty patients of both genders diagnosed to have COVID-19, were enrolled. Patient s ages were ranging from 17 to 70 years. The detailed demographics such as age, sex, and body mass index were recorded. 5 ml blood samples were taken from all the patients to check their vitamin D levels. Severe Vitamin D deficiency was defined as 25(OH)D <25 nmol/L (10 ng/dl). Association between mortality and morbidity was examined. Results: Ninety (56.25%) were males while 70 (43.75%) were females with mean age 40.15±17.37 years. Mean body mass index of patients was 24.16±7.26 kg/m2. Severe vitamin D deficiency was observed in 80 (50%) patients. Mortality found in 30 (18.75%) patients. Frequency of morbidity was among 66 (41.25%) patients. Patients with severe vitamin D deficiency had high rate of mortality 20 (25%) and morbidity 50 (62.5%) as compared to patients with no vitamin D deficiency had 10 (8%) mortality and 16 (20%) morbidity. A significant association was observed between severe vitamin D deficiency regarding morbidity and mortality among patients with covid-19 disease with p-value <0.05. Conclusion: The vitamin-D has strongest relationship among patients with covid-19 disease to reduce mortality and morbidity.
ABSTRACT
COVID-19 pandemic has increased the generalized anxiety among nursing staff. This cross-sectional questionnaire-based study aimed to determine the generalized anxiety disorders among the nursing staff working in secondary and tertiary care hospitals in Punjab province, Pakistan. A GAD-7 scale was used to assess anxiety. Non-parametric statistics were applied to estimate the difference among the groups. Multiple regression model was adopted to explore the impact of covariates on the GAD-7 score. A total of 133 nurses responded to this survey. It was revealed that being female (7.38 +/- 4.20, p=0.032) and having an age of >= 31 years (7.68 +/- 5.14) might lead to a higher GAD-7 score. 19.6% of the respondents had a high level of generalized anxiety (GAD-7 score >= 10), and about 49.6% were falling in the range of mild anxiety. Female nursing staff have the probability of higher GAD-7 score up to 15% [0.148(-0.450 - 4.697), p= 0.049]. Job experience, especially being new to the field (<= 3 years) might increase the likelihood of having a higher GAD-7 score by 14%. In conclusion, 19.6% of the respondents were meeting the GAD-7 criteria of moderate-severe level of generalized anxiety and depressive disorder. Being female, having less job experience, and no training on how to handle COVID patients were revealed to the main factors influencing the GAD-7 score. Risk of getting COVID, transmission of COVID to family members through them, and uncertainty about the consequence of COVID in Pakistan were some of the common stressors reported by the nurses who participated in this study.
ABSTRACT
Objectives: To evaluate Pakistani healthcare workers' knowledge, attitude and preventive practices related to COVID-19. Methods: A cross-sectional study was conducted among the healthcare workers (medical doctors, nurses, pharmacists, physiotherapists, hospital technicians and technologists) providing services at seven hospitals of Punjab province of Pakistan. A self-administered questionnaire was used to evaluate COVID-19 related knowledge, attitude and practices. Results: A total of 458 healthcare workers were approached and 429 were recruited (response rate = 93%). The mean age of the participants was 29.8 ± 5.7 years, with majority of medical doctors (42%) followed by nurses (38%) and pharmacists (14.9%). All of the participants reported that they were aware of COVID-19 outbreak and social media was the major source (65%) of this information. Mean knowledge score was 12 ± 2.1, with 75.5% of participants having satisfactory knowledge of COVID-19. Doctors were found have significantly better knowledge scores than other healthcare workers (p = 0.001). Mean attitude score was 8.0 ± 1.2, with a wide majority of healthcare workers (86.5%) having positive attitudes. Regarding COVID-19 related preventive practices, around 64% reported of always covering nose and mouth with a tissue during sneezing or coughing and nearly 65% disposed of the dirty tissue in trash bins. Only 40% of the participants reported that ‘if they do not have tissue, they cough or sneeze into upper sleeve’. Only 56% reported of always washing their hands, with soap and water, quickly after coughing or sneezing or touching contaminated objects like a tissue. Overall, mean practice score was 23.3 ± 3.6, with 73.4% of healthcare professionals having satisfactory preventive practices. Conclusions: Although overall COVID-19 related knowledge, attitude and practices of Pakistani healthcare workers are satisfactory, there are some misconceptions and malpractices that must be addressed.