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OBJECTIVE: To assess and compare the cognitive functioning of post-Covid patient with non-Covid person among the general population of Khyber Pakhtunkhwa province of Pakistan. METHODS: This descriptive cross-sectional study was conducted from January to May 2021. Sample of 500 community members, including both post-Covid and non-Covid, from population of Khyber Pakhtunkhwa, Pakistan. Male and female with age of 18-64 years were included, age less than 18 years, having any nervous system or psychiatric illness or previous known cognitive impairment were excluded from the study. Validated Cognitive Functioning Self Reporting Scale (CFSS) questionnaire was used. Data was analyzed through SPSS V.25. RESULTS: Out of 600 approached, 500 (83.3%) participants responded to online questionnaire. Mean age of participants was 45+or-22 years, Majority (n=174: 34.7%) of participants were from 31- 40 years' age group. Hypertension (n=33;6.6%) and Diabetes Mellitus (n=30;6%) were the most common comorbid conditions;while 378 (75.6%) had no comorbidities. Mean CFSS values was 38.4+or-11.5 and 42.2+or-12.04 for male (n=230) and female (n=270) participants respectively. Based on standard cut off values of CFSS, mild, moderate and severe cognitive impairment was observed in 46 (24.8%), 127 (68.6%) and 12 (6.4%) cases of post-COVID and 19 (20.4%), 73 (78.4%) and 1 (1.0%) cases of non-COVID participants having no comorbidities. CONCLUSION: Cognitive performance was moderately affected among post COVID patients as compared to non-Covid population, compromising daily executive functioning as well as other elements of mental health such as attention, memory, spatial functioning & inhibition.
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OBJECTIVES: To compare the values of the hematological and inflammatory markers in 1st and 4th waves to predict the outcome of COVID-19 in a hospital-based study. METHODOLOGY: This comparative study was conducted in the Department of Hematology, Hayatabad Medical Complex Peshawar, from April 2020 to 20 August 2021. Tests of significance (Independent t-test/Mann Whitney U test) and Chi-square test were used. Relevant information was recorded on a pre-designed proforma prepared following the study's objectives. RESULTS: A total of 178 patients, 71 from (the 1st wave) and 107 from (the 4th wave) with known outcomes, were studied. A statistically significant difference exists between the groups (1st vs 4th wave) regarding hematological markers;neutrophil to lymphocyte ratio (NLR) (p=0.02), Absolute Neutrophilic count (ANC) (p=0.01) and platelet count (p=0.001). Similarly, significantly higher inflammatory markers values were recorded in the 1st wave compared with the 4th wave regarding inflammatory markers;CRP (p=0.002) and D-dimer (p=0.001). During the 1st wave, Total Leukocyte Count (TLC), ANC and d-dimer were the leading prognostic indicators to predict mortality/worst outcome in COVID-19 with an Area Under Curve (AUC) of 0.74, 0.70 and 0.7 on receiver operating characteristics (ROC) respectively. In 4th, the Area under the curve (AUC) of d-dimer was 0.84 to predict mortality. CONCLUSION: TLC, ANC, NLR, and low platelet count were the worst hematological markers in COVID-19 in the first wave, while d-dimer and CRP were the primary prognostic inflammatory markers. Unlikely in the 4th wave, the prognostic values of hematological markers were merely significant. The d-dimer values in both the waves proved to be reliable for predicting the severity and mortality of COVID-19.
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OBJECTIVES: To assess the patient satisfaction with telepsychiatry consultations, and whether time and money was saved by patients availing the service. METHODS: Anonymous internet survey using Google Form method, was conducted between April 2020 and September 2020 to collect data from patients using teleconsultation in out-patients psychiatry clinic. The google form consisted of patient satisfaction questionnaire, demographic details, and additional questions about the money and time saved by patients using the service. RESULTS: Out of 260 participants, 152, (58.5%) were males, 148 (58.3%) were married and majority (n=157: 60.4%) of patients were <40 years of age. About 62.7% (n=163) were highly educated. Majority (n=108;41.5%) of the survey participants were from Khyber Pakhtunkhwa province. The average cost saving was Pakistani Rupees 3000 for the consultation whereas the average time saved was 1.5 days. Patients were happy during communication with doctor including seeing doctor on screen (85.7%), hearing to doctor (90.4%), talking to doctor (84.6%) and discussion of their care plan (81.6%). Majority (79.2%) of the survey participants were happy with the meeting of care needs and 86.5% were happy to avail the service in future. CONCLUSION: The study underscores the importance of telepsychiatry as mode of service delivery during the pandemics. The findings demonstrated a high level of patient satisfaction, considerable amount of time and money saving indicates the effectiveness of telepsychiatry consultation. It needs to expand the telepsychiatry service both in public and private hospitals and also test this model on a representative sample of patients in Pakistan.
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The novel coronavirus disease COVID-19 outbreak has caused significant global issues and challenged healthcare systems across the globe and in Pakistan as well. This infectious disease is found to be a pandemic and has massively impacted countries across the world. The disease is still rapidly spreading and has caused many deaths in Pakistan, according to the world health organization;early in the year of 2020, Pakistan was ranked among the top 10 countries in the world reporting the highest number of new cases of COVID-19 per day during the first wave of the outbreak. The second wave of COVID-19 was relatively high on the first wave of disease in the current scenario of the pandemic. In the all over Pakistan, the real-time PCR is being applied for the qualitative detection of COVID-19 in the human nasopharyngeal swab specimen. From Feb to Dec. 2020, in Pakistan there were a total of 416,499 cases registered across the country there have been (2%) deaths, with (85.2%) total recoveries. Sindh and Punjab were the most affected provinces, however, Balochistan, KPK, and other regions of Pakistan were less affected comparatively. This short communication is carried out to shed light on the coronavirus outbreak in the country;it will help to highlight the recoveries and mortalities rate of first and second waves of the disease.
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Background: Health care workers (HCWs) working on frontlines in COVID-19 pandemic are highly vulnerable to deteriorating physical and mental health. The quality of life of health care workers plays an important role in their skilful delivery of work. Our study assesses their quality of life (QOL) during COVID-19 pandemic so that appropriate measures can be taken to improve their well-being.