Health and Immune Boosting Techniques of General Adult Pakistani Population: A KAP Study.

OBJECTIVE: To discover Pakistani adult population's perception about their general health, immune status and knowledge regarding immunity, and to highlight their efforts to improve it. METHODS: The knowledge-attitude-practice study was conducted from January to May 2021, after approval ethics review committee of the Islamic International Medical College, Rawalpindi, Pakistan, and comprised individuals of either gender from the community aged 18 years or more and not suffering from any physical disability or mental illness. Data was collected using a pre-tested, self-administered questionnaire that was disseminated through online platforms. The collected data was analysed using SPSS 25. RESULTS: All the 455(100%) individuals approached responded to the questionnaire. The mean age of the subjects was 22.6±7.579 years. There were 256(56.3%) female respondents, 283(62.2%) were aged 20-21 years, and 359(78.9%) hailed from the Sindh province. Most participants perceived their general health as 'good' 197(43.3%). The immune system function was reported 'good' by 200(44%), and the perception of general knowledge of immunity was reported 'good' by 189(41.5%) subjects. Inverse relationships were identified between stress levels and self-perceived health, and between receiving effective homeopathic treatment and 'very good' self-perceived immune status (p<0.05). People willing to take non-obligatory vaccines had a positive opinion about their self-perceived knowledge on immunity that produced a direct relationship (p<0.05). CONCLUSIONS: The findings provide a framework of practices that should be promoted to improve health status of adult population in Pakistan.

Demographic Factors, Conspiracy Theories, and Beliefs Associated With COVID-19 Vaccine Hesitancy Among Pakistani Population: A Cross-Sectional Study.

Introduction The coverage of coronavirus disease 2019 (COVID-19) immunization uptake has been impacted by the acceptance of regular vaccine uptake and, like many other vaccination attempts in the past, it also faces issues of vaccine hesitancy. Through this study, we hoped to assess the conspiracy theories and beliefs attached to the COVID-19 vaccination efforts in Pakistan Methods This study was conducted among the general population of Pakistan, aged 16 and above, from April 29 to May 29, 2021. The data was collected through English and Urdu questionnaires by a method of convenient sampling. A total of 600 participants were asked to fill in 34 questions pertaining to vaccine hesitancy and conspiracies. We used the Modified Kuppuswamy Socioeconomic Scale, Kuppuswamy Socioeconomic Scale, Conspiracy Mentality Questionnaire (CMQ), and Vaccine Conspiracy Belief Scale (VCBS) as our questions. Results A total of 591 participants responded to our questionnaire. The majority were females (56.7%), had an undergraduate degree (41.5%), and belonged to the upper middle socioeconomic class (40%). Factors like occupation (p=0.001), education (p=0.001), socioeconomic status (p<0.001), any family member who contracted coronavirus (p=0.016), source of knowledge (p=0.002), and total monthly income (p<0.001) were found to be statistically significant. Conclusion The findings of this study suggest that conspiracy theories and misinformation about vaccinations are prevalent in our region. They are influenced by propaganda and negative cultural values among the population To combat and restrict the spread of this problem, our study can provide useful data to develop more appropriate policy measures.

Budding Medical Professionals And Covid-19: The Impact Of Covid-19 On Mental Health And Medical Students.

BACKGROUND: Due to the Novel Coronavirus Disease, medical education has transformed from a physical to an online-medium. The importance of physical education in low-and-middle-income countries (LMICs), where online education can be challenging there is a need to explore the factors that affect online education. This study assesses the perspective and mental health of students whose medical education has been impacted by the pandemic. Methods: An online-questionnaire was distributed through social media platforms from October-to-December 2020 through Google-Forms among medical students across Pakistan. Two grading-scales were used to score anxiety and depression. Descriptive statistics and a logistic regression analysis were used to identify factors associated with anxiety and depression among medical students. p<0.05 was considered as significant. Data was analyzed using STATA v.15. RESULTS: Total of 433 medical students participated in the study where 68.1% had some form of depression and 10.9% had anxiety. Around 65%-participants disagreed with the preference for online-classes. Seventy percent agreed on "Has the thought of the pandemic made you worry about your academic future" being associated with COVID-19 related-depression (OR: 2.03, 95%CI: 1.32-3.11). Multivariate analysis showed agreeing to "COVID affected my educational performance" was associated with anxiety (OR:1.45, 95%CI: 1.03-2.06) and depression (OR: 1.27, 95%CI: 1.03-1.56). CONCLUSIONS: Being part of the Low- and-Middle-Income Countries (LMIC), online-education itself becomes a challenge. Given the continued shutdown of universities across the country and the growing anxiety and depression amongst the students, adequate measures should be taken to help in coping up with the current challenge.

New-onset Parkinsonism as a Covid-19 infection sequela: A systematic review and meta-analysis.

Background: There remains a scarcity of literature regarding COVID-19 and its neurological sequelae. This study highlights Parkinsonism as a post-COVID-19 sequela and helps us understand a possible link between the two. Methods: A literature search covering relevant databases was conducted for studies reporting the development of Parkinsonism in patients recovering from COVID-19 infection. A quality assessment tool developed by The Joanna Briggs Institute Critical Appraisal tools for the assessment of case reports was utilized. Fisher's exact test was used to explore the factors associated with COVID-19 and Parkinsonism as its complication. Results: Ten studies were included in our study. The median age of patients was 60.0, with an interquartile range of 42.5-72.0. There were 8 males (61.5%) patients, and 53.8% of cases were reported to have at least one comorbidity. Cogwheel rigidity was the most common symptom of Parkinsonism in 11 patients. While the most standard treatment modality used was Levodopa in 76.9% of cases. Using the Fisher's Exact test, it was identified that 10 patients (76.9%) with bradykinesia made a full recovery. Conclusion: Despite presumed "recovery" from COVID-19, patients still face a wide range of neurological complications. One of these complications presenting as Parkinsonism requires health care professionals to be on the lookout for the long-term effects of COVID-19. Hence, our study provides information on the possible likely hood of a link between COVID-19 and the development of Parkinsonism as post-COVID neurological sequelae.

New-Onset Refractory Status Epilepticus Secondary to COVID-19 Infection in Adults: A Systematic Review.

Background: New-onset refractory status epilepticus (NORSE) has been reported in the scientific literature as a phenomenon associated with the COVID-19 infection. Given the resurgence of the newer variants of COVID-19 added with its multi-system manifestations, this project was conducted to study the clinical picture of NORSE secondary to COVID-19 infection. Methods: Three electronic databases were searched using an extensive search strategy from November 2019 to December 2021. Patients reporting NORSE secondary to COVID-19 were included in this review. The status epilepticus severity score (STESS) was calculated by the study authors for individual patients. Statistical analysis was performed using SPSS version 26 with a p-value <0.05 as statistically significant. Results: After screening, 12 patients were included in this study with a mean age of 61.6 ± 19.0-year olds. The most common type of status epilepticus reported in our study population was non-convulsive status epilepticus (NCSE) (7 out of 12 patients, 58.3%). The linear regression model revealed that STESS scores were significantly influenced by patients' age (p = 0.004) and intra-hospital occurrence (IHO) of status epilepticus (p = 0.026). Overall, 8 patients (66.7%) were discharged without complications. Conclusion: Given the observed association of STESS with the aging population and IHO of status epilepticus, special attention is due to the caretakers of this population, while further studies are needed to further build upon this review.

Residual symptoms and the quality of life in individuals recovered from COVID-19 infection: A survey from Pakistan.

BACKGROUND: There remains scarcity of literature regarding the patient's health status post-COVID-19 infection. This study analyzes the prevalence of residual symptoms and quality of life (QoL) after COVID-19. METHODS: An anonymous online survey was administrated in Pakistan from November 2020 to April 2021 in COVID-19 survivors. The questionnaire used the 12-Item Short Form Health Survey (SF-12) to assess mental and physical QoL. Multivariate linear regression was used to explore factors associated with mental and physical QoL scores. RESULTS: A total of 331 COVID-19 survivors participated in our survey. Around 42.0% of the cohort reported within 1-3 months of diagnosis of COVID-19. The common residual symptoms were body aches (39.9%), low mood (32.6%), and cough (30.2%). Better physical QoL was associated with being male (adjusted beta: 3.328) and having no residual symptoms (6.955). However, suffering from nausea/vomiting during initial COVID-19 infection (-4.026), being admitted to the ICU during COVID-19 infection (-9.164), and suffering from residual body aches (-5.209) and low mood (-2.959) was associated with poorer QoL. Better mental QoL was associated with being asymptomatic during initial COVID-19 infection (6.149) and post-COVID (6.685), while experiencing low mood post-COVID was associated with poorer mental QoL (-8.253 [-10.914, -5.592]). CONCLUSION: Despite presumed "recovery" from COVID-19, patients still face a wide range of residual symptoms months after initial infection, which contributes towards poorer QoL. Healthcare professionals must remain alert to the long-lasting effects of COVID-19 infection and aim to address them appropriately to improve patients' QoL.

The mystery of COVID-19 reinfections: A global systematic review and meta-analysis.

BACKGROUND: As the COVID-19 pandemic rages on, reports on disparities in vaccine roll out alongside COVID-19 reinfection have been emerging. We conducted a systematic review to assess the determinants and disease spectrum of COVID-19 reinfection. MATERIALS AND METHODS: A comprehensive search covering relevant databases was conducted for observational studies reporting Polymerase Chain Reaction (PCR) confirmed infection and reinfection cases. A quality assessment tool developed by the National Institute of Health (NIH) for the assessment of case series was utilized. Meta-analyses were performed using RevMan 5.3 for pooled proportions of findings in first infection and reinfection with a 95% confidence interval (CI). RESULTS: Eighty-one studies reporting 577 cases were included from 22 countries. The mean age of patients was 46.2 ± 18.9 years and 179 (31.0%) cases of comorbidities were reported. The average time duration between first infection and reinfection was 63.6 ± 48.9 days. During first infection and reinfection, fever was the most common symptom (41.4% and 36.4%, respectively) whilst anti-viral therapy was the most common treatment regimen administered (44.5% and 43.0%, respectively). Comparable odds of symptomatic presentation and management were reported for the two infections. However, a higher Intensive Care Unit (ICU) admission rate was observed in reinfection compared to first infection (10 vs 3). Ten deaths were reported with respiratory failure being the most common cause of death (7/10 deaths). CONCLUSION: Our findings support immunization practices given increased ICU admissions and mortality in reinfections. Our cohort serves as a guide for clinicians and authorities in devising an optimal strategy for controlling the pandemic. (249 words).

Acceptance of COVID-19 Vaccine in Pakistan: A Nationwide Cross-Sectional Study.

Introduction The coronavirus disease 2019 (COVID-19) vaccine is available across various countries worldwide, with public-private partnerships ensuring all individuals are vaccinated through a phased approach. Irrespective of the geographical spread, several myths pertaining to the COVID-19 vaccine have stemmed, ultimately limiting the national administration of vaccines and rollouts. This study assessed the acceptance of the COVID-19 vaccine among the general public in Pakistan. Methods A pre-validated questionnaire was administered from January 2021 to February 2021 to assess the public attitude and acceptance of the COVID-19 vaccine. Logistic regression analyses were run to identify factors associated with the acceptance among the population. Results A total of 936 responses were elicited, where 15% perceived their risk of being infected at 20-30% with an overall 70% agreeing to be vaccinated if recommended. Multivariate analysis identified higher acceptance in the male gender, healthcare workers, and students. Of all, 66% respondents chose healthcare workers and public officials, whereas 15.6% chose scientific literature, and 12.9% chose social media as the most reliable source of COVID-19 information. Conclusion Given the relatively greater trust in healthcare providers for information regarding COVID-19, healthcare workers ought to be on the frontline for vaccine campaigns and public outreach efforts, with governmental efforts in addition to the promotion of scientific materials for population-level understanding.

COVID-19: a look into the modern age pandemic

COVID-19 presents as a pandemic requiring the utmost attention from the world, especially the healthcare sector. This review intends to discuss the symptoms, prevention, and management carried out related to the coronavirus, while also providing the healthcare provider strategies used by different countries in combating the disease. This study was conducted over a period of 2 weeks where different sources were used to assess the ongoing situation regarding COVID-19. The data used in this study was verified and collected from authentic sources only. Results show that there is at present no definite cure for the disease and that prevention is the best possible defense at our disposal at the moment. Data reviewed suggests that social distancing and isolation is the best possible option at the moment. This study provides an overview of the developments taking place in response to the pandemic. More research is required, especially in the treatment and prevention of the disease, so that we may progress towards finding a cure as well as creating a vaccine for the COVID-19.