The SARS-CoV-2 pandemic continues to expand globally, with case numbers rising in many areas of the world, including the Indian sub-continent. Pakistan has one of the world’s largest populations, of over 200 million people and is experiencing a severe third wave of infections caused by SARS-CoV-2 that began in March 2021. In Pakistan, during the third wave until now only 12 SARS-CoV-2 genomes have been collected and among these nine are from Islamabad. This highlights the need for more genome sequencing to allow surveillance of variants in circulation. In fact, more genomes are available among travellers with a travel history from Pakistan, than from within the country itself. We thus aimed to provide a snapshot assessment of circulating lineages in Lahore and surrounding areas with a combined population of 11.1 million. Within a week of April 2021, 102 samples were sequenced. The samples were randomly collected from two hospitals with a diagnostic PCR cutoff value of less than 25 cycles. Analysis of the lineages shows that the Alpha variant of concern (first identified in the UK) dominates, accounting for 97.9 % (97/99) of cases, with the Beta variant of concern (first identified in South Africa) accounting for 2.0 % (2/99) of cases. No other lineages were observed. In depth analysis of the Alpha lineages indicated multiple separate introductions and subsequent establishment within the region. Eight samples were identical to genomes observed in Europe (seven UK, one Switzerland), indicating recent transmission. Genomes of other samples show evidence that these have evolved, indicating sustained transmission over a period of time either within Pakistan or other countries with low-density genome sequencing. Vaccines remain effective against Alpha, however, the low level of Beta against which some vaccines are less effective demonstrates the requirement for continued prospective genomic surveillance.
The SARS-CoV-2 pandemic continues to expand globally, with case numbers rising in many areas of the world, including the Indian sub-continent. Pakistan has one of the worlds largest populations, of over 200 million people and is experiencing a severe third wave of infections caused by SARS-CoV-2 beginning in March 2021. Currently very few SARS-CoV-2 genomes collected in Pakistan are available, with just 12 covering the third wave, 9 of which are from Islamabad. This highlights the need for more genome sequencing to allow surveillance of variants in circulation. In fact more genomes are available for travellers with a travel history from Pakistan, than from within the country itself. For an understanding of the circulating variants in Lahore and surrounding areas with a combined population of 11.1 million, 102 samples were sequenced, covering one week period from April 2021. The samples were randomly chosen from 2 hospitals with a diagnostic polymerase chain reaction (PCR) cutoff value of less than 25 cycles. Analysis of the lineages shows that B.1.1.7 (first identified in the UK, Alpha variant) dominates, accounting for 97.9% (97/99) of cases, with B.1.351 (first identified in South Africa, Beta variant) accounting for 2.0% (2/99) of cases. No other lineages were observed. In depth analysis of the B.1.1.7 lineages indicates multiple separate introductions and subsequent establishment within the region. Eight samples were identical to genomes observed in Europe (7 UK, 1 Switzerland), indicating recent transmission. Genomes of other samples show evidence that these have evolved, indicating sustained transmission over a period of time either within Pakistan or other countries with low density genome sequencing. Vaccines remain effective against B.1.1.7, however the low level of B.1.351 against which some vaccines are less effective demonstrates the requirement for continued prospective genomic surveillance.
The main causative factor for the chronic liver disease is infection with hepatitis C virus (HCV). Around the world, it has been estimated that almost 180 million people are carriers of HCV. Infection with HCV leads to hepatocellular carcinoma (HCC) that is a frequent cause of mortality in HCV-infected patient. Among the most common cancers, it is ranked fifth worldwide. The annually death rate of HCC patients being caused by HCV is approximately 1 million. Epidemiological studies have demonstrated that prolong infection with HCV is the main threat for the development of HCC. Keeping the knowledge about the causes of cirrhosis and development of HCC in HCV patients is consequently very important for improving treatment choices and health-care delivery. Effective precautionary measures that can prevent the progression of HCC have now been well illustrated. The perfect natural explanation of HCC pathogenesis is so diverse that treatment strategies are highly difficult. Therefore, in the case of nonmalignant hepatic disease follow-up of the patients and treatment options must take into account to prevent the progression to carcinoma. In this review, we have strived to describe natural disease course of HCV infection and the ways through which it progresses to malignant hepatic disease.
Background: This cross-sectional study being instrumented by a close ended questionnaire was conducted to evaluate society’s affirmation for being jabbed with COVID-19 vaccine, their acquisition towards immunization and associated anomalies in vaccinated people. According to the recent update from WHO, the glob is facing 5th wave of pandemic “Omicron”. However, the problem is that vaccines were in trials. Majority of people were demonstrating reluctance for being immunization against COVID-19 due prevailing oddities after vaccination. Aim: To measure the possible adverse effects caused by the vaccination and society’s participation towards immunization. Methodology: In this study we adapted cross sectional study design by means of convenience sampling. Study instrument was a close ended questionnaire. Data was collected from only vaccinated participants by visiting universities, medical personnel, colleges and other society sectors under the supervision of team members. Data transferred to software SPSS to extract the results. Cross tabulation was used for demographic analysis such as age, gender and vaccine type jabbed. Results: The most common adverse effects include inflammation at site of injection, fever, nausea and vomiting, diarrhea, abdominal pain, joint pain and numbness of limbs were highlighted. Mostly jabbed vaccine types include Sinopharm and Sinovac. Majority of respondents showed willingness for immunization however, only a small proportion was afraid for being vaccinated. The significance in our study that we have conducted study for acceptance of vaccine, intention of participants towards immunization and adverse events associated with different types of COVID-19 vaccines in vaccinated population residing in different towns of Lahore, Pakistan. Conclusions: In our local population, majority accepted the vaccine and didn’t deny to administer the vaccine. Pain, redness, lethargy, nausea, vomiting, diarrhea, abdominal pain, numbness and arthritis were noted to be the most common side effects of COVID- 19 vaccine. Keywords: COVID-19, Vaccine Acceptance, Pakistan, Vaccinated Population
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