Introduction The World Health Organization (WHO) recommends that all blood transfusion services must screen donated blood for human immunodeficiency virus (HIV) one and two, hepatitis B, hepatitis C and syphilis. A mandatory screening for malaria is also warranted in malaria endemic areas. Our study aimed at analyzing the prevalence and different diagnostic methods of screening transfusion transmitted infections (TTIs) in replacement and voluntary, non-remunerated donors in the blood bank of a tertiary care hospital in Islamabad, Pakistan. Methods The cross-sectional, descriptive study was conducted on 30,470 blood donors from July 2015 to October 2017, in the blood bank of a 500-bed teaching hospital in Islamabad. Initially all blood donors were screened for HIV one, HIV two, hepatitis B and hepatitis C by serological testing. The seronegative samples were further tested by nucleic acid amplification test (NAT). Malaria was screened using immuno-chromatographic antigen-detection tests, while treponema pallidum was screened by electrochemiluminescence immunoassay to detect treponema pallidum (TP) antibodies. All infected blood and blood products were discarded and donors were contacted. The donors were deferred from blood donation according to WHO guidelines. They were also counselled and referred to the infectious diseases clinic. The collected data was analyzed on IBM's statistical package for the social sciences (SPSS) version 21. Results The results revealed that amongst the 30,470 donors, 997 (3.27%) donors were found infected with one or more TTI while 29,473 (96.73%) donors were found safe. Individuals who tested positive on serology for hepatitis B were 322 (1.06%), hepatitis C were 392 (1.29%) and HIV were 49 (0.16%). The seronegative donors were tested by NAT. NAT on seronegative samples showed that 10 (0.03%) donors tested positive for hepatitis B virus deoxyribonucleic acid, while only three (0.01%) were positive for hepatitis C ribonucleic acid. No donor was found positive for HIV by NAT testing. Syphilis testing revealed a frequency of 228 (0.75%) positive results while only five (0.02%) donors were found infected with malaria. Conclusion The results testify that standardized blood component screening can save transmission of infections through blood transfusion. They also establish the superiority of NAT screening over serological tests in decreasing the residual risk of transfusion transmitted infections.

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Introduction Outbreak of corona virus disease in 2019 (COVID‐19) has resulted in significant morbidity and mortality worldwide. Our aim is to document hematological parameters of patients with COVID‐19 during initial stage of diagnosis and to identify early hematological indicators of severe infection. Materials and methods This retrospective study was conducted at Shifa International Hospital, Pakistan from April to November 2020. Patients hospitalized with COVID‐19, diagnosed on RT‐PCR and had a complete blood count (CBC) done within 48 hours of diagnosis were included. Data was analyzed using IBM® SPSS Statistics. Results A total of 425 patients were included in this study out of whom 272(64%) were males. The mean age was 55.61 ± 17.84 years. 95 patients (22.4%) had normal blood counts within 48 hours of COVID‐19 diagnosis. Cytopenias were seen in 193(45.4%) patients. There were 75(17.6%) mortalities during the study period. Chi‐square test showed that thrombocytopenia, lymphopenia and neutrophilic leucocytosis were significantly associated with mortality (P = .037, P < .001, P < .001 respectively) and need for ventilator (P = .009, P < .001, P < .001, respectively). Neutrophilia was also associated with development of Acute Respiratory Distress Syndrome (P < .001). On ROC analysis, Neutrophil‐to‐Lymphocyte Ratio yielded an area under the curve (AUC) of 0.693 and 0.660 for the outcomes mortality and need for ventilator, respectively. For a subset of 288 patients who had D‐dimer levels checked within 48 hours of COVID‐19 diagnosis, the AUC for mortality and ventilator need was 0.708 and 0.671, respectively. Conclusion Hematological indices are vital indicators in the prognosis and risk stratification of COVID‐19 during initial stages of disease.

Objective: To examine the management of power by doctors in medical consultations. The power is defined here as a dialogic, egalitarian, and patient-centered. Study Design: Qualitative study. Place and Duration of Study: Out-patient departments of Mayo Hospital, Lahore, Pakistan, from Nov 2019 fortwo weeks. Methodology: The data were collected through in-depth interviews and observations from outpatient departments of Mayo Hospital. Bourdieu's Social Practice Theory and Fairclough’s theory of Power and Language were used as a theoretical framework in the community of practice, for the interpretation of the qualitative data sets. Results: The interpretations of relational power by doctors and patients surface three themes: Power, Powerand Solidarity, and Solidarity. Although power-sharing is the modern rhetoric, it is hardly conceptualized in theselected hospital. Conclusion: With a proliferation of patient-centered approach of the medical profession, power-sharing withpatients might perpetuate dissatisfaction among the participants.

Introduction: Thalassemia Major is a hemolytic anemia which is prevalent in developing countries and is preventable by promoting awareness among the masses. Objectives: To assess the current general disease awareness and compare the level of understanding between parents attending government versus private thalassemia care facilities. Methods: This cross-sectional study was conducted in four thalassemia centers of Rawalpindi and Islamabad from December 2017 to January 2019. Parents/caregivers of Thalassemia Major Patients were included by non-probability purposive sampling and those having children having other blood disorders, were excluded. After taking informed consent, a pretested structured questionnaire was given to participants and awareness level was classified into ‘unaware’, ‘aware’ and ‘well-aware’ categories, based on the score achieved. Data was evaluated using SPSS version 23.0. Chi-square test was used for analysis. Results: A total of 277 parents were included. Parents who took their children to government and private centers were 161 (58.1%) vs 116 (41.9%) respectively. There was a statistically significant difference in the know-how about mode of disease transmission (p value=0.02), blood-borne diseases (p value=0.00), method of complete cure (p value= 0.05) and harmful effects of repetitive blood transfusions (p value=0.05) among parents visiting the two different facilities. While 80.2% parents in private centers were ‘well-aware’, the corresponding percentage in government centers was 57.1%. Conclusion: General disease awareness was average. Parents visiting private institutes have shown much better awareness. Funding and dedicated education, with focus on government organizations, which are accessible for the common man, is required.