Objective:To determine the knowledge among family members of Hepatitis C patients and correlate it with their educational status. Study Design: A cross sectional observational study. Place and Duration: Outpatient department of Aziz BhattiShaheed Teaching hospital, Gujrat from 1 st January 2015 to 31 st march 2015. Methodology: Data was collected to assess the fundamental knowledge and mode of transmission in people coming with HCV infected patients. Collected data was analyzed by SPSS V.20. Results: Two hundred and forty one participants were included in study with mean age of 33 years (+11.940 SD). Male to female ratio was 3.30:1, 65.98% married and 104 were below matric (SSC). Two hundred twenty (90%) attendants knew that HCV can cause chronic inflammation, liver failure and liver cancer. Sixty three (26%) assumed it to be a bacterial infection. 164 (Sixty eight %) thought vaccine is available. More than 90% of attendants knew that it is transmitted through sharing or reuse of syringes 236 (97.9%), blood transfusion without screening 235 (97.5%) and needle stick injuries 225 (93.4%). Two hundred thirty two (96.3 %) disagreed its transmission through holding hands, hugging and kissing. Ninety (37.3%) and fifty five (22.8%) assumed its spread through drinking polluted and unsafe sex respectively. Seventy (29%) disagreed its spread perinataly and contact with open wound. Male and above matric participants have significantly better knowledge (<0.05). Conclusion: Awareness about HCV among attendants of hepatitis C infected patients was inadequate and has lot of misconceptions especially among females and less educated people.

Objective: To determine the load, clinical and laboratory findings of the patients with decompensated cirrhosis admitted in medical department of tertiary care hospital and to make plan for the improvement of these patients. Study Design: Cross Sectional study. Setting: Department of medicine of Aziz Bhatti Shaheed Teaching Hospital, Gujrat. Period: from 1st January 2019 to 31st March 2019. Material & Methods: All 964 patients who were admitted included in study, clinical and laboratory features of patients with decompensated cirrhosis were recorded. Results: Male were in majority (53.7%), median age was 39 years. Decompensated cirrhosis was found  in  216 (22.4%), patients due to complication of  Diabetes Mellitus were 170 (17.6%), COPD & Asthma was found in 130 patients(13.5%), Stroke & Hypertension in 126 patients while Gastroenteritis 6% and infectious diseases RTI, UTI, Enteric Fever etc were present in 46 patients. Among 216 patients, one hundred & seventy eight were Hepatitis C Positive, fifteen had Hepatitis B, and eight had history of alcohol consumption. Seven patients were both Hepatitis B and C positive while in 3.6% etiology was other than mentioned above. Ascites was noted in two hundred six patients, 36.5% had variceal bleed while 51 admitted due to encephalopathy. Conclusion: HCV related cirrhosis and its complications like upper GI bleed, encephalopathy, ascites and hepatoma are major burden on our hospitals and need special attention.

Objective: To determine the frequency and in-hospital mortality of patients with complete heart blocks after STEMI. Study Design: Comparative Cross Sectional study. Study Setting: Department of Cardiology, Aziz Bhatti Shaheed Teaching Hospital, Nawaz Sharif Medical College, Gujrat. Period: January 2019 to December 2019. Material & Methods: Patients meeting selection criteria having age 35 to 65 of both genders with STEMI either thrombolysed or not were enrolled in the study after their informed consent, whereas patients with prior history of MI, PCI or CABG or patients with prior AV blocks were excluded from the study. All patients remained admitted and followed up for 3 to 4 days. Patients were evaluated by ECG for diagnosis of AV blocks. Two groups were made, one with and second without complete heart blocks. Incidence and mortality of CHB after STEMI noted. Data was analyzed with SPSS -23. Results: Out of167 patients, 103(61.6%) male, while 64(38.4%) were female. Mean age was 50.5+10. Patients with AWMI 85 (50.8%), IWMI 63(37.7%) and LWMI were 18(10.77%). Ten (5.9%) developed CHB. Two groups were made on the basis of presence or absence of CHB. In first group 7 out of 10 having CHB were expired, 2 discharged and one referred for permanent pacemaker or revascularization. In second group 23 (15%) expired out of 157, 110(70%) discharged while 24(15%) were referred for invasive management. Patients having IWMI (60%) developed CHB more as compared to anterior (20%) or lateral wall MI (20%). Mortality due to CHB complicating STEMI was 4.19% while overall mortality was 17.96% (30). Conclusion: Complete heart block is a known complication of patients with STEMI and is associated with poor prognosis. Thrombolytic agents were very useful in patients with STEMI for reversal of CHB in most of the patients.

Objective: To determine the Incidence of myocarditis in patients with COVID-19 and in-hospital mortality. Study Design: Observational Cohort study. Setting: Aziz Bhatti Shaheed Teaching Hospital, Nawaz Sharif Medical College, Gujrat. Period: 15 to 30 March 2020. Material & Methods: Patients with positive PCR results for COVID-19 were included in this study after informed consent; patients with prior history of any cardiovascular, pulmonary or other co-morbidity were excluded while patients having history of hypertension, diabetes or smoking were included in the study. All the patients remain admitted for 14 days. Patients were evaluated clinically, by ECG, troponins and echocardiographically for diagnosis of myocarditis. Patients were managed conservatively. Incidence of myocarditis and in-hospital mortality was noted. Successful treatment towards hospital discharge was relief of clinical symptoms, a-febrile, clear chest X-Ray and at least two consecutive negative PCR for covid-19. P-value <0.05 was considered as significant. Data was analyzed with SPSS -23. Results: Out of fifty five, 5(9%) patients were diabetics and 4 were hypertensive. Five (9%) developed mild pneumonia which recovered conservatively and three (5.4%) patients developed myocarditis. One (1.8%) patient expired having myocarditis. Duration of follow up was only during hospital stay. So our in-hospital mortality was 1.8%, p value was calculated as significant < 0.05. Conclusion: Myocarditis is a known but less common complication of COVID-19. Cardiac injury is more in those with previously having cardiovascular or other co-morbidities. In healthy and immunocompetent population its incidence is quite low.