No abstract

Background: There are different types of Coronavirus disease (COVID-19) vaccines available presently, and their emergency use has been approved by WHO worldwide on a mass scale. COVID-19 vaccine breakthrough infections have been reported worldwide. In Pakistan, there are limited data on COVID-19 vaccine breakthrough infections and their clinical course, especially in healthcare professionals (HCPs). Our study aims to investigate COVID-19 infections among vaccinated HCPs. Methods: A prospective study was conducted on 425 healthcare professionals. Data collected from healthcare professionals included names, age, gender, number of vaccination doses, COVID-19 infection pre and post-vaccination, the severity of COVID-19 infection (if positive), and co-morbid conditions. Ethical board approval was taken. Statistical Package for Social Sciences (SPSS) version 23 (IBM Corp., Armonk, NY) was used to analyze the data. Results: After complete vaccination, 17.27% acquired COVID-19 infection; 2.47% had COVID-19 infection both pre and post-vaccination. The mean age was 32.46 years (n=71) with a standard deviation of ±9.376. The male to female ratio was 1.53. COVID-19 PCR was positive in 95.77%. During the course of the disease, 4.2% were asymptomatic, 92.95% had mild symptoms, 1.4% were hospitalized, and 1.4% had to be managed in the intensive care unit. None of the HCPs who had received booster doses acquired a COVID-19 infection. Conclusion: It was found that prior COVID-19 infection and vaccination do not confer immunity from infection. However, proper vaccination limits the severity, morbidity, and mortality of COVID-19 infection.

No abstract

Introduction: Helicobacter pylori ( H. pylori ) colonization is prevalent all over the world, and it is associated with low socioeconomic status, poor hygiene, and overcrowding. Its eradication is important since it is an etiologic agent for gastritis, peptic ulcer, gastric carcinoma, and mucosa-associated lymphoid tissue lymphoma. Different regimens are available for the eradication of H. pylori and include triple therapy and sequential therapy. Our study aims to compare the efficacy of triple therapy versus sequential therapy in the eradication of H. pylori . Material and methods: This randomized clinical trial was conducted at the Pakistan Institute of Medical Sciences Hospital, Islamabad, from September 2016 to September 2017 after the approval of the institutional review board. A total of 160 patients were enrolled and equally divided into two, group A and group B. A twice-daily dose of amoxicillin 1,000 mg, rabeprazole 20 mg, and clarithromycin 500 mg was given to group A for 10 days, while group B was initially given rabeprazole 20 mg and amoxicillin 1,000 mg two times daily for the first five days (i.e., induction phase), followed by triple therapy that included rabeprazole 20 mg, clarithromycin 500 mg, and metronidazole/tinidazole 500 mg twice daily for the next five days. A negative stool antigen test performed four weeks after the completion of therapy was considered an effective eradication. A proforma was used to collect data that included age, gender, city or province of residence, family income, group (group A or group B), and eradication efficacy. Analysis of the data was performed using the Statistical Package for the Social Sciences version 17 (SPSS Inc., Chicago, USA). Results: A total of 160 patients were included, with mean age and standard deviation of 40.02±24.4 years. The male/female ratio was 1.8:1. Successful eradication of H. pylori achieved in group A was 67.5% (N=54) in comparison to group B, which was 95% (N=76) (p=0.001). Conclusion: Sequential therapy was superior to triple therapy in H. pylori eradication.

Aim: To determine the various causes of upper gastrointestinal bleeding through endoscopic method. Study design: Descriptive observational study Place and duration of study: Department of Medicine, SKZB, CMH Muzaffarabad from 1st January 2021 to 30th June 2022. Methodology: Ninety patients of upper gastrointestinal bleeding which were clinically and endoscopically confirmed of their state and between <25 to >66 years of age were included. Endoscopy procedure was conducted using lignocaine gargling as analgesia. Grading system was utilized for scoring endoscopy results as Grade I to IV. Results: There were 52 (57.8%) males and 38(42.2%) females. The mean age of the patients was 48.5±3.3 years. It was also seen that majority of the males as well as females had esophageal varices and peptic ulcer as the main cause of UGB followed by esophagitis and gastritis. Conclusion: Esophageal varices and peptic ulcer followed by esophagitis and gastritis are the main cause of upper gastrointestinal bleeding. Key words: Causes, Upper gastrointestinal bleeding, Endoscopic method