Madam, WHO is investigating a global outbreak of severe acute hepatitis of questionable aetiology among children. Since this is not linked to Hepatitis types A-E, there are still ongoing investigations to explore the causative agent for this worldwide outbreak. At least 228 cases of acute hepatitis of unknown origin had been recorded from 20 countries since May 1, 2022, in Europe, America and other countries, with the highest number of cases recorded in the United Kingdom, 145 since January (1). Adenovirus was found in 74 individuals, suggesting that there may be a possible association. However, this hypothesis needs further investigation. The United Kingdom has recently witnessed an increase in adenovirus infections; however, this might be due to increased testing rather than this epidemic. (2) As a result, affected countries have increased their surveillance efforts and are receiving additional support from WHO. Although the cases ranged in age from one month to sixteen years, the majority of the children who were affected were under the age of five and had gastrointestinal symptoms such as abdominal pain, nausea, and diarrhoea, as well as jaundice and elevated liver enzymes (AST and ALT greater than 500 IU/L). Infectious hepatitis (Types A, B, C, D, E), is the most common cause of hepatitis, was not found. Around 10% of these children have needed a liver transplant, and at least one has died. WHO's working probable case definition has been an individual presenting with acute hepatitis (non-hepatitis A-E) with serum transaminase >500 IU/L (AST or ALT), who is 16 years or younger, since 1 October 2021 (1,2). Hepatitis is a liver inflammation caused by viral infections, primarily the Hepatitis A, B, and C viruses, as well as a variety of other factors such as alcohol consumption, drugs, medicines, and other medical disorders. Fever, exhaustion, lack of appetite, nausea, vomiting, stomach discomfort, dark urine, light-coloured stools, joint pain, and jaundice are all signs and symptoms of hepatitis. The underlying cause determines the hepatitis treatment. (3). Parents and doctors are advised to look out for these signs and symptoms. Adenovirus, a double-stranded DNA virus distributed by close contact, respiratory droplets, and fomites, is most commonly associated with respiratory illness. ---Continue
Aberrant innominate artery lying high in the neck is a rare entity that can be encountered intraoperatively during midline neck surgeries such as thyroidectomy and tracheostomy. Surgeons should be mindful of this entity as injury to the artery can lead to life-threatening haemorrhage. We report a case of a 40 year old female in whom an aberrant innominate artery was identified high in the neck, while performing a total thyroidectomy. Keywords: Aberrant innominate artery, Thyroidectomy, Tracheostomy, Aorta.
Objective: To evaluate the role of the COVID-19 pandemic in the prevalence of nosocomial infections in patients admitted to the Ziauddin University Hospital, Clifton Campus, Karachi. Study Design: Retrospective Cross-sectional study. Setting: Ziauddin University Hospital, Clifton Campus, Karachi. Period: Pre-COVID: Feb 1, 2019 – Jan 31, 2019 Post-COVID: May 1 2020- Apr 30, 2021. Material & Methods: Clinicians retrospectively reviewed all Infectious Disease Department medical records for a list of all patients who developed a NI after 48 hours of admission to the hospital. The diagnosis of NI had been formulated by clinicians on the basis of clinical, radiological and microbiological findings. Results: We found an increase in certain types of NIs, and stability in the infection rate for many other organisms, which may be due to improved infection control practices during COVID. This information will lead to a better understanding of infection control practices in the future, and will better guide clinical decision making. Conclusion: The strict and proper implementation of infection control protocols during the COVID-19 outbreak has reduced the rate of NIs. It has been evident that NIs can be minimized by creating a positive attitude, improving awareness and staff hygiene practices and behaviours, and the provision of facilities to comply with the of infection control protocols’ standards.
Madam, In Pakistan's female population of 112 million (1) , Human Papillomavirus (HPV) has caused devastating results of cervical cancer in females aged fifteen years and older. Being the second most common cancer in females aged fifteen to forty-four years and third most common cancer amongst females, current statistics estimate 5000 victims and 3000 deaths annually due to HPV. (2)(3). This is becoming a huge burden and needs to be acknowledged. HPV, a circular double-stranded DNA virus, is a common infection of the reproductive tract. Worldwide accepted strategies to reduce the burden of this deadly virus is through vaccines and screening. Due to the uneven distribution of this lethal virus. there are currently three vaccines available that were approved by Food and Drug Administration (FDA) back in 2006, 2009 and 2014, namely Gardasil, Cervarix, and Gardasil-9, respectively(4). CDC has endorsed the need for two doses of the vaccine. At the age of 11-12, The first dose can also be given at 9 years followed by a second dose with an interval of 6-12 months (5). However, in a developing country like Pakistan, HPV vaccination programmes are still a challenge due to lack of awareness amongst the population and inconsistent efforts by the healthcare system in providing the screening and vaccination strategies. Many other factors are related with this gross burden: the availability of the vaccines, insufficient funds and various collateral factors associated with the spread of rumours through social media. A study recently proved the strength of vaccination at a young age. It concluded that females’ inoculation at the age of 12 to 13 years significantly reduced the risk of grade 3 cervical intraepithelial neoplasia (CIN) (6). Centres for disease and control and prevention (CDC) has stated that the majority of the people who are unvaccinated and sexually active will get HPV during their lives. Therefore, there is an essential need to vaccinate children below the age of fifteen years so that 33,000 of these cancers can be prevented that are caused by this infection. Since, cervical cancer is a public health problem, a global strategy for its elimination was inaugurated in 2020 by WHO. Despite the worldwide challenges, WHO did not take a step back and continued its challenging efforts. However, situation in Pakistan did not improve. ---Continue
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