The COVID-19 outbreak started as pneumonia in December 2019 in Wuhan, China. The subsequent pandemic was declared as the sixth public health emergency of international concern on January 30, 2020, by the World Health Organization. Pakistan could be a potential hotspot for COVID-19 owing to its high population of 204.65 million and its struggling health care and economic systems. Pakistan was able to tackle the challenge with relatively mild repercussions. The present analysis has been conducted to highlight the situation of the disease in Pakistan in 2020 and the measures taken by various stakeholders coupled with support from the community to abate the risk of catastrophic spread of the virus.

Background Since the first reports of COVID-19 infection, the foremost requirement has been to identify a treatment regimen that not only fights the causative agent but also controls the associated complications of the infection. Due to the time-consuming process of drug discovery, physicians have used readily available drugs and therapies for treatment of infections to minimize the death toll. Objective The aim of this study is to provide a snapshot analysis of the major drugs used in a cohort of 1562 Pakistani patients during the period from May to July 2020, when the first wave of COVID-19 peaked in Pakistan. Methods A retrospective observational study was performed to provide an overview of the major drugs used in a cohort of 1562 patients with COVID-19 admitted to the four major tertiary-care hospitals in the Rawalpindi-Islamabad region of Pakistan during the peak of the first wave of COVID-19 in the country (May-July 2020). Results Antibiotics were the most common choice out of all the therapies employed, and they were used as first line of treatment for COVID-19. Azithromycin was the most prescribed drug for treatment. No monthly trend was observed in the choice of antibiotics, and these drugs appeared to be a random but favored choice throughout the months of the study. It was also noted that even antibiotics used for multidrug resistant infections were prescribed irrespective of the severity or progression of the infection. The results of the analysis are alarming, as this approach may lead to antibiotic resistance and complications in immunocompromised patients with COVID-19. A total of 1562 patients (1064 male, 68.1%, and 498 female, 31.9%) with a mean age of 47.35 years (SD 17.03) were included in the study. The highest frequency of patient hospitalizations occurred in June (846/1562, 54.2%). Conclusions Guidelines for a targeted treatment regime are needed to control related complications and to limit the misuse of antibiotics in the management of COVID-19.

BackgroundTransgender males are at high risk for sexually transmitted diseases including AIDS caused by the notorious Human Immunodeficiency Virus (HIV), yet little consideration is given by the policy makers, researchers and non-governmental organizations (NGOs) towards this sensitive issue in Pakistan.MethodsIn this study, we have investigated the prevalence of HIV infection among 306 transgender males with a median age of 29 years (range 15–64 years) residing in Rawalpindi, Pakistan. Rapid HIV antibody-screening methods including the strip test and Enzyme Linked Immuno-absorbent tests were employed to detect HIV antibodies among the subjects. For further confirmation, Polymerase Chain Reaction (PCR) was carried out. Statistical analytical techniques utilized included logistic regression and chi-square.ResultsHIV-1 was found to be the predominant viral subtype. PCR confirmed 21.6% (Confidence Interval 0.17-0.26) of the respondents were reported being HIV positive. 15.7% of the transgender men who shave at home and 13.7% of the transgender men who were educated below 5th grade were found to have HIV.ConclusionThis study shows a very high prevalence of HIV among transgender males. Unawareness among these individuals about the ramifications of this infection owes largely to lack of education. The spread rate is alarming and HIV epidemic is imminent if awareness is not widespread.

Introduction: A conducive learning environment is crucial to the effective delivery of curriculum and professional and social development of the students. This cross-sectional study was conducted to investigate students’ perception of the learning environment in private-sector pharmacy institutes of Pakistan. Methods: The overall learning environment and its various aspects were compared between different pharmacy institutes, year of study and gender. Questionnaires, based on the Dundee Ready Education Environment Measure (DREEM) and demographic information, were completed by 527 undergraduate pharmacy students enrolled at six private-sector pharmacy institutes in Pakistan. Participants were selected by convenience sampling and the scores were compared across grouping variables identified via demographic information. Results: The total DREEM score across the sample was 116.10±25.39 (mean ± S.D), indicating an overall positive perception of the learning environment among students of the private-sector pharmacy institutes. Similarly, the sub- scale scores also reflected students’ positive perception of various aspects of the educational environment including learning, teachers, institutional atmosphere, academic self-perception and social self-perception across the sample. Total DREEM score and sub-scale scores were consistent between male and female students and across all years of Pharm. D. programme included in this study. Scores of the individual institutes reflect the prevalence of an overall conducive learning environment in the private-sector pharmacy institutes under study. A comparison of the total DREEM score and sub-scale scores of the individual institutes also reflects that learning environment of a few institutes, as perceived by their respective students, is significantly better than the others. Conclusion: The positive perception held by the students of private-sector pharmacy institutes in Pakistan is suggestive of the existence of a conducive learning environment that is contributory towards students’ learning of professional and social abilities.

BACKGROUND COVID-19 Lockdown has limited the non-essential movement of people. Consequently, the effects of lockdown had a remarkable impact on everyday life, including health, social sector, economic decline, supply chain sectors and education sector. Just because the social distancing is in ascend, people are looking up new ways to connect and Smart Phones are the most convenient, accessible, and cost-effective way to stay connected during this pandemic. People have become significantly dependent on their smart phones during COVID-19 pandemic that allow to work from home and stay connected with the world. Smartphone addiction is known as nomophobia (NMP) which is a fear of not using smart phone. OBJECTIVE This nondrug addiction is as dangerous as drug addiction. It produces behavioral modifications in everyday habits and actions. Much research is available on nomophobia, to the best of author’s knowledge, there is no literature available on the prevalence of NMP during COVID-19 lockdown METHODS It was a descriptive cross-sectional study. Subjects fulfilling the selection criteria were enrolled in the study through public sector universities of Islamabad and Rawalpindi. Non- Probability convenient sampling technique was used to select 580 students of both genders from 18 to 24 years of age. 18 Students who were corona positive or having any known psychiatric disorder were excluded from the study. A cross sectional survey was conducted online by via Google form. Validated Nomophobia Questionnaire (NMP-Q) was utilized. A self-reported questionnaire regarding demographic data and information regarding use of smart phone. It is the most widely used measurement instrument, proposed by Yildrim and Correia, anyone can use it for noncommercial research and educational projects. NMP-Q includes 20 Likert scale items rated from 1 strongly disagree to 7 strongly agree. The lowest score on the NMP-Q is 20 and 140 is the highest. 20 represent absent of nomophobia, 21 – 59 mild level, 60 – 99 moderate level and 100 – 140 severe nomophobia. Google forms automatically analyzed the collected data. RESULTS A total of 580 subjects 290 (50%) were male and 290 (50%) were female. Mean age was 21 ± 2.3 years. Out of 580 subjects 460(79.31%) were nomophobic. Subject who had severe nomophobia were 19%, moderate nomophobia 58% and mild nomophobia 23%. Subject reported that they could not stay away from their smart phones and keep their phones with them even at bedtime. 226 (38.9%) subjects never turned their phone off. 253 (43.6%) subjects carry a power bank with them so they may not run out of battery. Out of 290 female students 199 (68.6%) were nomophobic and out of 290 male subjects 261 (90%) were nomophobic. So, nomophobia was more prevalent in male. Most frequent reason for using smart phone was social networking (WhatsApp, Facebook, twitter, Instagram, tiktok, snapchat) 91% and playing games 73%. CONCLUSIONS High prevalence of nomophobia was found. Due to COVID -19 lockdown students have straight off become dependent on smart phones that allow them to work and learn from home and take online classes. Smart phone is only source of entertainment for them so there is a huge percentage of a student having moderate nomophobia. So time of using smart phones should be regularized in order to avoid serious harmful effects due to prolong use.