Background The medical community's understanding of the novel coronavirus disease (COVID-19) was limited initially, and many laboratory investigations were performed to observe effects of the virus on the body, its complications, and outcomes. We observed that some laboratory investigations provided redundant information regarding outcomes, and, therefore, were not necessary. Therefore, the extent of laboratory investigations may need to be pared down to not only avoid issues related to repeated blood sampling but also to minimize the financial burdens in poor socioeconomic countries. Objective This study aimed to observe trends of clinical and laboratory values in COVID-19 patients and their relationship to outcomes, including disease severity, length of hospital stay, and mortality. Methods We conducted an observational cohort study of COVID-19 patients treated as inpatients at the Shifa International Hospital (SIH) in Islamabad in April 2020. Patients were included if they were nonsurgical, adult inpatients of SIH diagnosed with COVID-19 via positive polymerase chain reaction test. We monitored study participants' clinical and laboratory values (including hypoxia) on admission and throughout the study period. We used IBM SPSS Statistics for Windows, Version 23.0 (IBM Corp., Armonk, NY, USA) for data entry and analysis. Descriptive statistics were calculated for qualitative and quantitative data. We determined the effect of all variables on outcomes through chi-squared or Fisher's exact test, and p-values <0.05 with 95% confidence interval were considered statistically significant. Results A total of 51 patients with COVID-19 were enrolled. Most of the study participants were men older than age 50 with multiple comorbidities and resided in Khyber Pakhtunkhwa. Length of hospital stay ranged from eight to 14 days, and most patients had severe disease and survived. Factors such as patient age, gender, comorbid conditions, residence, and medication did not significantly affect outcomes. Hypotension during the height of symptoms and oxygen saturations <80% on admission was associated with prolonged hospital stays. Two complete blood count (CBC) parameters (platelet counts and mean corpuscular volume, MCV) were strongly associated with mortality and severity in our patients. Four non-CBC parameters (alanine transaminase, ALT; D-dimer; C-reactive protein, CRP; and lactate dehydrogenase, LDH) had strong statistical impact on disease severity, length of hospital stay, and mortality in our patients. Conclusion In a resource-limited country, laboratory testing must be chosen wisely and used appropriately. Patient age, gender, comorbid conditions, drugs, residence, and ferritin levels did not affect COVID-19 outcomes. Hemoglobin, platelet count, MCV, CRP, D-dimer, ALT, LDH, hypoxia, and hypotension were all correlated to disease outcomes. Therefore, these factors are useful laboratory examinations for COVID-19 patients, especially in poor countries. Categories: Internal Medicine, Infectious Disease Keywords: covid-19, tren...

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Introduction: Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus (HIV) affect a significant proportion of the populace in developing countries. Pregnant women and deprived segments of the population are disproportionately affected. The aim of our study was to assess the awareness regarding the three blood-borne infections amongst pregnant Pakistani women belonging to low socioeconomic classes. Methodology: A cross-sectional survey was conducted among 297 pregnant women at two antenatal healthcare facilities in Islamabad, Pakistan between September and November 2019. A pretested structured questionnaire was employed for data collection and knowledge levels were classified into three categories i.e. “Good”, “Average”, and “Poor” according to pre-set criteria. Data were analyzed using Microsoft Excel 2016 and SPSS Version 21. Results: None of the study participants had “Good” knowledge regarding the three blood-borne infections. Around 52% of the women had “Poor” while 47% had “Average” knowledge. None of the study participants were aware that HIV can be transmitted during delivery. Women aged 30-35 years had significantly higher knowledge as compared to other age groups (p < 0.001). The difference in knowledge amongst women in association with education, income status, and previous pregnancies was not significant. Conclusions: Awareness regarding Hepatitis B, Hepatitis C, and HIV amongst pregnant Pakistani women of low socioeconomic status is insufficient which can lead to an increased risk of acquiring these infections, especially during childbirth. It is vital to impart health education regarding these diseases and monitor hygiene standards in health care facilities.

At present time portal hypertension is perceived as one of the complications of advanced liver disease. It results in various vascular changes in gastrointestinal tract (GI), including esophageal varices, gastric varices and portal hypertensive gastropathy (PHG). PHG and gastric varices are a common cause of acute as well as chronic bleeding from GI tract which resulted in significant mortality among patients. Objectives: To determine the frequency of gastric vascular changes in various causes of cirrhosis. Patients of age ≥30 years, with clinical evidence of cirrhosis and without prior treatment of esophagiogastric varices were included in the study. Results: A total of 100 patients were enrolled in the study out of which 47 were male and 53 were females with mean age of 53.6 years. The most common type of cirrhosis was turned out to be Hepatitis C affecting 50% of patients and most of the patients were in Child class C. Portal hypertensive gastropathy was present in 74% of patients. Among them 24.3% have mild changes while severe changes were present in75.7% of patients. Gastric varices were found in 40% of the patients and the most common type was IGV type I which was present in 29(72.5%) of the patients. Correlation of severity of PHG was seen with grading of esophageal varices, grading of gastric varices and Child class. Conclusion: Frequency of severe gastropathy is higher than the mild gastropathy. It is also concluded that gastric vascular changes are associated with cause of cirrhosis, child class and degree of portal hypertension.

At present time portal hypertension is perceived as one of the complications ofadvanced liver disease. It results in various vascular changes in gastrointestinal tract (GI),including esophageal varices, gastric varices and portal hypertensive gastropathy (PHG). PHGand gastric varices are a common cause of acute as well as chronic bleeding from GI tractwhich resulted in significant mortality among patients. Objectives: To determine the frequencyof gastric vascular changes in various causes of cirrhosis. Study Design: Cross sectional study.Setting: Department of Gastroenterology, Pakistan Institute of Medical Sciences, Islamabad.Period: 1st August 2007 to 31st July 2008. Materials and Methods: Patients of age ≥30 years,with clinical evidence of cirrhosis and without prior treatment of esophagiogastric varices wereincluded in the study. Results: A total of 100 patients were enrolled in the study out of which47 were male and 53 were females with mean age of 53.6 years. The most common type ofcirrhosis was turned out to be Hepatitis C affecting 50% of patients and most of the patientswere in Child class C. Portal hypertensive gastropathy was present in 74% of patients. Amongthem 24.3% have mild changes while severe changes were present in75.7% of patients. Gastricvarices were found in 40% of the patients and the most common type was IGV type I whichwas present in 29(72.5%) of the patients. Correlation of severity of PHG was seen with gradingof esophageal varices, grading of gastric varices and Child class. Conclusion: Frequency ofsevere gastropathy is higher than the mild gastropathy. It is also concluded that gastric vascularchanges are associated with cause of cirrhosis, child class and degree of portal hypertension.