Digital Commons Network^™

Diagnostic Accuracy Of High-Sensitivity Cardiac Troponin In The Diagnosis Of Acute Myocardial Infarction At The Aga Khan University Hospital Nairobi, Kenya, Assumpta Wanjiru Chege

Master of Medicine in Clinical Pathology

Methodology: This cross-sectional study was carried out at Aga Khan University Hospital, Nairobi between July 1st 2020 and December 31st 2021. Participants were adults aged 18 years and above presenting to the emergency department with signs and symptoms suggesting an acute myocardial infarction. Patients were identified on the hospital management information system (CARE 2000) using test results for baseline high-sensitivity cardiac troponin I. The final diagnosis as well as secondary clinical data was obtained from both physical and electronic patient medical records. The reference standard for the diagnosis of acute myocardial infarction was taken as the final clinical diagnosis made …

Emergence Of A Multidrug-Resistant And Virulent Streptococcus Pneumoniae Lineage Mediates Serotype Replacement After Pcv13: An International Whole-Genome Sequencing Study, Stephanie W. Lo, Kate Mellor, Robert Cohen, Alba Redin Alonso, Sophie Belman, Narender Kumar, Paulina A. Hawkins, Rebecca A. Gladstone, Sadia Shakoor, Muhammad Imran Nisar

Department of Pathology and Laboratory Medicine

Background: Serotype 24F is one of the emerging pneumococcal serotypes after the introduction of pneumococcal conjugate vaccine (PCV). We aimed to identify lineages driving the increase of serotype 24F in France and place these findings into a global context.
Methods: Whole-genome sequencing was performed on a collection of serotype 24F pneumococci from asymptomatic colonisation (n=229) and invasive disease (n=190) isolates among individuals younger than 18 years in France, from 2003 to 2018. To provide a global context, we included an additional collection of 24F isolates in the Global Pneumococcal Sequencing (GPS) project database for analysis. A Global Pneumococcal Sequence Cluster …

Adapting The Fast-M Maternal Sepsis Intervention For Implementation In Pakistan: A Qualitative Exploratory Study, Sheikh Irfan Ahmed, Bakhtawar M H. Khowaja, Rubina Barolia, Raheel Sikandar, Ghulam Kubra Rind, Sehrish Rani, Raheela Rani, James Cheshire, Catherine Louise Dunlop, Lumaan Sheikh

Department of Obstetrics & Gynaecology

Objective: A maternal sepsis management bundle for resource-limited settings was developed through a synthesis of evidence and international consensus. This bundle, called 'FAST-M' consists of: Fluids, Antibiotics, Source control, assessment of the need to Transport/Transfer to a higher level of care and ongoing Monitoring (of the mother and neonate). The study aimed to adapt the FAST-M intervention including the bundle care tools for early identification and management of maternal sepsis in a low-resource setting of Pakistan and identify potential facilitators and barriers to its implementation.
Setting: The study was conducted at the Liaquat University of Medical and Health Sciences, which …

Frequency Of Bystander Exposure To Antibiotics For Enteropathogenic Bacteria Among Young Children In Low-Resource Settings, Elizabeth T. Rogawski Mcquade, Stephanie A. Brennhofer, Sarah E. Elwood, Timothy L. Mcmurry, Joseph A. Lewnard, Estomih R. Mduma, Sanjaya Shrestha, Najeeha Talat Iqbal, Pascal O. Bessong, Gagandeep Kang

Department of Paediatrics and Child Health

Children in low-resource settings carry enteric pathogens asymptomatically and are frequently treated with antibiotics, resulting in opportunities for pathogens to be exposed to antibiotics when not the target of treatment (i.e., bystander exposure). We quantified the frequency of bystander antibiotic exposures for enteric pathogens and estimated associations with resistance among children in eight low-resource settings. We analyzed 15,697 antibiotic courses from 1,715 children aged 0 to 2 y from the MAL-ED birth cohort. We calculated the incidence of bystander exposures and attributed exposures to respiratory and diarrheal illnesses. We associated bystander exposure with phenotypic susceptibility of E. coli isolates in …

Knowledge And Practice Of Pediatricians In Kenya Regarding Helicobacter Pylori Infection In Children., Aura Mwende Nzinga

Master of Medicine in Paediatrics and Child Health

Background: Helicobacter pylori is one of the most common chronic bacterial infections. It affects more than half of the world’s population and is frequently associated with peptic ulcer disease, gastric carcinoma and other extra gastrointestinal manifestations. Globally, one third of the children are infected with the highest burdens observed in low and middle income countries. In Kenya the prevalence stands at 87% among school going children and 50% in children under three years. Justification: Studies in high income countries suggest poor knowledge and practice amongst physicians with limited data from Africa. There exists conflicting information regarding the pathogenic role and …

Communication Skills Of General Practitioners In Nairobi, Kenya: A Descriptive Observational Study, Gulnaz Mohamoud, Robert Mash

Family Medicine, East Africa

Background High-quality primary care needs to be person-centred, and GPs must communicate effectively to ensure continuity and coordination of care. In Kenya, there is little knowledge about the quality of communication in consultations by GPs.

Aim To evaluate the quality of communication in consultations by GPs.

Design & setting Descriptive, observational study of 23 GP consultations in 13 private sector primary care facilities in Nairobi, Kenya.

Method One consultation with a randomly selected adult patient was recorded per GP, and 16 communication skills evaluated with the Stellenbosch University Observation Tool (SUOT). A total percentage score was calculated per consultation, and …

Ambient Temperature During Pregnancy And Risk Of Maternal Hypertensive Disorders: A Time-To-Event Study In Johannesburg, South Africa, Chérie Part, Jean Le Roux, Matthew Chersichb, Shobna Sawry, Véronique Filippi, Nathalie Roos, Lee Fairlie, Britt Nakstad, Jeroen De Bont, Stanley Luchters

Institute for Human Development, East Africa

Hypertensive disorders in pregnancy are a leading cause of maternal and perinatal mortality and morbidity. We evaluate the effects of ambient temperature on risk of maternal hypertensive disorders throughout pregnancy. We used birth register data for all singleton births (22–43 weeks' gestation) recorded at a tertiary-level hospital in Johannesburg, South Africa, between July 2017–June 2018. Time-to-event analysis was combined with distributed lag non-linear models to examine the effects of mean weekly temperature, from conception to birth, on risk of (i) high blood pressure, hypertension, or gestational hypertension, and (ii) pre-eclampsia, eclampsia, or HELLP (hemolysis, elevated liver enzymes, low platelets). Low …

Genetic Structure Correlates With Ethnolinguistic Diversity In Eastern And Southern Africa, Elizabeth G. Atkinson, Shareefa Dalvie, Yakov Pichkar, Allan Kalungi, Lerato Majara, Anne Stevenson, Tamrat Abebe, Dickens Akena, Melkam Alemayehu, Lukoye Atwoli

Brain and Mind Institute

African populations are the most diverse in the world yet are sorely underrepresented in medical genetics research. Here, we examine the structure of African populations using genetic and comprehensive multi-generational ethnolinguistic data from the Neuropsychiatric Genetics of African Populations-Psychosis study (NeuroGAP-Psychosis) consisting of 900 individuals from Ethiopia, Kenya, South Africa, and Uganda. We find that self-reported language classifications meaningfully tag underlying genetic variation that would be missed with consideration of geography alone, highlighting the importance of culture in shaping genetic diversity. Leveraging our uniquely rich multi-generational ethnolinguistic metadata, we track language transmission through the pedigree, observing the disappearance of several …

Assessment Of Cardiac, Vascular, And Pulmonary Pathobiology In Vivo During Acute Covid‐19, Shirjel R. Alam, Sudhir Vinayak, Adeel Shah, Jeilan Mohamed, Redemptar Kimeu, Felix Riunga, Sylvia Gachoka, Rodney Adam, Mariah Obino, Khalid Makhdomi, Kevin Ombati, Edward Nganga, Samuel Gitau

Imaging & Diagnostic Radiology, East Africa

Background: Acute COVID‐19–related myocardial, pulmonary, and vascular pathology and how these relate to each other remain unclear. To our knowledge, no studies have used complementary imaging techniques, including molecular imaging, to elucidate this. We used multimodality imaging and biochemical sampling in vivo to identify the pathobiology of acute COVID‐19. Specifically, we investigated the presence of myocardial inflammation and its association with coronary artery disease, systemic vasculitis, and pneumonitis.

Methods and Results: Consecutive patients presenting with acute COVID‐19 were prospectively recruited during hospital admission in this cross‐sectional study. Imaging involved computed tomography coronary angiography (identified coronary disease), cardiac 2‐deoxy‐2‐[fluorine‐18]fluoro‐D‐glucose positron emission …

Preadmission Testing For Covid-19 As A Screening Strategy: A Retrospective Chart Review From A Tertiary Hospital In Kenya, David Odada, James Ndai, Jemimah Kimeu, Jasmit Shah, Reena Shah

School of Nursing & Midwifery, East Africa

Background: Since COVID-19 was declared a pandemic in March 2020, hospitals and patient care facilities have faced challenges in protecting healthcare workers and patients from being exposed to the infection. The main challenge has been how exposure to COVID-19 can be controlled when asymptomatic patientscan transmit the infection. This study aims to evaluate pre-admission testing of COVID-19 in patients at the Aga Khan University Hospital, Nairobi as a screening strategy for understanding, preventing and controlling exposure to COVID-19.

Methods: This was a descriptive retrospective chart review study that analysed the incidence of COVID-19, incidental detection of laboratory-confirmed COVID-19 …

The Covid-19 Pandemic And Disruptions To Essential Health Services In Kenya: A Retrospective Time-Series Analysis, Helen Kiarie, Marleen Temmerman, Mutono Nyamai, Nzisa Liku, Wangari Thuo, Violet Oramisi, Lilly Nyaga, Janette Karimi, Phidelis Wamalwa, Gladwell Gatheca

Obstetrics and Gynaecology, East Africa

Background: Public health emergencies can disrupt the provision of and access to essential health-care services, exacerbating health crises. We aimed to assess the effect of the COVID-19 pandemic on essential health-care services in Kenya.

Methods: Using county-level data routinely collected from the health information system from health facilities across the country, we used a robust mixed-effect model to examine changes in 17 indicators of essential health services across four periods: the pre-pandemic period (from January, 2018 to February, 2020), two pandemic periods (from March to November 2020, and February to October, 2021), and the period during the COVID-19-associated health-care workers’ …

Exploring The Impact Of Health Worker Strikes On Maternal And Child Health In A Kenyan County, Abdu Mohiddin, Eva Langat, James Orwa, Violet Naanyu, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Studies of the impact of health care workers’ strikes tend to look at facility-level activity rather than populations, with evidence from low and middle-income countries relatively sparse. This study explored the effect of national strikes on maternal and child health. It looked at the impact on health system activity in both public and non-public sectors (e.g. private, faith-based), on health promotion investments like immunisation, and on disease detection like post-partum haemorrhage (PPH). A 100 day doctors’ strike started in December 2016, a 150 day nurses strike from June 2017 and then the clinical officers for 21 days that …

The Impact Of The Covid-19 Pandemic On The Career Choice Of Medicine: A Cross-Sectional Study Amongst Pre-Medical Students In Pakistan, Raisa Saleh, Russell Seth Martins, Muhammad Saad, Asad Saulat Fatimi, Manzar Abbas, Inaara Akbar, Hamzah Jehanzeb, Shamila Ladak, Shamama Kaleem, Sarah Nadeem

Medical College Documents

Background: The COVID-19 pandemic has significantly affected the lives of healthcare workers due to the frontline nature of their work. Their hard work and sacrifice have forged new perceptions of healthcare workers. These changes may potentially influence students' interest in medicine. This study explores how the COVID-19 pandemic has affected premedical students' decisions to pursue medicine as a career.
Methods: A cross-sectional study using a self-designed online questionnaire was carried out amongst pre-medical students across Pakistan.
Results: A total of 1695 students from 93 public and private schools filled in the survey. After the onset of the COVID-19 pandemic, significantly …

Igg Antibodies To Sars-Cov-2 In Asymptomatic Blood Donors At Two Time Points In Karachi, Muhammad Hasan, Bushra Moiz, Shama Qaiser, Kiran I. Masood, Zara Ghous, Areeba Hussain, Natasha Bahadur Ali, Syed Hani Abidi, Kulsoom Ghias, Erum Khan, Zahra Hasan

Department of Pathology and Laboratory Medicine

Introduction: An estimated 1.5 million cases were reported in Pakistan until 23 March, 2022. However, SARS-CoV-2 PCR testing capacity has been limited and the incidence of COVID-19 infections is unknown. Volunteer healthy blood donors can be a control population for assessment of SARS-CoV-2 exposure in the population. We determined COVID-19 seroprevalence during the second pandemic wave in Karachi in donors without known infections or symptoms in 4 weeks prior to enrollment.
Materials and methods: We enrolled 558 healthy blood donors at the Aga Khan University Hospital between December 2020 and February 2021. ABO blood groups were determined. Serum IgG reactivity …

Practical Approaches To Improve Vancomycin-Related Patient Outcomes In Pediatrics- An Alternative Strategy When Auc/Mic Is Not Feasible, Kashif Hussain, Muhammad Sohail Salat, Shahzad Rauf, Manoj Rathi, Midhat Khan, Fizzah Naz, Wasif Ahmed Khan, Rahila Ikram, Gul Ambreen

Department of Biological & Biomedical Sciences

Background: Anecdotal experience and studies have shown that most pediatric patients fail to reach target therapeutic vancomycin trough levels (VTLs) and required higher total daily doses (TDD). This retrospective study aims to evaluate the frequency of hospitalized children who achieved target VTLs with a vancomycin (VNCO) dosing regimen of 40-60 mg/kg/d q6h and to assess the VNCO-TDD required to attain the target and their effects on clinical outcomes in pediatric patients.
Methods: After ethical approval, patients of 3 month-12 years were evaluated in this chart review study who received ≥ 3 intravenous-VNCO doses and appropriately drawn blood samples of VTLs …

Cmv And Ebv Co-Infection In Hiv-Infected Children: Infection Rates And Analysis Of Differential Expression Of Cytokines In Hiv Mono- And Hiv-Cmv-Ebv Co-Infected Groups, Fizza Nazim, Hammad Afzal Kayani, Aspara Ali Nathwani, Fatima Mir, Syed Hani Abidi

Department of Biological & Biomedical Sciences

Background: CMV and EBV co-infections can affect the HIV disease progression by modulating the immune system. The disease dynamics can differ in HIV-positive adults and children. In Pakistan, HIV is rapidly expanding, especially in children; however, the prevalence of CMV and EBV co-infection and the effect on immune modulation in HIV-positive children are not known. This study aimed to bridge this gap by estimating the rate of active CMV and EBV co-infection in HIV-positive children, followed by the analysis of differential expression of cytokines in HIV mono- and HIV/CMV/EBV co-infected children.
Methods: DNA samples from 319 HIV-positive children, previously recruited …

Omicron Spike Function And Neutralizing Activity Elicited By A Comprehensive Panel Of Vaccines, John E. Bowen, Amin Addetia, Ha V Dang, Cameron Stewart, Jack T. Brown, William K. Sharkey, Kaitlin R. Sprouse, Kumail Ahmed, Asefa Shariq Ansari, Najeeha Talat Iqbal

Department of Paediatrics and Child Health

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant of concern comprises several sublineages, with BA.2 and BA.2.12.1 having replaced the previously dominant BA.1 and with BA.4 and BA.5 increasing in prevalence worldwide. We show that the large number of Omicron sublineage spike mutations leads to enhanced angiotensin-converting enzyme 2 (ACE2) binding, reduced fusogenicity, and severe dampening of plasma neutralizing activity elicited by infection or seven clinical vaccines relative to the ancestral virus. Administration of a homologous or heterologous booster based on the Wuhan-Hu-1 spike sequence markedly increased neutralizing antibody titers and breadth against BA.1, BA.2, BA.2.12.1, BA.4, and …

Covad Survey 2 Long-Term Outcomes: Unmet Need And Protocol, Zoha Zahid Fazal, Parikshit Sen, Mrudula Joshi, Naveen Ravichandran, James B. Lilleker, Vishwesh Agarwal, Sinan Kardes, Minchul Kim, Jessica Day, Ashima Makol

Medical College Documents

Vaccine hesitancy is considered a major barrier to achieving herd immunity against COVID-19. While multiple alternative and synergistic approaches including heterologous vaccination, booster doses, and antiviral drugs have been developed, equitable vaccine uptake remains the foremost strategy to manage pandemic. Although none of the currently approved vaccines are live-attenuated, several reports of disease flares, waning protection, and acute-onset syndromes have emerged as short-term adverse events after vaccination. Hence, scientific literature falls short when discussing potential long-term effects in vulnerable cohorts. The COVAD-2 survey follows on from the baseline COVAD-1 survey with the aim to collect patient-reported data on the long-term …

Prevalence And Factors Associated With Undernutrition Among Children With Congenital Heart Disease At Three Tertiary Hospitals In Nairobi, Kenya., Shamsa Yahya

Master of Medicine in Paediatrics and Child Health

Background: Congenital heart disease (CHD) is the commonest birth defect. Children with CHD have a high burden of undernutrition and its consequences. Some of the factors that are associated with undernutrition in children with CHD include the type and complexity of the heart defect, associated pulmonary hypertension, late diagnosis, timing of surgical correction, low socioeconomic status, lack of adequate nutritional support, associated genetic conditions and the presence of other clinical comorbidities. Justification: Although these factors are well defined, they vary geographically in their distribution and extent to which they influence the level of undernutrition. This limits the extrapolation of findings …

Narrative Synthesis Systematic Review Of Pakistani Women's Health Outcomes From Primary Care Interventions, Sara Rizvi Jafree, Qaisar Khalid Mahmood, Sohail Mujahid, Muhammad Asim, Jane Barlow

Community Health Sciences

Objective: Women living in Pakistan have complex health problems including infectious and non-communicable diseases, accident and injuries, and mental health problems. While a majority of these women rely on primary healthcare services for all of their healthcare needs, there has to date been no overview of the extent of their effectiveness. The objective of this review was to (1) synthesise the available evidence regarding the effectiveness of primary care based interventions aimed at improving women's mental and physical health and (2) identify the factors that promote effectiveness for women's health outcomes.
Methods: Five academic databases were searched, including PubMed, BMC …

A Scoping Review Of Preterm Births In Sub-Saharan Africa: Burden, Risk Factors And Outcomes, Adam Mabrouk, Amina Abubakar, Ezra Too, Esther Chongwo, Ifedayo M. Adetifa

Institute for Human Development, East Africa

Preterm births (PTB) are the leading cause of neonatal deaths, the majority of which occur in low- and middle-income countries, particularly those in Sub-Saharan Africa (SSA). Understanding the epidemiology of prematurity is an essential step towards tackling the challenge of PTB in the sub-continent. We performed a scoping review of the burden, predictors and outcomes of PTB in SSA. We searched PubMed, Embase, and three other databases for articles published from the database inception to 10 July 2021. Studies reporting the prevalence of PTB, the associated risk factors, and/or its outcomes were eligible for inclusion in this review. Our literature …

Early Childhood Development In Uganda: Investing In Human And National Development – Reflections From The Covid-19 Pandemic, Anil Khamis

Book Chapters / Conference Papers

This chapter presents an analysis of the development of early childhood development in Uganda from policy to programme development in the light of the COVID-19 pandemic. It highlights the achievements and challenges as well as the opportunities for government and its partners whilst navigating an evolving and increasingly competitive political economy. The chapter identifies gaps that need to be addressed in terms of human development, which is argued to be the basis of national development. The United Nations Sustainable Development Goals are presented as an acceptable and agreed framework by all stakeholders as Uganda and other nations confront uncertain futures. …

Inspire : Vol 5, Issue 8, Department Of Medicine

INSPIRE – Department of Medicine Archives

• Message from the Chair
• Medicine at National and International Forums
• AKU- AKHSP Research Bootcamp
• Multidisciplinary Webinar of colorectal cancer
• 19th Annual conference of Medical Microbiology and Infectious Diseases Society of Pakistan (MMIDSP)
• Dermatopathology Mock Workshop
• Student Activity - World Digestive Health Day
• Nephrology- Online certificate course
• Awareness Session - World Hepatitis Day
• In-depth- featuring Associate Prof. & Section Head (Gastroenterology) Dr Om Parkash
• Featured Faculty – Dr Lubna Kamani – Lecturer – Gastroenterology section “… An equal world is an enabled world…”
• Poem Section
• What are Academics Around the World Reading This Month?
• Publications

Longitudinal Reduction In Diversity Of Maternal Gut Microbiota During Pregnancy Is Observed In Multiple Low-Resource Settings: Results From The Women First Trial, Minghua Tang, Nicholas E. Weaver, Daniel N. Frank, Diana Ir, Charles E. Robertson, Jennifer F. Kemp, Jamie Westcott, Kartik Shankar, Sumera Aziz Ali, Sarah Saleem

Community Health Sciences

Objective: To characterize the changes in gut microbiota during pregnancy and determine the effects of nutritional intervention on gut microbiota in women from sub-Saharan Africa (the Democratic Republic of the Congo, DRC), South Asia (India and Pakistan), and Central America (Guatemala).
Methods: Pregnant women in the Women First (WF) Preconception Maternal Nutrition Trial were included in this analysis. Participants were randomized to receive a lipid-based micronutrient supplement either ≥3 months before pregnancy (Arm 1); started the same intervention late in the first trimester (Arm 2); or received no nutrition supplements besides those self-administered or prescribed through local health services (Arm …

Unusual Presentation Of Multisystemic Inflammatory Syndrome, Farah Ebrahim, George Moturi, Newnex Mongare, Reena Shah

Internal Medicine, East Africa

COVID-19 pneumonia in children presents with very mild symptoms through an entity of multisystem inflammatory syndrome and can result in a life-threatening hyperinflammatory condition, with involvement of at least four organ systems and a marked inflammatory state. We present an 18-year-old high school student who presented with a sore throat, macular rash, abdominal pain, diarrhea, fevers, and joint pains. He presented with acute kidney injury and confusion with multiple tests and was eventually diagnosed with multisystem inflammatory syndrome in children (MIS-C).

Are Kenyans Likely To Use Covid-19 Self-Testing Kits? Results From A Cross-Sectional Survey, Griffins Manguro, Sonjelle Shilton, Sharon Omenda, Patrica Owira, Deepshikha Batheja, Abhik Banerji, Sophie Chabeda, Marleen Temmerman, Walter Jako, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Objectives: To understand the public’s perceptions around rapid SARS-CoV-2 antigen self-testing in Kenya, including the drivers of acceptability, willingness to pay, and adherence to hygiene and prevention recommendations following a positive self-test.

Methods: A household-based, cross-sectional survey, using a 35-item questionnaire, was conducted in Mombasa and Taita–Taveta counties, Kenya, during August 2021. Individuals aged ≥18 years were enrolled using a stratified sampling approach.

Results: There were 419 participants (mean age 35.7 years). A minority (10.5%) had ever tested for SARS-CoV-2. If SARS-CoV-2 self-testing were available, 39.9% and 41.5% would be likely and very likely, respectively, to use it. If unavailable …

Covid-19 Vaccine Hesitancy Among Non-Refugees And Refugees In Kenya, Ryan Rego, Anthony Ngugi, Antonia Johanna Sophie Delius, Stanley Luchters, Joseph C. Kolars, Furqan B. Irfan, Eileen Weinheimer-Haus, Amina Abubakar, Reena Shah, Ji Zhu

Population Health, East Africa

Factors associated with COVID-19 vaccine hesitancy (which we define as refusal to be vaccinated when asked, resulting in delayed or non- vaccination) are poorly studied in sub-Saharan Africa and among refugees, particularly in Kenya. Using survey data from wave five (March to June 2021) of the Kenya Rapid Response Phone Survey (RRPS), a household survey representative of the population of Kenya, we estimated the self-reported rates and factors associated with vaccine hesitancy among non-refugees and refugees in Kenya. Non-refugee households were recruited through sampling of the 2015/16 Kenya Household Budget Survey and random digit dialing. Refugee households were recruited through …

Acquired Hemophilia A: A Possibly Fatal Complication Of Sars-Cov-2 Infection, Hasan Fareed Siddiqui, Taymmia Ejaz, Aisha Fareed Siddiqui, Fahd Niaz Shaikh

Department of Medicine

No abstract provided.

Social Contributors For The Rise Of Covid-19 Infections In South Asia: A Large Cross-Sectional Survey, Zouina Sarfraz, Azza Sarfraz, Muzna Sarfraz, Nishwa Azeem, Namrata Hange, Miguel Felix, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: The ongoing global coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was first reported in South Asia on 30th January 2020 in India. Ever since, certain countries have witnessed multiple waves of COVID-19, requiring attention by public health experts and strategists in the region. The objectives of this study are to assess social contributors to the recurrent waves of COVID-19 in South Asia including first demographic traits, second household characteristics and social measures, third workplace trends and personal protective equipment use, and fourth satisfaction and attitudes concerning public health measures and vaccination status. …

Microplastics In Freshly Fallen Snow: How May It Adversely Impact Human Health And Exacerbate The Covid-19 Crisis?, Ayesha Liaquat, Aleena Kashif, Sushma Rathi, Alishba Raza

Medical College Documents

No abstract provided.