There is a lack of awareness about hepatitis C due to poverty, involvement of quacks and less penetration of mass media. To develop the awareness of hepatitis C among primary grade students. A total of 150 students of primary grade among 300, of Government sector Middle School Lahore were selected throughmultistage cluster sampling. A quasi-experimental study was conducted in the time period of 6 months from April 2014 to Sep 2014. Data analysis was done with SPSS 20. After describing the important variables, average percentages were used to find out the difference between pre and post awareness performances andt score and p value was calculated. All the students (150) were boys, 98% belonged to a lower middle class family with the age of 9-12 years. During pre-testing evaluation, students were never given the knowledge about hepatitis C, its source of transmission (contaminated syringes) and its secondary prevention. Only3% knew that it can be prevented. About 61% thought that it is a disease of adults. Only 21.1% students thought it can be cured. In post awareness assessment after 3 sessions of interactive learning, 92% students understood the prevention of hepatitis C disease, its transmission (syringes 88.7%, blood transfusion 91%),signs (effects on liver 92.9%), symptoms (88%), prevention in high prevalent areas (sterilized syringes and screened blood transfusion 86.5%) and management (88.7%). This study showed that it may be an important school health based intervention to educate students about the transmission, prevention and management of hepatitis C, which may help in declining the disease burden. Hepatitis C, Unsterilized syringes, Hepatitis C Awareness, Prevention of Hepatitis C.

Coronavirus 2019 (COVID-19) affects the cardiorespiratory systems by causing inflammation of the circulatory systems, hence, causing more cardiac complications in COVID-19 patients Objective: To observe the frequency of cardiac complications in COVID-19 patients during the second wave Methods: 235 COVID-19 patients presenting with cardiac complication to the Cardiology Department of Mayo Hospital, Lahore during 6 month periods of second wave of COVID-19 were included. Data regarding the medical history, age, gender was taken and the observed cardiac complication were noted Results: There were 76.6% male patients and 23.4% female patients. 56.2 % patients were already hypertensive, 37.9% were diabetic, 18.3% had familial history of cardiac diseases. The cardiovascular manifestations observed were, myocardial infarction (57.82%), 7.3% had angina, 21.3% had acute coronary syndrome and 12.3% had non ST elevation myocardial infarction. Conclusions: Our study suggests that there is a prevalence of cardiovascular diseases in COVID-patients which is a major concern as they are at increased risk for severe infection.

The ongoing inflammatory process in COVID infection is reported to cause acute cardiac injury either due to direct cytotoxicity or oxidative stress injury to myocytes. Hypercoagulability and endothelial dysfunction are the two main events resulting in the transient thrombotic process. Objective: To assess the coronary artery occlusion in COVID infected patients presenting with ST-elevation myocardial injury. Methods: A descriptive case series study was conducted on 52 patients presenting with ST-elevation myocardial infarction along with COVID infection. Data was collected regarding demographic profile, Troponin levels, COVID PCR, changes in ECG, Echocardiographic findings and coronary arteries were assessed angiographically. Data were analyzed using SPSS software and various percentages were calculated. Results: Of all the 52 patients studied, 46 patients (88%) tested positive for COVID -19 on RT-PCR done via nasopharyngeal swab. Other 6 patients tested negative initially but they had findings on their CXR and HRCT suggestive of interstitial pneumonia. All the patients were in age group 30-60 years with 32 patients (62%) being males and 20 being females (38%). None of the patients previously had any history of angina or myocardial infarction. Inflammatory markers were raised in about 43 patients (82.7%). ECG showed ST segment elevation in anterior leads in 35 patients (67%) and in inferior leads in 9 patients (17%) and in lateral leads in 2 patients (3.8%). Qualitative Troponin I test was positive in all the patients, whereas, about 41 patients (78%) had Quantitative Troponin I test in high probability range. About 50 patients (96%) had Ejection Fraction greater than 45% and normal segmental wall motion analysis. The coronary arteries were reported to be normal or recanalized in 40 patients (76%) and mild-moderate disease in single or two vessels are present in rest of the 12 patients. None of the patients had shown culprit artery severe disease or clot burden on angiograms. Conclusions: Acute Cardiac injury in previously asymptomatic patients may be related to the pro-thrombotic state created by COVID-19 infection resulting in endothelial dysfunction and mimicking ST-elevation myocardial injury raising Troponin levels indicated by raised D-Dimers and CRP level. The auto-recanalization of the coronary arteries and normal echocardiographic findings, are good prognostic factors for the post cardiac injury rehabilitation.

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e18839 Background: Cancer, as well as immunosuppression from chemotherapy, aggravates thromboembolism risk. The risk is likely amplified in an additive fashion with COVID-19 infection, which confers a higher risk of VTE risk with viral sepsis, endothelial inflammation, and microthrombi formation. Numerous studies have shown the heightened risk of pulmonary embolism among severe COVID-19 patients. We sought to evaluate further the extent of COVID-19-associated coagulopathy and associated outcomes. Methods: National Inpatient Sample 2020 was used to identify non-elective hospitalizations of patients with a secondary diagnosis of any cancer. These were stratified into two cohorts based on the presence of the primary diagnosis of COVID-19. Primary outcomes include venous thromboembolism, PE, and VTE without PE in cancer patients with and without Covid-19 infection. The secondary outcomes examined were in-patient mortality, the average length of stay (LOS), and total hospital charge (THC). Multivariate analysis was performed to obtain the odds ratio. All weighted analysis was conducted through STATA 17. Results: Out of 1,734,735 non-elective admissions of patients with cancer, 36,295 (2%) were admitted for COVID-19. Our analysis showed statistically non-significant increased odds of venous thromboembolism(aOR:1.09 CI 0.99-1.20) in cancer patients with COVID. There was, however, a significant increase in the odds of pulmonary embolism(aOR 1.7, CI: 1.51- 1.91) among cancer patients with Covid-19. There were decreased odds of VTE without PE(aOR: 0.67 CI: 0.57-0.78). There was a statistically significant increase in odds of mortality (aOR: 2.8 CI: 2.63-3.0), length of stay(aOR:1.85 CI: 1.65- 2.05), total hospital charges($83,201 vs. $78,869 p: < 0.01) in cancer patients with COVID-19 compared to cancer patients without COVID-19. Conclusions: This study shows that COVID-19 in cancer patients has deleterious effects, including an increased risk of pulmonary embolism and poor in-hospital outcomes. The finding of a lower incidence of non-PE VTE in patients with cancer is likely related to limitations with coding in NIS, in which lower complexity codes might be omitted in patients with multiple diagnoses. With significantly increased mortality and economic burden, these findings emphasize the significance of thrombotic prophylaxis and vaccination in cancer patients. [Table: see text]