Background and Objectives: In 2004 Pakistan escalated from ‘low-prevalence’ to ‘concentrated’ phase of HIV epidemic. Despite global decline in HIV incidence since 1997, rate of HIV infections in Pakistan is persistently rising since 1990. Available literature focusses on key populations or localized outbreaks limited by short study duration and regional applicability of results. We studied HIV seroconversion trends over a period of 8 years in a geographically diverse population and evaluated associated risk factors. Methods: A desk review of HIV surveillance data from 2010 to 2017 was carried out at Armed Forces Institute of Pathology. A case was defined as any adult employed in organization ‘X’, initially screened for HIV but later seroconverted on ELISA and western blot. Case-control study was conducted on cases diagnosed in 2017. Age and sex matched controls were identified from same population sub-group. Structured telephonic interviews were conducted and statistical analysis done at 5% margin of error. Results: The annual HIV diagnosis rate remained relatively stable till 2015 (< 40 /100,000/yr) after which it rose sharply to 60/100,000/yr in 2016. Upward trend continued in 2017 to reach 125/100,000/yr (>200% increase from baseline). Acquisition of HIV was significantly associated with commercial sex activities (OR=9; 95%CI: 1.25-395). Conclusion: HIV seroconversion rates among employees of organization X have increased significantly in the past two years. Unlike HIV outbreaks previously reported from Pakistan, sexual route seems to be the predominant mode of transmission. Focus is mandated on prevention of sexual transmission of HIV at national level as well for all vulnerable populations. doi: https://doi.org/10.12669/pjms.36.6.1735 How to cite this:Mansoor E, Azam N, Niazi SK, Sheikh N, Baig MA, Azim MT, et al. Rising HIV seroconversion rates & associated risks among employees of organization ‘X’: A case control study, Pakistan, 2017. Pak J Med Sci. 2020;36(6):---------.   doi: https://doi.org/10.12669/pjms.36.6.1735 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Objective: To determine the frequency and association of different risk factors for morbidity and mortality in neonates. Study Design: Case-control study. Place and Duration of Study: Department of Paediatrics, Pak-Emirates Military Hospital, Rawalpindi, Nov 2021 to Apr 2022. Methodology: A total of 332 patients (166 cases and 166 controls) admitted in the neonatal intensive care setting were includedin our study. Patients who were stillborn or had incomplete records were excluded. All patients were followed up till discharge or death and were documented for various risk factors. Results: The mean age of our study population was 11.52 ± 6.45 days, with 176 (53.0%) males. Risk factors such as low birthweight (2.06 [95% Cl 1.20-3.54]), multiple gestations (2.09 [95% Cl 1.87-2.35]), premature delivery (1.61 [95% Cl 1.01-2.57]),male gender (1.62 [95% Cl 1.05-2.51]) and lack of antenatal care (1.61 [95% Cl 1.01-2.57]) showed an association with mortality.Early-onset neonatal sepsis (1.78 [95% Cl 0.98-3.22]), hypoxic ischaemic encephalopathy (3.01 [95% Cl 1.55-5.82]), meconiumaspiration syndrome (2.42 [95% Cl 0.97-6.05]), congenital anomalies (4.15 [95% Cl 0.87 – 19.85]) and inborn errors of metabolism (7.26 [95% Cl 0.88-59.71]) were all associated with an increase in mortality. Conclusion: Increased risk for mortality in critically ill neonates is multifactorial and requires intervention at multiple levels to reduce mortality at all phases of gestation.

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