Objectives We studied the impact of the Covid-19 pandemic on the physical and mental health of patients with chronic illnesses and their behavioural responses. Methods We conducted a cross-sectional knowledge, attitudes and practices (KAP) survey among outpatients with chronic illnesses in Lahore, Pakistan. Results Four hundred and one participants were surveyed (84% above 50 years of age). One or two chronic illnesses were present in 130 (32%), three or four in 211 (53%) and more than four in 60 (15%). The majority correctly identified the sources of Covid-19 infection and higher risk patients. Of the respondents, 127 (32%) described feeling more vulnerable. Respondents reported a lack of trust in the community response (199; 49.6%) and hospital measures (167; 41.6%) to slow the spread of Covid-19 and 369 (92%) practiced some degree of social distancing. Respondents described negative impacts of lockdown measures on their physical and mental health (235; 58.6% and 262; 65.3%, respectively). Many reported difficulty in getting medical help during the pandemic (302; 75.2%). Half of the respondents (200; 49.8%) felt that delays in receiving care had adversely affected their health. Conclusions Respondents with chronic illnesses frequently reported negative behavioural and health impacts during the Covid-19 pandemic.

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OBJECTIVES The study’s objective was to assess the knowledge of primiparous mothers for exclusive breastfeeding to babies for the first six months on their first postnatal follow-up. METHODOLOGY A cross-sectional descriptive was conducted at Pediatrics Department, KRL Hospital Islamabad, for six months over 100 women from October 2022 to March 2023. A self-administered questionnaire was used to obtain information from the study participants. Females with primi gravida were selected, and interviews were conducted on a specific breastfeeding awareness questionnaire. The participant with correct and incorrect responses scored 1 and 0, respectively. Participants with scores of 0-4 were regarded as having poor knowledge, 4-7 as average and 7-10 as good knowledge regarding breastfeeding. The latest SPSS version analyzed Data. RESULTSResults show that the mean age was 24 years SD ± 1.2. Forty-one per cent of mothers were illiterate, 42% had Primary education, 15% had secondary school education, and only 2 % were university educated. Fifty-nine per cent of mothers were housewives, 29% were students, and 12% were working women. Moreover, 21% of mothers had poor knowledge of breastfeeding, 12% had average knowledge of breastfeeding, and 67% had good knowledge of breastfeeding. CONCLUSION Our study concludes that the knowledge of the primiparous mothers about breastfeeding was adequate.

Background: COVID-19 has superseded all medical scientific challenges in 2020. It presented with a range of respiratory involvement from the mild upper respiratory tract to severe pneumonia with ARDS. A percentage of these patients manifested variable neurological presentations expanding the challenges of patients’ assessment, care, and management. Objective: To discuss the neurological manifestations and the possible immunopathology of COVID-19. Methods: A literature search was performed in the PubMed database for the relevant articles published in English language between April 9th , 2020 and June 1, 2020. Few papers were extracted from Google Scholar and pre-print material as well. The keywords used to perform search included “COVID-19,” “SARS Cov2,” “neurological manifestations,” and “immunology and pathology of COVID-19”. However, animal studies were excluded in the neurological manifestations, and the final number of literature search outcome was 27 articles. Results: The immunopathology involves angiotensin-converting enzyme (ACE) receptor 2 and spike protein S1. COVID-19 has a tremendous affinity to the ACE2 receptor. The status of secondary hemophagocytic lymphohistiocytosis (sHLH) and the cytokine storm lead to different organ damage and the corresponding clinical manifestations. The documented neurological manifestations mainly include acute ischemic stroke, hemorrhagic stroke, temporal lobe, thalamic encephalitis, and one case of Guillain-Barre Syndrome, in addition to agitation, headache, and seizures. Conclusion: Although the intimate relationship between the neurons and the immune activation is the basic concept of COVID-19 immunopathology, the definite routes of entry to the neuronal cells are yet to be disclosed. Acute stroke, myositis, headache, and meningoencephalitis are the most common types of complications of COVID-19 so far.