Background: Health care workers (HCWs) are exposed to high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to close contact with infected patients in hospital. The objective of this study was to estimate the seroprevalence and to identify the exposure risk of various subgroups among HCWs to prioritize them for early vaccination. Methods: This was a multicentre cross-sectional study conducted between 15 and 29 June 2020. A total of 987 HCWs were recruited randomly from two major tertiary-care hospitals of Peshawar city, Pakistan. The HCWs included doctors, nurses, paramedics and hospital support staff. The US Food and Drug Administration (FDA)–approved kit was used for the detection of SARS-CoV-2 antibodies. Results: Overall, 310 (31.4%) HCWs were seropositive for SARS-CoV-2 antibodies (95% confidence interval, CI: 28.5–34.4). Seroprevalence was higher in males (33.5%) and in age group 51–60 years (40.9%). Seropositivity increased with increasing age from 8.3% in age group ⩽20 to 40.9% in 51–60 years of age group ( p < 0.05). The highest seroprevalence was identified in paramedical staff (42·5%, 95% CI: 36.6–48.6) followed by nursing staff (38·8%, 95% CI: 32.1–45.7). In logistic regression, being a male HCW led to higher risk of seropositivity (odds ratio, OR: 1.50, 95% CI: 1·06–2.13. p < 0.05) compared with female staff members. The odds of seropositivity was higher in nurses (OR: 3·47, 95% CI: 1.99–6.05. p < 0.01), paramedical staff (OR: 3·19, 95% CI: 1.93–5.28. p < 0.01) and hospital support staff (OR: 2·47, 95% CI: 1.29–4.7. p < 0.01) compared with consultants. Conclusion: Overall, our results concluded that nursing and paramedical staff are at higher risk and should be vaccinated on priority.

Background Since the pandemic of SARS-CoV-2 began, our understanding of the pathogenesis and immune responses to this virus has continued to evolve. It has been shown that this infection produces natural detectable immune responses in many cases. However, the duration and durability of immunity and its effect on the severity of the illness are still under investigation. Moreover, the protective effects of antibodies against new SARS-CoV-2 variants still remain unclear. Objectives To assess the incidence and associated demographic features of SARS-CoV-2 infection in anti-nucleocapsid IgG-positive and anti-nucleocapsid IgG-negative healthcare workers. Material and methods This prospective longitudinal cohort study was conducted in Peshawar Medical College group of hospitals of Prime Foundation. Anti-nucleocapsid IgG sero-positive and anti-nucleocapsid IgG sero-negative healthcare workers were followed for a period of 6 months (from 1 Aug 2020 to 31 Jan 2021), and the incidence of SARS-CoV-2 was confirmed by RT-PCR. Results A total number of 555 cohorts were followed for a period of 6 months; of them 365 (65.7%) were anti-nucleocapsid-negative (group A) and 190 (34.3%) were anti-nucleocapsid-positive (group B) healthcare workers. The mean age of the study cohort was 33.85 ± 9.80 (anti-N (–), 34.2 ± 10.58; anti-N ( +), 33.5 ± 9.50). The median antibody level in anti-nucleocapsid-positive HCWs was 15.95 (IQR: 5.24–53.4). Male gender was the majority in both groups (group A, 246 (67%), group B, 143 (48%)) with statistically significant difference ( P < 0.05). Majority of the HCWs were blood group B in both groups (34% each). None of the 190 anti-nucleocapsid-positive HCWs developed subsequent SARS-CoV-2 re-infection, while 17% ( n = 65) HCWs developed infection in anti-nucleocapsid-negative group during the 6-month follow-up period. Conclusion In conclusion, none of the anti-nucleocapsid-positive HCWs developed SARS-CoV-2 re-infection in this study, and the presence of IgG anti-nucleocapsid antibodies substantially reduce the risk of re-infection for a period of 6 months. Supplementary information The online version contains supplementary material available at 10.1007/s11845-022-02997-w.

Objectives: To determine whether serum vitamin D levels are correlated with serum levels of alkaline phosphatase or not? Study Design: Case control cross sectional study. Setting: Gastroenterology unit of private teaching hospital in Peshawar. Period: From November 2015-Januaray 2016. Material and Methods: 100 participants meeting the criteria were included in the study. Fifty clinically normal young adults and fifty were non cirrhotic chronic hepatitis C patients were included in the study. Venous blood samples were taken from all the study participants and serum vitamin D levels were determined by Electro-chemiluminescence binding assay (ECLIA) and serum alkaline phosphatase was determined by Photometric Kinetics. Results: patients were divided into two groups on the basis of gender i.e.25 males and 25 females. A correlation between vitamin D and alkaline phosphatase was determined. Alkaline phosphatase was raised in the non cirrhotic chronic hepatitis C patients. Pearson correlation was applied to find out the relation between vitamin D levels and alkaline phosphatase in the two groups which had a significant relationship with a p-value of 0.01. A positive correlation between alkaline phosphatase and parathyroid hormone was found with a p value of <0.0001. Conclusion: In our study alkaline phosphate was considerably increased in chronic hepatitis C patients who might be due to underlying liver disease. In chronic liver disease the hepatocytes swell up and due to damage to the liver parenchyma the level of alkaline phosphatase increases.

Objectives: To determine and compare vitamin D status in chronic hepatitis C patients and normal healthy matching controls. Study Design: A case control study. Setting: A private clinic of Peshawar. Period: 1st November 2015 to 31st January 2016. Material & Methods: Fifty clinically normal young adults and fifty non cirrhotic chronic hepatitis C patients were included in the study. Vitamin D was determined by electro chemiluminescence. Student t test was used to analyze the data in SPSS version 21. Results: The mean age of the study population was 30.68+ 5. Vitamin D deficiency was divided into three categories. 21% of the study population had severe vitamin D deficiency, 33% had mild to moderate deficiency and 46% of the study population had normal levels. Females population were more vitamin D deficient as compared to males (p-value<0.05). Vitamin D levels were comparatively decreased in the non cirrhotic chronic hepatitis C patients. Statistically significant (p value <0.05) results were obtained while comparing means of serum vitamin D of non-cirrhotic chronic hepatitis C patients with healthy matching controls. Conclusion: It is concluded from this study that a significant number of apparently healthy individual have low vitamin D level and some even fall in the severely deficient group without any active complains. Patients with chronic hepatitis C had rather increased levels of vitamin D as compared to normal healthy adults There might be some genetic factors underlying which affects the availability of Vitamin D.

Multidrug-resistant Escherichia coli have become a main public health distress in Pakistan and many countries, causing failure in treatment with the resultingenormous health burden. The current study was aimed to find the prevalence of E. coli among clinical isolates and their antibiotics susceptibility pattern using standard procedures. The Purpose of the present study to investigate the Prevalence and antibiotic susceptibility pattern of E. coli detected from clinical patients visiting Khyber teaching hospital Peshawar. In this study a total 415 sample were isolated from the patient of Khyber teaching hospital (KTH) Peshawar. The collected samples were processed for identification including Gram staining and biochemical test. Furthermore, the antibiotic susceptibility pattern of all the positive strains of E. coli was tested using selected antibiotic discs by disc diffusion method as per CLSI guidelines 2019.A total of 415 samples, 112 clinical isolates yielded the growth of E. coli using standard procedures. Out of 112 isolates, 52% were recovered from male patients while 60% were females. The positive samples were obtained from urine (58%), pus (14.3%), swab (8.9%), sputum (10.7%), and others 8.0% respectively. The highest sensitive drugs are FOS (99.1%), AK (98.2%), TZP (97.3%), MEM (93.8%), TGC (91.1%), CN (89.3%), SCF (78.6%), DO (65.2%), CT (60.7%), F (49.1%), ATM (27.7%) AMP (23.2%), CAZ (23.2%), CPM (22.3%) , CRO (19.6%) ,CTX (13.4%) and the lowest sensitive drug is CIP which is (7.1%) . The drugs which show high resistance are CIP (92.9%), CTX (86.6%), CRO (80.4%), CPM (77.7%), CAZ (76.8%), AMP (76.8%) , ATM (72.3%) , CT( 39.3%) , DO (34.8%), SCF (21.4%), CN(10.7%),TGC(8.9%), F(8.9%),MEM(6.3%) ,TZP(2.7%),AK (1.8%) ,and the lowest resistance drug is FOS (0.9%).Drug resistance monitoring and the epidemiological analysis of patient data are needed regularly and can be useful for the adequate management of antimicrobial resistance. Key words: Multidrug-resistant, Antimicrobial Resistance, Clinical Isolates, Bacteria, Peshawar