The government of Pakistan started vaccination campaign for the frontline healthcare providers, as they are more likely to be exposed to COVID-19 patients. In the next step, it extended the free vaccination campaign to include people above 60 and 50 years of age respectively. The drive is now open to all citizens >18 years of age. There is a significant reluctance to get vaccinated even though the government has provided it free of cost. The project uses self-reporting method to assess reasons of vaccine hesitancy among Pakistanis and possible solutions to overcome this problem. Concern for serious side effects was the most common issue 154 (48.42%) reported among all groups of people, including the healthcare workers. The major sources of COVID-19 related information were television 117 (36.8%) and healthcare professionals 105 (33%). The participants reported that they can be convinced to get vaccinated if more published data related to vaccine efficacy and safety is available 118 (37.1%), they observe no side effect among vaccine recipients 90 (28.3%) or higher government officials get the same vaccine 39 (12.3%). Vigorous analysis and publication of data generated is paramount to increase the percentage of people being vaccinated. The healthcare professionals should share evidence-based knowledge related to vaccine efficacy and safety through television and social media to increase acceptance rates and hence, decrease mortality and morbidity from COVID-19 in Pakistan.

Background: To determine the safety profile of Sinopharm COVID19 vaccine and identify breakthrough infections. Method: The study design was analytical cross sectional. An online questionnaire was filled by 1033 respondents between 16th and 22nd April 2021. Adults who had received both doses of Sinopharm COVID19 vaccine more than a week ago or only a single dose with serious side effect were included in the study. The frequency and severity of vaccination related side effects were assessed and breakthrough infection identified. Results: The mean age of participants was 36.7 12.91(18 to 92) years. Ninety one percent of participants (n=946) were health care professionals. One fifth (n=225/1033, 21.8%) had suffered from COVID-19 infection prior to vaccination, confirmed using the nasal RT-PCR test. None of the participants reported serious (grade III) or life threatening (grade IV) adverse reactions after either of the two doses. The most common side effects after the first dose were pain at injection site (20.3%), fatigue (20.3%), headache (13.9%), myalgia (12.5%) and fever (9.3%) whereas after the second dose were fatigue (16.8%), pain at injection site (15.8%), myalgia (14%) and fever (6.7%). The side effects were more common in participants who had previous history of COVID-19 infection. Of 225 previously infected participants, 97(43.1%) (p value=0.020) and 90 (40%) (p value=0.001) participants had side effects after 1st and 2nd dose respectively. 16 participants (1.55%) developed PCR positive COVID-19 infection two weeks after the second dose while 3(0.29%) participants had a re-infection. There was one case of probable severe COVID-19 infection, 2 weeks after the second dose and recovered completely with treatment. Conclusion: Our study shows that Sinopharm COVID19 vaccine is generally safe with no serious side effects. The side effects were however, more common in inviduals who already had COVID19 infection. The COVID19 breakthrough infection and reinfection could occur after the vaccination.

Zellweger syndrome (ZS) is the severest variety of peroxisomal biogenesis disorder (PBD). This is a fatal hereditary, autosomal recessive disorder. It is characterized by the absence of peroxisomes in the cells which are essential for many metabolic functions especially beta oxidation of very long chain fatty acids (VLCFAs). We report the case of a female Saudi toddler. She presented with dysmorphism, profound hypotonia, psychomotor retardation, seizures, and loss of hearing and vision with findings of optic atrophy. Biochemical study revealed significantly elevated level of VLCFAs, cerotic acid and phytanic acid. She also had periventricular leukomalacia and abnormal electroencephalography results and a PEX 1 gene mutation. The clinical data and investigations were consistent with ZS. As it is fatal in early life, genetic counseling and prenatal diagnosis are thus crucial.

Abstract:To determine the risk factors and complications in patients expired due to measles. Background:Measles is one of the vaccine-preventable diseases. Mortality and morbidity due to it has been decreased in many countries with preventive measures. However, epidemics occur off and on in some communities. Pakistan has faced an epidemic in 2012-13. Started from one province and affected others. Due to some risk factors, Pakistani children suffered from many complications.

Background: To determine the safety profile of Sinopharm COVID-19 vaccine and identify breakthrough infections. Method: The study design was analytical cross sectional. An online questionnaire was filled by 1033 respondents between 16th and 22nd April 2021. Adults who had received both doses of Sinopharm COVID-19 vaccine more than a week ago or only a single dose with serious side effect were included in the study. The frequency and severity of vaccination related side effects were assessed and breakthrough infection identified. Results: The mean age of participants was 36.7 ± 12.91(18 – 92) years. Ninety one percent of participants (n=946) were health care professionals. One fifth (n=225/1033, 21.8%) had suffered from COVID-19 infection prior to vaccination, confirmed using the nasal RT-PCR test. None of the participants reported serious (grade III) or life threatening (grade IV) adverse reactions after either of the two doses. The most common side effects after the first dose were pain at injection site (20.3%), fatigue (20.3%), headache (13.9%), myalgia (12.5%) and fever (9.3%) whereas after the second dose were fatigue (16.8%), pain at injection site (15.8%), myalgia (14%) and fever (6.7%). The side effects were more common in participants who had previous history of COVID-19 infection. Of 225 previously infected participants, 97(43.1%) (p value=0.020) and 90 (40%) (p value=0.001) participants had side effects after 1st and 2nd dose respectively. 16 participants (1.55%) developed PCR positive COVID-19 infection two weeks after the second dose while 3(0.29%) participants had a re-infection. There was one case of probable severe COVID-19 infection, 2 weeks after the second dose and recovered completely with treatment. Conclusion: Our study shows that Sinopharm COVID-19 vaccine is generally safe with no serious side effects. The side effects were however, more common in inviduals who already had COVID-19 infection. The COVID-19 breakthrough infection and reinfection could occur after the vaccination.