Aim: We conducted this study to determine the increase rate of mortality and effect of anesthesia in covid-19 patients with severe vitamin D deficiency. Study Design: Observational study Place and Duration: King Salman Armed Forces Hospital Tabuk, Saudia Arabia/ Rashid Latif Medical College, Lahore. Jan 2021-Jun 2021 Materials & Methods: One hundred and seven patients, both males and females, with pandemic disease (coronavirus) were included in the study. Patients ranged in age from 16 to 80 years. Following the receipt of written consent, demographic information such as age, gender, and BMI were collected and analysed. A 5 mL blood sample was taken from each patient in order to determine their vitamin D levels. Patients in the intensive care unit (ICU) who were seriously ill or experiencing severe pain were given general anaesthesia. If 25(OH)D was less than 25 nmol/L (10 ng/dL), severe vitamin D deficiency was considered. The relationship between vitamin D deficiency and the rate of mortality among patients was investigated. The SPSS 25.0 version was used to analyze all of the data in this study. Results: 33.07±12.87 years were the mean age of the patients with mean BMI 23.01±6.32 kg/m2. Among 107 cases, most of the patients were males 67 (62.6%). Vitamin D deficiency was found among 55 (51.4%) patients in which most of the patients were serious ill those received anesthesia. We found that 33 (30.8%) patients were died in which most of the patients. Patients with covid-19 disease who had low vitamin D levels had a higher mortality rate than those who had normal vitamin D levels, according to a study that was statistically significant at the 0.04 level of significance. Conclusion: We concluded in this study that the patients with severe coronavirus disease with vitamin D deficiency had higher rate of mortality. Keywords: Severe Vitamin D Deficiency, Mortality, Anesthesia, Pandemic Disease

Objective: Aim of current study is to determine the effectiveness of prone position in patients presented with severe coronavirus disease. Study Design: Observational /Retrospective study Place and Duration: King Salman Armed Forces Hospital Tabuk KSA. Feb 2021-Dec 2021 Methods: This research comprised a total of 85 patients with respiratory failure who were admitted to the ICU. Patients ranged in age from 20 to 75. After obtaining written permission from each patient, demographic information such as age, gender, and BMI was collected. A and B were the two groups of patients that were studied. Group A included 40 patients with COVID-19 who completed prone position testing, whereas group II included 45 patients as a comparison group. During the 15-day follow up period, patients in group A were remained in a prone posture whereas those in group B were subjected to invasive ventilation. Outcomes among both groups were compared in terms of mortality, hospital stay and reduction in intubation rate. Analyzation of data was completed by using SPSS 24.0 version. Results: The majority of the patients were men, with 60 (70.6%) of the total, while the others were females, with 25 (29.4%). The mean age of the patients in the prone posture group was 48.12 years, with a mean BMI of 27.5 kg/m2, whereas the mean age of the patients in the control group was 50.4 years, with a mean BMI of 27.9 kg/m2. The average time spent in the prone position was 6.08 hours. When comparing the prone group to the controlled group, the mean PF ratio was higher in the former. The average length of stay in group A was 7.2 days, whereas the average length of stay in group B was 10.5 days. Group A had a death rate of 2 (5%), while group B had a mortality rate of 5 (11.1%). Conclusion: As a result of this research, we came to the conclusion that the prone position was an effective and safe approach for reducing intubation, mortality, and hospital stay in patients of COVID-19. After this procedure, no side effects were observed. Keywords: Respiratory Failure, Mortality, Prone Position, Covid-19,

Objective: The purpose of this study is to examine the severity of illness and length of ICU stay in covid-19 patients who have received vaccination vs those who have not received vaccination. Study Design: A Retrospective/ Comparative study Place and Duration: King Salman Armed Forces Hospital Tabuk KSA. Nov 2021-July 2021 Methods: This research included 160 individuals of both sexes who had coronavirus illness. Patients were between the ages of 18 and 75. After obtaining informed written permission, demographic data on patients, such as age, gender, BMI, place of residence were gathered. It was determined that the coronavirus was present in all instances by RT-PCR. Two sets of patients were admitted to COVID 19 ward, and they were subsequently separated. Both groups were underwent for X-ray of chest. Two groups were formed: one with 80 vaccinated patients and the other with 80 unvaccinated individuals. In both groups, the prevalence of co-morbidities was evaluated. Both groups' recovery and results were assessed by looking at things like mortality and the severity of the condition. Complete data was analzsed using SPSS 22.0. Results: Among 160 cases, 100 (62.5%) were males and 60 (37.5%) females in this study. There was no any significantly difference between both groups related to age and body mass index. We found severity of disease among non-vaccinated patients was significantly high with p value <0.05.Diabetes mellitus and hypertension were the most common comorbidities among all cases. Frequency of interstitial infiltrates was found in 55 (68.8%) in group I and 60 (75%) in group II. In both groups, fever, cough, and dyspnea were the most prevalent symptoms. Frequency of discharged patients in group I was greater 66 (82.5%) as compared to non-vaccinated 29 (36.3%). ICU stay and mortality was significantly higher in group II 16 (20%),24 (30%) as compared to group I with p value <0.05. Conclusion: This research found that immunization against coronavirus illness is both effective and useful in lowering the severity of the condition. However, vaccination may lower the incidence of bad outcomes (ICU stay) and people should be made aware of the necessity of being vaccinated immediately. Keywords: Mortality, COVID 19, Vaccination, ICU stay

Objective: Aim of current study is to evaluate the frequency of hypoglycemia in patients of type-2 diabetes mellitus. Study Design:Cross-sectional Place and Duration: King Salman Armed Forces Hospital Tabuk KSA and Muhammed Medical College & Hospital, Mirpurkhas, Sindh during from June, 2020 to Dec, 2020. Methods: There were 115 patients of both genders had type-2 diabetes mellitus were presented.Patients ranged in age from 20 to 60 years old. Individuals participated in the study were asked to sign a permission form acknowledging they had read the information and understood its significance before having their demographic data collected. Frequency of hypoglycemia was recorded by Whipple’s triad questionnaire based information. Symptoms of hypoglycemia were also recorded. SPSS 23.0 was used to analyze all data. Results:Among 115 patients, majority of the patients 65 (56.5%) were males and 50 (43.5%) were females. Mean age of the patients was 51.6±11.54 years and had mean BMI 27.5±8.34 kg/m2. There were 70 (60.9%) cases had rural residency and 45 (39.1%) patients had urban residency.Most common symptoms were dizziness, weakness and sweating among all cases. Metformin was the most common treatment used among all cases, followed by glynase and insulin. We found frequency of hypoglycemia among 50 (43.5%) in which majority of the cases were females. Among 50 cases of hypoglycemia, 11 cases had severe hypoglycemia, 20 cases had moderate and 19 cases had mild hypoglycemia. Conclusion: In this research, we found that type-2 diabetic patients, most of whom were female and rural, had a high incidence of hypoglycemia. The high incidence requires primary care doctors to ask for hypoglycemia symptoms at each diabetes patient visit. It's also crucial to educate patients about hypoglycemic symptoms and the need of reporting them to alter dosage and avoid recurrence bouts. Keywords:Type 2-diabetes Mellitus, Hypoglycemia, Dizziness, Glynase

Objective: The purpose of this research is to evaluate how well individuals with chronic hepatitis C respond to a combination treatment consisting of sofosbuvir and velpatasvir. Study Design: Observational/ Prospective study Place of Study: King Salman Armed Forces Hospital Tabuk KSA and Dow University of Health Sciences Karachi Pakistan. Duration of Study: Jan, 2021 to Dec, 2021 Methods: This research included 42 participants of both sexes. Patients ranged in age from 20 to 78. After obtaining written permission, we collected demographic data about the patient, including age, gender, and height and weight. Patients with known genotypes of hepatitis C were presented. Patients were treated for 15 weeks with a SOF/VLP regimen that included sofosbuvir and velpatasvir. SPSS 24.0 version was used to analyse all of the data. Results: There were majority males in this study. The mean age of the cases was 33.8±7.43 years with mean BMI 23.18±7.31 kg/m2. Comorbidities were HTN, DM and obesity among all cases. There were 12 (28.6%) patients had treatment experienced. Frequency of effectiveness was found among 40 (95.2%) cases and 2 (4.8%) patients were died. Post-treatment, we found significantly improvement in aspartate aminotransferase (AST) 36.11 ± 9.13, alanine aminotransferase (ALT) 27.23 ± 11.45 and hemoglobin level 13.8 ± 4.19. Conclusion: The results of this trial led us to the conclusion that the combination therapy of hepatitis C patients with sofosbuvir and velpatasvir was successful, safe, and well tolerated by the patients. Keywords:, Sofosbuvir, Hepatitis C, Velpatasvir, Comorbidities