Objective: To determine the diagnostic accuracy of fully automated electro-chemiluminescence immunoassay (ECLIA) anti-SARS-CoV-2 serological test for detection of past SARS-CoV-2 infection and to be used in seroprevalence surveys. Method: A total of 426 patients who had tested for anti-SARS-CoV-2 from August 1 to 31, 2020 were selected for the study. Informed consent was obtained and a questionnaire including the patient’s age, gender, symptoms, and past polymerase chain reaction (PCR) status was filled by the patient. Samples were analyzed for anti-SARS-CoV-2 antibodies on Roche Cobas e601. Results: The mean age of the patients was 42.43±16.67 years. One hundred and five (24.6%) were PCR positive, while 321 (75.4%) were PCR negative. Most patients were males 241 (56.6%) while 185(43.3%) were females. Over 185(43.3%) patients presented with symptoms, and the rest of the patients 241 (56.6%) were asymptomatic. Anti-SARS-CoV-2 had sensitivity 89.5%, specificity 99.06%, positive predictive value (PPV) 96.90%, negative predictive value (NPV) 96.6%, and positive likelihood ratio 4.26, while negative likelihood ratio 0.1. Diagnostic accuracy of anti-SARS-CoV-2 was 96.7% based on receiver-operating characteristic (ROC) curve analysis. Conclusion: Anti-SARS-CoV-2 is very useful for the detection of past COVID-19 infection; it can be proved helpful in the identification of post-COVID complications and actual disease burden in a population.

Objective: To evaluate the diagnostic accuracy of positron emission tomography combined with CT scan (PET-CT Scan) in detecting bone marrow involvement in patients with diffuse large B-cell lymphoma, keeping bone marrow biopsy as gold standard. Methodology: From November 2017 to May 2018, a cross sectional validation study was carried out at the Aga Khan University in Karachi Department of Oncology's Section of Clinical Hematology. The study comprised a total of 112 patients who were identified as having diffuse large B cell lymphoma after a lymph node was implicated was histopathologically examined. All patients had a PET-CT scan and bone marrow biopsy technique as part of the staging workup. With bone marrow biopsy acting as the gold standard, the diagnostic efficacy of a PET-CT scan for identifying bone marrow involvement was evaluated. Results: Of 112 patients, there were 71(63.39%) males and 41(36.61%) females. The mean age was 45.09±17.36 years. The mean duration of diagnosis was 17.19±6.02 days. Through biopsy, bone marrow involvement was identified in 40 (35.7%) cases. Through a PET-CT scan, bone marrow involvement was identified in 47 (41.9%) cases. The PET- CT scan in comparison with bone marrow biopsy for detecting bone marrow involvement in patients with DLBCL had a sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of 95%, 87.7%, 80.85%, 96.92% and 90.18% respectively. Conclusion: PET-CT scan can accurately detect bone marrow involvement in patients with DLBCL so it can be used in most patients instead of invasive bone marrow biopsy procedure for staging of DLBCL patients.

Objective: This study aims to determine the trend of seropositivity of anti-SARS-CoV-2 antibodies (total including IgM, Ig G) in patients presenting at a private hospital in Karachi. Materials & Methods: A total of 2500 patients were included in the study. Informed consent was obtained and a questionnaire including patient’s age, gender, symptoms, history of traveling, contact with people who had travelled recently, contact with confirmed/suspected COVID-19 patient at home or work was filled. Samples were analyzed for anti-SARS-CoV-2 antibodies on Roche Cobase601. Results: The mean age of the patients was 41.045±20.48 years. 674(26.96%) were reactive, while 1826(73.04%) were non-reactive. Mostly patients were males 1388(55.52%).The seroprevalence was higher in males 29.75% while females showed 23.47% seroprevalence. Commonest symptoms were found to be fever(88.73%) and dry cough(57.20%).The frequency of seropositive patients revealed an increasing trend with 20.5%and 27.8 % in first andlast 15 days of June respectively, 30.7% and 31.4% in first andlast 15 days of July 2020 respectively.Only221(32.79%) reactive patients reported recent symptoms while 453(67.21%)patients were completely asymptomatic.Odds Ratio(OR) for participants with recent history of travelling, contact with people who had travelled recently,exposure with COVID-19 patients at home or work was 11.50, 3.28, 8.45 and 0.72 respectively. Conclusion: The seropositivity has shown a definite gradual upward trend over the study period and approximately two thirds of the patients being completely asymptomatic pointing towards the fact that many people are silently exposed to the disease and develop antibodies through their natural immune mechanism. Keywords: COVID 19, Anti-SARS-CoV-2 antibodies, Trend, Seropositivity, Dry cough, Diarrhea.

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Hepatitis E virus (HEV) is an RNA virus that is transmitted faeco-orally. Due to unhygienic living conditions and unsatisfactory treatment of drinking water, it is a major cause of acute viral hepatitis in Pakistan. Hepatitis E infection in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency may cause prolonged jaundice resulting in serious complications like, severe haemolysis, acute renal failure, encephalopathy and even demise. Although both these diseases occur frequently in our country there is a dearth of literature on the effect of Hepatitis E infection in G6PD deficient patients, leading to higher rate of complications in such patients. We report a case of 37 years old male who was referred to our hospital with worsening jaundice. Patient had HEV infection with concomitant G6PD deficiency. This case had a different prospect, since it resulted in prolonged jaundice and severe haemolysis. However patient’s condition improved with conservative management.