ABSTRACT Introduction: Hepatitis B is a risk factor for Health Care Workers (HCW) and medical students attending wards at hospital. Hepatitis B vaccine has been recommended since 1982 for use by HCWs to prevent HBV infection. The aim of this study was to evaluate the vaccination coverage among HCWs and medical students, their level of knowledge regarding vaccination as well as and their beliefs regarding Hepatitis B vaccine at a Teaching District Headquarter (DHQ) Hospital of Punjab, Pakistan. Subjects and Methods:  This cross sectional descriptive study based on a questionnaire-based survey was carried out at DHQ Teaching Hospital, Sahiwal, Pakistan from 01-04-2019 to 31-07-2019. Doctors, medical students and paramedical staff involved in active physical care of the patients were included in the study. Results: A total of 300 participants were provided questionnaire including consent, out of which 285 participants responded. There were 127 doctors (44.56%), 86 medical students (30.18%) and 72 paramedics (25.26%). 132 (46.31%) participants were fully vaccinated, 9.12% had received 2 doses of vaccine, 8.77% received only one dose whereas 35.43% were unvaccinated. Out of unvaccinated individuals, 32.35% reasoned lack of time being the main cause followed by other reasons including lack of need, lack of awareness and accessibility. Conclusion: This study showed that vaccination coverage among HCWs was alarmingly low along with lesser knowledge of vaccination and infection. Therefore, HCWs and medical students are at an increased risk of acquiring Hepatitis B infection.

Objective: To document demographic profile, clinical features and management of patients presented with PPD/Kala Pathar poisoning at District Teaching Hospital Sahiwal, Pakistan. Methods: This cross-sectional study utilized data for cases of PPD poisoning presented at study place from 1st July 2019 to 30th June 2020. Relevant information was recorded on a proforma. Results: A total of 111 cases were included in study. Mean age was 23.01 ± 7.24 years. Majority of cases were observed in females (82%) and majority presented from rural areas (87.4%). Cervico-facial edema (78.4%) and respiratory distress (66.7%) were the most common findings. Evidence of some level of organ damage was recorded in following manner: kidneys (44.1%), musculoskeletal (50.5%) and cardiac (45.9%). Tracheostomy was carried out in 47.7% cases and dialysis in 11.7% cases. All cases ingested PPD in raw form. Mortality rate was 50.5%. Conclusion: PPD poisoning is associated with high rate of morbidity and mortality. Effective clinical management requires multidisciplinary approach. Measures to restrict access to this means of suicide are urgently needed. We need to set up a surveillance system for cases of attempted suicide. doi: https://doi.org/10.12669/pjms.37.5.4251 How to cite this:Akbar S, Siddiqui ZK, Diwan RA, Rehm MH. Demographic profile and clinical picture of patients presented with Paraphenylene Diamine (PPD)/ Kala Pathar poisoning at a District Teaching Hospital. Pak J Med Sci. 2021;37(5):---------.  doi: https://doi.org/10.12669/pjms.37.5.4251 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Insulin-dependent Diabetes Mellitus Type 1 (T1D) also referred to as autoimmune diabetes. T1D is a chronic disease which is characterized by way of insulin deficiency. The deficiency is due to the loss of pancreatic β cells and leads to hyperglycemia. There are many factors which play a significant role in T1D disease pathogenicity including genetic predisposition, the immune system, and environmental factors. The environmental factors may include Coxsackie B4 virus, a small RNA virus. Objective: The objective of current in silico study is to identify active lead compounds against Coxsackie B4 virus, a small RNA virus which has been reported in diabetic patients after PCR. There is a need to predict inhibitors against TID caused by Coxsackie B4 viral protein that may be used as a drug against TID in the future. Methods: For this purpose, different bioinformatics databases and tools were used. The protein structure generation and validation, retrieval of ligands and their properties analysis were performed by different databases, web servers, and software tools. Moreover, the docking tools were used to identify the target site of the protein and interaction of different inhibitors with the target protein molecule. Results: Based on the analysis, two lead compounds ZINC00034488 and ZINC00034585 were selected as potential drugs. These compounds are non-toxic and have best interaction energy and fulfill Lipinski rule, Veber rule, Ghose Rule, Weighted QED, Unweighted QED and BBB likeness parameters. Conclusion: Our work will help researchers to get an idea about the understanding of chemicals against Coxsackie B4 Viruses and helpful to design a drug and test these chemicals to overcome Diabetes Mellitus Type 1 caused by Coxsackie B4 virus.

Hepatitis C is prominently a hepatic disease whose infection ranges in severity from a mild illness to serious lifelong complications. Multiple organ systems in the body may get affected. Depression is an important complication in almost 70% of HCV patients. Objectives: To find out the frequency of depression in chronic hepatitis C infected population of District Sahiwal. Methods: Descriptive cross-sectional study was performed at Gastroenterology Clinic, Haji Abdul Qayyum Hospital, Sahiwal during nine months from September 2020 to June 2021.Total 350 patients were selected by non - probability purposive sampling on the basis of preset inclusion and exclusion criteria. Beck’s Depression Inventory Scale was utilized to assess the patients for depression and correlate it with level of education and occupation. Results: Out of 350 patients of CHC, 56.6% were male and 43.4% were female.  4.3% patients were suffering from borderline depression; 42.3% were suffering from moderate depression; 46.3% were suffering from severe depression and 2.3 % were suffering from extreme depression. Association of depression with household income (p = 0.044) and duration of disease (p = 0.00) were significant while association of depression with level of education (p = 0.655) and occupation (p = 0.219) were not significant. Conclusion: Level of depression in patients of CHC is dangerously high. Level of depression in patients of CHC is strongly dependent on household income and duration of disease and independent of level of education and occupation.

During December 2019, a novel coronavirus named SARS-CoV-2 has emerged in Wuhan, China. The human to human transmission of this virus has also been established. The virus has so far infected more than 2 million people and spread over 200 countries. The World Health Organization (WHO) has declared COVID-19 a global health emergency due to its spread well beyond China. It has been established that this virus originates from bats and uses an intermediate host for transfer to humans. The knowledge about the intermediate host is important to find the virus shuttle mechanism to stop future outbreaks. For this, the genetic and structural analysis of coronaviruses spike proteins was performed using a computer-assisted approach.To conduct the In silico analysis, 43 sequences of spike protein belong to different species were retrieved from the NCBI nucleotide database. Pairwise and multiple sequence alignments were performed to check the similarities and differences of the retrieved sequences. Moreover, to highlight relationships among different species, phylogenetics analysis was performed using the MEGA software tool. In the end, protein structure alignment (superimposition) was performed against the reference structure by UCSF Chimera software. The results highlighted that the maximum similarity of human protein was found against Bat and Pangolinsequences. Moreover, among Bat and Pangolin, the highest similarity was found against pangolin based on phylogenetics analysis. These results suggest that SARS-CoV-2 transfers from bats to humans through pangolins.