Background: Currently, the world is in a challenging situation due to Covid-19. The ministry of health in Pakistan reported the first case of Covid-19 on 26th February 2020 in Karachi whereas on the same day in Islamabad, the second case was confirmed in Pakistan. Objective: To assess the prevalence and risk factors of covid-19 mortality and its impact on social life of Pakistani population Methodology: This retrospective study was carried out at the Department of Pathology, Gomal Medical College, Medical Teaching Institute, Dera Ismail Khan, Pakistan for a period of ten months from March 2021 to December 2021. All the data was taken from the hospital record to determine the prevalence and risk factors associated with the mortality of covid-19. For determining the influence of covid-19 on the social life, online survey was conducted. Data was entered and analyzed by using SPSS version 24. Results: In the current study, the overall prevalence of covid-19 was 6%. The most common risk factors associated with the covid-19 was Diabetes mellitus in 25 (71.43%) subjects, hypertension in 22 (62.86%), ischemic heart disease in 16 (45.71%) while chronic liver disease was observed in 3 (8.57%) subjects. According to the survey, 420 (70%) participants thought that covid-19 will be controlled worldwide while 450 (75%) subjects thought that covid-19 will be controlled in Pakistan. Worry of contracting covid-19 even with protective measures was observed in 420 (70%) subjects. Conclusion: Our study reported that the prevalence of covid-19 was 6%. Diabetes mellitus, hypertension and ischemic heart disease were the major associated risk factors with the mortality of covid-19 and the overall impact of covid-19 on social life of Pakistani population was not good according to our study. Keywords: Covid-19; Prevalence; Mortality; Social life

Background: Erythropoietin, a hormone produced by the kidney, activates the bone marrow upon demand. Recombinant erythropoietin can be subcutaneously injected to maintain red blood cell counts in chronic renal failure patients. Some time being recognized as foreign antigens, the patient occasionally produces antibodies against erythropoietin. Objective of current study was to investigate the existence of Anti-Erythropoietin Antibodies in Chronic Renal Failure (CRF) affected individuals during hemodialysis. Methods: The current study was performed at the Pathology Department, Khyber Teaching Hospital, Peshawar, Pakistan. After the assent of ethical committee, data collection was initiated to carry out the study. All the patients filled the informed consent proforma. The blood sample was collected in two EDTA and Gel tubes for complete blood count and for anti-EPO-antibodies respectively. ELISA tests for anti-EPO antibodies were performed on all patients who were classified into two groups based on whether antibodies were present or not. The data was analyzed using SPSS version 25.0. Results: In this study, 150 patients suffering from Chronic Kidney Disease on dialysis were included in which 79 (52.7%) were males. Moreover, age-wise group 41-60 years (n=93, 62%) were more suffering as compared to age group 21-40 years (n=24, 16%). In our study, hypertension was found to be a leading cause of death for 65(43.3%), diabetes 32(21.3%), hypertension and diabetes mellitus 10(6.7%), and miscellaneous accounted for 28.7%. There were 56(37.3%) patients who received dialysis twice a week, and 94 patients (62.6%) received it three times a week. Patients had transfusion history were 136(90.7%), while 92 (61.3%) patients were found to have anti-EPO antibodies. Conclusion: Anti-EPO antibodies are frequently demonstrated in patients with CKD undergoing hemodialysis. Due to the lack of correlation between antibody levels and Hb or reticulocyte counts, these antibodies might not be neutralizing antibodies. Keywords: Anti-EPO antibodies, Chronic Renal Failure, Hypertension, Peshawar.

Coronavirus Disease 2019 (COVID-19) has emerged at the end of 2019 from China and less than half a year was declared as a pandemic [1] . A rapid increase in the number of cases and deaths urged the scientific community to respond quickly and deal with the virus in a dual strategy: Treat the sick and find ways to halt the spread of the disease [2] . Vaccines got the spotlight and with an exceptional pace, different vaccine candidates were launched [3] . The incidence of COVID-19 related hospitalizations and deaths was reduced drastically upon the use of vaccines [4] .Vaccines were thought at first to prevent from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection [5] . This seemed quite desirable and achievable at the start. But as more and more people got vaccinated, certain breaches occurred, though less common but significant importance was noted. Breakthrough infections were one such concern that shifted the focus much on symptomatology of the disease after many studies reported cases of infections within 1-7 d following vaccination [6,7] . It was established that "the vaccine provides protection Al-Raddadi et al.: Immunological Response to COVID-19 Vaccines in Pakistani Healthy Recipients Coronavirus disease 2019 mass vaccination has led to drastic reduction in hospitalizations and mortality. A number of case reports have emerged reporting coronavirus disease 2019 infection within days following vaccination. There is a need to understand development of immune antibodies in the early post-vaccination period. A prospective analysis of immunoglobulin M and immunoglobulin G kinetics was conducted during the first 28 d following vaccination with either CanSino or Sinovac vaccines in a cohort of 40 healthy volunteers. Serial blood samples were collected from the volunteers right before the first dose of vaccine (d 0) and then on d 4, d 7, d 14, d 21, d 24 and d 28 post-vaccination. Using enzyme-linked immunosorbent assay, circulating anti-severe acute respiratory syndrome coronavirus 2 receptor binding domain immunoglobulin M and immunoglobulin G antibodies were analyzed. Most vaccine recipients (31/40) did not develop any circulating immunoglobulin M. The remaining 9 recipients showed a typical immunoglobulin M curve with antibodies appearing on d 4, peaking on d 7 and declining on d 21 and beyond. Immunoglobulin G response was more typical within 38/40 recipients showing the appearance of immunoglobulin G on d 4, which continued till the end of the study period. This study demonstrates that vaccine-induced immunoglobulin M-based immunity cannot be relied during the first few days following vaccination and more time is needed to have a better picture of the real situation.

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Objective: The primary emphasis of our research is on people with hematologic malignancies, and we want to learn more about the features of clinical and environmental Aspergillus isolates by doing so. Study Design: Prospective study Place and Duration: This study was carried out at Department of Pathology, Mardan Medical Complex from October 2021 to March 2022 Methods: There were 160 patients of both genders included in this study. Included patients were aged between 18-80 years. Patients with hematologic malignancy were included. Invasive aspergiluus isolates from all patients in which 80 were clinical and 80 were environmental. . With the help of SPSS 22.0, clinical data were analyzed and Aspergillus species-level cryptic identification, antifungal susceptibilities, and cyp51 gene sequencing were all carried out. Results: Among 160 included patients, majority of the cases 95 (59.4%) were males and 65 (40.6%) patients were females. We found that 75 (46.9%) cases had age >50 years. Most common diagnostic criteria were probable IA found in 140 (87.5%) cases. Co-morbidities were pulmonary disease, neurological disease, autoimmune disease, cardiac disease and burns. Cryptic Aspergillus species composed 37.5% of environmental and clinical isolates. Section Nigri had a significant value (70.5%) of cryptic species, mostly among A. awamori and A. tubingensis the former was prevalent in ambient samples and the latter in clinical isolates (P 0.003). Twelve (7.5%) of 80 A. fumigatus isolates were azole resistant. At 90 days, A.fumigatus was 100% responsible for all deaths by resistant to azoles. Conclusion:Comparing clinical and environmental isolates, this study reveals a large proportion of cryptic Aspergillus species, highlights the clinical consequences of azole resistance.