Background and aims We sought to measure the effect of lockdown, implemented to contain COVID-19 infection, on routine living and health of patients with chronic diseases and challenges faced by them. Methods A semi-structured online questionnaire was generated using “Google forms” and sent to the patients with chronic diseases using WhatsApp. Data were retrieved and analyzed using SPSS. Results Out of 181 participants, 98% reported effect of lockdown on their routine living while 45% reported an effect on their health. The key challenges due to lockdown were to do daily exercise, missed routine checkup/lab testing and daily health care. Conclusion It is important to strategize the plan for patients with chronic diseases during pandemic or lockdown.

Hepatitis B and C are chronic diseases with mental and social impacts which can result in poor quality of life. The aim of this study was to determine the experiences of stigma in a sample of hepatitis B-and C-positive patients in Pakistan. In a cross-sectional study, 140 inpatients and outpatients from 3 tertiary-care hospitals in Islamabad and Rawalpindi answered a semi-structured questionnaire about stigma experienced from relatives, friends, spouse and health-care providers, and about work/financial problems. The majority of patients (75%) said they had had to change their lifestyle, and significantly more were males than females. Stigma was marked in terms of disease transmission, with 66% of patients fearing that they could transmit the infection to others; 19% said that family members avoided sharing towels, soap and eating and drinking utensils. Marital relationships were affected for 51% of married patients who had told their spouse. Patients' comments showed a sense of family and societal discrimination resulting in feelings of disappointment and isolation.1 Pakistan Medical Research Council, Islamabad, Pakistan (Correspondence to M.A.N. Saqib: arif289@gmail.com

The COVID-19 pandemic has created a global health emergency and has a huge impact on the health care workers, especially on their mental health. The dataset presented was an assessment of COVID-19 related knowledge, attitude, practices and its effects on the mental health of frontline healthcare workers in Pakistan. The data were collected using a snowball sampling technique. A questionnaire was developed assessing sociodemographic characteristics (6 items), knowledge (11 items), attitude (5 items), practices (6 items), information sources (1 item) and psychological implications (12 items) and distributed using online tools. The dataset includes 476 healthcare workers in Pakistan. The dataset will help to prevent and curb the spread of COVID-19 among health workers and contribute to policymakers. Furthermore, our dataset provides detailed insights into different risk factors of psychological problems, and it may be served as the reference for various in-depth surveys.

Introduction. The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. Methods. We used data from two multicentre prospective cohort studies which enrolled very old intensive care unit patients in 26 countries to evaluate the influence of modelling approach on the association between the CFS score and mortality. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient's age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. Results. The median age in the sample of 7487 consecutive patients was 84 years (IQR 81-87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01). Conclusion. Knowledge about a patient's frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided.

Background Stigma has negative effects on self-esteem resulting in decreased quality of life in affected individuals and is a major obstruction in the testing, management and treatment. This study was conducted to assess stigma among hepatitis B and C patients in our society. Methods A total of 140 indoor and outpatient hepatitis B/C positive patients were enrolled from tertiary care hospitals of Islamabad and Rawalpindi, Pakistan. Semi-structured questionnaire was used for interview and focus group discussions (FGD's) with patients and their relatives were also conducted. Results Majority of patients (81%) were HCV. When patients were asked how they got hepatitis, about 58% had no idea. Similarly 59% patients got information about hepatitis after getting diagnosed. Majority (83%) was worried and in 74%, life style was affected due to weakness and emotional disturbances. Martial relationship was affected in about half of the cases.About 66% patients had fear of disease transmission to others and among them 64% believed that this can be transmitted by sharing eating utensils. When participants were asked about sharing of utensils and towels, eating, sitting and shaking hand, it was found that family members, relatives and friend were hesitant and in some cases, patients were ignored.During focus group discussions, it was found that in Pakistan, hepatitis B and C patients had variety of stigmas such as fear of transmission of disease, social isolation, and discrimination in getting job, break up of engagement, divorce. Similarly patients were having different conceptions about disease treatment as one quarter was taking medication other than allopathic. Conclusion This study showed the presences of misconception and stigma in society which need to be addressed by public awareness programmes. Background An increasing body of evidence indicates venues where people recruit sex partners have a role in spread of STIs. Swingers recruit their sex partners by physical venues (clubs) and virtual venues (websites), forming so-called sexual affiliation networks. Objective of the present paper is to examine how these sexual affiliation networks of swingers can be relevant for STI prevention. Methods Participants of our swinger's cohort were followed using questionnaires. We used both conventional epidemiological and social network methods (descriptive and Exponential Random Graph Models (ERGM)) for the analysis. Because couples swing together, they were found equal in their choices of venues and taken as a swing unit (SU). Results The 57 SU frequented 13 (33.3%) clubs and 26 (66.7%) websites; 59.6% (n = 34) of the SU frequented both websites and clubs, 36.8% (n = 21) frequented only websites and 2(3.5%) solely clubs.