Objective: To determine the frequency of deranged cardiac biomarkers and associated socio-demographic factors among patients of epilepsy presenting at our hospital. Study Design: Cross-sectional study. Setting: Department of Medicine, Sheikh Khalifa Bin Zyed Al-Nyhan Hospital Rawalakot. Period: August 2019 to September 2020. Material & Methods: We evaluated 85 consecutive patients who presented at Department of Medicine, Sheikh Khalifa Bin Zyed Al-Nyhan hospital. Cardiac Biomarkers (Troponin I, CK-MB and pro-BNP) and EKG were requested in all patients. The questionnaire used for interview consisted of demographic details and disease related parameters (duration of epilepsy and number of antiepileptic drugs). Results: Out of 85 patients included in the study, 35 (41.2%) were male while 45 (58.8%) were female. Out of these 85 patients of epilepsy, 15 (17.6%) had one or more cardiac biomarker positive while 70 (82.4%) had no change in ECG or any positive cardiac biomarker. All ECG changes were non-specific. After applying the logistic regression, we found that long duration of illness and poly-pharmacy had significant association with the presence of positive cardiac biomarkers among the patients of epilepsy. Conclusion: Less than 1/5th of the patients with epilepsy had positive cardiac biomarkers or ECG changes in our study. Patients with longer duration of epilepsy or those whose epilepsy has been managed with more than one drug were found more at risk of having abnormal cardiac biomarkers in our target population.

Background and Aim: Respiratory symptoms are mostly present in Coronavirus disease 2019 patients; however, a manifestation of gastrointestinal symptoms can be presented alone or with respiratory symptoms. The present study aimed to evaluate the prevalence and outcomes of gastrointestinal symptoms in corona virus disease-19 patients. Methodology: This multi-center cross-sectional study was conducted on 486 confirmed coronavirus disease-19 patients in the Department of Gastroenterology at Tertiary Care Hospitals (KMU IMS Kohat, Poonch medical college / CMH Rawlakot Azad Kashmir, and Bhitai Dental and Medical College Mirpurkhas) from May 2021 to October 2021. COVID-19 disease was confirmed through polymerase chain reaction testing. The patient’s demographic details, symptoms, and clinical history were recorded. Intensive care admission, mortality, and intubation were determined based on medical queries. Demographic details such as gender, age, and BMI were calculated based on multivariate logistic regression. SPSS version 21 was used for data analysis. Results: Of the total 486 corona virus-positive patients, the prevalence of gastrointestinal disease patients was 30.04% (n=146) whereas the incidence of fever, cough, and short breathiness was 181 (37.2%), 211 (43.5%), and 191 (39.4%) respectively. Out of gastrointestinal patients, diarrhea was the prevalent symptom whereas abdominal pain, vomiting, and decreased appetites were the other symptoms. The prevalence of abdominal pain, vomiting, and decreased appetites was 5.6% (n=8), 12.6% (n=18), and 10.5% (n=15) respectively. Mortality rate caused by diarrhea was higher (OR 2.81; p=0.005, CI; 1.43-5.95) and needed intensive care unit (ICU) admission (OR 1.89; p=0.021; CI 1.14-3.9), and intubation (OR 3.23; p=0.001; CI 1.6-5.53). Acute kidney injury, vasopressors, and shock presence were additional outcomes. These outcomes were more prevalent in coronavirus patients with gastrointestinal symptoms of diarrhea. Conclusion: Our study found that the prevalence of gastrointestinal symptoms in coronavirus patients was 30.04%. COVID-19 patients with respiratory symptoms are frequently followed by gastrointestinal symptoms such as diarrhea and vomiting. These patients should be given extra attention to avoid misdiagnosis or delayed treatment. Keywords: Coronavirus disease, Gastrointestinal Symptoms, Outcomes