Objectives: To assess the COVID-19 associated fatalities with respect to demographics, comorbidity, critical illness, and length of hospital stay in tertiary care hospitals. Subjects & Methods: A retrospective hospital data-based research was done among 216 COVID-19 associated mortalities registered in 4 tertiary care hospitals Holy Family Hospital (HFH), Benazir Bhutto Hospital (BBH), District Head Quarters Hospital (DHQ) and Rawalpindi Institute of Urology & Transplantation (RIU & T) affiliated with Rawalpindi Medical University from 29th March-15th June 2020. The data was gathered by consecutive sampling pertinent to demographics, hospital stay, comorbidity, critical illness, and ventilator or oxygen support. The length of hospital stay among fatalities with and without comorbidity was compared by an independent sample z-test. Data were analyzed by using SPSS version 25.0. Results: Of the total 216 COVID-19 related mortalities, 150(69.4%) were males and 66(30.6%) were females. The mean age of fatalities was 55.66 ± 13.97 years. About 76.7% of dying males were 41-70 years old while 56.1% of females dying of COVID-19 were 41-60 years old. Most (60.8%) of study subjects had hypertension followed by diabetes (53.8%), Ischemic Heart Disease (17.5%), and respiratory disorders (12.3%). About 75% of the critically ill patients needed a ventilator for respiratory support. Length of hospital stay was determined to have a statistically insignificant association (P > 0.10) with the presence or absence of comorbidity among COVID-19 patients. Critical illness had a highly significant association (P < 0.000) with ventilator support among COVID-19 related mortalities. Conclusion: People 41-70 years should preferably adopt stringent precautions for protection against COVID-19. Comorbid states chiefly hypertension, diabetes, cardiac and respiratory diseases need special consideration amid COVID-19 pandemic to abstain from adverse health outcomes.

The detrimental consequences of Coronavirus infection are distinctly evident following its declaration as to the 6th Public Health Emergency of International Concern (PHEIC) by the World Health Organization on 30th January 2020 and its distressing and negative implications experienced across the globe. Apart from drastically impacting the healthcare of the population, a worrisome reduction in the universal economy is also attributed to this menace.The government of Pakistan is cognizant of its responsibilities took stringent measures to curb the coronavirus infection by the endowment of services for early case detection, contact tracing, isolation, and quarantine. Still, the first wave of COVID-19 resulted in a distressing scenario with the fast growth of this havoc in addition to those experienced in the United States, United Kingdom, Italy, and Spain. However, World Health Organization acknowledged the diligent efforts of the Pakistani government, healthcare professionals, and administrators in combating the first wave of COVID with an earlier reduction in effective Reproduction number (Rt) to 0.746 that was primarily attributed to Intermittent lockdown imposition, closure of educational institutes, avoidance of huge ceremonial gatherings and strict compliance to Standard Operating Procedures (SOPs).Although fewer chances of the second wave of COVID were anticipated in Pakistan due to early flattening of the curve during the first wave of COVID-19 in comparison with those of industrialized countries8 non-compliance to SOPs contributed to the rapid surge of the second wave. The government of Pakistan declared the occurrence of the second wave of COVID on 28th October 2020 when around 750 cases per day were reported. Active cases rapidly escalated to 11,000 and approximately 93 hospitalized patients were put on ventilators. Commencement of anti-government rallies and non-compliance to health guidelines are key contributors to this havoc. Currently, about 3499 active cases on daily basis are registered across the country with 39 deaths. About 410,000 active cases are detected nationally till now with 8260 fatalities. National Command and Operation Centre has accounted for a threefold ascend of infection since 12th October 2020. The steep ascend of cases during the second wave compelled the authorities to proceed with the shutting of learning institutes, the commencement of online education, and the postponement of all types of scheduled assessments except entrance exams. Even the employees of public and private sector medical institutes were vigilantly instructed to come to their offices on alternate days and keep working at home during the rest of the days from 25th November 2020 to 31st January 2021. Although these recommendations and initiatives by the concerned authorities can be of great assistance to curb the COVID pandemic but remaining extra cautious and strict observance of SOPs is of paramount significance to halt the rapid transmissibility of COVID. Stringent efforts of Rawalpindi Medical University-affiliated hospitals in battling the second wave of COVID are worth mentioning. Apart from Holy Family Hospital and Benazir Bhutto Hospital working to treat their respective catchment population, Rawalpindi Institute of Urology / Corona Hospital was reopened to cope up with the patient load amid the COVID pandemic. An adequate number of beds and necessary equipment were made available to manage the emerging infected cases.

Objectives: To determine the effectiveness of e-learning and hurdles confronted to the undergraduate medical students of Rawalpindi Medical University in continuation of academics during COVID-19 pandemic. Subjects & Methods: A survey was carried out during July 2020 to scrutinize the experience of 1041 medical students enrolled at Rawalpindi Medical University regarding their academic experience through Microsoft Teams. A self- structured questionnaire was digitally administered for this purpose to gather their responses about academic coverage, prior intimation about the lecture topic, opportunities for interaction with teachers, internet connectivity and various teaching methods employed by the teachers and recommendations for improvement. The data was analyzed by means of SPSS version 25.0. Percentages were computed for responses on all the variables. Results: Total 1041 medical students gave feedback regarding their e-learning through Microsoft Teams. Theoretical aspect coverage, prior intimation of topic to be covered and student-teacher interaction during online classes were satisfactory according to 68%, 85% and 61% of students respectively. About 70% respondents claimed frequent internet connectivity issues during e-learning while 63% found Microsoft Teams interface incompatible. Broad band internet connection at home was available to only 60.10% students. Most (25%) students wanted improvement in software for smooth execution of their e-learning. Conclusion: Although online learning proved as blessing in disguise amid COVID-19 pandemic but being new experience for both students and teachers some problems were faced that can easily be rectified.

Objectives: To determine the source of infection, comorbidity and health outcome of COVID-19 patients admitted in Rawalpindi Institute of Urology & Transplantation (RIU & T) Pakistan. Methods: A cross sectional descriptive study was carried out among 106 Polymerase Chain Reaction (PCR) confirmed COVID-19 cases admitted at Rawalpindi Institute of Urology & Transplantation from 20 th March-13 th April 2020. These patients were enrolled in research through consecutive sampling. The data was gathered pertinent to demographics, symptoms, source of infection, comorbidity and health outcome of the COVID-19 patients. The data was analyzed by means of SPSS version 25.0.Results: Of the total 106 COVID-19 cases, 74(69.8%) were males and 32(30.2%) were females. Mean age of COVID-19 patients was 45.24±18.63 years. About 73(69%) had contact history with their close family members while 31(29.2%) had travel history. About 35(33.02%) had persistent dry cough, 31(29.24%) had high grade fever 16(15.1%) had shortness of breath and 21(19.8%) complained of sore throat. Time period between positive PCR diagnostic report and negative PCR report was determined to be 11.5±1.32 days. Most 22(71%) had one comorbidity and hypertension was most prevalent among our patients followed by diabetes, renal, hepatic and cardiovascular diseases. Comorbidity showed statistically significant association (P<0.01) with critical illness among COVID-19 patients. Hydroxychloroquine and Azithromycin were given to all the patients. Conclusion:Most of the COVID-19 patients were infected by close contacts who returned from abroad. All COVID-19 patients were alive. Older hypertensive males being more at risk of coronavirus infection should strictly seek precautionary measures.

Objectives: To determine the gender and age based disparities in side effects among healthcare workers in response to COVID-19 (Sinopharm) vaccination Subjects & Methods: Total 216 healthcare workers were vaccinated against COVID-19 by administering Sinopharm vaccine during February and March 2021 at Infectious Diseases Department of Holy Family Hospital Rawalpindi were enrolled in the study through consecutive sampling. Data for this cross-sectional descriptive study was gathered pertinent to age, gender and side effects of Sinopharm vaccination. The information regarding vaccination side effects was inquired through telephonic calls. Data was analyzed by means of SPSS version 25.0. Results: Mean age of healthcare workers in our study was 35.7 ± 9.5 years. Most (54.6%) of them were females. About 79.2% of health professionals were 21-40 years old. Side effects after first dose of Sinopharm vaccine were experienced by 46.3% males and 42.4% females. About 45.2% and 42.3% males and females respectively overlooked the second jab adversity. Greater proportion (43.6%) complained of vaccine related side effects after the second dose than 37.5% subjects who noted side effects after the first dose of vaccine. Bodyaches, injection site pain, headache and fever were established as the commonest post-vaccination side effects. Conclusion: Side effects resulting from Sinopharm vaccine among our healthcare personnel were minimal. Fortunately none of them complained of serious aftereffects. Despite the COVID vaccination, our healthcare workers should strictly adhere to COVID SOPs amidst pandemic in order to avoid catastrophe in future.