Huma Hussain's research while affiliated with Wah Medical College and other places

Objective: Neutrophil-to-lymphocyte and lymphocyte-to-C-reactive protein ratios are important prognostic indicators for disease severity measurement among coronavirus patients. To predict the disease severity, CURB-65 scores, and outcome after 14 days of admission using two proxy biomarkers (neutrophil lymphocyte and lymphocyte C-reactive protein ratios) in COVID-19 patients. Methodology: A prospective study was done at the Department of Medicine, Pakistan Ordinance Factory (POF) hospital, Wah Cantt, Pakistan, from April to August 2022. A total of 123 coronavirus patients were included. Patients with clinical manifestations, decreased lymphocyte and leukocyte counts, imaging characteristics of pneumonia, etiological evidence of a positive real time PCR test of blood or respiratory samples, and viral gene sequencing similar to known COVID-19 were measured. Patients underwent laboratory measurements and imaging analysis for biomarker indications. The analysis of the data was conducted using SPSS version 23. Results: The patients mean age was 53.83±16.2 years. Among 123 COVID-19 patients, 80 (65%) were males and 43 (35%) were females. It was found to have high NLR and low LCR in severe disease (p = 0.05, p = 0.01). NLR and LCR showed 11% variance for disease severity (β = 0.143, p = 0.00, and β = -0.293, p = 0.01). NLR and LCR showed 29% variance for CURB 65 scores (β = 0.48, p = 0.634, and β = -0.159, p = 0.08). NLR and LCR showed 22% variance for outcome after 14 days of admission (β=-0.53, p=0.562, & β=-0.132, p=0.149). Conclusion: Neutrophil to lymphocyte and lymphocyte to C-reactive protein ratios are effective prognostic biomarkers for measuring the severity of disease in COVID-19 patients. High neutrophil-to-lymphocyte and low lymphocyte-to-C-reactive protein ratios significantly predict disease severity.

Background: Patients in ICU presenting with severe disease suffer from multidrug-resistant bacteria, resuting in reduced therapeutic options which cover ICU pathogens spectrum. Identification of causative organism and its antibiotics sensitivity pattern has become cornerstone for antibiotic selection. β-Lactams i.e. cephalosporins, carbapenems, penicillins, and monobactams constitute 60% of total antibacterials used, however; with high usage of such antibiotics the emergence of resistance. Aim: To determine prevalence of local type of bacterial isolates and their antibiotic susceptibility. Study Design: Cross sectional study Place and Duration of Study: Medical ICU, Pakistan Ordinance Factories Hospital, Wah Cantt from 1st January 2020 till 31st July 2021. Methodology: One hundred patients were enrolled. Samples were taken from blood, sputum, bronchoalveolar lavage and tracheal secretions of the patient and sent to microbiologist for culture and sensitivity reports. Results: The mean age was 57.52+13.427 years, 47 females and 53 male patients. 72 patients were shifted out and remaining 28 died. In 57 patients, sputum specimen was taken, blood specimen of 24 patients, tracheal secretion of 8 patients and 11 patients bronchoalveolar lavage was taken. 33 were positive for Klebsiella pneumoniae, 29 patients were positive for acinetobacter baumanii. Pseudomonas aeuriginosa was positive in 18 patients, 05 patients for E. coli. In gram positive category; 05 patients were positive for staph aureus, 06 patients for MRCONS, 3 to MRSA and 1 patient for coagulase negative staphylococcus species. Conclusion: The high levels of antibiotic resistance are seen among both gram negative and gram positive isolates. Presence of elevated resistance to multiple drugs is an indicator for high prevalence of multi-drug resistant gram positive as well as gram negative organisms, so proper identification of organism in order to ascertain administration of emperical drugs most effective against the isolated organism is recommended in severe cases. Keywords: Antibiogram, Bacterial isolate, Pneumonia, Sensitivity

BACKGROUND & OBJECTIVE: Coronavirus disease (COVID-19) is an emerging public health challenge. Study was conducted to determine the association of prognostic factors with disease severity in COVID-19 patients at POF Hospital, Wah Cantt. We conductedadescriptivecross-sectional study at a department of Medicine, POF Hospital, Wah Medical College (affiliated with National University of Medical Sciences) Wah Cantt. METHODOLOGY: We calculateda sample size of 158 patients (WHO Calculator). The study duration was 6 months (November 2020-April 2021).The selection of COVID patients was done through non probability sampling (consecutive). Respiratory sample for all participating patients were collected (from throat or sputum). These samples were tested for SARS-CoV-2 using WHO standard. SPSS version 24 was utilized for data analysis purpose. Chi square test and independent t-test were applied. Logistic regression was applied. RESULTS:Total data consist of 158 patients with COVID-19. Mean age of patients was52.3±3.26 years. Total leukocytes count (p=0.02), absolute neutrophil count (p=0.000), C reactive protein (p=0.000), NLR (p=0.03) were comparatively greater in patients with Severe COVID-19. While absolute lymphocyte were significantly lower in severe COVID-19 patients as compared to non-severe (p=0.03). Age[OR, 1.06 ;95% CI (1.027-1.114);p=0.01], diabetes mellitus[OR, 0.281 ;95% CI (0.100-0.788) p=0.016 and Hypertension [OR, 3.045 ;(1.044-8.878)95% CI p=0.04] are significant predictors of COVID-19 severity CONCLUSION:Prognostic factors of COVID-19 increased the likelihood of disease progression. C reactive protein andALC were significant predictors of COVID-19.

Background: Bleeding from esophageal varices is a life-threatening complication in cirrhosis. Screening endoscopy is recommended in cirrhotic patients to identify patients at risk of variceal hemorrhage, but this is an invasive procedure and has limitations. Therefore, thrombocytopenia has been proposed to predict the existence and grade of esophageal varices. The aim of the current study was to determine a correlation between platelet count and grades of esophageal varices in patients with liver cirrhosis. Methods: This cross-sectional study was conducted at the POF Hospital, Wah Cantt from 1st October, 2017 to 30th May, 2018. Newly diagnosed cases of cirrhosis having varices of any grade on endoscopy were included. Endoscopic findings of patients were standardized using Paquet grading system. On the basis of platelet count, patients were divided into four subgroups. Platelet count groups were correlated with grading of esophageal varices using Spearman rank correlations. Chi Square test was used to see association between the platelet count and grade of esophageal varices. Results: 110 patients were included in the study, 55.5% (n=61) were male. Mean age of the patients was 59.89±9.01 years. Platelet count was 150,000/uL in 25.5% patients. Grade I esophageal varices were found in 23.6% of patients, whereas grade II, III and IV were found in 24.5%, 33.6% and 18.2% of patients, respectively. Mean platelet count was 213884.62/mm3 in patients with grade I varices, whereas it was 119518.52/mm3, 58386.49/mm3 and 21600.00/mm3 in patients with grade II, III and IV varices, respectively (p

The coronavirus disease 2019 (COVID-19) frequently involves the respiratory system causing pneumonia. The disease started in December 2019 and is now a global pandemic. The disease is not limited to the respiratory system and cardiac, cutaneous, and neurological involvement has been reported. Psychiatric features of agitation and delirium have also been described in COVID-19. It is yet to be determined whether this will have any long term effect on the quality of life of these patients. We report a case of delirium in a COVID-19 patient who had also developed spontaneous pneumothorax on the day 15 of illness. Few of such case reports have been reported internationally but to the best of authors' knowledge, no such case has been reported in Pakistan.

Background: Bleeding from esophageal varices is a life-threatening complication in cirrhosis. Screening endoscopy is recommended in cirrhotic patients to identify patients at risk of variceal hemorrhage, but this is an invasive procedure and has limitations. Therefore, thrombocytopenia has been proposed to predict the existence and grade of esophageal varices. The aim of the current study was to determine a correlation between platelet count and grades of esophageal varices in patients with liver cirrhosis. Methods: This cross-sectional study was conducted at the POF Hospital, Wah Cantt from 1 st October, 2017 to 30 th May, 2018. Newly diagnosed cases of cirrhosis having varices of any grade on endoscopy were included. Endoscopic findings of patients were standardized using Paquet grading system. On the basis of platelet count, patients were divided into four subgroups. Platelet count groups were correlated with grading of esophageal varices using Spearman rank correlations. Chi Square test was used to see association between the platelet count and grade of esophageal varices. Results: 110 patients were included in the study, 55.5% (n=61) were male. Mean age of the patients was 59.89±9.01 years. Platelet count was <50,000/uL in 35.5% patients, 50,000-99,000/uL in 26.4%, 100,000-150000 in 12.7%, and >150,000/uL in 25.5% patients. Grade I esophageal varices were found in 23.6% of patients, whereas grade II, III and IV were found in 24.5%, 33.6% and 18.2% of patients, respectively. Mean platelet count was 213884.62/mm ³ in patients with grade I varices, whereas it was 119518.52/mm ³ , 58386.49/mm ³ and 21600.00/mm ³ in patients with grade II, III and IV varices, respectively (p=<0.0001). A significant negative correlation between platelet count and grades of esophageal varices was found (p<0.001). Conclusion: Platelet count can predict the grade of esophageal varices in cirrhotic patients. There is significant negative correlation between platelet count and grades of esophageal varices.

Background: Coronavirus disease (COVID-19) is a global outbreak caused by novel SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). Study aims to evaluate knowledge and practices of healthcare workers (HCW) regarding infection prevention and control of corona virus disease Material and methods: A cross sectional validation study was conducted. Study was conducted at department of Medicine, Pakistan Ordinance Factory Hospital, Wah Cantt. Study duration was 2 months (May 2020-June2020)A sample size of 217 HCW was calculated using WHO calculator. HCW were selected through non probability sampling (consecutive). Ethical permission was taken and research consent was signed by each participant. SPSS version 24 was used for analysis purpose. Post stratification fissure exact and chi-square test was applied. We found p value ≤0.05 as statistically significant. Results: Total 217 HCW were included in our study. Out of them, 85 (39.2%) were male and 132 (60.8%) were female in our study. Mean age of HCW was 34.5±2.4SD. In knowledge assessment majority of HCW had fair knowledge (46.5%), followed by good (30%) and poor knowledge (23.5%) regarding corona virus associated infection control and prevention. In practice assessment, among all those, 38.2% HCW showed better practices while 61.8% showed poor practices. Knowledge is significantly associated with virus transmission mode (p = 0.00), close contact (p = 0.000), protection from COVID-19 in triage area (p = 0.000), wearing PPE (p = 0.000) etc. Conclusion: Corona virus disease is a major challenge in resource limited countries. Healthcare workers showed relatively improved knowledge and practices regarding infection prevention and control in this COVID-19 Pandemic. Key words: Corona virus disease, Healthcare workers, Infection Prevention and Control, Knowledge, Practices Citation: Yasmin R, Hussain H, Abidi STF, Shah SAA, Kazmi TH, Hussain H. Knowledge and practice of infection prevention and control among healthcare workers: a COVID-19 pandemic experience. Anaesth pain intensive care 2020;24 (6):597-602 Received: 8 November 2020, Reviewed: 17 November 2020, Accepted: 19 November 2020