Comparison of Chest X-rays findings in COVID-19 suspected and confirmed cases at a university teaching hospital: A retrospective comparative study.

OBJECTIVES: To compare Chest X-rays findings in COVID -19 suspected and confirmed patients on RT-PCR, presented at corona filtration center, Benazir Bhutto hospital Rawalpindi. METHODS: In this study, Chest radiographs of 100 COVID-19 RT-PCR positive confirmed patients were compared with 100 RT-PCR negative suspected COVID-19 patients screened at corona filtration center, Benazir Bhutto Hospital Rawalpindi from November 2020 to December 2020. Data on demographics, presenting complaints, co-morbid, lesion characteristic, distribution and attenuation, lobar involvement, pleural effusion and lymphadenopathy were collected. Associations between imaging characteristics and COVID-19 pneumonia were analyzed with univariate and multivariate logistic regression modals. RESULTS: Chest X-rays findings revealed bilateral lung consolidation with peripheral and diffuse distribution, involving middle and lower lobe to be statistically significant (p<0.05) between RT-PCR positives and negative patients. Peripheral distribution was associated with an 11.08-fold risk in COVID-19 positive patients than diffuse distribution. Middle lobe involvement had four folds risk and lower lobe involvement had 11.04 folds risk in COVID-19 cases as compared to upper lobe involvement. Consolidation had 2.6 folds risk in COVID-19 positive cases. CONCLUSIONS: Bilateral, peripheral distribution of middle and lower lobes ground glass haze or consolidation with no pleural effusion is significantly related to COVID-19 pneumonia. Overlapping imaging features of the infectious and non-infectious COVID mimickers can be further excluded by detailed clinical evaluation and further radiological workup.

Assessment of Lead and Cadmium Pollution in Soil and Wild Plants at Different Functional Areas of Sialkot.

Heavy metal pollution is a great hazard to the environment that enters the ecosystem through different natural and anthropogenic sources. A study was performed to evaluate concentrations of Cd and Pb in selected plants, Ricinus communis and Parthenium hysterophorus, and soils from different functional sites in Sialkot. Maximum fresh and dry weights of R. communis were recorded from control and field sites. Highest concentrations of Cd in P. hysterophorus (33.5 mg kg-1) and R. communis (24.36 ± 2.83 mg kg-1) were recorded at residential and industrial sites, respectively. However, road site samples showed maximum concentrations of Pb both in R. communis (9.06 ± 0.35 mg kg-1) and P. hysterophorus (7.90 ± 0.36 mg kg-1). Soil from the road site were found to be highly acidic (pH 4.75 ± 0.04), while the field site showed highest EC (494 ± 3.60) and TDS (509 ± 3.00) values. Generally, there were reductions in chlorophyll a and carotenoids, but an increase in chlorophyll b was observed in both plants at all sites compared to the control.

Chest X-rays findings in COVID 19 patients at a University Teaching Hospital - A descriptive study.

OBJECTIVE: To analyze Chest X-ray findings in COVID 19 positive patients, presented at corona filtration center, Benazir Bhutto Hospital Rawalpindi, based on CXR classification of British Society of Thoracic Imaging (BSTI). METHODS: In this study, all RT-PCR COVID-19 positive patients screened at corona filtration center, Benazir Bhutto hospital Rawalpindi from 20th March 2020 to 10th April 2020 were included. Mean age of the cohort with age range was calculated. Presenting complaints & Co-morbid were analyzed and tabulated in frequencies and percentages. Portable CXR findings were classified according to BSTI classification and documented in frequencies and percentages. RESULTS: Mean age of the patients was 44 years. Presenting complaints were cough 20 (67%), fever 18 (60%), shortness of breath 11 (37%), sore throat six (20%), loss of sense of taste and smell four(13%). Main co-morbid was hypertension six (20%). Two (7%) patients had normal and seven (23%) had classical COVID CXRs. 21 (70%) patients were in indeterminate group with only one (3%) having unilateral lung disease. Three (10%) patients had diffuse lung involvement and 18(60%) had peripheral lung involvement. Majority of patients 19 (63%), had bilateral middle and lower zonal involvement. CONCLUSIONS: In this study, COVID-19 CXRs generally manifested a spectrum of pure ground glass, mixed ground glass opacities to consolidation in bilateral peripheral middle and lower lung zones. BSTI CXR reporting classification of COVID-19 is valid in our patients with addition of middle zonal involvement in classical COVID-19 criteria as opposed to just lower zone involvement.

Sporadic actinomycosis of the hip complicated by Central Nervous System infection.

Actinomycosis is caused by the Gram positive filamentous Actinomyces bacterial species that are normal commensals of the oral cavity. Due to their low virulence, disease is rare in the immune competent patient. Although it may afflict any system in the body, involvement of the musculoskeletal system is uncommon. Here in, we describe the case of a 60 year old lady presenting with low grade fever, left hip pain and drowsiness. She was diagnosed as left hip actinomycosis on Computed tomogram (CT) guided biopsy and histopathological analysis of infiltrative lesions identified on Magnetic Resonance Imaging (MRI). She also had meningitis diagnosed on cerebrospinal fluid analysis which improved with treatment of actinomycosis. Actinomycosis of the hip is rare, and occurs in the presence of described predisposing factors. To the best of our knowledge, this is the first case of sporadic actinomycosis of the hip complicated by meningitis in an immune competent individual.

Arrhythmogenic right ventricular cardiomyopathy: Unveiling clinical presentations, CMR insights and prognosis in a single-center retrospective study.

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is a hereditary condition with a prevalence ranging from 1 in 2000 to 1 in 5000 individuals. ARVC is a significant contributor to sudden cardiac death, particularly in young individuals and athletes, and remains challenging to diagnose definitively. We conducted a single-center retrospective study to evaluate the presentations, electrocardiogram findings, and imaging characteristics of ARVC patients evaluated at our center between 2021 and 2023. Notably, our study is the second investigation of ARVC conducted in Pakistan. We report divergent symptom prevalence as compared to the current literature and have incorporated the Task Force Criteria. Despite limited access to cardiac magnetic resonance (CMR) facilities worldwide, our findings underscore the critical role ofCMR in ARVC diagnosis. Our cohort had a mortality rate of 17 % highlighting the importance of early detection and the need for improved diagnostic facilities for ARVC in the region.

Rupture of sinus of Valsalva in a young laborer: A rare case report.

Ruptured sinus of Valsalva (RSOV) upon physical exertion is rare but should be considered in differential in young adults. Symptoms of acute heart failure, hemodynamic instability, and continuous heart murmur raises suspicion for RSOV and requires emergent surgical repair of right ventricular outflow tract.

Awareness of Cardiovascular Disease Risk Factors by Community Pharmacists in Saudi Arabia.

BACKGROUND: Pharmacists in community settings are recognized as highly accessible healthcare practitioners and demonstrate a crucial role in the primary prevention of cardiovascular disease. Evidence indicates that community pharmacists can make a significant impact on controlling cardiovascular disease risk factors, particularly on hypertension. OBJECTIVES: We aimed to assess the knowledge of community pharmacists in Saudi Arabia regarding cardiovascular disease risk factors. METHODS: A cross-sectional study involving community pharmacists was conducted. The knowledge of cardiovascular disease risk factors was assessed with the Heart Disease Fact Questionnaire (HDFQ). A web link for an anonymous questionnaire was shared with the licensed community pharmacists in Saudi Arabia using the "Seha" platform of the Ministry of Health. Data analysis was performed with R version 4.0.5. RESULTS: Three hundred seventy-four community pharmacists responded to the questionnaire. Many community pharmacists (94.4%) had satisfactory awareness of cardiovascular disease risk factors. The odds of having satisfactory HDFQ knowledge for community pharmacists seeing more than 20 individuals with diabetes per month were 20 times (AOR = 19.9, 95% CI: 1.73-260, and p = 0.019) more compared to those seeing fewer than 10 individuals with diabetes per month. The age of the community pharmacists and the average number of individuals with diabetes seen per month were found to be factors associated with satisfactory HDFQ knowledge. CONCLUSION: The practicing pharmacists had a substantial understanding of cardiovascular disease risk factors. In line with counseling and education, the implementation of community pharmacy models for improving the knowledge of pharmacists, particularly the young pharmacists, is needed to effectively assist patients with cardiovascular disease.

Assessment of composition and spatial dynamics of weed communities in agroecosystem under varying edaphic factors.

Weeds are important components of the agroecosystems due to their role as primary producers within the farming systems, yet they are considered as major constraints to crop production. A phytosociological study was conducted to assess the composition and spatial distribution of existing weed species under the influence of various edaphic factors in the 15 wheat fields. Quadrat method was applied and different phytosociological attributes including abundance, density, and frequency were estimated by randomly laying down 10 square-shaped quadrats of size 1m2 in each wheat field. A total of 34 weed species belonging to 17 families and 30 genera were explored from 150 quadrats. Fabaceae and Asteraceae were ubiquitous plant families. Various edaphic factors such as; soil texture, electrical conductivity, soil pH, total dissolved solids, nitrogen, calcium carbonate, organic matter, NaCl, calcium, phosphorous, potassium, sodium, and zinc were determined. Pearson's correlation was employed to correlate weeds and the potential edaphic variables. The results depicted that most of these weed pairs' associations correlated positively. Simultaneously, the abundant weed species including Trifolium repens, Coronopus didymus, and Urtica dioica showed a positive correlation with most of the investigated ecological variables.

Hospital pharmacists' awareness and perspective toward the management of COVID-19 pandemic in the Kingdom of Saudi Arabia.

Objectives: This study investigates the hospital pharmacists' awareness of important facts about the COVID-19 disease and their source of information, as well as their perception. Methods: This cross-sectional study using a self-administered questionnaire was conducted from November 2020 to March 2021 in the Kingdom of Saudi Arabia (KSA). The questionnaire was developed via electronic platform and invitations were sent to pharmacists working in private and government hospitals. A multivariate logistic regression was used to identify factors associated with awareness of COVID-19. Results: A total of 272 pharmacists submitted their responses via weblink. Many pharmacists (n=228, 84%) followed the latest COVID-19 updates on treatment and updated their information mainly through World Health Organization documents (n=151, 56%). Pharmacists working in secondary and tertiary hospitals were relatively five-times times (AOR = 4.59; 95% CI: 1.69-12.8; p-value = 0.003) and three-times (AOR = 2.93; 95% CI: 1.35-6.72; p-value = 0.008) more aware of COVID-19 than those working in primary hospitals. Pharmacists with prior adequate knowledge regarding epidemics and pandemics were two-times more likely to have a good awareness of COVID-19 compared to those who had received none (AOR = 2.15; 95% CI: 1.09-4.35; p-value = 0.030). Conclusions: Half of the pharmacists believed that they received required education in the past about epidemics and pandemics, and many follow the recent COVID-19 updates on medicines predominantly from the WHO followed by the government awareness campaigns. Many pharmacists believed they have a key role in the management of epidemics/pandemics via their hospital pharmacy. However, this study identified certain awareness gaps regarding COVID-19, highlighting areas of improvement.