The National Medical Newspaper CORONAVIRUS IN PAKISTAN CONFIRMED CASES 905,852 REPORTED DEATH 20,400 SINDH PUNJAB 310,557 335,577

Pakistan’s First ISLAMABAD BALOCHISTAN Independent 80,529 24,638

Medical Periodical from KHYBER PAKHTUNKHWA AJK/GB Karachi 130,187 18,852 / 5,512 Vol. 53 No. 22 May 1-14, 2021 RECOVERED CASES Published Fortnightly Reg. No. ID. MC-153 ISSN 1728-1520 Controlled Circulation 823,157

*Stats as of 25 May, 2021 - 10:03am, Provided by Ministry Edhi Foundation PMA ready to DRAP approves country’s of National Health Services Regulations & Coordination, Inside offers assistance to ... 02 provide technical ... 03 ‘first ICU ventilator’ ... 12 Government of Pakistan Pakistan starts receiving vaccine under Covax

MN Report the diasporas of the two countries ISLAMABAD - The first batch of interact closely in Gulf states. over 1.2 million doses of Oxford- According to the NCOC statement, AstraZeneca COVID-19 vaccines 1.23 million doses of AstraZeneca reached the country on Saturday vaccine reached Islamabad under the Covax scheme as through the Covax programme. another 120 people fell victim to Covax is an alliance set up by the virus. Gavi, Coalition for Epidemic by an additional 1,236,000 doses "In this unprecedented crisis, we On the other hand, the Drug Preparedness Innovations and the in a few days. It added that the appreciate Covax and Gavi's Regulatory Authority of Pakistan World Health Organisation in April doses would serve to support the (Global Alliance for Vaccines and (DRAP) has notified a formula to last year. The alliance has pledged government's ongoing drive to Immunisation) contribution to the fix prices of COVID-19 vaccines. to provide free vaccine to 20 per bring the pandemic to an end. collective effort to fight COVID-19 Meanwhile, all educational cent of the population of different "Further allocations from June in Pakistan," Dr Sultan said. institutions in the country will countries, including Pakistan. onwards will be confirmed in due "Sometimes, such crises propel remain closed till May 23, the "It aims to provide at least two course. The goal of the Covax innovation and to this end, we were National Command and Operation billion doses of approved COVID- facility is to supply Pakistan with able to quickly expand the capacity Centre (NCOC) has announced. 19 vaccines by the end of 2021, enough doses to vaccinate 20pc of the Expanded Programme on As Pakistan continues to witness enabling the protection of frontline of the population depending on Immunisation's (EPI) facilities to over 100 COVID-related deaths healthcare and social workers, as availability," the statement added. vaccinate our eligible population daily for a couple of weeks now, a well as other high-risk and Special Assistant to the Prime against COVID-19. Recently, we research centre in Karachi on vulnerable groups in what will be Minister on Health Dr Faisal Sultan have been administering almost Saturday expressed concern that the largest immunisation campaign received the consignment at the 200,000 doses a day and we will there was a high possibility that in history," the statement said. National Emergency Operations be able to increase to 500,000 the variant that has claimed It said the first consignment Centre headquarters with doses a day very soon," he added. thousands of lives in India has consisted of 1,238,400 vaccine representatives from Covax's Dr Sultan also urged everyone already reached Pakistan since doses, which would be followed technical and funding partners. Continued on Page 10 24-hour mega vaccination centre at

Founder: Ayaz Mahmood Expo Centre becomes operational Publisher: M Hassan Mahmood MN Report Chief Executive: Syed Hashim Hasan vaccination centres established /MedicalNewsPk KARACHI - The Sindh in Karachi and other parts of Online Editor: Haseeb Uddin /MedicalNewsPk government is set to take a Sindh, a huge facility was set to Assistant Editor: major leap in the ongoing start its operation, which could Dr Muattar Hanif nationwide COVID-19 expedite the process manifold. Honorary Advisor: Dr Sulman Akhtur vaccination drive by opening "We can vaccinate up to 25,000 Manager Production a massive facility at the Expo people in a day," said Dr Sohail & Coordination: M Irfan Ali medicalnewspk.com Centre recently, said to be Sheikh of the Sindh health Advertising Manager the largest in the country, department who is looking after Tel: 021-35833172 SM Shakil (0300-2559344) 021-35872289 where an estimated 25,000 the operation of the newly Business Executives people could be inoculated in a Officials and sources said on established vaccination centre at Khawaja Akhlaq Ahmed (0342-2393917) day with round-the-clock service Saturday that the month-long the Expo Centre. `This would be Haroon Rashid (Islamabad: 0300-9710774) to be offered to visitors registered effort of the Sindh health a huge and nrst of its kind [project] Designing & Layout by the federal government for the department finally started yielding in the province. I am not sure Sh M Sadiq Ali jabs. results and after a number of Continued on Page 10 COVID-19 vaccination needs to be sped up: PIMA MN Report KARACHI - The Pakistan Islamic Medical Association (PIMA) Karachi has expressed concern over the slow COVID-19 vaccination drive in Pakistan and urged the concerned authorities to accelerate the vaccination drive.

Edhi Foundation offers assistance to India to counter the COVID emergency These views were expressed by President PIMA MN Report with you greatly, and during this strenuous Karachi, Prof Dr Abdullah Mutaki, in a press KARACHI - Head of Edhi Foundation, time, we would like to extend our help in conference held at the Karachi Press Club. Prof Faisal Edhi, expressed grave concern over the form of a fleet of 50 ambulances along Dr Sohail Akhter, Dr Shayan Shadmani, Dr the coronavirus situation in India and with our services to assist you in addressing Azizullah Khan, Dr Kashif Shazli and Dr Zeeshan offered his help in the form of a fleet of 50 and further circumventing the current health Ansari were also present on this occasion. ambulances along with a team to deal with conditions. Prof Dr Abdullah Mutaki said Pakistan is passing through a heightened wave of COVID-19 with the COVID-19 emergency. Faisal Edhi, the Managing Trustee of the over 5000 cases reported daily and a test positivity In a letter written to the Prime Minister of Edhi Foundation, personally offered to lead rate of over 10 per cent. The situation in some India, Narendra Modi, Faisal Edhi said that and manage the humanitarian team from cities of Punjab and Khyber Pakhtunkhwa is the Edhi Foundation had been closely his organization. The Edhi organization worse than it was at the start of the pandemic. following the current impact that the COVID- understands the gravity of the situation There is an acute shortage of hospitals beds for 19 crisis has had on the people of India. and wishes to lend India its support without sick patients. Evidence of new strains spreading We are very sorry to hear about the any inconvenience, which is why it will faster and affecting younger people is adding to exceptionally heavy impact that the arrange all the necessary supplies that the the already huge problems. pandemic has had on your country, where team needs to assist the people of India. Apart from Punjab and KP, he informed that a tremendous number of people are The Edhi Foundation is not requesting any COVID-19 cases are also increasing in Karachi suffering immensely. other assistance from India as it is willing for a couple of weeks, and there is an urgent As a neighbouring friend, we sympathize Continued on Page 10 need to strictly implement SOPs to prevent the virus from spreading in the Sindh province in the coming months. PIMA rejects DRAP’s notification He also expressed concern over the slow vaccination drive in the country as the overall MN Report coverage of vaccination in Pakistan is KARACHI - The Pakistan disappointingly low at below one per cent. This Islamic Medical Association is lower than India (8%), Bangladesh and Sri (PIMA) has expressed deep Lanka (4%). As per the government figure, only concern over the DRAP's 1.5 million doses out of 2.5million procured from notification which directed China mainly have been given to roughly 0.8 doctors to prescribe generic million in a population of 220 million. names of medicines instead Prof Sohail Akhter said about 70 per cent of the of their brand name. population of the country should be vaccinated; Dr Khubaib Shahid, Central however, the vaccination drive is very slow in the President of the PIMA, in a country. He suggested the government increase statement, said that COVID-19 vaccination centres and allowed private unplanned actions would is taking place in many stores that have no quality welfare organizations like the Al-Khidmat to import COVID-19 vaccines to fasten the vaccination have a negative impact on countries of the world, but control experience. As a drive. the healthcare system. It is it has only become possible result, a new door of Dr Azizullah Khan said four Indian companies not a jurisdiction of the after systematic planning corruption or have been manufacturing the COVID-19 vaccine, DRAP to issue instructions and the establishment of mismanagement may and Pakistan must take the initiative to to doctors to write trade infrastructure. open, and it will affect only manufacture the vaccine as per the country's names or generic names of There should be specified the patient or common man. requirement. He recommended the vaccination drugs. Regulatory bodies, appropriate procedures to The PIMA strongly of teachers and professors on an urgent basis including the Pakistan test the quality of hundreds condemns any such move. and to reopen educational institutes. Medical Commission and of pharmaceutical In the past, such measures They demanded COVID-19 vaccination to be the health department, have companies in the country. have not had a significant sped up on a priority basis, and the available a responsibility to issue any Doctors deal directly with effect. As a result, the stock of effective vaccines be increased for free such directives. The patients, and they gain government withdrew those supply to the population. Charitable organizations relevant government confidence in certain moves. He said that the should be allowed to import vaccines, and more departments should issue brands after years of using implementation of any such vaccination centres should be established. They a policy statement in this different medications. This decision without also demanded the government launch a mass regard. move could shift the choice infrastructure should be public awareness drive. He added that this practice of medicine to medical avoided. 02 MEDICAL NEWS / May 1-14, 2021 PMA ready to provide technical assistance to the Indian government

MN Report made mandatory. People should KARACHI - The Pakistan Medical get registered and vaccinated on Association (PMA) offered the the spot under a walk-in facility at provision of technical assistance the vaccination centres. The age to the Indian government to limit on vaccination should be counter the ongoing coronavirus removed. If the vaccination emergency situation in the process is not expedited, it might neighbouring country if the federal take years to achieve the goals of government allows it. the vaccination campaign, and we This offer was made by President could face a polio-like situation. PMA Centre (Telephonic link), Dr They also requested the Salma Aslam Kundi, and government put an end to the age Secretary-General PMA Centre, limit for speedy vaccination. Dr S M Qaisar Sajjad, during a Treasurer, PMA Centre, Dr Qazi press conference held at the PMA Muhammad Wasiq, said that India House. Treasurer, PMA Centre, also had the same situation in the Dr Qazi Muhammad Wasiq, and 118 deaths were reported, and Passengers coming from other beginning as we are facing today. General Secretary PMA Karachi, two days back, a record of 157 provinces in Sindh should be They neglected SOPs, and as a Dr Abdul Ghafoor Shoro, also deaths were reported since the strictly monitored through a result, they are facing a horrible spoke on occasion. outbreak of the pandemic in the scanning process at the entry emergency situation. They had They said that the PMA is holding country. These numbers show that points. Same for the people been conducting political and this press conference to talk about the COVID situation in the country coming from abroad; they should religious gatherings (Kumbh), due the rapid increase in corona cases is getting serious. also be examined for COVID-19 to which the tally of patients has in the country. We have been Dr Qaisar Sajjad recalled that the to avoid its spread. We appreciate reached a level where they are requesting the government and government relaxed most of the the Sindh Government for banning facing an acute shortage of the public for the last three weeks restrictions on commercial intercity transport. oxygen. People are dying outside to play their role to control the activities, schools, offices and President PMA Centre, Dr Salma hospitals without getting any corona case count in Pakistan. other workplaces, allowing them Aslam Kundi, urged people to treatment. We warned that corona cases to function at full strength on 24 adopt preventive measures for the It is very unfortunate that Fawad could increase during the holy February 2021. The PMA opposed sake of their families and the Chaudhry, Federal Information month of Ramadan if SOPs are this decision declaring it hasty. whole society. Wear a mask Minister, said that 90% of our not implemented and followed. We were of the opinion that the whenever you go out, keep social oxygen supply had been Unfortunately, we remained government should have given distance, and wash or sanitize consumed in the health sector. careless, and the cases have priority to public health rather than your hands at proper intervals. It The oxygen producers in Pakistan amplified. We fear that if we do financial concerns and advised has been observed that people have warned us that we may also not take the appropriate the authorities to lift the restrictions gather at restaurants at Sehri and face a shortage of oxygen gas measures, the number of cases stepwise only when the number Iftar without adopting SOPs. The due to a manifold increase in its and deaths could increase, and of cases was declining. Just a few government should also ensure demand after the surge in COVID- the pleasures of upcoming Eid days after the hasty decision, the the implementation of SOPs 19 cases. The government should could turn pale. cases begin to rise, and till then, strictly. Moreover, by preventing take immediate steps to avoid the The PMA is very concerned about we have been facing the third COVID-19, we will be able to keep shortage of oxygen and other the speedy surge in COVID-19 wave. This all happened due to on moving our trade and business; necessary facilities in the future. patients and the terrible increase negligence in adopting preventive otherwise, the government will be He requested the government and in the number of COVID-related measures against the coronavirus. compelled to impose a lockdown all the political parties to join hands deaths. It is also very disturbing He said that the corona situation in the country. to save the lives of the people of that patients are getting serious, in the country is very alarming. It She said that the vaccine is the Pakistan and form a uniform policy and ventilators at hospitals are deteriorated in Punjab, KPK, most protective shield against to curtail the coronavirus. We also filling speedily, particularly in Baluchistan, and Islamabad. The COVID-19. The PMA advises request the government and the Punjab. If we do not gain control COVID-19 positivity ratio is rapidly people to get vaccinated as soon opposition to avoid organizing over the situation, we may run increasing in major cities of the as possible. Do not listen to or gatherings. They themselves short of beds for oxygen and country. The overall positivity ratio pay attention to should follow the SOPs strictly. ventilators. of Pakistan is 11, which is misunderstandings and myths We also request the Election According to the National alarming. To overcome the related to COVID-19 vaccines; it Commission of Pakistan to Command and Operation Center situation, the government should is not harmful in any way. The implement strict SOPs during the (NCOC), at present, there are take immediate preventive people who do not get themselves elections at NA 249. approximately 90,000 active cases measures before it gets late. SOPs vaccinated could face the intricacy The PMA is very thankful to Asad in the country. Five hundred should be implemented strictly to of the disease. Umar, Head of National Command seventy patients are on ventilators. save the lives of people and to The PMA advised the government and Operation Center (NCOC), There are 634 Corona Designated avoid an India like situation. There to increase vaccination facilities and Dr Faisal Sultan, Special Hospitals in the country, and 5810 should be no hesitation in to vaccinate more people in a Assistant to Prime Minister on patients, at present, are admitted imposing a curfew if needed to shorter time. At least 70 -75% of Health, for restoring the priority to these hospitals. save the lives of the people. the population of Pakistan should registration of healthcare workers According to the NCOC to date, Dr Qaisar Sajjad said now; the be vaccinated as early as possible. on our request. We appreciate the the confirmed cases has reached deadly virus is rapidly spreading The PMA feels that our vaccination swift response of both authorities. 800,452, and the death toll has in Sindh also particularly in Karachi process is very slow; the process This restoration will boost the reached 17,187. During the last and Hyderabad. The situation of registration through 1166 is morale of the frontline soldiers, 24 hours, 4825 cases have been could worsen in these two cities perplexing, so we suggest that the and they will serve the nation with reported positive, and 70 deaths if the government fails to availability of a Computerized more courage and dedication. This were reported. Just a day back, implement SOPs strictly. National Identity Card should be Continued on Page 09

MEDICAL NEWS / May 1-14, 2021 03 PMA delegation meets with COVID-19 pandemic exposes flaws CM and Azra Pechuho of Pakistan healthcare system

MN Report MN Report KARACHI - A high-level KARACHI - The delegation of the Pakistan COVID-19 pandemic Medical Association (PMA) has exposed the recently met with Chief Minister vulnerabilities and Sindh Murad Ali Shah and Health weaknesses of the Minister Sindh Dr Azra Fazal Pakistani healthcare Pechuho and discussed the system. When the COVID situation in the Sindh He advised that there is a need pandemic emerged, province. to check the people who are the nation was in dire The delegation comprised of Dr travelling to Sindh from other need of developing S M Qaisar Sajjad, Secretary- parts of the country. testing, tracking, and Coordinator-General over 2,500 tests every General PMA, Dr Qazi Wasiq, President, PMA Sindh, Dr Mirza treatment facilities for expressed these views day, the largest in the Treasurer PMA Centre, Dr Mirza Ali Azhar, raised the issue of the sixth largest while presiding over a country, he said, Ali Azhar, President, Dr Rafiqul contract doctors and their population. recent meeting held at adding that the Chief Hassan Khokhar, GS PMA salaries, support money for the The National Institute the Dr Panjwani Minister of Sindh was Sindh, Dr Sharif Hashmani, families of shaheed doctors and of Virology, Center for Molecular personally monitoring President, Dr Abdul Ghafoor healthcare providers, loss of established in 2018 in Medicine and Drug the development of Shoro, General Secretary, PMA lives due to measles and other collaboration with the Research (PCMD). this superlab. Karachi, and other stakeholders. preventable diseases, COVID Wuhan Institute of Prof Choudhary said Talking about the Minister Local Bodies Syed Nasir vaccinations and issues related Virology (China), at the that at this time of importance of genome Hussain Shah, Adviser Barrister to the malfunctioning of the International Center national need, several surveillance, Prof Murtaza Wahab, Health Sindh Healthcare Commission. for Chemical and academic and Choudhary said that Secretary Sindh and others were General Secretary, PMA Sindh, Biological Sciences research institutions equally important in also present on this occasion. Dr Rafiqul Hassan Khokhar, (ICCBS), University of move forward to controlling the Dr Kazim Jatoi, Heath Secretary stressed vaccination across the Karachi, has played a contribute to meeting pandemic was to Sindh, gave a presentation board and issues raised by significant role in the the health challenge monitor the changes informing the audience regarding young doctors. He categorically national fight against of unprecedented occurring in this the current situation and the stated that the PMA does not the ongoing pandemic magnitude. The SARS-CoV-2 virus. Sindh Government's efforts to believe in strikes, old closures, by conducting more ICCBS, Pakistan's This nationwide deal with the pandemic. Sectary and roadblocks. We want our than 100,000 premier academic genome surveillance General, PMA, Dr S M Qaisar issues to be solved coronavirus tests in a research institute, was was conducted at the Sajjad appreciated the efforts of democratically. few months and other a forerunner in this Jamil ur Rahman the Sindh Government and In the end, Chief Minister services. national service, he Center for Genomics particularly thanked Dr Azra summarized the meeting by Prof Dr Iqbal observed. at the ICCBS, he said. Fazal Pechuho for her support responding to all the issues in Choudhary, Director of Currently, the centre So far, 77 full genomes to the PMA in the vaccination the queries raised by the the International crossed a staggering of the SARS-CoV-2 campaign. Dr S M Qaisar Sajjad participants. He assured to do Center for Chemical number of 150,000 virus were sequenced gave valuable suggestions to his best to solve all problems and Biological PCR-based tests and and globally reported curb the further spread of the of the doctors on a priority Sciences, and developed the from the genome virus. basis. COMSTECH capacity to conduct Continued on Page 09 SHCC lodges FIRs against habitual quacks involved in illegal de-sealing of sealed clinics

MN Report the law to establish the writ of Sheikh, shared his comments KARACHI - The Directorate of the government, i.e., SHCC. that as per the law, the SHCC Anti-Quackery, Sindh Healthcare In compliance with the decision, is mandated to regularize Commission (SHCC), under the Director, Anti-Quackery, Yaseen healthcare services provided in directions of Dr Khalid Sheikh, Veesar, with his team, conducted the province of Sindh and will Convener of Anti-Quackery multiple meetings with the SSPs take stern actions, especially Committee, registered FIRs of the concerned districts and against quackery practices. Dr against habitual quacks, who with the support of the Police, Sheikh added that MBBS have been involved in the illegal the Directorate has lodged FIRs doctors submitted their apologies de-sealing of officially sealed under the Pakistan Penal Code. in writing and confessed that clinics. Meanwhile, during this week, dispensers or compounders A total of 7 FIRs were registered, the team visited 90 clinics and were practising medicine illegally out of which four were in Badin, sealed 48 clinics on account of in their absence. one in Karachi and two at practising quackery. However, They ensured that the doctors Jacobabad against 14 quacks. 20 practitioners and clinic would not allow dispensers or In the meeting, the Anti- owners submitted around a PKR compounders to treat patients Quackery Committee, headed 1 million penalty amount without qualified doctors. These by Dr Khalid Sheikh, and imposed by the Board of applications were disposed of comprised of the Board of Commissioners during the with the imposition of penalties. Commissioners, SHCC, Jawad decision against de-sealing Moreover, follow up visits will be Amin and Dr A Razaq Sheikh, applications. conducted to these legally de- decided to take stern action Convener, Anti-Quackery sealed clinics to ensure that rules against the culprits, who violated Committee, SHCC, Dr Khalid are followed.

04 MEDICAL NEWS / May 1-14, 2021 MEDICAL NEWS / May 1-14, 2021 05 Routine immunization lags owing to the COVID situation

MN Report diseases. He stressed that World KARACHI - The urgency of the safety Immunization Week is observed in the measures taken for the COVID-19 pandemic province of Sindh to raise have impacted the routine immunization of awareness about the children in Sindh, and it must be countered importance of immunization with the mass information campaign regarding and vaccinations. vaccination safety and need, experts stressed "Currently, the EPI is at a webinar debunking vaccination myths, providing 11 antigens organized by the Jinnah Sindh Medical against 11 diseases, University (JSMU) with the Extended and many of the Immunization Program, Sindh (EPI). preventable diseases The webinar titled 'Myths and Facts About are on course to Immunization During the Pandemic' was held eradication from the as part of the World Immunization Week to country," stated Dr address the myths and misconceptions about Muhammad Juman the COVID-19 vaccines. Bahoto, Program "The earlier we achieve universal immunization Director EPI. against COVID, the better it will be for our Tariq, Professor of children who can then receive routine Pathology, noted the immunization easily and safely," said Prof prevalence of negative Lubna Ansari Baig, Chairperson APPNA propaganda against the Institute of Public Health (AIPH-JSMU). She COVID vaccination and drew attention to the impact of COVID-19 on explained that people can still JSMU, the routine immunization of children and contract the virus but through explained discussed the vaccination record of the past mutation, and not because of the how the five years compared to the past year. "Almost vaccination. She recommended pandemic has 40 million children missed the polio vaccine exercising complete transparency and interrupted the Childhood in Sindh last year while the BCG was the most extensive sharing of information with the public Immunization Programs in 70 Countries and missed vaccine in the province," she quoted about the testing, development of vaccines, said that immunization was among the top a recent study. "One in two children missed and the adverse effects. "Sharing data about interventions of the Sustainable Development routine immunization during the lockdown in the COVID vaccine and mass information Goals (SDG) 1, 2, and 3. Sindh; therefore, there is an increasing risk campaign presenting the true results are Dr Zaeema Ahmer, Assistant Professor, AIPH- of a vaccine-preventable disease outbreak," essential to building the public's trust and JSMU, highlighted some of the most commonly she warned. confidence in vaccination," she said. quoted myths about the COVID-19 Antigens Dr Muhammad Juman Bahoto, the newly "Governments must set timelines for achieving by the general public and clarified that there appointed Director of EPI, Sindh, shared that mass immunity and work towards that goal had been no safety issues to date among the the EPI focuses on following deadly Vaccines with all available resources, including public people who have received the vaccination. Preventable Diseases (VPDs). Currently, the information," she emphasized. Dr Saima Ibad, a lecturer at AIPH-JSMU, EPI is providing 11 antigens against 11 Dr Shiraz Shaikh, Associate Professor, AIPH- moderated the session.

Dr Akram Sultan SMBBMU appoints posted as MC CHK Registrar

MN Report MN Report KARACHI - LARKANA - The Shaheed Mohtarma Services, General Benazir Bhutto Medical University Administration and (SMBBMU) finally got a Registrar on Coordination a regular basis for the first time since Department, Sindh, 2008 when the university was has appointed Dr established. It was learnt through a Muhammad Akram Sultan as the spokesperson of the university, Abdul Medical Superintendent of the Dr Ruth Samad Bhatti. Pfau Civil Hospital Karachi (CHK), Doctors, medical reps Bhatti said in his statement that the relieving Dr Noor Ahmed of the Chandka Medical College was additional charge. nexus irk patients at CHK established in 1973, which is the According to a notification, Dr largest medical institution in Northern Muhammad Akram Sultan, Senior MN Report Sindh, whereas the foundation stone Medical Officer (BS-20), presently KARACHI - Some doctors of the Accident & Emergency of the SMBBMU was laid in 2008. The posted as Project Director, Expanded Department at the Dr Ruth Pfau Civil Hospital Karachi Registrar is very important to run the Program for Immunization, Sindh, has (CHK) have been prescribing costly medicines to patient's affairs of a university. Dr Syed Qararo been transferred with immediate effect attendants so as to enhance the sales of their favourite Shah has been appointed as the and until further orders as MS, CHK, medical stores for personal interests, sources at the Chandka Medical College Registrar reliving Dr Noor Ahmed Soomro, of CHK noted recently. through the Selection Board. the additional charge. Some doctors performing duties in the Emergency Meanwhile, credible sources said that Dr Juman Bahotu, Senior Medical Department of the hospital have started malpractice and Dr Shah had been appointed on a Officer (BS-20), presently as District are openly breaching medical ethics in Sindh's largest one-year contract basis which is Health Officer, Hyderabad, has been teaching hospital due to the hospital's poor surveillance extendable on a performance basis. transferred with immediate effect and system. The patient's attendants are suffering due to In contrast, according to the university until further orders as Project Director, this breach of medical ethics in the institution as doctors statutes, the Registrar is to be EPI, Sindh. Continued on Page 09 appointed for three years.

06 MEDICAL NEWS / May 1-14, 2021 Global study finds COVID-19 substantially raises the risk of maternal and newborn complications

MN Report KARACHI - Pregnant women who contract COVID-19 are 22 times more likely to die and 50 per cent more likely to experience pregnancy- related complications than expecting women unaffected by COVID-19, according to a global study of over 2,100 pregnant women across 18 countries, including Pakistan, published in JAMA Paediatrics. AKU faculty Prof Zulfiqar A. Bhutta, Dr Shabina Ariff, Dr Ghulam Zainab, Dr Lumaan Shaikh and Dr Khalil Ahmed from the departments of paediatrics and child health, and obstetrics and gynaecology contributed to the study which recruited over 300 pregnant women from Pakistan to the global study. with COVID-19 during COVID-19 positive during and babies in Pakistan had ventilators. The INTERCOVID study - pregnancy were at pregnancy also tested better outcomes than the AKU faculty have led by the University of increased risk of positive for the virus during rest of the world, with lower collaborated with the Oxford - involved pregnancy-related the first few days after pre-term births, intensive University of Oxford-led collaborations with 43 complications such as birth. Explaining the care unit admissions, consortium of over 100 maternity hospitals from premature birth, pre- implications of this finding, neonatal oxygen researchers around the low, middle and high- eclampsia, admission to José Villar, professor of requirements and length world on three studies prior income countries to intensive care and death. perinatal medicine at the of hospital stay. to INTERCOVID under the conduct one of the first Newborns of infected University of Oxford, who "Our findings merit further INTERGROWTH-21st detailed comparative women were also nearly co-led the study, said: exploration as to why Project series of studies studies into the effects of three times more at risk of "Importantly, breastfeeding Pakistani mothers and into global maternal and the coronavirus on severe medical does not seem to be newborns fared better than child health. outcomes for mothers and complications, such as related to this increase. the rest of the world," said The INTERCOVID study babies during the admission to a neonatal Delivery by caesarean AKU's Dr Shabina Ariff, demonstrates the pandemic. The study is intensive care unit, mostly section, however, may be primary investigator of the importance of partnerships unique because each due to premature birth. associated with an study in Pakistan. "A in collecting large-scale woman affected by "We now know that the increased risk of having possible explanation may multinational data quickly COVID-19 was compared risks to mothers and an infected newborn." be that we have had fewer during a health crisis, as to two non-infected babies are greater than we Researchers stated that and less virulent COVID- researchers were able to pregnant women giving assumed at the start of the current evidence shows 19 variants in Pakistan. complete the study in only birth at the same time in pandemic and that known that breastfeeding is safe, Inherent immunity and nine months, using the same hospital. health measures when even if mothers have differences in the level of infrastructure that was The researchers sought to implemented must include COVID-19, and its benefits care received at the already in place from understand the effects of pregnant women," said outweigh the potential risk hospital may also have previous studies. COVID-19 in pregnancy Stephen Kennedy, of transmission. played a role. Future Oxford University's by collecting robust data professor of reproductive Breastfeeding should studies will be needed to Professor Villar said: "The on expecting women with medicine at the University continue to be promoted, substantiate these points." existing INTERGROWTH- and without a diagnosis of of Oxford, who co-led the with mothers being In the Pakistan cohort, only 21st infrastructure was COVID-19, an important study. "The information encouraged to take two babies, born to critical in enabling step to ensure that families should help families, as preventive measures such mothers with COVID-19, researchers worldwide to understand the risks the need to do all one can as washing their hands tested positive for COVID- implement this urgent involved, mothers and to avoid becoming infected and wearing face masks 19. While both were born initiative in record time, babies receive the best is now clear. It also while nursing, they added. pre-term and required and their commitment to possible care and health strengthens the case for AKU faculty recruited over admission to the neonatal the study was remarkable. resources, such as offering vaccination to 300 pregnant women in intensive care unit for Examining the long-term vaccines, are appropriately pregnant women." Pakistan to the global respiratory distress, they effects on mothers and allocated. Around 1 in 10 babies of study. They noted that did not require invasive children is the next They found that women mothers who tested women with COVID-19 support such as challenge."

MEDICAL NEWS / May 1-14, 2021 07 08 MEDICAL NEWS / May 1-14, 2021 Shortage of blood Pilot study to introduce mental health increases the miseries of services in homes across Badin thalassaemia patients MN Report KARACHI - Lady Health MN Report Workers, LHWs, in Badin will KARACHI - The Patients Welfare Association provide mental health (PWA), a charitable organization run by the services at the doorstep of students of the DUHS, has been facing an communities as part of a pilot acute shortage of blood, and they appealed study launched by to citizens to donate blood to save researchers from the Aga thalassaemia patients with emergency blood Khan University. needs. Badin has the second-highest mood-lifting exercises, as well in the knowledge and skills Spokesperson PWA informed that the PWA is suicide rate in the province, as tracking and referral of of health workers in treating a non-governmental and non-political according to a 2021 report high-risk cases to the next mental health issues. A series organization run by the students of the Dow by the Sindh Mental Health level of care. of interviews and focus Medical College (DMC) established at the Dr Authority. Access to mental "This study will provide an groups with stakeholders K M Ruth Pfau Civil Hospital Karachi (CHK). healthcare is a major innovative technological across the system will also challenge for people in rural solution to provide be held to identify factors that parts of the district, and community-based mental can facilitate or hinder the treatment is often avoided health services through potential scale-up of the due to the stigma attached. frontline healthcare workers. intervention to other Mental health practitioners Very few studies have provinces. are not available locally, and described the burden of The study, which has been accessing care from much- mental health problems in endorsed by the Sindh needed psychiatrists and Pakistan. This will be a government, is being psychologists requires travel pioneering study to establish conducted by faculty at Aga to hospitals in megacities like estimates of anxiety and Khan University's department Hyderabad and Karachi. depression at the population of community health sciences The first phase of the study level in a rural setting," says in collaboration with the The PWA voluntary blood bank is the largest will involve cases of anxiety Prof Fauziah Rabbani, the University's Brain and Mind single outlet blood bank of Pakistan that and depression being project's principal investigator. Institute. Its objectives are in dispatches around 200 blood bags and identified through a survey of "Even though Pakistan is line with targets under goal provides blood transfusion and iron chelation households in Badin. LHWs facing a rising burden of non- 3 of the sustainable therapy to 250 registered thalassaemia and Lady Health Supervisors, communicable diseases, development goals, Good patients. LHSs, will subsequently mental health continues to Health and Wellbeing, which The spokesperson said that the PWA blood receive training in community be a neglected and call for special efforts to bank has been facing a shortage of blood and mental health modules under overlooked area. Our study promote mental health and needs the public's help to replenish its the World Health seeks to integrate mental wellbeing. bloodstock. She informed that the PWA is Organization's Mental Health health services into essential The project builds on the launching a door-to-door blood drive, and Gap (mhGAP) intervention primary healthcare packages successes of the University's people can register their names for blood guide, which has been and will generate evidence WHO funded NIGRAAN and donations. specifically designed for use on whether frontline Bill and Melinda Gates When contacted, Director, Sindh Blood in non-specialised health healthcare workers can Foundation-sponsored Transfusion Authority (SBTA), Dr Dur-e-Naz settings. effectively improve the mental Umeed-e-Nau NIGRAAN Jamal, said that there was no shortage of The study will then see health of vulnerable PLUS project s in Badin and blood in Sindh as the new blood bank has LHWs, LHSs and field staff communities." Mirpurkhas, respectively, been established at the Shaheed Mohtarma in Badin apply their training Following the intervention, which improved the ability of Benazir Bhutto (SMBB) Institute of Trauma, and use mPareshan, a researchers will evaluate LHWs to diagnose and treat Karachi, to provide blood to needy patients. mobile health app, during changes in participants' cases of pneumonia and She said that the PWA could contact the SBTA household visits to provide depression and anxiety diarrhoea, and enhanced the if there is any shortage. lay counselling services, scores and assess changes supervisory skills of LHSs.

PMA ready to provide ... are allowed to come to the PMA at the hospital during the evening medicines are available in the Continued from page 03 House Karachi for vaccination and night hours where they hospital pharmacy free of cost portal for the registration of from 10:00 am to 02:00 pm daily prescribe unnecessary and costly distribution. healthcare workers is open till 30th except Friday and Sunday. medicines of their favourite Additional Medical April, so we request all healthcare companies. Superintendent, CHK, Dr workers, including medical COVID-19 pandemic exposes ... Sources said that the hospital's Nasrullah Memon, students, to get registered Continued from page 04 administration has been unable was not available to make any immediately on are prescribing unnecessary costly to control these illegal activities comments. covid.gov.pk/vaccine. medicines to attendants so as to despite several complaints from General Secretary PMA Karachi, increase the sales of their favourite the general public. Although Doctors, medical reps nexus ... Dr Abdul Ghafoor Shoro, thanked pharmaceutical companies who medicine is available to treat Continued from page 06 Dr Azra Fazal Pechuho, Health reward them with a commission patients with emergency treatment centre of the ICCBS, he said, Minister of Sindh, for establishing and other benefits. requirements, unfortunately, these adding that so far, 350 genetic a corona vaccination centre for Such malpractice is present in doctors prescribe expensive mutations have been identified by healthcare workers at the PMA almost all government-run medicines from medical stores of the centre. He mentioned that House Karachi. We are also hospitals of Karachi, but some their choice situated outside the researchers at the Dr Panjwani thankful to the DHO South and doctors of the Emergency hospital rather than providing Center were engaged in his team for making all Department with the nexus of medicines from the hospital's high-quality research work on arrangements to run this centre. pharmaceutical companies have pharmacy. various aspects of pandemic Doctors and healthcare workers started this sort of private practice The sad fact is that these and its treatment.

MEDICAL NEWS / May 1-14, 2021 09 Pakistan starts receiving ... Pakistan Alexa Reynolds said: the death toll has climbed to government, experts and Continued from front page "This delivery - the first of many - 18,797. professionals and volunteers are above 40 years of age to register is the product of an unprecedented On the other hand, 4,957 patients giving their 100 per cent. Their themselves for vaccination so the global partnership to ensure no recovered from the deadly virus, commitment andambitions give us mission to "immunise our fellow country is left behind in the global taking the number of total belief that we would meet the citizens, especially the ones who race for COVID-19 vaccines." recoveries to 752,712. According challenge. fall in the high-risk and vulnerable She said the vaccines were safe to the NCOC, active COVID-19 It was in December when Sindh groups" could be continued, said and effective and would "play an cases across the country stood at Health Minister Dr Azra Pechuho the statement. important role in helping the country 82,731. hinted at turning the Karachi Expo "Very soon, we will be able to to end this pandemic". Meanwhile, Sindh has recorded 911 new cases, Centre into a coronavirus expand the campaign to other age the American embassy, in a taking the provincial tally to vaccination centre. The minister groups and demographics," he statement, said the US government 291,667. The number of casualties had also visited the centre to review said. welcomed the successful arrival in now stands at 4,726 while 676 the proposal and get a briefing from According to the NCOC statement, Pakistan of 1.2 million doses of patients have recovered. A total of the experts about the possibility of AstraZeneca vaccine would the?AstraZeneca COVID-19 13,079 tests were conducted in the the plan. supplement the vaccines vaccine, which landed at Islamabad last 24 hours. An official said that Sindh had purchased by the government and International Airport today Azad Jammu and Kashmir has already launched COVID-19 help bolster the drive to immunise (Saturday).? reported 103 new patients during vaccination for housebound people. frontline healthcare workers, senior "The shipment of this vaccine was the last 24 hours, after which the He said besides the Expo Centre citizens and other priority groups made possible through the Covax region's total positive cases have facility, the Sindh health department identified in the National Advance Market Commitment, a reached 17,866. had launched free COVID-19home Deployment and Vaccination Plan. global initiative to support equitable Punjab saw another 1,817 people vaccination for people who are "More than 3.3m vaccine doses access to COVID-19 vaccines, it contracting the virus and 60 homebound. `The service is have been administered to said, adding that the United States breathing their last. The provincial available in Karachi and Hyderabad healthcare workers and citizens at contributed $2 billion and will tally of positive cases has now risen for now and people who want this large," said the statement, adding contribute an additional $2 billion to 316,224. facility can call at 9123 and 1025 that the Ministry of National Health through 2022 to Gavi, the Vaccine from their cell phones. Those Services had also ramped up the Alliance to support Covax, making 24-hour mega vaccination ... calling from a landline should dial cold chain capacity of the EPI to the country the single largest Continued from front page 021-111-119-123. meet the requirements of the contributor to global COVID-19 about other parts of the country but Over two dozen centres in Karachi vaccine deployment plan. vaccine access. we firmly believe that such a centre `With services at the Expo Centre "This also includes ultra-cold chain "This is an extremely difficult time is not yet operational anywhere in in place and facility for homebound facilities in 15 large cities. for Pakistan and the rest of the Pakistan. people to get them vaccinated at Sinopharm, Sinovac, CanSino-Bio world, and we are proud to stand 100 booths to inoculate people He home, we hope the number of and Sputnik [vaccine] doses have with the government of Pakistan said initially the department made vaccinated people would start been administered in Pakistan so as partners in addressing the arrangements in Hall No 4 of the increasing manifoldsin the days to far," the statement said. devastating effects the COVID-19 centre where 100 cubicles had come,` he added. "The 2.47m doses of Oxford- pandemic has had on the country," been set up in line with all the In Karachi, he said, more than 25 AstraZeneca's COVID-19 vaccine said US Embassy Chargé d' required standard operating vaccination centres were working will be used to immunise about affaires Angela P. Aggeler. procedures (SOPs). where hundreds of registered 1.24m high-risk people against the "The United States has been He said some 500-strong workforce people were vaccinated every day. virus," it added. standing side-by-side with our of the Sindh health depart-ment Among the centres, he said, four Speaking on the occasion, Unicef Pakistani counterparts throughout comprising doctors, physicians, were operating in district South and representative in Pakistan Aida this challenging period to help stop healthcare workers and volunteers five in district East. Girma said Unicef was proud to be the spread of COVID-19, and we would be serving at the centre `In districts Central and Malir five leading efforts to procure and will continue to work together until round the clock for speedy and and three vaccination centres are supply safe, effective and this deadly disease is under swift services to all visitors. operating, respectively, and districts affordable COVID-19 vaccines on control," she added. `We are confident that here visitors West and Korangi six and four behalf of the Covax facility which According to the NCOC data, 4,109 would not spend more than 30 centres are working, respectively. aimed to quickly reach people in new coronavirus cases and 120 minutes in getting vaccinated,` said The number of these centres would low and middle-income countries deaths were reported in the country Dr Sheikh. `This is a national be further increased in other Sindh and ensure that no one at risk was in a single day. challenge and everyone needs to districts as well,` he added. left behind. With the latest count, the tally of put [in j his or her contribution. The Gavi Senior Country Manager for cases has risen to 854,420 and people here [Expo Centre], the Edhi Foundation offers ... Continued from page 02 to provide the fuel, food, and other necessary amenities that the team requires. The Edhi team consists of emergency medical technicians, office staff, drivers, and supporting staff. In order to implement the proposed service, the Edhi Foundation's only request was permission to enter India as well as any necessary guidance from the local administration and the police department. The Edh Foundation is willing and ready to deploy its team into any critical areas of concern in India's direction without hesitation. We look forward to assisting you in managing the current humanitarian crises and hope only whatever way that we can, for the benefit of the people of India, noted Faisal Edhi. 10 MEDICAL NEWS / May 1-14, 2021 Corona situation in India and Iran very dangerous

MN Report He further said that KARACHI - Spokesperson of people should refrain from the Sindh Government and performing Sehri and Iftar Advisor for Law, Environment collectively as much as & Coastal Development, possible. Next year, Barrister Murtaza Wahab, has Ramadan and Eid will said that the people should come again. In the last 24 take the precautionary hours, 201 Pakistanis measures taken during the have died from the corona first wave of the coronavirus. epidemic. During the third wave, the He added that tough federal government should decisions are not only to play its role in providing be taken by the vaccines to the people. It government but also the should be paid because the people should support the coronavirus situation in our government in this neighbouring countries, India situation, and citizens are and Iran, has become very requested to worship at dangerous. necessary facilities. Today, 50,000 tests are home during Ramadan. He also said that the Addressing a press conference in the being performed daily. age condition should be abolished in the auditorium of the Sindh Assembly Building, He appealed to the people that Eid and process of vaccination, and those who think the Sindh Government Spokesperson said Ramadan will come again next year and if a that Pakistan has overcome the coronavirus that more than 100,000 Pakistanis had been loved one leaves, they will not come back. are not like that. People should not leave their vaccinated yesterday, which was welcome, In the current situation, the government needs homes unnecessarily. He also thanked the but those who want to be vaccinated by the to take tough decisions because the PIA and said that the PIA plane had brought private sector should be provided with the coronavirus situation has become dangerous. the vaccine from China. New deadly surge threatens to reverse gains against COVID: New report reveals

KATHMANDU - UN Information numbers than ever before. They Centre Islamabad reported on are losing parents and caregivers, Wednesday that the scenes we becoming witnesses to scenes are witnessing in South Asia are no child should ever see and unlike anything our region has being cut off from their schools seen before. Family members of and vital support networks. And patients are pleading for help as as resources are diverted and the region reels under an acute services saturated, the essential shortage of medical-grade health services they so heavily oxygen. Exhausted health rely on - including routine workers are being pushed to the immunization programs - are now brink of collapse. We are faced at risk of being compromised, if with a real possibility that our not shuttered entirely. health systems will be strained "If this happens, it will once more to a breaking point - leading to be the most vulnerable children even more loss of life. and families who will suffer most. According to a UN Information The first wave of the pandemic Centre Islamabad statement, forget our individual responsibility. spiralling even further out of caused drastic cuts in the "Urgent action and steadfast Every decision we make has the control. In almost all countries in availability and use of essential leadership are indispensable to potential to alter the course of the region, with the exception of public health services in South stop the catastrophe. this surge - and to either Maldives and Bhutan, fewer than Asia, costing us the lives of an Governments must do everything safeguard or endanger the lives 1 in 10 people have been estimated 228,000 children and within their power to stop the of those around us. We may be vaccinated. Now more than ever, 11,000 mothers. We simply devastation, and partners that are exhausted, but the virus is not we must ensure vaccines cannot let this happen again. We able to send assistance must do yet exhausted. Now more than equitably reach all populations. must do everything within our so immediately. The international ever, we must commit ourselves Manufacturing must be ramped power to keep essential health, community must step up without to wear masks, handwashing with up, technology transferred, and immunization and nutrition delay. This is not just a moral soap as often as possible, doses equitably shared. None of services running - and make sure imperative. The deadly new surge keeping physical distance and us is safe until all of us are safe. women and children everywhere in South Asia threatens us all. It getting ourselves vaccinated if "As we work to respond to the feel safe to use them. "Viruses has the potential to reverse hard- we have the opportunity to do so. public health emergency, we know no borders. We must come earned global gains against the cannot forget the profound together now as a global pandemic if not halted as soon It further says: "The very low impacts of the pandemic on community to stop the as possible. " levels of vaccination in South Asia children. Children are directly devastation and protect our The statement says, let us not magnify the likelihood of the virus affected by the disease in higher children," the statement added.

MEDICAL NEWS / May 1-14, 2021 11 DRAP approves country’s ‘first ICU ventilator’ developed by Pakistan Atomic Energy Commission

MN Report ISLAMABAD - The Pakistan Atomic Energy Commission (PAEC) announced recently that it had developed the country's "first indigenous intensive care unit (ICU) ventilator." The ventilator was developed by PAEC's scientists and engineers while keeping in view all essential quality standards and regulatory requirements, the body said in a statement, adding that doctors at the PAEC hospital in Islamabad also provided input during the development process. "Besides passing through all internal reviews and testing, the 'i-Live' ventilator also successfully passed the independent reviews and testing conducted throughout the development lifecycle by the evaluation team DRAP DRUG REGULATORY from Pakistan Innovation and Technology AUTHORITY OF PAKISTAN Centre and the Pakistan Engineering Council (PEC)," PAEC said. "This is a giant leap towards self-reliance in international-level medical equipment in the Clinical trials of the ventilator were also designing and manufacturing of life-saving last two years is worth appreciating. I want conducted at Jinnah Hospital in Lahore under equipment," he added. to congratulate engineers, technicians and the supervision of senior doctors, biomedical PAEC Chairman Mohammad Naeem the entire team. You have raised our heads engineers, and medical researchers, the congratulated the scientists, engineers and with pride," he tweeted. statement said. doctors involved in the ventilator's A day earlier, Minister for Science and "The ventilator successfully passed all stages development, saying that "massive production Technology Senator Shibli Faraz said his of engineering evaluation and medical of i-Live would be commenced immediately ministry would expedite the registration of validation." to meet the growing demand of hospitals for ventilators with DRAP to ensure their timely PAEC spokesperson Shahid Riaz Khan said this crucial equipment in the context of availability for induction in the healthcare the ventilator was approved by the Drug ongoing corona pandemic." system and export. Regulatory Authority of Pakistan (DRAP) Minister for Information Fawad Chaudhry Another ventilator - Pak Vent-1 which was today, following which "i-Live" would now be congratulated PAEC for developing the developed by Nescom - has been cleared manufactured and supplied by PAEC to "#MadeInPakistan" ventilator. by the PEC and is awaiting approval from hospitals in the country. "Pakistan's success in developing DRAP. PMC allowed to run readmission Renowned gynaecologist, process at medical colleges Dr Feridoon Setna passes away MN Report MN Report KARACHI - One of ISLAMABAD - The Islamabad High Court Karachi's most famous has directed the Pakistan Medical Commission gynaecologists, to continue the process of readmission at Faridoon Setna, FRCOG, medical colleges. The PMC has also been has passed away, ordered not to take any disciplinary action recently. against the petitioner students whose Dr Sethna was the Clinical application against re-admission at medical Director of The Fertility Clinic. He was a Fellow colleges is pending before the court. of the Royal College of Obstetricians and The court on Friday heard the petition filed Gynaecologists, UK and did his training in by the PMC and the plea of students of a Scotland. He was the former Medical private medical college in Lahore. On behalf Superintendent of the Lady Dufferin of the PMC, Sardar Taimur Aslam sought Hospital, in Karachi, and was awarded the direction from the court on the process of On the other hand, the court heard the petition Sitara-e-Imtiaz for his contributions to the field readmission, recalling that the court had barred filed by the students against the re-admission of maternal medicine in Pakistan. them from taking any action against some process at medical colleges. The court issued He worked in the field for over 50 years and students of the Rawal Medical College who notices to the PMC and other parties and was known for dealing with high-risk had filed the petition against readmission sought a reply. It may be recalled that the obstetrics, complex gynecological problems process. The court directed the PMC to PMC had issued readmission orders due to and infertility treatments. He was one of the continue the process of readmissions but not irregularities in admissions to medical colleges. most experienced practitioners in Pakistan in to take any action against the students who The PMC has sought applications for the field of infertility and helped hundreds of had filed the petition. readmission in private colleges. couples to conceive through IVF.

12 MEDICAL NEWS / May 1-14, 2021

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