Disease Spectrum in COVID-19 Cohort with Travel History from Iran

Background: Coronavirus disease 2019 (Covid-19), declared as a pandemic in March 2020, is an acute respiratory tract illness caused by coronavirus 2 (SARS-CoV2) with clinical manifestations ranging from mild upper respiratory tract symptoms to severe pneumonia. Objectives: To determine the disease spectrum of Covid-19 in a cohort with a travel history from Iran. Materials & Methods: This cross-sectional study with a retrospective collection of data was conducted at Agha Khan University, Karachi from 15th March to 19th April 2020. One hundred and fifty-five laboratory-confirmed cases of Covid-19 were recruited from a government quarantine facility. Data were obtained from the Punjab Emergency Services (Rescue 1122) database where a record of SARS-CoV-2 positive cases and quarantined persons is maintained. Study subjects with a travel history to Iran were contacted by telephone to obtain information about demographics, symptoms, and co-morbid conditions.  SPSS version 24 was used to analyze the data. Frequencies and percentages were calculated. Results: Among the returning travelers, 213 had laboratory-confirmed Covid-19, out of which 155 were included in this study. 56.1% were males with a mean age of 40 years. Among the study participants, 91.6% remained asymptomatic throughout the stay, while 8.4 % became symptomatic. 77.5% of the participants had received BCG vaccination in childhood. Among symptomatic cases 15.4% had asthma and 7.7% had hypertension. The most common clinical manifestation was cough which was present in 38.5% of the study participants. None died among the study participants. Conclusion: A mild presentation of COVID-19 was seen in our study participants with 91.6% among them being asymptomatic, while 8.4% were symptomatic. There was a high positivity rate in males as compared to females.  

Prevalence and Factors Associated With Depression Among Patients With Epilepsy in a Kenyan Tertiary Care Hospital

Aim: To determine the prevalence and factors associated with depression in patients with epilepsy at Aga Khan University Hospital Nairobi. Design: Cross-sectional Survey Background: Depression is a recognized common co-morbidity of epilepsy that often goes untreated and has great impact on quality of life of patients and management of patients with epilepsy. Patients and Setting: Patients with epilepsy on follow up at the Aga Khan University Hospital were evaluated for presence and factors associated with depression. Methodology: The study recruited eligible patients with epilepsy who were on follow up in the neurology clinic. Beck Depression Inventory was administered to evaluate for presence of depression. Patients identified as having co-morbid depression were evaluated for associated factors. Results: Three hundred and twenty seven patients were evaluated for presence of depression in this study. The prevalence of depression based on the Beck Depression Inventory was 16.5 %, (95 % CI 12.7-21.0) representing a total of 54 patients diagnosed to have depression among the 327 patients with epilepsy. Twenty five patients (7.6%)[95% CI 5-11.1] as a subset of the total study population, had mild depression, 18 (5.5% [95% CI 3.3-8.6]) patients had moderate depression and 11 (3.4%[95% CI 1.7-5.9]) patients had severe depression. There was weak association between mild depression and polytherapy (use of two or more antiepileptic drugs), with OR 2.3, 95%CI 0.9-5.8 however, none between polytherapy and moderate or severe depression. No statistically significant association was found between depression and duration of epilepsy or number of seizures per month over last three months. Conclusion: Based on these results, we concluded that the prevalence of depression in patients with epilepsy at Aga Khan University Hospital, Nairobi was 16.5 %( 95% CI 12.7-21.0) and polytherapy was weakly associated with mild depression.