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Background: The non-medical use of dependence-producing drugs is not a new phenomenon and is strongly related with the global health burden. This study was conducted to ascertain the usage of different types along with risk assessment and the need for intervention of substance/ drug use among the medical students across Karachi, Pakistan. Methods: This cross – sectional study was performed at four medical colleges (two public and two private) across Karachi, Pakistan from July 2018 to January 2019. A total of 445 participants who fulfilled the inclusion criteria were inducted in present chosen for this study. A self administered self-administered screening questionnaire designed by World Health Organization ASSIST (i.e. (Alcohol, Smoking and Substance Involvement Screening Test) for assessing various levels of substance abuse was used to collect the information, which was then noted and analyzed using SPSS version 20. Results: Out of 445 respondents, 273 (61.3%) had never used any psychoactive substance, 97 (21.8%) had tried at least one, 34(7.6%) had used at least two, 23(5.2%) had tried three, while 18 (4%) had tried four or more psychoactive drugs in their life time. Nearly 26.3% respondents reported Tobacco consummation, was reportedly consumed by approximately 26.3% respondents, where in which 82% were found with at low risk/no intervention, 17.1% having moderate risk/brief intervention and 0.9% had high risk/intensive treatment category. Use of psychoactive drug was significantly higher among private medical college male students. Conclusion: As illustrated by this study, the wieldiest most commonly abused substance was tobacco-containing compounds followed by sedatives. The aforementioned trend occurrence was largeliest larcenist noted in private colleges where male students were remained as major contributors, mostly seen among male medical student belonging to the private sectors as compared to females and public sector colleges.

Availability of mobile laboratories can facilitate rapid on-spot detection of pathogens, monitor its presence in certain populations and inform health authorities to take immediate remedial measures. Currently available biosafety and biosecurity guidelines and policies may not completely articulate the increased demand to manage mobile units in infectious disease outbreaks in remote parts of the country for rapid diagnosis, and also allows research and epidemiological study take place appropriately.The main objective of this study is to evaluate the current limitations and develop and implement biosafety and biosecurity guidelines as well as the protocols for operations, security, and response plan of mobile biosafety level 2 laboratories and their deployment.Keeping in view the sensitivity of it, a comprehensive plan was developed to address it in view of Global Health Security framework. Biosafety and biosecurity protocols were developed including Risk Assessment Tool (RAT) fitting the needs and strengthen the diagnostic and epidemiological capacity in the field covering remote parts of country to fill the gaps observed during the COVID-19 pandemic.Currently the biosafety and biosecurity best practices guidelines and biosecurity policy and regulations are directed mostly towards static laboratories. A biosafety and biosecurity manual developed to adopt and meet the requirements for MBSL 2. For acute health infectious threats including the COVID-19 outbreak and other epidemics, rapid diagnosis can curb and mitigate the problem before it gets out of its boundaries creating significant health risks for the public and economy. The deployment of mobile laboratories will certainly help in curbing these catastrophes.

Experimental research with animals can help the prevention, cure, and alleviation of human ailments. Animal research facilities are critical for scientific advancement, but they can also pose a higher risk than other biomedical laboratories. Zoonosis, allergic reactions, bites, cuts, and scratches by animals are all substantial concerns that can occur in animal facilities. Furthermore, human error and unexpected animal behavior pose a risk not just to humans, but also to the environment and the animals themselves. The majority of biosafety and biosecurity training programs focus on clinical and biomedical laboratories dealing with human safety factors, with little emphasis on animal biosafety. The current virtual training was designed to improve biosafety and biosecurity capabilities of animal laboratory personnel, researchers, and veterinarians from different regions of Pakistan. The results revealed that understanding was improved regarding triggers for risk assessment in addition to annual and regular reviews (56% to 69%), biosecurity (21% to 50%), decontamination (17% to 35%), safe handling of sharps (21% to 35%), Dual Use Research of Concern (DURC) (17% to 40%), Personal Protective Equipment (PPE) usage by waste handlers (60.9% to 75%), waste management (56% to 85%), animal biosafety levels (40.57% to 45%), and good microbiological practices and procedures (17% to 35%). To bring human and animal laboratories up to the same level in terms of biosafety and biosecurity, it is critical to focus on areas that have been overlooked in the past. Training programs focusing on animal biosafety should be conducted more frequently to strengthen bio risk management systems in animal research facilities.

The increasing threat posed by state and nonstate actors seeking to misuse scientific and technological developments means it is more important than ever to ensure the responsible conduct of life sciences research, biosecurity research, and dual-use research of concern (DURC). Pakistan has a rapidly growing research environment and, being a signatory to the Biological Toxins and Weapons Convention, is committed to raising DURC awareness among its researchers. To this end, a series of five workshops were conducted in Pakistan between July 2018 and January 2020 with the support of the United States organization Health Security Partners. The workshops targeted universities offering postgraduate programs in life and medical sciences. The purpose of the workshops was to enable participants to understand the concept of DURC, review their own research, determine if any of their experiments may be DURC, identify potential risks while conducting the research, and develop protocols to mitigate DURC threats. A pre-and post-workshop questionnaire evaluated the knowledge of the participants. Evaluations of both the course and facilitators were obtained at each workshop.

IntroductionThe COVID-19 pandemic has resulted in enormous increases in laboratory activities to keep pace with diagnostic testing and research efforts. However, traditional training, technical assistance, and capacity-building approaches were disrupted by the travel and movement restrictions put in place to control the spread of the disease. To address the needs of laboratorians and managers to conduct laboratory activities safely and securely during the pandemic, a highly interactive virtual training (IVT) workshop on biorisk management during COVID-19 was conducted through active learning strategies that connected speakers with participants. The objective of the training was to increase the basic knowledge and standards of biosafety and biosecurity practices, risk assessment, and control measures with reference specifically to the context of the COVID-19 pandemic and apply a rigorous evaluation methodology to assess the effectiveness of the IVT. The training covered a broad range of topics and encompassed national to international guidelines.MethodsParticipants were selected through official channels at the national level, focusing on institutions within Pakistan. The sessions included lectures from international experts in biorisk management concepts, and incorporated poll questions as well as pre- and post-tests and feedback on the speakers' knowledge and presentation skills, to increase interactivity. The pre- and post-test comprised similar multiple-choice questions and provided to every participant to ascertain the impact of the training on awareness and knowledge of biorisk management topics and concepts, and results were compared using paired t-tests. For feedback on the speakers, participants were asked to submit their ratings measured on a five-point Likert scale. The reliability of the Likert scale was estimated using Cronbach's alpha. Analyses were performed using Microsoft Excel and SPSS version 23.ResultsIn total, 52 individuals from different laboratories across Pakistan and Pakistani students from abroad (China) as well participated in at least one session of the IVT. The participants' pre- and post-test scores showed a significant increase in knowledge and awareness (p < 0.001). The obtained Cronbach's alpha score was >0.8, indicating high reliability of the generated feedback on the IVT approach and speakers.ConclusionThe IVT on biosafety and biosecurity in the context of the COVID-19 pandemic proved beneficial for laboratory professionals and could be a useful model to continue in the future for raising awareness and knowledge.

Introduction: Past incidences have been recorded relating to mishandling of hazardous material either due to insufficient knowledge or inappropriate equipment resulting in the indirect transfer of infectious agents. It is necessary to identify gaps that inhibit proper protection of healthcare professionals from being inadvertently exposed to biological risks. Methods: A cross sectional study was conducted at multiple laboratories across Karachi, Pakistan from January to August 2018. Descriptive questionnaire was used to record data about types and usage of Biological Safety Cabinets (BSCs), along with policies and practices adapted for its certification. Results: A total of 30 laboratories were visited which included Clinical/Biomedical, University hospital, R&D and animal laboratories. Among these 60% always used BSCs, 30% periodically used BSCs while 10% did not have any BSCs. Among these facilities 63.6% had BSC class II-A2, 39.9% had BSC class II-B2, 4.5% had BSC class III and only 0.9% had BSC class I cabinet. No protocols for field certification of BSCs were available. Conclusion: Establishment of biosafety training sessions, implementation and development of protocol for field certification for proper and safe use of BSCs on a local basis accompanied by continuous monitoring is required, for creating a safe environment for all laboratory staff.

Financial, cultural, and managerial hurdles have made biosafety and biosecurity measures difficult in resource-constrained countries like Pakistan. Because of increasing awareness of biorisk management, diagnostic and research laboratories have made major advances in biosafety and biosecurity in the recent decade. As a result, identifying and addressing gaps in biorisk management has never been more critical. The purpose of this study was to assess the current situation of personal protective equipment (PPE), biosafety behavior, waste management, biosafety and biosecurity measures, training and safety, and health services in diagnostic and research laboratories across Pakistan's Khyber Pakhtunkhwa (KP) province. We adapted the WHO Laboratory Assessment tool (2012) and CWA 15793 (Biorisk management guidelines) for conducting a cross-sectional survey, which was distributed among various laboratories in KP. The survey included 30 laboratories, including 11 diagnostic and 19 research laboratories. In comparison to diagnostic laboratories, biorisk management practices in research laboratories were better in terms of PPE, biosafety behavior, waste management, biosafety measures, biosecurity measures, trainings, and safety and health services. KP laboratories' biorisk management practices have improved over time, according to our findings. However, we were able to identify inadequacies that would require considerable improvements to the current setups based on the WHO and CWA 15793 recommendations. Organizations can tailor their biosafety measures and training to address identified gaps using the presented KP snapshot.

Introduction: Pakistan Biological Safety Association (PBSA) is a not for profit, nongovernmental, professional organization established in 2008 and is striving to promote and implement Bio risk management in Pakistan. PBSA accelerated its program for strategic training of the national life scientists from 2013 and is still working on that mandate with the help of Fogarty International Center (FIC) & National Institute of Health USA and other international organizations working on this Global Health Security Initiative and subsequently Agenda (GHSA) Aims & Objectives: This biosafety training program was developed for capacity building of M.Phil. and PhD graduates the future laboratory users of Basic Medical Sciences Institute (BMSI), Jinnah Post Graduate Medical Center which is the largest tertiary care hospital in Karachi, Pakistan involved in Research &Development (R&D) in medical sciences. Materials & Methods: This Pre post study was carried at Basic Medical Sciences Institute (JPMC), during the period of October 2018 to January 2019. A total of 48 (16 PhD. 32 M.Phil.) Grads students participated in the following study. The training program is administered through, custom made 4-month course having 16 contact hours also 4 hours of practical training. Training was evaluated using written assessment. The pre and post-training test was conducted after each session. Each test comprised of 15 multiple choice questions (MCQs) pre and post session making it 30 MCQs in total for each session. A final assessment consisting 30 MCQs conducted at the end of course. Results: There was vast difference observed in the post assessment results as compared to the pre assessment results. At the end of the course final assessment was carried out which gave an overall impression of vast change (83.3%) in awareness regarding bio risk management among the graduate students, which reflected the efficacy of this training. To ensure the validity of results and the intention to improvise the quality of course in future, feedback regarding the course and trainer was obtain through Likert scale. Reliability of Likert scale carried through Cronbach’s alpha, showed all variables with a maximum score of 0.9, indicating high reliability of the generated feedback evaluation. Conclusion: This study highlighted that through concerted efforts of professional organizations, proper awareness of public and concerned personals, regarding Biosafety & Biosecurity can certainly reduce the chances of errors and will ensure potential safety and security to the laboratory workers, community and environment, potentially exposed to these pathogens & toxins which are regarded as biohazards.

Background: Anemia is the most common blood disorder in patients with Type 2 diabetes. The hematological profile of diabetic patients is often missed clinically until to start the manifestation of clinical features of anemia. Anemia increases the hindrances and financial burden on the patient by frequent hospitalization. It increases the risk of microvascular complications, heart diseases, morbidity and death in diabetes mellitus. Therefore, it is imperative to recognize and treat anemia for the sake of patient care. Objectives: To evaluate the frequency of anemia in Type 2 Diabetic patients attending diabetic outpatients clinics of Mirpurkhas, Sindh. Methodology: A case-control study has been done to compare the hemoglobin level of Type 2 diabetics and non-diabetics. The data was collected over a period of three months from the patients who were visiting the diabetes clinic for their regular checkup. Data for controls were collected from the patient’s attendants. Diabetics and non-diabetics were under observations throughout the period. There were 206 subjects’ including 106 diabetics (52 females and 54 males) and 100 non-diabetics (50 females and 50 males). Research concerns included the duration of the disease, family history & presence of hypertension. Methods such as cyan methemoglobin were used to estimate hemoglobin & random blood glucose by glucose oxidase as recommended by the World Health Organization (WHO) and then read through Micro-lab 300 chemistry analyzer. Results: The frequency of occurrence of anemia in diabetics was 33.3% in males and 48.1% in females. Whereas in controls, 16.0% males and 32.0% females were anemic. The family history of diabetes and hypertension was also found higher among diabetic individuals as compare to healthy counterparts. Conclusion: The study has shown that anemia is twice as common in diabetics as compared with non-diabetics. Early diagnosis of anemia in a diabetic patient, and to treat so, will improve the quality of life and delay the complications to be developed in these patients.

The object of the study was to determine the ratio of incidence and genotyping of hepatitis C virus (HCV) infection with reference to different typable and untypable strains in various populations of Mirpur, Azad Jammu and Kashmir (AJK). This was done by taking into account different modalities with reference to gender, age and socio-economic perspective. A total of 88 patients were included in the studyand the screening was initially carried out by rapid diagnostic tests (RDT) with further confirmation by polymerase chain reaction (PCR) method. The real time PCR (qPCR) was performed at Genetic and Molecular Center, Lahore. These tests were done at Biosafety Level 2 (BSL 2) laboratory (according to Biorisk Management CWA15793-2008)which was the criteria determined by risk assessment performed by principal investigator and the scientificofficer of the facility. The genotype 3a was found to be the most common type in affected patients which certainly determined the management of these infections in a more targeted manner.The study was able to determine the prevalence rate on gender basis which was important on local basis and can be the basis to initiate the study for finding out the reasons for the same. The age group most affected was found to be in the younger group. In addition, introduction of Biorisk Management was very encouraging and the professionals showed keen interest in this scientific discipline and were eager to learn the key concepts of it.

Laboratory-acquired infections (LAIs), an occupational illness, are defined as all infections acquired through laboratory or laboratory-related activities. A report published in 1898 described an LAI resulting from Corynebacterium diphtheriae being transmitted through mouth pipetting. Despite all efforts, LAIs continue, especially in developing countries like Pakistan, which has been fighting to curb many infectious diseases. As reflected in the published literature, the biosafety culture is severely lacking in many laboratories, and there are no data available from Pakistan on LAIs. Our objective was to ascertain the frequency and rate of LAIs in various labs with versatile portfolios in relation to biosafety and biosecurity practices in Karachi. Ours is a descriptive multicenter cross-sectional study conducted in 30 laboratories located in Karachi from November 2017 to April 2018. Data were collected from laboratories including the university hospital labs, research labs, animal labs, and biomedical labs. Out of 30 facilities, half ( n  = 15) were clinical/biomedical laboratories, 16.6% ( n  = 5) were university hospital laboratories, 26.6% ( n  = 8) were R&D laboratories, and 6.6% ( n  = 2) were animal laboratories. Needle stick was found to be the most common injury, followed by animal bite/scratch, cut on mucous membrane, falling of personnel, and burn injury.