Ethics in Surgical Practice and Research.

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Effectiveness of early pharmaceutical interventions in symptomatic COVID-19 patients: A randomized clinical trial.

Objective: We assessed the effectiveness of oral Hydroxychloroquine (HC), Azithromycin (AZ) and Oseltamivir (OS), alone or combined, among patients hospitalized with mildly symptomatic coronavirus infectious disease (COVID-19).

Methods: Following the approval of the National Bioethics Committee and prospective registration (clinicaltrials.gov NCT04338698), a multicenter randomized clinical trial of adaptive design was conducted at 10 multispecialty hospitals in Pakistan.

Immunoinformatics-Based Proteome Mining to Develop a Next-Generation Vaccine Design against : The Cause of Lyme Borreliosis.

The tick-borne bacterium, has been implicated in Lyme disease-a deadly infection, formerly confined to North America, but currently widespread across Europe and Asia. Despite the severity of this disease, there is still no human Lyme disease vaccine available. A reliable immunoinformatic approach is urgently needed for designing a therapeutic vaccine against this Gram-negative pathogen.

Application of Artificial Intelligence in Vascular Surgery.

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Efficacy and Safety of the RBD-Dimer-Based Covid-19 Vaccine ZF2001 in Adults.

Background: The ZF2001 vaccine, which contains a dimeric form of the receptor-binding domain of severe acute respiratory syndrome coronavirus 2 and aluminum hydroxide as an adjuvant, was shown to be safe, with an acceptable side-effect profile, and immunogenic in adults in phase 1 and 2 clinical trials.

Methods: We conducted a randomized, double-blind, placebo-controlled, phase 3 trial to investigate the efficacy and confirm the safety of ZF2001. The trial was performed at 31 clinical centers across Uzbekistan, Indonesia, Pakistan, and Ecuador; an additional center in China was included in the safety analysis only.

Students Dreem From Pre-Clinical To Clinical Years-A Cross Sectional Analysis From Rehman Medical College, Peshawar.

Background: Educational environment is a key indicator of student learning and reflects quality of education and curriculum. With the boom of medical colleges in the private sector, parents put great stress on education and educational environment. The purpose of this study was to investigate the difference in perceptions regarding educational environment between pre-clinical and clinical year MBBS students and to determine year wise strengths and weaknesses of the MBBS program.

screening, SAR and kinetic studies of naturally occurring flavonoids against SARS CoV-2 main protease.

The Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) pandemic has become a global challenge based on its replication within the host cells that relies on non-structural proteins, protease (M). Flavonoids, an important class of naturally occurring compounds with medicinal importance, are frequently available within fruits and vegetables. Herein, we report the studies on naturally occurring flavonoids consisting of molecular docking studies and evaluation of theoretical kinetics.

Comparison of Different Molecular Subtypes with 14% Ki-67 Cut-off Threshold in Breast Cancer Patients of Pakistan- An Indication of Poor Prognosis.

Background: Ki-67 is a proliferation marker that is used not only to categorize patients in luminal A and B subtypes of breast cancers, but also to determine the aggressiveness of the disease in triple negative and human epidermal growth factor 2 (HER2) over expressed molecular subtypes. The present study was designed to evaluate the role of Ki-67 with cut off value of 14% in molecular subgroups and its association with patient prognosis.

Methods: Immunostaining was performed on histopathologically confirmed sections (n = 278) to assess expression of Ki-67, estrogen receptor (ER), progesterone receptor (PR) and HER2.

Metadherin (MTDH) overexpression significantly correlates with advanced tumor grade and stages among colorectal cancer patients.

Background: Colorectal cancer is the 4th leading cause of cancer related deaths affecting both men and women worldwide. In the present study, any probable role of MTDH mRNA expression in CRC tumorigenesis was explored using both discovery and validation cohorts.

Methods And Results: After prior ethical and biosafety approvals, tumor tissue samples along with their adjacent controls were collected for this study from Pakistani patients diagnosed with colorectal cancer.

Influence of ABCB1 gene polymorphism on concentration to dose ratio and adverse effects of tacrolimus in Pakistani liver transplant recipients.

Objective: To evaluate the possible association of ABCB1 single nucleotide polymorphism (SNPs) of the ABCB1 gene with tacrolimus dosages, concentration-to-dose ratios (CDR) and adverse effects in Pakistani liver transplant recipients.

Methods: This observational study was conducted at Shifa International Hospital, Shifa Tameer-e-Millat University, Islamabad and Basic Medical Sciences Institute, Karachi from September 2016 to July 2020. Eighty-one liver transplant recipients were included.

Clinical and genetic characterization of congenital lipoid adrenal hyperplasia.

Disorders of steroid synthesis are a group of anomalies caused by defects in any step of conversion of cholesterol into steroid hormones. The disorders are characterized by defects leading to abnormalities of salt-water balance and/or sexual differentiation. Congenital lipoid adrenal hyperplasia (CLAH) is the most severe form of steroid synthesis disorder caused by the accumulation of cholesterol in the outer mitochondrial membrane due to steroidogenic acute regulatory protein (StAR) deficiency.

Sequence variants in three genes underlying leukodystrophy in Pakistani families.

Leukodystrophies (LDs) are a heterogeneous group of rare and progressive genetic diseases that affect brain, spinal cord, and often the peripheral nerves. They are characterized by abnormal development or destruction of the myelin sheath of the brain. This study was aimed to search for the causative variants in three unrelated consanguineous families presented with LD.

WhatsApp an informal learning and communication tool: Perception of medical officers working in low resource setting: A Focus Group Discussion.

Objective: To assess if WhatsApp communication improves clinical knowledge and to explore the perception of its use among medical officers at a secondary care facility.

Methods: The mixed method study was conducted at the Department of Obstetrics and Gynaecology, Aga Khan Hospital for Women and Children, Kharadar, Karachi, from May to July,2018, and comprised medical officers working at the secondary care facility. All the officers were added to a WhatsApp group with a consultant.

Traumatic Right Diaphragmatic Hernia; A Delayed Presentation.

Diaphragmatic rupture following blunt or penetrating thoraco-abdominal trauma is frequently missed. It presents years later with herniation of abdominal viscera. Surgical treatment should be sought for when diagnosed.

Sweat Gland Carcinoma With Lymphadenopathy.

Sweat gland carcinoma is a rare tumour, being almost 1% of primary skin lesions. The tumour has tendency to spread to regional lymph nodes and distant metastases has also been reported. Their exact incidence in Pakistan is not known.

Postpancreatitis Abscess of Falciform Ligament: An Unusual Presentation.

Pathologies of the falciform ligament are extremely rare entities ranging from cyst and hematoma to abscess and gangrene. Intestinal obstruction, secondary to extensive falciform ligament abscess, has not been reported to date. On account of being rare, diseases of falciform ligament have perplexing presentations leading to unwanted delays in diagnosis and management.

Comparison of BISAP Score with Ranson's Score in Determining the Severity of Acute Pancreatitis.

Objective: To determine the accuracy of BISAP score in finding out the frequency of severity and mortality in patients with acute pancreatitis by comparing it with Ranson's score.

Study Design: Crosse-sectional study.

Place And Duration Of Study: Department of Surgery, Pakistan Institute of Medical Sciences, Islamabad, from April to December 2010.

Reliability of results produced through objectively structured assessment of technical skills (OSATS) for endotracheal intubation (ETI).

Objective: To estimate the reliability of an objectively structured assessment of technical skills (OSATS) in patients for Endotracheal Intubation (ETI), using task-specific checklists during administration of general anaesthesia.

Study Design: Co-relational reliability study.

Place And Duration Of Study: Department of Anaesthesia and Medical Education, Pakistan Institute of Medical Sciences, Islamabad, from September to November 2010.

Abdominal compartment syndrome among critically ill surgical and traumatised patients: experience at Pims, Islamabad.

Background: Raised intra-abdominal pressure (IAP) accompanied by evidence of organ dysfunction constitutes abdominal compartment syndrome (ACS). The ACS is now becoming an increasingly recognised fatal entity in the critically ill surgical and traumatized patients receiving critical care. The objectives were to determine the frequency of abdominal compartment syndrome (ACS) in critically ill surgical and traumatised patients and to identify the risk factors associated with its development in our patients.

Treating infected diabetic wounds with superoxidized water as anti-septic agent : a preliminary experience.

Objective: To evaluate the effectiveness of superoxidized water (MicrocynTM) in diabetic patients with different wounds.

Study Design: Single-centre single blinded randomized controlled trial.

Place And Duration Of Study: Department of General Surgery, Orthopaedics and General Medicine at Pakistan Institute of Medical Sciences, Islamabad, from April to June 2006.

Sentinel node localization in breast carcinoma.

Objective: To determine the success rate of sentinel node dissection and the sensitivity of sentinel node to determine the presence of axillary node metastasis in women with clinically node negative breast cancer.

Design: Case series.

Place And Duration Of Study: The study was conducted at Department of General Surgery Pakistan Institute of Medical Sciences, Islamabad (PIMS) and Nuclear Oncology and Radiotherapy Institute, Islamabad (NORI) from January 2002 to December 2003.