Exploring the Effect of Metformin to Lower Thyroid-Stimulating Hormone in Euthyroid and Hypothyroid Type-2 Diabetic Patients.

Introduction Metformin is one of the safest, first-line oral hypoglycemic agents used in type-2 diabetes mellitus patients. This study aims to study the effect of metformin on thyroid-stimulating hormone (TSH) in hypothyroid and euthyroid individuals, as both these diseases have an increased prevalence and coexistence. Method This hospital-based study was conducted in Jinnah Allama Iqbal Institute of Diabetes and Endocrinology (JAIDE), Allama Iqbal Medical College/Jinnah Hospital Lahore, Pakistan, from October 2019 to April 2020.

Ampullary Carcinosarcoma with Enteroblastic Differentiation: A Case Report.

Adenocarcinoma with enteroblastic differentiation is an extremely rare tumor with poor prognosis and unique pathologic features. The tumor appears to be relatively more common in stomach, with rare cases reported in esophagus, colon, rectum and ampulla. Underrecognition by pathologists may be a contributing factor towards underreporting of this tumor.

Infective Endocarditis Leading to Intracranial Abscess: A Case Report and Literature Review.

Neurologic complications are a hallmark of infective endocarditis (IE). IE leading to intracranial abscess has an unfavorable prognosis. A 17-year-old boy with a past medical history of aortic valve replacement presented with fever and seizure.

Diagnostic and treatment delays in breast cancer in association with multiple factors in Pakistan.

Background: Breast cancer has the highest incidence rate among all types of cancer worldwide. There is strong evidence that delay in presentation to an oncologist may lead to a decrease in survival.

Aims: This study explores factors causing diagnostic and treatment delays among the breast cancer patients enrolled in Jinnah Hospital, Lahore, from 2016 to 2018.

Risk Assessment of Patients After ST-Segment Elevation Myocardial Infarction by Killip Classification: An Institutional Experience.

Introduction The Killip classification system was introduced for clinical assessment of patients with acute myocardial infarction (MI). It stratifies individuals according to the severity of their post-MI heart failure. This system provides effective stratification of long-term and short-term outcomes in patients with acute MI and influences the treatment strategies.

Is anaemia frequent in HIV/AIDS patients presenting to a tertiary care hospital?

Objective: To determine the frequency of anaemia among patients with human immune-deficiency virus / acquired immunodeficiency syndrome.

Methods: The descriptive cross-sectional single-blind study was conducted at Jinnah Hospital, Lahore, Pakistan, from June 25 to December 25, 2016, and comprised human immune-deficiency virus / acquire immunodeficiency syndrome patients diagnosed at least 3 months earlier. Demographic information was obtained along with sample of patient's blood for haemoglobin level estimation.

COVID-19 Induced Myocarditis: A Rare Cause of Heart Failure.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing lung injury has been well documented in the literature recently. They do so primarily by binding to the membrane-bound form of angiotensin-converting enzyme 2 (ACE-2) receptors. However, since these receptors are also expressed in the heart and blood vessels, coronavirus can also cause damage to these organs by binding to the ACE-2 receptors.

A missense allele of PEX5 is responsible for the defective import of PTS2 cargo proteins into peroxisomes.

Peroxisomes, single-membrane intracellular organelles, play an important role in various metabolic pathways. The translocation of proteins from the cytosol to peroxisomes depends on peroxisome import receptor proteins and defects in peroxisome transport result in a wide spectrum of peroxisomal disorders. Here, we report a large consanguineous family with autosomal recessive congenital cataracts and developmental defects.

Reinfection of COVID-19 in Pakistan: A First Case Report.

Since its spread across the world, coronavirus disease 2019 (COVID-19) has posed a severe public health threat, and many unanswered questions about COVID-19 remain. Antibodies have been detected a few days after the onset of infection, and in some patients, these antibodies wane quickly. To date, it is unknown whether all infected patients induce an adequate protective immune response or how long this effect remains.

A Rare Case of Hemichorea-Hemiballismus Due to Chronic Uncontrolled Hyperglycemia.

Chronic uncontrolled hyperglycemia is a rare yet important cause of hemichorea-hemiballismus and very common among postmenopausal women. This case report illustrates the importance of recognizing hyperglycemia as a potential cause of hemiballismus. There is a need to differentiate hyperglycaemic intracranial changes from other intracranial pathologies, as prompt glycemic control can help improve hemiballistic symptoms and prevent a more aggressive or invasive workup.

Cytomegalovirus Hepatitis in an Immunocompetent Patient: A Cause of Fever of Unknown Origin.

Acute hepatitis is most often self-resolving and a benign condition that rarely requires any anti-viral drugs. In immunocompromised patients (HIV-infected patients and transplant recipients), the morbidity and mortality associated with cytomegalovirus (CMV) infection have been extensively reported in the medical literature. We are describing a rare case of acute severe cytomegalovirus hepatitis in an immunocompetent host.

Takotsubo Cardiomyopathy Triggered by the Death of Pets (Cats): Two Case Reports.

Takotsubo cardiomyopathy otherwise called stress cardiomyopathy, which results in debilitating of a segment of heart muscles, is a sort of non-ischemic cardiomyopathy, set off by stress. We describe two case reports of takotsubo cardiomyopathy triggered by the significant stressful event being the death of pet cats. The rare nature of the type of stressor and the manifestation is something to be considered by healthcare providers.

Clinical, Radiological, and Molecular Findings of Acute Encephalitis in a COVID-19 Patient: A Rare Case Report.

We report a case of encephalitis in a young male patient with severe coronavirus disease 2019 (COVID-19) who initially presented with typical symptoms of fever, dry cough, and shortness of breath but later on developed acute respiratory distress syndrome and required mechanical ventilation. Two days post-extubation, the patient developed new-onset generalized tonic-clonic seizures and confusion. MRI of the brain was done and it showed an abnormal signal in the bilateral medial cortical frontal region.

Role of Mass Media and Public Health Communications in the COVID-19 Pandemic.

In Dec 2019, a novel pathogen emerged, and within weeks, led to the emergence of the biggest global health crises seen to date. The virus called 'SARS-CoV-2', causes coronavirus disease which was named 'COVID-19' by the World Health Organization (WHO). The speedy spread of this infection globally became a source of public worry and several unknowns regarding this new pathogen created a state of panic.

A Review of the Risk Factors Associated With Poor Outcomes in Patients With Coronavirus Disease 2019.

The global pandemic of coronavirus disease 2019 (COVID-19) and its rapid spread throughout the globe is of much concern. With little known about the peculiar virus and the changing mortality and morbidity, we attempt to review the risk factors associated with significant outcome.  We conducted a review of the information available in medical journals published on COVID-19 risk factors associated with poor outcomes using PubMed®, Google Scholar, and material published online.

Mouse Models of Human Pathogenic Variants of Associated with Non-Syndromic Deafness DFNB86 and DFNA65 and Syndromes Involving Deafness.

Human pathogenic variants of are associated with clinically heterogeneous phenotypes, including recessive nonsyndromic deafness DFNB86, dominant nonsyndromic deafness DFNA65, seizure accompanied by deafness, a variety of isolated seizure phenotypes and DOORS syndrome, characterized by deafness, onychodystrophy, osteodystrophy, intellectual disability and seizures. Thirty-five pathogenic variants of human associated with deafness have been reported. However, functions of TBC1D24 in the inner ear and the pathophysiology of TBC1D24-related deafness are unknown.

Determining the Frequency of Acquired Cystic Kidney Disease in End Stage Renal Disease Patients on Hemodialysis at Dialysis Centre of Tertiary Care Hospital.

Objectives To determine the frequency of acquired cystic kidney disease (ACKD) among patients of end-stage renal disease. Methods This cross-sectional study was conducted at the University of Lahore Teaching Hospital after approval from the ethical review committee. About 150 patients with end-stage renal disease fulfilling the inclusion criteria and undergoing three hemodialysis sessions per week for six months were approached.

Incidental Intramyocardial Bridging in a Myocarditis Patient Presenting With Focal ST Segment Depressions.

Myopericarditis is an entity known to present with typical symptoms of viral prodrome and diffuse ST elevation (STE) and/or PR depressions on electrocardiogram (EKG). Atypical presentations of myocarditis such as focal STE have been cited in the literature, reflecting true coronary ischemia. However, myocarditis or pericarditis presenting with focal ST depressions is rarely seen.

Reverse vaccinology assisted designing of multiepitope-based subunit vaccine against SARS-CoV-2.

Background: Coronavirus disease 2019 (COVID-19) linked with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cause severe illness and life-threatening pneumonia in humans. The current COVID-19 pandemic demands an effective vaccine to acquire protection against the infection. Therefore, the present study was aimed to design a multiepitope-based subunit vaccine (MESV) against COVID-19.

Frequency of Venous Thromboembolism in Patients with Liver Cirrhosis.

Introduction The major hemostatic problem in cirrhotic patients is the increased risk of bleeding, but venous thromboembolism is also being reported as a noticeable feature of cirrhosis. Therefore, we conducted this study to determine the frequency of venous thromboembolism in patients with liver cirrhosis. Materials and methods This cross-sectional study took place at a major metropolitan hospital in Karachi for a period of six months.

Role of intraoperative computed tomography scanner in modern neurosurgery - An early experience.

Background: Intraoperative imaging addresses the limitations of frameless neuronavigation systems by providing real-time image updates. With the advent of new multidetector intraoperative computed tomography (CT), soft tissue can be visualized far better than before. We report the early departmental experience of our intraoperative CT scanner's use in a wide range of technically challenging neurosurgical cases.

Sequence Types Harboring Genes Encoding Aminoglycoside Modifying Enzymes and 16SrRNA Methylase; a Multicenter Study from Pakistan.

Introduction: The aminoglycosides are widely used for the therapeutic management of infections caused by gram-negative bacteria, including the strains. However, the resistance to the members of the aminoglycoside family, such as amikacin, gentamicin, and tobramycin, is increasingly being common among the clinical isolates.

Purpose: This study aimed to investigate the presence of 16SrRNA methylases and aminoglycoside modifying enzymes (AMEs) genes among aminoglycoside resistant isolates and to study the genetic diversity of the clinical population of in local hospitals.