Efficacy and safety of combination of empagliflozin and metformin with combination of sitagliptin and metformin during Ramadan: an observational study.

Background: Management of diabetes during fasting is a clinical challenge. Sodium glucose co-transporter -2 inhibitors (SGLT2i) are considered safe with a low risk of hypoglycemia. However, studies on SGLT2i are scarce.

Perspectives of the General Public Regarding Government Policies in Combating the COVID-19 Pandemic.

Background The world has been hit with one of the deadliest pandemics in history. This pandemic has affected almost all countries and more than 50 million people globally. This paper takes an in-depth look at all government policies that were developed to prevent the spread of coronavirus disease 2019 (COVID-19) in Pakistan and the perception of the general population regarding these policies.

Red Man Syndrome Due to Oral Vancomycin in Chronic Kidney Disease Patients: A Case Report.

The red man syndrome is a known complication of vancomycin. It is commonly seen with intravenous (IV) use but is also documented with oral use. We aim to describe a case of a chronic kidney disease (CKD) patient who developed red man syndrome secondary to oral vancomycin use.

A novel chest CT severity score in COVID-19 and its correlation with severity and prognosis of the lung disease: A retrospective cohort study.

Background: HRCT chest has a high sensitivity in the diagnosis of patients with COVID-19 infection. Through our study, we intend to evaluate the diagnostic accuracy and inter-reader variability of a semi-quantitative CT severity score, a novel parameter designed for risk stratification and prognostication of COVID-19 pneumonia with clinical staging of disease.

Methods: It was a single-center retrospective analysis performed on an original cohort of 4180 symptomatic patients with the suspicion of SARS-CoV-2 interstitial pneumonia.

Rare pathogenic mutation in the thymidine phosphorylase gene (TYMP) causing mitochondrial neurogastrointestinal encephalomyelopathy.

Background: Mitochondrial neurogastrointestinal encephalopathy (MNGIE) disease is a rare multisystem disorder that mainly affects the digestive and nervous systems. Key features of the disease include cachexia, ptosis, external ophthalmoplegia, peripheral neuropathy and leucoencephalopathy. Symptoms most often begin by age 20 and overlap several other Metabolic and endocrine disorders making the diagnosis challenging.

A Novel Protein Elicitor (PELL1) Extracted from Induced Resistance against (Hemiptera: Aleyrodidae) in L.

Protein elicitors play a key role in signaling or displaying plant defense mechanism and emerging as vital tools for biocontrol of insects. This study was aimed at the characterization of the novel protein elicitor isolated from entomopathogenic fungi (V3) strain and its activity against whitefly, , in cotton ( L.).

An unusual presentation of transverse colon volvulus in a patient with Williams Syndrome: Case report and literature review.

Introduction: and Importance: Williams Syndrome (WS) is a well-recognized genetic disorder characterized by multi-system clinical manifestations. However, there are very rare gastrointestinal complications associated with patients with Williams Syndrome. We report the first transverse colon volvulus (TCV) case in an adult with pre-diagnosed Williams Syndrome.

Chronic Suppurative Otitis Media leading to cerebellar brain abscess, still a problem in 21st century: A case report.

Introduction And Importance: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear associated with tympanic membrane rupture and purulent discharge for at least 6 weeks. Owing to the proper use and easy availability of antibiotics, these types of cases are rare in developed regions, but they are still occasionally seen in the developing world with poor hygiene and a lack of availability of antibiotics and immunizations.

Case Presentation: Patient presented with complaints of headache, yellow-colored discharge from ear, fever and vomiting.

Pneumothorax as a Complication of Bevacizumab-Containing Chemotherapy: A Systematic Review of Case Reports.

Bevacizumab is a monoclonal anti-vascular endothelial growth factor (VEGF) antibody that binds to and makes all of the VEGF isoforms inactive, and thus prevents angiogenesis, development, and the spread of the tumor. The most reported side effects after administering bevacizumab include bleeding, high blood pressure, heart failure, proteinuria, thrombosis, and gastrointestinal perforation. Pneumothorax has rarely been reported as a complication of bevacizumab, but with an unclear mechanism.

Radiographic patterns on Chest X-ray as a supporting imaging tool in triaging of suspected Corona Virus Disease (COVID) patients.

Objective: To evaluate the radiographic patterns on Chest X-Ray (CXR) in accordance with Modified Brixia Scoring as supporting imaging tool in triaging of Corona Virus Disease (COVID-19) pneumonia.

Methods: In this cross-sectional study, chest radiographs of suspected COVID patients at emergency triage, Lady Reading Hospital (LRH) from April 18 to July 22 2020 were evaluated for patterns of COVID pneumonia and scored in accordance with modified Brixia score. Each zone was categorized as score of "one" for interstitial pattern, "two" for mixed interstitial /alveolar pattern and "three" for alveolar pattern.

Comparison of outcome of Ponseti method with traditional clubfoot treatment in children up to five years of age at tertiary care hospital.

Objectives: To compare the outcomes of Ponseti treatment with the traditional treatment method for clubfoot.

Methods: A cross-sectional comparative study was conducted at the orthopedic department of Nishtar Medical Hospital & University Multan for one year. The study included 40 children (29 clubfeet) treated with conventional treatment (pre-Ponseti group) who were compared with 55 Ponseti-treated children (72 clubfeet) (Ponseti group).

Treatment success with two doses of methotrexate vs single dose of methotrexate in Ectopic Tubal Pregnancy.

Objectives: To compare the success rates and safety of two-doses of methotrexate versus single dose of methotrexate in ectopic tubal pregnancy.

Methods: This was an open-label, randomized controlled trial done at "The Department of Obstetrics & Gynecology, Nishtar University Hospital, Multan" from January 2020 to July 2021. A total of 100 women (50 in each group), aged 20 to 35 years with a tubal ectopic pregnancy were enrolled.

Outcomes of topiramate for prophylaxis of chronic migraine headache.

Objectives: To explore the prophylactic outcome and tolerability of topiramate in patients suffering from chronic episodes of migraine.

Methods: A prospective, non-interventional study was conducted at the Neurology Department of Nishtar Medical University & Hospital Multan from 17th Aug 2020 to 17th Aug 2021. The eligible patients were administered topiramate (flexible dose) for six months while the treatment was continued for another six months upon the advice of the physician.

Safety and outcomes of thrombolytic therapy in patients with pulmonary embolism and thrombocytopenia: A systematic review.

Thrombolysis is an established therapeutic modality for patients with high-risk (and some selected intermediate-risk) pulmonary embolism (PE) with hemodynamic instability. Physicians sometimes experience cases where both a high-risk PE and thrombocytopenia coexist. Although thrombocytopenia of <  100 × 10/mm is considered a contraindication in patients with ischemic stroke, the safety and outcomes of thrombolysis in patients with acute PE and thrombocytopenia are unknown.

Efficacy and Safety of Colchicine in Prevention of Secondary Cardiovascular Outcomes Among Patients With Coronary Vessel Disease: A Meta-Analysis.

Coronary vessel disease (CVD) is a class of diseases that impacts the blood vessels and heart and is one of the leading causes of disability and death. CVD includes cerebrovascular disease and coronary heart disease, both illnesses of the vessels transporting the oxygenated blood to the brain or heart. Colchicine is an inexpensive and old drug with strong anti-inflammatory effects.

Lipid Lowering Therapy: An Era Beyond Statins.

Dyslipidemia, specifically elevated low-density lipoprotein (LDL) cholesterol levels, causes atherosclerotic cardiovascular disease (ASCVD) and increases the risk of myocardial infarction and stroke. Statins, a class of drugs that exert their effects by inhibiting HMG-CoA reductase, a key enzyme in the synthesis of cholesterol, have been the mainstay of therapy for the primary prevention of cardiovascular disease and lipids reduction. Statins are associated with side effects, most commonly myopathy and myalgias, despite their proven efficacy.

Complications of invasive mechanical ventilation in critically Ill Covid-19 patients - A narrative review.

Critically ill COVID-19 patients have to undergo positive pressure ventilation, a non-physiological and invasive intervention that can be lifesaving in severe ARDS. Similar to any other intervention, it has its pros and cons. Despite following Lung Protective Ventilation (LPV), some of the complications are frequently reported in these critically ill patients and significantly impact overall mortality.

Knowledge, Attitude, and Perception of Cancer Patients towards COVID-19 in Pakistan: A Cross-Sectional Study.

Background: Cancer patients, being immunocompromised, are at higher risk of coronavirus disease (COVID-19). The current study determines cancer patients’ knowledge, attitude, perception, and impact of the COVID-19 pandemic. Method: A cross-sectional online survey was conducted in Pakistan from 1 April 2020 to 1 May 2020.

Efficacy of letrozole versus clomiphene citrate on ovulation induction in patients with polycystic ovarian syndrome.

Objectives: To compare the efficacy of letrozole (LTZ) vs clomiphene citrate (CC) for ovulation induction in patients having polycystic ovarian syndrome (PCOS).

Methods: This randomized controlled trial was conducted at The Department of Obstetrics & Gynecology, Nishtar Medical University Hospital, Multan, Pakistan from January 2021 to June 2021. A total of 78 women aged 18 to 30 years, diagnosed having PCOS were enrolled.

Intravenous Tranexamic acid versus placebo during Caesarian section: A comparative study.

Objectives: To evaluate the effectiveness of Tranexamic Acid in preventing postpartum hemorrhage against placebo in high-risk women undergoing cesarean section.

Methods: A double-blinded placebo-controlled comparative trial was conducted at the Obstetrics and Gynecology Department of Nishtar Hospital for one year, from 15 June 2020 to 15 June 2021. A total of 60 women who were at high risk of postpartum hemorrhage and had to undergo elective cesarean sections were included in the study.

Effect of androgen deprivation therapy on bone mineral density in patients with prostate cancer.

Objectives: To access the effects of acute and chronic Androgen Deprivation Therapy on Bone Marrow Density and related bone markers; to compare the bone loss among the patients who terminated GnRH use and control group (not given ADP therapy at all) with the ones with acute or chronic Androgen Deprivation Therapy.

Methods: A cross-sectional study was conducted in the Oncology Department of Nishtar Medical University & Hospital Multan for one year. Bone mineral density of the entire body, 1/3 distal radius, ultra-distal forearm, femoral neck, and lumbar spine, was measured in 40 patients diagnosed with non-metastatic prostate cancer at baseline for the duration of six months.

Macrosomia predictors and pregnancy outcomes in Gestational Diabetes patients: An observational study from Ha'il, Saudi Arabia.

Objectives: To determine the prevalence, risk factors for macrosomia and pregnancy outcome in women with gestational diabetes (GDM).

Methods: In this prospective observational study, we included the data of 161 pregnant females diagnosed with GDM. The study was conducted from December 1st, 2020 to June 30, 2021, at the Maternity and Children Hospital (MCH) of Hail, Saudi Arabia.

Comparison between outcome of single dose of prophylactic antibiotic versus postoperative antibiotic in inguinal hernia surgery.

Objectives: To compare the outcome prophylactic antibiotics and routine pre-surgical and post-surgical in terms of incidence of surgical site infection (SSI) and to explore the effect of various factors such as duration of surgery and patient characteristics (if any).

Methods: A double-blinded prospective analysis of a total of 60 patients with the primary inguinal hernia was conducted from 24 August 2020 to 24 August 2021 at the Surgical Department of Nishtar Medical University & Hospital, Multan. The participants of the study were categorized into two groups such that 30 consecutive patients were placed in the study group who were administered with a single dose of prophylactic antibiotic 30 minutes before to mesh repair surgery and the remaining 30 patients were placed in the control group who were administered routine antibiotics pre and post-operatively.

Psychosis during the COVID-19 pandemic: A systematic review of case reports and case series.

Background: Preliminary data suggest that patients with COVID-19 may experience psychiatric symptoms, including psychosis. We systematically reviewed the literature to evaluate the concurrence of new-onset psychosis or exacerbation of clinically stable psychosis through case reports and case series.

Methods: Six databases were searched, followed by an electronic and manual search of the relevant articles.