The COVID-19 pandemic has resulted in a global humanitarian crisis. Despite ongoing research, transmission risks and many disease characteristics remain unclear. Most patients have displayed elevated levels of certain inflammatory markers, which we sought to investigate further in relation to disease severity. The aim of this study was to examine the correlation between inflammatory markers and the severity of COVID-19 among patients. We conducted a cross-sectional study from April to September 2020, involving 143 COVID-19 PCR-positive patients from Ziauddin Hospital. Electronic patient records provided data on demographics, clinical status, and laboratory results. The majority of PCR-positive patients were elderly males with comorbidities such as diabetes and hypertension. Almost all patients exhibited increased levels of various inflammatory markers, with procalcitonin (97.2%) being the most common. Statistically significant differences were observed in the levels of TLC (p=0.005), CRP (p=0.001), LDH (p=0.001), Ferritin (p=0.001), D-dimer (p=0.001), and procalcitonin (p=0.028), in relation to COVID-19 severity. The data suggest a significant association between levels of inflammatory markers and COVID-19 severity. All markers, except procalcitonin, demonstrated a significant correlation with disease severity. These results could enhance our understanding of COVID-19 pathogenesis and help predict and manage severe cases.

Science is digging for the varied presentation of COVID-19 patients exposed to the same risk factors, and medical conditions may be influenced by the presence of polymorphic genetic variants. This study investigated the link between ACE2 gene polymorphisms and the severity of SARS-CoV-2. This cross-sectional study recruited COVID-19 PCR-positive patients by consecutive sampling from Ziauddin Hospital from April to September 2020. DNA was extracted from whole blood, followed by gene amplification and Sanger’s sequencing. Most of the patients, 77: 53.8%, were serious. Males were higher (80; 55.9%) with age more than 50 years (106: 74.1%). We found 22 ACE2 SNPs. rs2285666 SNP was most prevalent with 49.2% CC, 45.2% TT, 4.8% CT heterozygosity, and 0.8% AA genotypes. Variants with multiple genotypes were also insignificantly associated with the severity of COVID-19 in the analysis of the dominant model. Only rs2285666 had a significant statistical link with gender (p-value 0.034, OR; 1.438, CI; 1.028–2.011) while rs768883316 with age groups (p-value 0.026, OR; 1.953, CI; 1.085–3.514). Haplotypes ATC of three polymorphisms (rs560997634, rs201159862, and rs751170930) commonly found in 120 (69.77%) and TTTGTAGTTAGTA haplotype consisting of 13 polymorphisms (rs756737634, rs146991645, rs1601703288, rs1927830489, rs1927831624, rs764947941, rs752242172, rs73195521, rs781378335, rs756597390, rs780478736, rs148006212, rs768583671) in 112 (90.32%) had statistically significant association with the severity having p = value 0.029 and 0.001 respectively. Males of old age and diabetics are found to have more severe COVID-19 infection in the current study. We also found that common ACE2 polymorphism rs2285666 influences the susceptibility of acquiring the severe SARS-CoV-2 infection.

Despite an increasing incidence of Staphylococcus aureus infection and dissemination in Pakistan, the epidemiology of different Staphylococcus aureus research clones has been the subject of only a small number of investigations. By analyzing the collected data sequence, this study was designed to study the epidemiology of Staphylococcus aureus in the area using multilocus sequence typing (MLST). A total of 1015 staphylococcus strains collected from the city's tertiary care facilities were biochemically screened, followed by antimicrobial susceptibility testing against a panel of 13 antibiotics. Analyzed methicillin-resistant Staphylococcus aureus (MRSA) was subjected to molecular characterization using multilocus sequence typing (MLST), clonal complex analysis, recombination testing, and phylogenetic analysis. Approximately 421 bacteria were verified as Staphylococcus aureus by biochemical analysis. 57% of the isolates exhibited multidrug resistance, of which 89% were found to be methicillin-resistant Staphylococcus aureus (MRSA). MLST results in a total of 39 sequence types (ST) and 5 clonal complexes (CC), out of which twenty-two STs were newly documented worldwide. The most common CC identified was CC8. The direct sequencing data also revealed significant shifts at MLST loci, with point mutations resulting in the aroE-343 and tpi-278 alleles. This study concludes that there is high diversity in the locally circulating clones of Staphylococcus aureus present in nature and that they are defined by their geographic epidemiology. These findings have practical implications for public health, including the need for tailored infection control strategies, antibiotic stewardship, global surveillance, and a deeper understanding of bacterial evolution.

Background: The coronavirus disease of 2019 (COVID-19) pandemic is the world's worst problem and the global health disaster of our time. In order to fully comprehend the advantages of COVID-19 immunization, illness attenuation must be considered. This should be done by investigating whether those who contract COVID-19 despite vaccination experience milder symptoms than those who are unvaccinated. The COVID-19 pandemic brought on by is still a serious public health issue on a global scale. Aim: To evaluate the significant impact and efficacy of vaccination in positive SARS-CoV-2 patients during different timelines of a pandemic. Methodology: This is a cross sectional study involving 212 PCR-positive SARS-CoV-2 patients with their clinical–epidemiological findings admitted at Ziauddin Hospital between the years 2021 to 2022. SARS-CoV-2. RNA positivity was determined using qualitative RT-PCR with in vitro diagnostic kits, following the manufacturer's recommendations. SARS-CoV-2 positive patients had at least one positive RT-PCR test result, while SARS-CoV-2 negative patients had solely negative RT-PCR test findings. The data was provided through electronic patient records. The patients were categorized into Asymptomatic, Mild, Moderate and Severe/Critical as per WHO and CDC guidelines. Results: Among total of 212 patients there were 5(2.4%) vaccinated and 20(9.4%) unvaccinated asymptomatic, 6(2.8%) vaccinated and 12(5.7%) unvaccinated mild, 16(7.5%) vaccinated and 39(18.4%) unvaccinated moderate and 27(12.7%) vaccinated and 87(41%) unvaccinated severely/critically ill patients. The association between the severity of illness and vaccination status of patients showed significantly positive results with a p-value of 0.005. Conclusion: It was concluded that vaccine plays a significant role in the course of illness and severity of disease, this study investigated the impact of vaccination status on patients with positive SARS-CoV-2 to compare the severity and course of illness between the vaccinated and unvaccinated groups based on a number of clinical indicators. but the efficacy of these vaccines remains a point of concern for future studies. Key words: COVID-19, pneumonia, SARS-CoV-2, immunization

Background: PONV remained the common cause of patient’s discomfort after anaesthesia 30% in all post-surgical patients and 80% in high-risk patients. With other common and serious complications of surgeries vomiting and nausea remained unpleasant trigger for patients who underwent the surgeries that prolongs the hospital stay and also leads to recurrent admissions. Therefore in this study we want to compare the effectiveness of pre-operative single-dose dexamethasone versus ondansetron in reducing post-operative nausea and vomiting after laparoscopic surgeries. Methods: Patients admitted for laparoscopic procedures at Ziauddin Hospital North site were recruited for this quasi-experimental study. All consecutive patients were assigned to one of the two groups (1 or 2) using computer generated simple randomised numbers and given either of the two treatments: single dose dexamethasone (5-8mg) or ondansetron (4mg). Researcher assessed post-operative nausea and vomiting at thirty minutes, two, four, eight, and twenty-four hours after the procedure. For statistical association the chi-square test and independent t-test were applied. Significant was defined as a P-value of less than 0.05. Results: The mean age of patients was 42.9±16.6years with mean weight of 62.9±8.8 kilograms. All the operation performed as laparoscopic and common procedure was cholecystectomy (72/98: 73.5%), followed by appendectomy (17/98: 17.3%). Patients with ondansetron had more episodes of vomiting after 30 minutes of laparoscopic surgery. In addition, we discovered a correlation between the two groups' nausea episodes 30 minutes after surgery. After 30 minutes of laparoscopic surgery, patients who took ondansetron reported more nausea episodes. Conclusion:  Prophylactic dexamethasone 8 mg i.v. significantly reduced the incidence of PONV in patients undergoing laparoscopic surgery.

Background: In the 1970’s the introduction of Fine Need Aspiration Cytology (FNAC) proved to be the key method for examining the nature and malignant potential of many palpable lesions like thyroid, salivary glands and lymphadenopathies. Breast pathologies is one of the entity that can also be diagnosed with FNAC. Breast cancer is the most common malignancy of women with overall 100,000 cases being reported annually around the globe. The most frequent lesion encountered using FNAC in breast is fibro-adenoma followed by fibrocystic disease, breast abscess, chronic inflammatory conditions and suspicious malignant masses. In current cross sectional study we tried to find frequency of different breast lesions by FNAC. Methodology and Results: 649 samples were recruited from the Vital Laboratory Larkana with different pathological lesions of breast during the year 2014 and 2015 by non-probability consecutive sampling. 613 (95%) were females and 32 (5%) were male with mean age of 30.8±12.8 years. Majority of case were of 20-39 years of age (55.8%). Most of the cases were diagnosed with benign lesions (329, 51%) followed by inflammatory lesions (132, 20.5%) and gynecomastia (15, 2.3%). Right breast was more affected (329, 51%). In present study we found a strong association of diagnosis with gender (p =0.000) and age (p =0.000). Conclusion: So in this study it is concluded that large number of females with breast pathologies present with benign lesions like fibro-adenoma at the age of 20-39 years. It is also concluded that in this age group mastitis and abscesses are common due to different risk factors.