Most multiple congenital abnormality syndromes associated with uveal colobomata have their origins dating from before intrauterine development. Causative genetic and chromosomal influences were reviewed (James, Karseras, and Wybar, 1974), but associated abnornalities of the sex chromosomes were not observed in their series and are a rare occurrence in the literature. It is of interest therefore to record uveal colobomata occurring in a patient with Klinefelter syndrome and to discuss the possible implications. This association has not been recorded in Britain previously. Material and methods CASE REPORTA z7-year-old White youth presented with concemr about the lack of development of his external genitalia. Bilateral iris colobomata had been noted at birth and he had attended an ophthalmologist from that time. He had been wearing contact lenses for three years.The parents were unrelated and there was no family history of ocular abnormality. Examination of both .. a l parents revealed normal eyes. The father and mother were both 45 years old at the time of his conception.There was one normal brother, three years older, and the mother had had a diagnostic x-ray of the pelvis luring the pregnancy of this child. uxillary hair was scanty and pubic hair had a female listribution (Fig. 3). There was a mild gynaecomastia

During pandemics, hospital administration does not allow family members to visit their loved ones. There is a need to develop standards and processes that may be followed when a family member enters an ICU or ward to prevent cross infection. These rules should also be put in place during epidemics to ensure that family have safe access to their patients.

Introduction: COVID-19 virus initiates an inflammatory response in the body involving many cytokines. Interluukin-6 (IL-6) is one of them, elevated levels of which found to be directly related to morbidity and mortality of infected patients. The aim of the current study was to evaluate the clinical benefits of Tocilizumab, a monoclonal antibody against interleukin-6 receptor, as a therapeutic agent for the treatment of Coronavirus disease 2019. Methods: The current retrospective study was conducted at Bahria Town International hospital from rom May 1st to 5th July 2020. Total of one twenty (n=120) moderate to severely ill patients (94 males and 26 females), infected with SARS-CoV-2 virus, were included to assess the effect of TOCILIZUMAB in improvement of PF ratio and other biochemical variables of prognostic importance, including CRP, serum ferritin levels, D-dimers and LDH. These parameters were compared before and after the ten days of treatment with tocilizumab. Demographic, laboratory and clinical finding were recorded for the feather analyses.  Statistical analysis was performed by using software SPSS version 21.0. The Wilcoxon signed‐rank test used to compare parameters whenever appropriate. A P‐value of less than .05 was considered statistically significant. Results: The results of our study showed statistically significant improvement in PF ratio and decrease in CRP levels. Other parameters such as D-Dimer, Serum ferritin levels and LDH showed no change before and after treatment with tocilizumab. Conclusion: In summary, TOCILIZUMAB improved the PF and CRP ratio in COVID-19 patients, but other markers did not improve in response to TOCILIZUMAB in critically ill COVID-19 patients.

Severe acute respiratory coronavirus 2 (SARS-CoV-2), COVID-19, caused a pandemic that took millions of lives worldwide. The main reason is a lack of preparedness and knowledge about the treatment options. With the advancement in the understanding of the SARS-CoV-2 virus, many treatment options have been analyzed that helped effectively to decrease the mortality caused by this virus. Vitamin C is known to boost immunity and slow down the progression of viral infection. The current study was designed to assess the effectiveness of a high dose of intravenous (IV) vitamin C in COVID-19 infection.  The clinical trial registered on 23/12/2020 at ClinicalTrials.gov (NCT04682574) was conducted in Bahria Town International Hospital, Lahore (BTIHL), Fatima Memorial Hospital, Lahore (FMH), and Evercare Hospital Lahore from 28/12/2020 to 10/4/2022. Two hundred seventy-eight critically ill patients with COVID-19 were categorized into two groups. One hundred thirty-nine patients were randomized in group VC (vitamin C), which was given a high dose (30 grams) of intravenous (IV) vitamin C for four days, whereas distilled water as a placebo was given to the control group (n=139) along with standard treatment protocols. All the patients were analyzed for primary outcomes in partial pressure of arterial oxygen (PaO2) to Fraction inspired oxygen (P/F) ratio and survival analysis. At the same time, levels of inflammatory and biochemical markers needed for intubation and length of hospital stay in both groups were compared as the study's secondary endpoint. Among the two groups, we did not find any differences in 28-day mortality (Log Rank P= 0.11). Similarly, no difference in the P/F ratio on the fourth day after the start of IV vitamin C treatment was noted (p=0.24). The median values of biochemical and inflammatory variables improved significantly in group VC on day 4. However, only hemoglobin levels remained non-significant between the groups. Mean days of hospital stay were slightly longer in group C. However, no statistical significance (p=0.941) was found. Although Group VC needed fewer intubations than Group C, results remained statistically insignificant (p= 0.273). This trial did not find any mortality benefit or improvement of the P/F ratio in critically ill patients. However, the VC group showed improvement in biochemical variables of prognostic importance, which seems to lower the chance of intubation and LOS in group VC. A further clinical trial with a large sample size is needed to reach the final conclusion.

Background: Since SARS CoV-2 infection began in China and has evolved into a pandemic, mortality associated with this illness has been under discussion and hypercoagubility, severe acute respiratory syndrome and septicemia with multiple organ insufficiency have been cursed as potential causes of death in cases infected with the novel coronavirus. We did a retrospective analysis of cases admitted to our highly dependent and intensive care unit, and we tried to identify the leading cause of death in our cases. Methods: This is a single center retrospective study carried out at Bahria International Hospital Lahore over a 3-month period (May 10th to July 10th 2020) in which we analyzed the clinical and biochemical profiles of the COVID-19 patients who died during this period. Results: A total of 108 patients were admitted during this period out of which 11 patients died. 7 of them were men and 4 women. Majority of them had sudden cardiac arrest due to acute coronary syndrome followed by multiorgan dysfunction syndrome and acute respiratory distress syndrome. Conclusion: Acute coronary syndrome due to hypercoagubility was the leading cause of death in our patients.