Aim: To evaluate the perception of educational environment of post-graduate residents in teaching hospitals of Pakistan. Methodology: This cross-sectional descriptive study was conducted in four tertiary care hospitals in Pakistan from January 2020 to November 2020.The Post-graduate Hospital Education Environment Measure (PHEEM) inventory (40 items on a 0-4 Likert scale) was distributed among 195 post-graduate residents of multiple specialties by convenience non-probability sampling technique. Response was recorded into three subscales which included perception of teaching, role of autonomy and social support. The total score of these three domains had a combined maximum and minimum of 160 and 0, respectively. Results: Cumulative mean score obtained in our study showed a total score of 23.69 ± 16.247 / 56 for the theme: Perception of Role of autonomy, 24.17 ± 16.928 / 60 for Perception of Teaching and 19.35 ± 13.224 / 44 for Perception of Social Support. Conclusion: There are no drastic flaws in the post-graduate medical education residency-training program currently running in Pakistan. However, there is need for further improvement in teaching attitude of instructors and the need to eradicate discriminatory behavior felt by the post-graduate residents in certain circumstances. Keywords: Perception, Educational environment, Postgraduate Residents, Pakistan

Aim: To access the prevalence and investigate the contributing risk factors of myopia in M.B.B.S students impacted by medical school lifestyle practices Methodology: A cross-sectional study was conducted for a period of two months between September and October of 2020, among the students of Services Institute of Medical Sciences, Lahore, Pakistan. Data was collected by using questionnaires from medical students. IRB approval was granted. Descriptive analysis was done using the research tool SPSS 25. Results: Out of 110 medical students, majority were male and 83.6% were myopic. Off which, 56.4% had a refractive error less than -3.00 D, 22.7% had a refractive error between -3.00 D to -6.00 D and 1.8% above -6.00 D. About 61.8% students had the onset of myopia in their adult age, while 23.6% since childhood. 54 students have a myopic familial history. Students spent most of their time doing near work like studying with 58.2% students reported use of digital devices (also at night). Most of the students wear prescription glasses, with 67.3% use it while writing. About 73.6% students do not take rest after doing work. About 70% students do not do any hourly outdoor exercise. Only 12.7 % of the students have an intake of vitamin A supplements. 97 % students do not have any history of ocular trauma, ocular surgery and laser treatment. Conclusion: Proper measures need to be taken by health authorities and medical college’s student affairs department to guide the students on how to improve heathy eye hygiene and routines. Regular ocular checkups should also be encouraged. It is recommended for students to study in good light, take proper rest, reduce their nutritional deficiencies and most importantly limit their screen time, especially at night. Health education programmers and medical education policy makers should be involved to ensure the implementation of frameworks that facilitate the control of risk factors of myopia amongst medical students. Keywords: Medical students, Myopia, Near work, Screen time.

Aim: To determine the viral load in the patients admitted in Covid-19 isolation and its correlation with the inflammatory markers and the following clinical outcome. Methodology: A retrospective study was conducted in the Pathology Department of Doctors Hospital and Medical Centre in Lahore, Pakistan from November 2020 to January 2021. IRB approval was granted. A total of 86 patients met the inclusion criteria for the study. Data was analyzed using research tool SPSS 24. Results: Increased serum viral load in SARS-CoV-2 infection showed positive correlation with inflammatory markers IL-6 (P =0.04) and D-dimer (P =0.029). Inflammatory markers LDH, Ferritin, Procalcitonin, D-Dimers and viral load itself (CT) all correlated with higher mortality while IL-6 did not. Conclusion: Serum viral load in patients infected with SARS-CoV-2 correlates with higher mortality rates itself and also raises certain inflammatory markers (IL-6, D-Dimers), which are independently accountable for causing higher mortality as well. Hence, increased inflammatory markers resulted in poor prognosis regardless of high or low viral load. Their correlation with mortality can still serve as prognostic indicators. Keywords: viral load, inflammatory markers, Covid-19, mortality

Around the globe, hypertension is a silent pandemic. After diabetic retinopathies, hypertensive retinal vascular diseases are one of the most prevalent. In Pakistan, diagnostic investigations due to their cost are not done on regular screening basis as the financial burden of management is a point at issue. Thus, such conditions can often go undetected or therapeutically compromised. Here is a case of unilateral ischemic branch retinal vein occlusion in a 48-year-old male with a history of uncontrolled hypertension and diabetes. Additional laboratory investigations were carried out including complete lipid profile, serum urea and creatinine levels. Fundus fluorescein angiography and optical coherence tomography was done. The patient was managed on anti-VEGF injections and Argon Laser. Follow-up along with a multi-disciplinary management approach is essential for the best possible prognosis. Keywords: hypertension, central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO)

Fibroid is a benign lump of growth, occurring within or outside the uterus. It is a rarity for such growths to occur intra-abdominally. Such cases are of aggressive fibromatosis which are marked by the presence of desmoid tumours. It is most commonly seen in patients with a history of familial adenomatous polyposis (FAP) or past surgical procedures. As FAP has a wide fibroepithelial growth spectrum, the symptomatology and therefore the prognosis varies. Unpredictable clinical behaviour, varied location and non-specific presentation are the factors accounting to diagnostic difficulty. Therefore, misdiagnosing the disease is not uncommon. Here we report a case ofa26-year-old pregnant female presenting with lower abdominal pain and mass. Preoperative diagnosis was of uterine fibroids as per radiological evidence, but on exploration it turned out to be a large right colonic mass. The patient underwent right hemicolectomy. Histopathological reports confirmed morphological and immuno-histochemical features indicating fibromatosis. This fibromatous mass though intra-abdominal was not growing from the mesentery/mesocolon or the pelvis. It appeared to grow from the wall of the colon. This is a confirmatory presentation of true colonic wall fibromatosis which is deep and isolated form of intra-abdominal desmoid tumours. As this lesion was isolated in nature, the treatment of choice was surgical resection. It is essential to have a multi-disciplinary team approach in the management of such a patient. This improves the treatment and the prognostic outcomes. Keywords: Fibroid, Colon, Fibromatosis, Hemicolectomy, Desmoid Tumour