Objective: To determine the frequency of elevated C-reactive protein in type 2 diabetics and to compare the levels of C-reactive protein between people with diabetes and non-diabetics nephropathy among the population of Rawalpindi, Pakistan. Methodology: This cross-sectional study Diabetic and Medical OPD of Fauji Foundation Hospital, Rawalpindi from January 2019 to July 2019. A total of 150 patients who had type 2 diabetes, aged between 35 to 60 years, irrespective of gender, were included. Blood samples were collected for blood sugar random, fasting, renal function test, WBC count, and C-reactive protein. Urine samples were collected for the measurement of 24-hour urinary proteins. The presence or absence of proteinuria was used to categorize patients into two groups. Group A consisted of 58 patients with type 2 diabetes who did not have nephropathy, and Group B consisted of 92 patients with type 2 diabetes who had nephropathy (proteinuria greater than 30 mg/dl in 24 hours). Results: The mean age in our study was 49.41+7.66. Ninety-two patients (61.3%) presented with diabetic nephropathy. CRP levels (> 8200 ng/ml) were raised in 50 (54.3%) patients of group B and 19 (32.8%) patients of group A. The difference was statistically significant (p-value 0.010). Conclusion: This study showed a higher prevalence of raised CRP in type 2 diabetics with nephropathy. This reinforces the idea that low-grade inflammation has an essential role in the inception and evolution of diabetic renal disease.

Introduction: In this changing paradigm of flipped classrooms, online learning is becoming center of focus. The spread of CoVID-19 pandemic has prompted medical institutions to quickly adopt online curriculum delivery to avoid any breaks. This transition seems to adequately serve the needs of medical education. As this new technology is rapidly being implemented, the students’ and teachers’ perspectives need to be evaluated to assess the outcome of these changes and to design effective strategies. Objectives: To assess the impact of online learning by recording experiences and attitudes of faculty members and students from two medical institutions. Materials & Methods: The study was conducted at SCM and FUMC, Islamabad. 275 3rd year MBBS students from both medical colleges along with 40 faculty members were enrolled after taking consent. Their perspectives were taken by a questionnaire. They were asked about familiarity of e-learning, its advantages, disadvantages, credibility of online assessments and whether e-learning should be part of future medical education. The data was analyzed using SPSS23. Results: 34 faculty members and 214 students from both institutes completed the questionnaire. Majority of the faculty members and students believed that e-learning can only serve as complementary role to traditional teaching. Conclusion: E-learning provided us the needed mode to continue delivering the course in the need of the hour. Both faculty and students deemed that online learning is not as proficient as face-to-face teaching however, hybrid model combining both modalities can achieve better results.

Pulmonary tuberculosis is one of the leading causes of infectious disease related mortality. Transbonchial biopsy and bronchoalveolar lavage smear obtained by bronchoscopy provides greater quantity of material for analysis, thus increases the chances of diagnosing the disease. Objectives: To diagnose sputum smear negative pulmonary tuberculosis patients by Transbronchial Biopsy and Bronchoalveolar smear keeping bronchoalvelar lavage culture as gold standard. To calculate and compare the diagnostic accuracy of transbronchial biopsy and bronchoalveolar lavage smear in sputum negative patients. Study Design: Cross-sectional validation study. Setting: Department of histopathology, Foundation University Medical College, Islamabad and Department of Pulmonology and Microbiology, Fauji Foundation Hospital, Rawalpindi. Period: From May 2016 to May 2017. Materials & Methods: It comprised 96 patients who underwent bronchoscopy. Transbronchial biopsy, bronchoalveolar lavage smear preparation and bronchoalveolar lavage culture was performed on specimens of all patients. Results: Out of 96 patients 22 (22.91%) patients were actually having tuberculosis whereas 74 (77%) had only clinical and radiological suspicion of tuberculosis. The mean age of patients was 43 years with a standard deviation of ±19.1 .The age range was 12-80 years. The sensitivity, specificity, positive predictive value, negative predictive value and true positives of transbronchial biopsy were 68.1%, 77%, 46.8%, 89% and15.62% while the values for bronchoalveolar lavage were 50%, 97.29%, 84.6%, 86.7% and 11.45% respectively. Thus, the diagnostic accuracy calculated for transbronchial biopsy and bronchoalveolar lavage was 75% and 13.54% respectively. Conclusions: Bronchoscopy should be done in all sputum negative tuberculosis patients having strong clinical and radiological suspicion to obtain transbronchial biopsy and bronchoalveolar lavage for timely diagnosis, treatment and prevention of disease transmission as well as to avoid empirical treatment and its side effects in patients having no tuberculosis. The diagnostic accuracy of transbronchial biopsy is almost 5 times more compared to bronchoalveolar lavage smear.

Objectives: To determine the frequency of immunohistochemical expression of CD10 and CA19.9 in patients with papillary urothelial carcinoma of the bladder in accordance with the WHO 2004 grading of the tumor. Methodology: This descriptive cross-sectional study was conducted at the Foundation University Medical College Islamabad, from October 2017 to October 2018. Seventy-five patients from both genders, aged 40 to 80 years, undergoing trans urethral resection of bladder tumors to diagnose papillary urothelial bladder were included in our study. The data were analyzed with SPSS version 17. Immunohistochemical processing was performed and the results were interpreted by the consultant pathologist for the expression of CD10 and CA19.9 on transitional cell carcinoma with respect to the 2004 grading of the tumor. Results: age range in this study was from 40 to 80 years with a mean age of 52.60 ± 7.60 years. Out of these 75 patients, 39 (52.0%) were male and 36 (48.0%) were female, with a male-to-female ratio of 1.1:1. The frequency of positive expression of CD10 and CA19.9 on immunohistochemistry in patients with papillary urothelial carcinoma of the bladder was found in 41 (54.67%) and 39 (52.0%) cases, respectively. It was seen that positive CD10 expression was found in 12 (31.58%) low grade tumors and in 24 (63.16%) high grade tumors. Positive CA19.9 expression was found in 29 (78.38%) low grade tumors and 15 (40.54%) high grade tumors. Conclusion:  The study concluded that there was a slightly increased expression of CD10 in transitional cell carcinoma of the urinary bladder compared with CA19.9. However, high-grade urothelial carcinomas showed increased expression of CD10 in contrast to low-grade urothelial carcinomas, which revealed increased positive expression of CA19.9.

Introduction: Galectin-3 has been reported quite accurate to detect or exclude malignancy in nodules with prior indeterminate Fine Needle Aspiration Cytology and per operative findings. Keeping this fact in mind, Galectin-3 can have a pivotal role in separating benign from the malignant thyroid neoplasms. We aim to determine the frequency and intensity of Galectin-3 immunohistochemical expression among benign and malignant thyroid neoplasms confirmed on histopathology. Materials and Methods: We studied 78 thyroid specimens diagnosed with thyroid neoplasms on histopathology. Out of these 39 were benign cases (follicular adenoma and hurthle cell adenoma) and 39 were malignant cases (papillary thyroid carcinomas, follicular carcinoma, medullary carcinoma and poorly differentiated carcinoma). Each specimen was examined grossly and microscopically and checked for immunohistochemical staining pattern of Galectin-3 under the microscope. Results: Age range in this study was from 15 to 65 years with mean age of 44.97 ± 10.78 years. Out of these 78 patients, 17 (21.79%) were male and 61 (78.21%) were female with male to female ratio of 1:3.6. Frequency of positive Galectin-3 immuno histochemical expression among thyroid neoplasms was found in 32 (41.03%) cases with Galectin-3 showing positive staining in 21 (53.85%) of all malignant and 11 (28.21%) of all benign cases .Among the malignant neoplasms, positivity was seen most frequently in papillary thyroid carcinomas as compared to the other malignancies. Conclusion: This study concluded that positive Galectin-3 immunohistochemical expression is more in malignant thyroid neoplasms (53.85%) as compare to the benign lesions (28.21%). Therefore, we recommend that this marker cannot be used alone for the routine diagnosis of malignant lesions as it has shown less sensitivity and specificity. Moreover it also has shown no significant role in differentiating between the benign and the malignant thyroid neoplasms.