Aim: To assess the common clinical sign and symptoms in Patients of Thyrotoxicosis in Gujranwala, Pakistan. This study was conducted at the Civil Hospital and Salamat Hospital & Healthcare Center, Gujranwala from July 2019 to February 2020. Methods: This was a prospective study consisted of 120, male and female patients of different age groups, diagnosed with thyroid gland disorder. The Clinical features and history related to thyroid disorders was taken. Complete thyroid profile was checked in initial screening of Thyrotoxicosis.The bloodscreening for various thyroid hormonal levels,Thyroid imaging for the patients with neck swelling and clinically various thyroid function tests were done by using Radiation Imaging (Radiotracers) techniques. Aninformed consent of all patients was taken before tests and study. The data was recorded on designed Performa. Results: In this study the prevalence of Thyrotoxicosis patients was higher in females (78) than male (42) and majority of patients belonged to 31-50 years of age range. Various typical clinical sign and symptoms of Thyrotoxicosis like Goiter, sweating, heat intolerance, Hoarseness, Tremors, Diarrhoea, anxiety, hair loss, Menstrual irregularities in females, Exophthlmus, increased appetite and poly urea were observed in patients diagnosed with Thyrotoxicosis.While in blood screening, marked mean ±SD of BMI, free T3ng/dL, T4(ng/dL) and TSH(mlU/L) were found in male & female patients (table 2). Conclusion and practical implication: Thyroid casesare found high in our population. This high prevalence rate is affecting the health and quality of life of affected persons. So it is deeply felt that awareness to use dietary iodineand other remedies isa need of hour for our communities to decrease high prevalence of the thyroid dysfunctions and improve health and quality of life of the community. Keywords: Thyrotoxicosis, Radiotracers, Radiation Imaging Technique, Signs and Symptoms, TSH, T3 and T4, Prevalence.

Background: The Covid-19 pandemic has wreaked havoc throughout the world, with 150 million cases to date and over 3 million lives claimed worldwide. Aim: To explored the difference in levels of SaO2 of COVID-19 positive patients with and without COPD. Study design: Experimental Study. Methodology: From May2020 to 2021 patients admitted at Aziz Bhatti Shaheed hospital were included in this studies. COVID-19 was confirmed by RT-PCR.COPD was confirmed by using GOLD standard of diagnostic criteria. SaO2 was measured by using pulse oximeter and confirmed by blood samples measurement of SaO2. Statistical analysis: SPSS version 22 was used for data analysis. Paired sample t test was performed to evaluate the hypoxia levels between three pairs among the time distribution of 1st, 3rd, and 6th, day. Results: Levels of SaO2 were statistically significant between COVID-19 positive patients and COVID-19 positive patients with COPD. We calculated the levels of SaO2 at day1, 3rd, and 6th day and results were significant to show that COPD might be having some protective effect against hypoxia and that might be due to use of medications or adaptation of pulmonary cells. Conclusion: It was concluded that levels of SaO2 was significantly reduced in COVID-19 patients without COPD in comparison to patients without COPD. Keywords: COVID-19, COPD and SaO2.

Background: The Covid-19 pandemic has wreaked havoc throughout the world, with 150 million cases to date and over 3 million lives claimed worldwide. Aim: To explore the hypoxemia in COVID-19 patients in relation with genomic mutation and co-morbidities. Study Design: Experimental Study. Methodology: A total of 16 COVID-19 positive patients admitted to Aziz Bhatti hospital were included in this study. COVID-19 was confirm through nasopharyngeal swab specimen diluted in normal saline subsequent RT-PCR was performed as per the standard operating procedure. Genome sequencing and interpretation of analysis was done through Illumina MiSeq. Results: There was statistically significant difference (P < 0.05) in SaO2 in patients with N (Nucleocapisd) protein mutation compared with NSP13( Helicase) mutation. Conclusion: It was concluded that mutation of N (Nucleocapisd) protein causes more pronounced hypoxia compared with Helicase mutation of COVID-19 genome. Keywords: COVID-19, Hypoxia, Mutation and Genome.

Background: HIV treatment centres register HIV positive patients, specially trained doctors prescribe Antiretroviral Therapy to the selected cases that fulfill the criteria for initiation of HAART. Aim: To establish predictive markers of failure of 1st line ART in HIV positive patients on first line ART under treatment in HIV Treatment Centre of PIMS Islamabad. Study design: Retrospective case control study. Methodology: Retrospective case control study done at HIV Treatment Centre at PIMS Islamabad. Cases were patients who failed 1st line ART and started on second line ART from November 2005 to June 2020. Patients responding well to first line ART since more than five years or more were taken as controls. Various factors were analyzed in both groups and compared to find their level of significance. Data was analyzed by SPSS software, version 25 as qualitative variables were expressed as frequencies and percentages. Results: CD4 count of all 38 patients was below 300 on diagnosis. In 21 patients (55.3%) CD4 count initially increased but there was no rise in CD4 count in 17 patients (44.7%) after start of 1st line ART. Conclusion: We concluded that CD4 count is one of the most important predictive markers in success or failure of ART. Rising number of CD4 count on follow up visits gives a strong indication that patient is responding well to the prescribed treatment and is likely to benefit from the current regimen of ARVs for a longer period in future. Keywords: Predictive Markers, CD4 count, Viral Load, HIV, ART, Compliance and Co-morbidities

Background: First case of pandemic COVID-19 was diagnosed in December 2019 in China from where it spread throughout the world. In Pakistan, first case was diagnosed in February 2020 which resulted in a complete and several smart national lockdowns. National Command and Operation Center (NCOC) and Ministry of Health published guidelines for patient’s treatments during pandemic which includes: 1) providing only emergency Treatments 2) Patient’s pre-admittance Questioning, 3) Increasing intervals between appointment, 4) prevent crowding in waiting rooms, 5) Wearing masks at all times. 6) Wearing PPE. Methods: Data from all clinical departments of Frontier Medical and Dental College and Hospital Abbottabad was collected between March and December 2020 which included Number of; 1) Patients treated 2) Medical Staff 3) patients with positive COVID-19 reports 4) healthcare workers suffering from COVID-19. And 6) Post treatment Virus Infected patients. Results: 291 health care staff including 135 medical and dental doctors, 4 dental hygienists, 82 paramedics and 70 Administrative staff worked during the study period and 3280 procedures were performed. Out of these, thirty-eight (38) staff members treated 190 verified COVID-19 patients. During the study period 6 dentists (2.06%) and 9 (3.09%) medical doctors, 2 (0.7%) assistants and 3 (1.03%) admin staff were tested positive for the virus. Conclusion: Present study highlights the importance of education and stickiness to the infection control guidelines thus minimizing the risk of transmission of corona virus among the Healthcare professionals in hospitals. Keywords: COVID-19; Infection control, PPE, NCOC