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Objective: To study the frequency of left ventricular diastolic dysfunction in patients with type 2 diabetes mellitus presenting to a tertiary care hospital. Study Design: Cross sectional study. Place and Duration of Study: Medicine Dept, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Mar to Aug 2022. Methodology: Fifty-one patients between the ages of 30 to 65 years were enrolled, belonging to either gender, presenting to outdoor department, with diagnosed type 2 diabetes mellitus for at least 1 year, on oral hypoglycemic drugs or insulin, and no underlying hypertensive cardiac pathology or diastolic dysfunction. These patients were further analyzed using statistical software based on their 2D echocardiogram findings. Results: Out of 51 type 2 diabetes mellitus patients, there were more males 32(62.7%) as compared to females 19(37.3%), with mean age of 52.25±8.09 years. We observed that 21(41.2%) patients did not have left ventricular diastolic dysfunction at the time of our study, but among these patients, 13(61.9%) had type 2 diabetes mellitus for 1-3 years while remaining 30(58.8%) patients had both type 2 diabetes mellitus and left ventricular diastolic dysfunction, with 13(25.5%) having grade-I, 10(19.6%) having grade-II and 7(13.7%) having grade-III categorization. Conclusion: There was an increased risk of left ventricular diastolic dysfunction in type 2 diabetes mellitus with longer duration of disease and higher HbA1c. Patients with type 2 diabetes mellitus to be followed up for diabetic control and monitored for the presence of asymptomatic left ventricular diastolic dysfunction with measures to be taken to prevent it. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of comorbid illnesses in fatal cases of COVID-19 in various hospitals of Rawalpindi/Islamabad during the first three months of pandemic in Pakistan. Study Design: Case series study. Place and Duration of Study: Combined Military Hospital Rawalpindi (CMH), Pak Emirates Military Hospital Rawalpindi (PEMH), Benazir Bhutto Hospital (BBH), Rawalpindi Institute of Urology (RIU) and Pakistan Institute of Medical Sciences Islamabad (PIMS), from 20th Feb 2020 to 19th May 2020. Methodology: A total of 51 adult fatal cases were studied retrospectively during the subject period. The patients were admitted in any of above mentioned hospitals for variable time during the study period. There were 35 males and 16 females. Patients' ages ranged from 24 to 90 years. The cases were studied for presence of various comorbid illnesses that could have aggravated the complications of COVID-19 and contributed towards mortality. Results: Out of 51 fatal cases 23/51 (45%) had Diabetes mellitus (DM), 18/51 (35%) had Hypertension, 12/51 (23%) Ischemic Heart Disease, 03/51 (06%) had Chronic Renal Failure and Cancer, 02/51 (4%) had Chronic Obstructive Pulmonary Diseases (COPD) and Tuberculosis (TB). Conclusion: Diabetes mellitus and cardiovascular illnesses were the commonest comorbid in patients who died of COVID-19 followed by Chronic Renal Diseases, Malignancy, Tuberculosis (TB) and Chronic Obstructive Pulmonary Diseases (COPD). [ABSTRACT FROM AUTHOR]

Crimean Congo Hemorrhagic Fever (CCHF) one of the fatal viral infections has been described in around 30 countries around the world and is endemic in some parts of Pakistan. The fever is transmitted to humans by the bite of an infected tick either by direct contact with the blood or tissue via infected humans and livestock. We present here case of a 34-year-old Pak defense services officer who reported with nonspecific symptoms of high grade fever, myalgias and vomiting but rapidly deteriorated and developed bleeding diathesis. He was diagnosed to have CCHF and managed with Ribavirin, repeated transfusions and IV fluids with strict nursing barrier and use of Personal Protective Equipment (PPE). The patient recovered well. [ABSTRACT FROM AUTHOR]

Objective: To look for the factors associated with outcomes in patients managed for invasive fungal infections at the Infectious Diseases Department of a Tertiary Care Hospital Study Design: Comparative cross-sectional study Place and Duration of Study: Department of Infectious Diseases, Pak Emirates Military Hospital, Rawalpindi Pakistan,from Apr 2021 to Sep 2022. Methodology: A total of 90 patients with a different types of invasive fungal infections diagnosed by consultant infectious diseases were recruited. First, they were given standard treatment for fungal infection; they were diagnosed as per guidelines. Then, they were followed up for one month to look for an outcome. Results: Out of 90 patients with invasive fungal infections included in the study, 62(68.8%) had a good outcome, while 28(31.2%) had a poor outcome. The mean age of the patients recruited in our study was 39.54±6.27 years. Of all the participants, 65(72.2%) patients were male, while 25(27.8%) were female. Statistical analysis revealed that poorly controlled diabetes, COVID-19 infection and HIV positive were statistically significantly associated with poor outcomes in our study participants (p-value<0.05). Conclusion: The Considerable number of patients with invasive fungal infections had a poor outcome in our study. The presence of poorly controlled diabetes, COVID-19 infection and being HIV positive were the factors associated with poor outcomes in our study participants. [ABSTRACT FROM AUTHOR]

Thyroid storm is caused by the excess of thyroid hormone; it is a rare as well as fatal condition. The most effective way to decrease the mortality and morbidity caused by this disease is to diagnose it as soon as possible. The presenting features comprise a multitude of non-specific symptoms such as high fever, tachycardia, heart failure, gastrointestinal upsets, delirium, and coma. We presented a unique incident of thyroid storm in a middle aged woman who was admitted for high fever, confusion and atrial fibrillation. Clinical diagnosis of thyroid storm was augmented by laboratory findings of hyperthyroidism. The patient was managed accordingly and she eventually recovered. [ABSTRACT FROM AUTHOR]

Introduction: Disorders of sexual differentiation (DSD) is the term used for neonates without a definite male or female phenotype. Previously, terms like "intersex" and "pseudohermaphroditism" were used for such individuals. However, DSD is the recommended terminology since 2006. According to a study, about 1 in 3000 children is born with ambiguous genitalia. True hermaphrodite or ovo-testicular disorder of sexual differentiation (OVO-DSD) is the rarest variety. The gonads in these individuals are asymmetric with bilateral ovarian and testicular tissue (in varying ratios), which may be separate or combined as ovo-testes. Karyotype varies from 46XX to 46XY to 46 XY/46 XX mosaicism. [ABSTRACT FROM AUTHOR]