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Objective: To validate a clinical scoring system for defining the severity of ailment that will assist in developing strategies for management prioritisation. Study Design: Cross-sectional analytical study. Place and Duration of Study: Paediatric Department, Combined Military Hospital Lahore, Pakistan, form Jan 2020 to Jul 2021. Methodology: The paediatric patients who reported to the Medical Reception Centre and were admitted to an Inpatient Facility were enrolled. Demographic profile, temperature, oxygen saturation, pulse, respiratory rate, seizures, and sensorium labelled as "TOPRS" score was recorded with "0 - Normal" and "1 - Abnormal" and scores calculated for each patient with the incorporation of systemic inflammatory response and advanced paediatric life support criteria. Results: A total of 300 paediatric patients with an age range of 1-18 years (mean: 3.86±5.43) were included. Of 300 patients, 237(79%) were discharged after improvement, and the mortality rate was 63(21%). A significant association with the mortality rate was deciphered with temperature, oxygen saturation, and respiratory rate variables. In contrast, pulse rate, sensorium, and seizures were concluded to have an insignificant association. Score "0" mortality was associated with the 4.4% mortality, whereas score "5" enumerated an 80% death rate. Conclusion: The TOPRS clinical scoring system has significant value in the diagnosis of mortality and morbidity of paediatric patients and, hence, can assist in early recognition and triage of patients, consequently aiding in the provision of prioriti sation protocols and management in a befitting manner. [ABSTRACT FROM AUTHOR]

The population is increasing rapidly globally, and urban expansion of the cities has become an extensive trend in developing nations. Urban expansion patterns, such as transportation structure and road networks, affect transportation planning. This research was conducted on a mega project in Lahore city of Pakistan, i.e., the Lahore Ring Road (LRR) project. Limited research focused on the beneficiary assessment of the road project, and this research was carried out to fill this research gap. This research aims to evaluate the beneficiary assessment of DHA Phase 8 and Halloki Settlement along the Lahore Ring Road. The simple Random Sampling technique was used to conduct the household survey in the study area. This study concluded that most of the residents did not modify their houses nor increase the built-up area and height after the introduction of the project. This study inferred that the rental potential was high at some locations and low at old existing settlements. This research further concluded that community participation was ignored, and public facilities were not improved in the study area. But a project of LRR was very much beneficial and alive for the residents of Lahore city. Community participation should be enhanced in such types of megaprojects, and allied facilities in the nearby community should be upgraded. This research will be helpful for policymakers, urban planners, transportation planners, development authorities, and other stakeholders in planning future road projects in the country. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) caused by the novel coronavirus-infected millions globally. Despite a wide range of advised options for the treatment of COVID-19, a single strategy to tackle this pandemic remains elusive, thus far. That is why we are conducting a clinical trial to find out the efficacy of iodine complex to clear a viral load of severe respiratory syndrome coronavirus-2 (SARS-CoV-2) along with a reduction in time taken to alleviate symptoms.Method: The proposed study is a placebo-controlled, add-on, randomized trial using parallel group designs. This is a closed-label and adaptive with sample size reassessment, multi-centered design with a 1:1:1:1 allocation ratio and superiority framework. It will be conducted in Shaikh Zayed Post-Graduate Medical Complex, Ali Clinic, and Doctors Lounge, Lahore, Pakistan. This study will have three arms of mild to moderately symptomatic COVID-19 patients (50 patients in each) which will receive ionic-iodine polymer complex with 200 mg of elemental iodine: interventional arm A will have encapsulated, arm B will receive suspension syrup form, arm C will get throat spray, while arm X will be standard care with placebo. Data will be collected on self-constructed, close-ended questionnaires after obtaining written consent. Data will be analyzed using SAS version 9.4. COVID-19 patients will be monitored by RT-PCR and HRCT (high-resolution computed tomography) chest. In addition to these, the duration of the symptomatic phase and mortality benefits will be analyzed in both groups.Discussion: The study is designed to measure the superior efficacy of the iodine complex as an add-on in treating COVID-19-positive patients with mild to moderate symptoms. This combination is hypothesized to improve various parameters like rapid viral load reduction, clinical and radiological improvement, lower mortality, and reduction in hospitalization. The trial will aid in devising a better strategy to cope with COVID-19 in a relatively inexpensive and accessible way. The implications are global, and this could prove itself to be the most manageable intervention against COVID-19 especially for patients from limited-resource countries with deprived socioeconomic status.Trial Registration: ClinicalTrials.gov NCT04473261 . Registered on July 16, 2020. [ABSTRACT FROM AUTHOR]

Objective: To assess the predictors associated with mortality within 8 weeks in patients undergoing endoscopic N-butyl-2-cyanoacrylate treatment. Study Design: Prospective comparative study. Place and Duration of Study: Department of Gastroenterology, Services Institute of Medical Sciences, Lahore Pakistan, from Mar 2018 to Mar 2019. Methodology: A total of 106 patients of gastric variceal bleed were enrolled in the study. Tissue glue was injected into the varix endoscopically and mortality within 8 weeks after endoscopic intervention was noted. Results: Among the enrolled patients, 65 (61.3%) were male and 41(38.7%) were female. Mortality was noted in 19 (17.9%) patients within 8 weeks after endoscopic therapy. Chi-square analysis showed creatinine >1.5, Child Pugh score >9, MELD score >18, re-bleeding within 7 days, low blood pressure <90/60 at presentation and hepatic encephalopathy as significant predictors of mortality (p<0.005). Conclusion: Cirrhotic patients undergoing endoscopic injection of gastric varix with N-butyl 2-cyanoacrylate after gastric variceal bleed have high risk of death within 8 weeks. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of adjuvant Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) therapy in neonatal sepsis. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Lahore Pakistan, Mar 2019 to Mar 2020. Methodology: Thirty neonates (15 cases and 15 controls) were randomly selected for this study. The Interventional Group was given GM-CSF and standard-of-care treatment; the Control Group only received standard care. Both groups were followed for the primary outcome (i.e., discharge or death). Secondary outcomes included the effects of GM-CSF on haematological parameters of neonatal sepsis. Results: The mean gestational age of the children was 33.46±2.47 weeks. In the Interventional-Group, 56.7% of the neonates were discharged with the resolution of the sepsis. There was no significant difference concerning the secondary outcome, but the mortality was higher in the neonates among the Control-Group (p-value>0.05). Conclusion: Our study showed no difference in mortality between the Interventional and the Control Groups. The GM-CSF therapy could be used as an adjuvant therapy in neonates with neonatal sepsis to increase the total leukocyte and absolute neutrophil counts. Further studies are needed to holistically chart the clinical benefit of GM-CSF adjuvant therapy. [ABSTRACT FROM AUTHOR]