Medicine Publications (BUCM-IC)

Assessiing Endobronchiiall Washiing Mycobactteriium Tubercullosiis Gene Xpertt''s Rolle iin Diiagnosiing Pullmonary Tubercullosiis iin Sputtum Smear Negattiive Pattiientts

2026-03-09T03:20:26Z

Assessiing Endobronchiiall Washiing Mycobactteriium Tubercullosiis Gene Xpertt''s Rolle iin Diiagnosiing Pullmonary Tubercullosiis iin Sputtum Smear Negattiive Pattiientts Muhammad Amir, Muhammad Iqbal, Ehsan Elahi, Muhammad Faraz, Owais Amjad Janjua,Muhammad Faizan Objective: To see diagnostic accuracy of GeneXpert MTB in diagnosing pulmonary tuberculosis in sputum smear negative patients. Study Design: Cross-sectional Study. Place and Duration of Study: Department of Pulmonology, Pakistan Emirates Military Hospital Rawalpindi, Pakistan from May to Oct 2024. Methodology: Patients having at least any of two clinical criteria and at least one radiological finding suspected of TB and were included. The clinical criteria comprised of intermittent fever or persistent cough for greater than 3 weeks, drenching night sweats for more than 2 weeks, HIV positive patients, weight loss greater 5% of body weight, and haemoptysis. The radiological criteria included cavitatory lesions, consolidation, pleural effusion or hilar adenopathy on chest radiographs. After initial history and investigations, all patients went through fiber optic bronchoscopy. The Lowenstein Jensen (LJ) medium was used for sample inoculation and incubated for 8 weeks. The GeneXpert MTB samples were processed as per manufacturer's specifications. Results: In this study, one hundred and twenty-two (n=122) patients median age of 46.00(28.75-59.25) years were included. The cough 95(77.87%), fever 79(64.75%) and weight loss 74(60.66%) were common symptoms respectively. The upper lung zone 84(68.85%) and middle lung zone 12(9.84%) were commonly involved. The GeneXpert MTB was reported high positive in 41(33.61%) patients. The GeneXpert MTB was found to be 92.64% sensitive, 85.71% specific and 90.98% accurate. The positive predictive and negative predictive values were 91.30% and 90.56% respectively. Conclusion: GeneXpert MTB is a reliable tool to test smear-negative patients suspected of tuberculosis. Prof Dr Muhammad Amir, Medicine, BUCM

A comprehensive narrative review on precision medicine approach to hypertension: exploring the role of genetics, epigenetics, microbiome, and artificial intelligence

2025-12-30T07:20:25Z

A comprehensive narrative review on precision medicine approach to hypertension: exploring the role of genetics, epigenetics, microbiome, and artificial intelligence Nisar, Shazia; Abdul Sami, Rizwan Ashraf, Zille Huma Mustehsan, Muhammad Ahsan Javed, Dilber Uzun Ozsahin and Yasir Waheed Background Hypertension (HTN) impacts approximately 1.28 billion individuals globally and poses a great burden of disease. The objectives of this study are to explore the role of genetics, epigenetics, microbiome, and artificial intelligence (AI) in the management of HTN. A thorough literature search was conducted across various databases including PubMed, Google Scholar, Web of Science (WoS), and Medline to retrieve articles related to the role of genetics, epigenetics, microbiome, and AI in the precision medicine of HTN. Genes—including ACE, NOS3, ADD1, CYP11B2, NPPA, and NPPB—have a profound impact on blood pressure (BP) regulation in our body and polymorphism in these key genes can lead to HTN. Up or down-regulation of genes by epigenetic factors such as miRNA-155, miRNA-210, and miRNA-122 can significantly contribute to the development of HTN. These genetic and epigenetic factors can also be used as specific targets for gene editing and gene therapy for long-term management of HTN. However, the implementation of these techniques has not been possible in clinical settings due to lack of human studies and safety concerns related to unpredictable DNA alterations, nucleotide deletions, and loss of allelespecific chromosomes. Modulation of gut microbiome through oral supplements, fecal microbiota transplant (FMT), and dietary interventions has emerged as one the most effective and safe techniques for managing HTN in human models. AI-based cutting-edge models have helped curate personalized diet plans based on an individual’s unique microbiome, genomic information, and physiological conditions leading to a reduction in BMI, fat, BP, and heart rate while improving overall cardiac health and gut microbial diversity. Despite the significant advantages offered by AI-based medicine, ethical concerns—related to data privacy, bias, and discrimination—and ineffective models have led to limited integration of AI in precision medicine of HTN. The integration of genetics, epigenetics, microbiome, and AI-based models can play a key role in improving the current landscape of precision medicine of HTN. These cutting-edge techniques can lead to a shift from the current one-size-fits all approach to more personalized treatment plan however further research in human models is needed to determine the safety and true efficacy of these techniques. Additionally, new AI-models need to be developed that address ethical concerns and are effective in real-world clinical settings. Senior Professor Medicine BUCM

Diagnostic Accuracy of Pleural Fluid Cholesterol Levels in Differentiating Between Exudative and Transudative Pleural Effusions

2026-01-26T06:35:08Z

Diagnostic Accuracy of Pleural Fluid Cholesterol Levels in Differentiating Between Exudative and Transudative Pleural Effusions Najmush Shakireen, Muhammad Amir, Abdul Rehman Arshad, Sadia Gul, Javeria Wazir, Zia ul Arifeen Objective: To determine the utility of pleural fluid cholesterol levels in differentiating between exudative and transudative pleural effusions. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Pulmonology, Combined Military Hospital, Peshawar Pakistan, from Sep to Dec 2021. Methodology: All patients aged less than 18 years, with pleural effusion confirmed on chest ultrasound, were included in our study. Patients with International Normalized Ratio >1.5, patients who were already under treatment for pleural effusion, patients on diuretics for more than 48 hours and patients not willing to participate in the study, were excluded. Light’s Criteria was used to label effusions as either exudates or transudates. Pleural fluid cholesterol ≥1.2mmol/L was considered as exudate. Results: Our study included a total of 78 patients, aged 52±21.27 years. Majority 63(80.7%) were males and most 51(65.4%) patients had exudative pleural effusion, while 27(34.6%) had transudative pleural effusion, as per Light’s Criteria. Out of 51 patients with exudative pleural effusion by Light’s Criteria, 41 had exudative pleural effusion on the basis of fluid cholesterol levels where mean pleural fluid cholesterol levels were 2.0±0.93 mmol/L and 1.04±2.32 mmol/L in exudative and transudative pleural effusions, respectively (p=0.01). Pleural fluid cholesterol levels of more than 1.2mmol/L had a diagnostic accuracy of 82%, sensitivity of 80% and specificity of 93% while the Positive Predictive Value was 95% and the Negative Predictive Value was 71%. Conclusion: Pleural fluid cholesterol levels of more than 1.2mmol/L can reliably differentiate between exudative and transudative pleural effusions. Prof Dr Muhammad Amir, Medicine, BUCM

Comparison of Frequency of Pathogenic Micro-Organisms Causing BloodstreamInfections in Patients Admitted at Tertiary Care Hospital Rawalpindi

2026-01-01T03:48:39Z

Comparison of Frequency of Pathogenic Micro-Organisms Causing BloodstreamInfections in Patients Admitted at Tertiary Care Hospital Rawalpindi Shazia Nisar, Saeed Shafait, Kinza Nawabi, Hassan Riaz, Ayesha Masood and Mehtab Ahmed Blood Stream Infections (BSI) are frequently occurring thing in hospital setting and if not tested and appropriate medicine not used, it has signicant mortality and also adds an extra burden on health care. Objective: To nd the frequency of various pathogenic micro-organisms causing bloodstream infections. Methods:Cross-sectional study was done in tertiary Care Hospital Rawalpindi from April 23 to August 23. Blood samples of 50 patients from two age groups were collected (n=25 above 60 years and n=25 ages 30-60 years). Blood samples were drawn into glass vial containing 20% EDTA to prevent blood clotting and then culture studies were performed. Results:Mean participant age in both study groups was 75.76 ± 8.9 and 46.88 ± 7.7 years (p<0.001). Blood culture analysis revealed that 42 isolates of Staphylococcus aureuswas present in >60 years of patients and 55 isolates of Staphylococcus aureuswere present in 30-60 years age group. 255 isolates of Escherichia coli.was present in >60 years' patients and 312 isolates of Escherichia coliwere present in 30-60 years' age group. 9 isolates of Klebsiellawas present in >60 years patients and 05 isolates ofKlebsiellawere present in 30-60 years age group years. Conclusions:Studyshowedthatsignicantnumberofmicroorganismwerepresentin collected blood culture samples. Among various strains of microorganisms, most common is Escherichia coli. Followed by Staphylococcus aureus. Study also highlights that BSI is a frequent occurring problem in hospital setting and if proper antibiotic administered, early cure can be achieved. Senior Prof Dr Shazia Nisar Medicine BUCM