PAKISTAN MEDICAL RESEARCH CENTER (PMRC)
Dr. Iffat Shabbir, MBBS. M. Phil Officer Incharge.

Brief History and Introduction

PMRC TB Research Center, Mayo Hospital Lahore was established as a Research unit in 1974 under the auspices of Pakistan Medical Research Council, Islamabad. The center is located adjacent to department of chest diseases King Edward Medical University, Mayo Hospital, Lahore. Center has well equipped research laboratory and qualified staff for doing microscopy, culture and drug susceptibility for mycobacterium tuberculosis and its other strains. This center is only of its kind, which is regularly monitoring anti TB drug susceptibility pattern and publishing its results since more than 30 years. TB Chest, Medical, Surgical, Pediatrics, Cardiology, Urology, Orthopaedics and other wards of King Edward Medical University, Lahore get facilitated form this center.

Income Generation Programme inducted with the approval of BOG in 1999 to meet the financial constraints of the center. Now at large we are meeting our running expenses. Keeping in view the financial position of poor TB patients charges are made only from limited 15% affording private patients of consultants, 85% of TB patients are not in the position to pay charges, they are also treated free in the hospital. All TB patients of DOT are provided free diagnostic facility at the center.

Faculty List

S.NO. Name Designation Qualifications.
1. Dr. Iffat Shabbir Officer in charge MBBS, M.Phil.
2. Dr. Nazir Mirza SMO MBBS
3. Dr. Rizwan Iqbal SMO MBBS

Collaboration with National TB Control Programme.

PMRC TB RESEARCH CENTER has established collaboration with National TB Control Programme and has been declared provincial referral laboratory for the training of technicians in DOT Programme and providing microscopy, culture and TB drug monitoring facilities for TB patients of Punjab. So far many batches of technicians (each having eight technicians) from different districts of Punjab have been trained. Staff of TB research center has also been trained for this purpose at National TB Center, Rawalpindi. National TB Control Programme has provided three binocular microscopes for this purpose.

Objectives

1. To provide full support by training technicians from various districts of Punjab in TB DOT Programme.

2. To identify the resistant cases of TB and thus helping in DOT program to provide the appropriate medication.

3. To promote basic diagnostic research techniques by educating and training the postgraduate medical students and paramedics of Punjab in the field of tuberculosis.

4. To establish comprehensive working with collaboration of local, medical institutions and hospitals on various aspects of pulmonary and extra pulmonary tuberculosis.

5. To develop new research methodology under recent medical knowledge and advance techniques, efforts to introduce and implement these techniques in control and eradication of tuberculosis.

6. To conduct regular monitoring of TB drug resistance figures, which help the clinicians in treating TB patients.

7. To provide supervision and technical skill in the field of tuberculosis bacteriology to adjoining centers government chest clinic and independent bodies involved in the process of control and eradication of tuberculosis.

Research projects from K.E.M.U, Lahore.

Research projects are invited from all departments of King Edward Medical University and we help them to get funds for these projects from Pakistan Medical Research Council, Islamabad.

Research Facilities & Linkages

The center is affiliated to the Postgraduate Medical Institute, Centre of Excellence in Molecular Biology (CEMB) and University of Punjab, Lahore for providing all facilities of training to postgraduate students of these Institutions.

Hameed Latif Hospital, Shalimar Hospital, Lahore General Hospital, Lady Willingdon Hospital, Lady Atchison Hospital, and various other hospitals inside and outside Lahore also send their specimens for screening of TB patients to this center. It also has the referral TB diagnostic facility for Microscopy, culture, Identification and determining the anti TB drug susceptibility patterns.

Research Core Group

In collaboration with Provincial TB control program research core group has been established to develop research proposals, which will help to control TB in Punjab.

Research Priorities

1. Regular monitoring and updating the pattern of TB drug resistance.

2. To know the figures of the multi drug resistance tuberculosis.

3. To establish close collaboration with other departments doing health related research.

4. To work in more close collaboration with National TB Control Programme thus contributing in the eradication of tuberculosis from the country.

5. To induct infectious diseases surveillance programme in our center.

6. To train microscopists from all districts of Punjab in DOT Programme.

Number of research publications:

(During the last 5 years)

1. TB drug resistance; An emerging challenge (Editorial) PJMR vol.38 (4); 1999:p.134-135

2. Value of AFB smear microscopy in the diagnosis of pulmonary Tuberculosis; Medical Forum, Vol.11 (6); June 2000.P4-6.

3. Screening of AFB in sputum by concentration or direct smear method, PJMR, Vol.39 (1), 2000:p.35-36

4. Extra pulmonary tuberculosis (Editorial) PJMR, Vol. (4); 2000: P.134.

5. Extra pulmonary tuberculosis. An analysis of 2211 cases at PMRC TB Research Centre, Lahore. Pak. Jr. of Chest Medicine, Vol.7 (1); 20001:p.27-32.

6. Colonization of Candida albicans in pregnant women. (PJMR) Vol.40, No.1, 2001.p.24-26.

7. Trends in Multi Drug Resistant Tuberculosis. Pak. Jr. of Chest Med., Vol.7, No.3, and July-Sept.2001: p.21-28.

8. TB Case Management by Doctors in District Rajanpur. PJMR Vol.40, No.2, 2001.p.64-68.

9. Facts about Anthrax. Editorial PJMR.Vol.40, No.4, 2001.p.106.

10. Sensitivity Pattern of Mycobacterium Tuberculosis at Lahore (Pakistan). Annals of King Edward Medical College, Lahore Vol. 8,No.3, Jul-Sep 2002.p.190-193.

11. Viral Hemorrhagic Fevers. (Review Article). PJMR Vol.41, No.3, 2002.P.130-133.

12. TB Drug Resistance An Alarming Challenge – Answer Dots. PJMR Vol. 42, No. 3, 2003.

13. Severe Acute Respiratory Syndrome. (Editorial). Accepted for Publication in of PJMR.

14. TB Drug Resistance An Update. Pakistan Journal of Chest Medicine. Vol.10, No.2, 2004,P.15-17.

15. Is Drug Resistance in Tuberculosis On The Increase In Pakistan? A Follow Up Study. (Paper Accepted for publication in International Journal of Tuberculosis And Lung Diseases.)

16. Non-Compliance To Treatment In Tuberculosis Patients. Pakistan Journal Of Chest Medicine. Vol.10, No.3 July-September, 2004,P.31-34.

17. Clinico epidemiological profile of one hundred AFB smears positive cases of pulmonary TB. Pakistan journal of chest medicine. Vol. 11, No.4, Oct- Dec 2005. p. 29-33.

18. Pattern of Drug Resistance in Tuberculosis. Pak J Med Res. Vol. 44, No. 4, 2005. p. 136-139.

Completed research studies

1. Value of ABF smears microscopy in the diagnosis of pulmonary tuberculosis. Screening of AFB in sputum of direct smear and concentration method.

2. An analysis of 2211 cases of extra pulmonary tuberculosis at PMRC TB Research Center.

3. Trends in Multi drugs resistance tuberculosis study based on 228 cases.

4. Colonization of Candida albicans in the women of childbearing age.

5. Study of anti tuberculosis Drugs Sensitivity pattern in separate form of drug and in fixed combination form (500 case study completed).

6. Study based on 240 cases showing the anti tuberculosis drug resistance pattern for the year 2999 completed.

7. Study based on 678 cases showing AFB culture positive were subjected to anti tuberculosis drug resistance pattern for the year 2000 to 2002 completed.

8. Capacity development for heath research in Pakistan evaluating a decade of efforts.

9. EMRO / TDR sponsored Health Research System Development and mapping of health research in Pakistan.

On Going Research Studies: (Future Strategy)

1. “Transferred out and their treatment outcome; the contribution in treatment success and testing a better strategy for surveillance in Punjab. Project being funded and approved by WHO.

2. Monitoring of Anti TB Drug resistance pattern 1000 case study.

3. Radiological diagnosis of smears positive pulmonary tuberculosis 300 case studies.

4. Development of PCR-SS CP for the detection of mutation in Isoniazid resistant mycobacterium study in collaboration with CEMB.

Number and list of submitted research studies.

1. ‘Study of Anti tuberculosis drug sensitivity pattern in separate form of drug and in fixed combination form’ (500 case study). Submitted to APUD Islamabad, March 1999.

2. ‘Need for Rapid Assessment of Antibiotic Susceptibility Testing by using Luciferase Reporter Phage and the Bronx Box’ submitted to: WHO (TDR) Geneva Switzerland dated: 30-101999.

3. ‘Rapid Culture and Drug Susceptibility Method to make TB Control measures effective’ Submitted to:-INFO: Research Grants WHO Geneva, Switzerland, dated: 21-06-2000.

4. ‘Rapid Tuberculosis Assessment of Antibiotic Susceptibility Testing by BACTEC 460 Radiometric system’ Submitted to: - WHO (TDR) Geneva Switzerland. Dated: 20-11-2000.

5. ‘Rapid Tuberculosis diagnosis and Assessment of Drug Susceptibility Testing by BACTEC 460 Radiometric System’ submitted: - tbnet INFO Research Grants. Rock Fellar foundation dated: 31-01-2001.

6. Research proposals entitled WHO/TDR TB specimen bank site description submitted to WHO on 07-08-2002.

7. Comprehensive research proposal entitled “Hospital based data collection analysis and follow up of TB patients in Lahore” submitted to EMRO special grant for research in priority areas of public health dated: 26-06-2003.

8. “ TRANSFERRED OUT ,, As Treatment Outcome: The Contribution to Treatment Success and Testing A Better Strategy For Surveillance In Punjab.

9. (Project Approved and work underway.)

10. Rescreening of TB suspects at referral laboratory who were declared microscopy

11. Negative at district laboratory, hence to improve sputum smear positivity rate and to achieve better TB control measures. EMRO TDR GRANTS, WHO. February 2005.

12. To study the first and second line of Anti TB drug resistance pattern in treatment failure cases. Thus to establish Invitro susceptibility pattern of second line of anti TB drugs in multiple drug resistant cases. Submitted to Ministry of Health Pakistan through PMRC Islamabad. 25- 05-2005.

13. Screening for latent tuberculosis with commitment to control the disease. Submitted to EMRO WHO through NTP IN February 2006.

Services

• Microscopy of mycobacterium by concentration method.
• Pulmonary and extra pulmonary culture of mycobacterium on LJ Medium.
• Drug sensitivity of TB culture by standard proportion method.

Key aim of our center.

Our main aim is to get PMRC TB Research Center recognized as W.H.O. Referral center on TB which will be the first and only of its kind in Pakistan. All our efforts are focused in this direction Dr. Salman H. Siddiqi presently Becton. Dickenson. Fellow in USA and our Honorary Technical Advisor is providing all the technical expertise and guidance to achieve this prestigious goal.