DR. Rizwan Iqbal MBBS Officer In charge PMRC TB Research Centre KEMU/Mayo Hospital, Lahore

Brief History and Introduction

PMRC TB Research Centre, Mayo Hospital, King Edward Medical University, Lahore was established in 1973. At present it has well equipped research laboratory with latest equipment provided by National TB Control Program (NTP). The centre has qualified staff for laboratory diagnosis of Mycobacterium tuberculosis, which includes microscopy, culture, and drug susceptibility testing for first line as well as second line of anti tubercular drugs. Almost all the departments of Mayo hospital are utilizing diagnostic facilities of PMRC centre on regular basis. About 95% of TB patients are provided free diagnostic facilities.

The centre is working in close collaboration with National and Provincial TB Control Program, providing microscopy facility to patients enrolled under DOTs program. Around 50 patients visit TB centre each day to get their tests done. The centre is also working for NTP AS “National Referral Laboratory for monitoring Drug Resistance in anti TB drugs”.

The centre has recently been renovated and equipped to cater the growing needs in this field of research. Apart from working on first line anti TB drugs since its establishment now centre has started to work on second line of anti TB drugs.

Faculty List

Name Designation Qualifications
1. Prof. Dr. Muhammad Zafar Ullah Khan. VC./Honorary Director.
2. Dr. Rizwan Iqbal, Officer In charge MBBS.
3. Muhammad Kashif Munir, Research Officer M Sc Microbiology.

Objectives

To identify the resistant cases of TB in DOT Programme.

Collaborative research on various aspects of pulmonary and extra pulmonary tuberculosis especially at molecular level.

Training technicians, under and postgraduate medical students and paramedical staff of Punjab in TB DOTS Programme.

To provide technical skill and supervise adjoining centre’s, government chest clinics and independent bodies involved in the process of control and eradication of tuberculosis.

To train microscopists of DOTS programme from various districts of Punjab.

Research priorities

Regular monitoring and updating the pattern of first and second line anti TB drug resistance.

To work at molecular level in the field of tuberculosis.

Collaborative research with national and provincial TB control programme.

Mycobacteriology Laboratory

The centre is fully equipped with most updated equipment such as biological safety cabinet (Class 11 B), incubator (Germany make), inspissator (UK make) international centrifuge (Germany make), PH meter, table top (UK make), oven (Hot Air) (Germany make), Analytical Balance (Germany make), Pipetting Syringes (Germany make) and Slide Drawing Plate (Spain make) being donated by National TB Control Programme, Islamabad. Now we can perform microscopy, isolation, identification and culture sensitivity of M. tuberculosis isolates more efficiently. In addition all facility is in use to determine multi and multiple drug resistance among the isolated strains of M. tuberculosis. This facility is extended to all institutes, hospitals and private sector institutes.

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 centre 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 Wallington 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.

Number of Research Publications (During the last 5 years)

1. Munir M K., Shabbir I., Iqbal R., Khan S U. Comparison of detection of acid fast bacilli in clinical samples by AFB smear microscopy and culture in the diagnosis of tuberculosis in tertiary care settings. Pak. J Chest Med 15. (4). 14-18, 2009.

2. Iqbal R, Shabbir I. World Asthama Day. Editorial. Pak. Jour. of Medical & Health Sciences, Vol.1 No.1; 1, 2009.

3. Munir MK, Shabbir I, Iqbal R, Comparison of AFB Smear Microscopy and Culture from Specimens Received for Diagnosis of Extra Pulmonary Tuberculosis: Pak. Jour. of Medical & Health Sciences, Vol.1 No.1; 59-61, 2009.

4. Munir MK, Shabbir I, Iqbal R, Khan SU. Diagnosis of extra pulmonary
tuberculosis: Conventional versus newer methods. Pakistan Journal
of Chest Medicine 2009; 15: No. 1: 11-14.

5. Shabbir I, Iqbal R, Qadeer E. Screening of tuberculosis in
Kharal Abbasian Azad Kashmir. Pak J Med Res 2009; 48: 1-3

6. Iqbal R, Shabbir I, Khan SU, Saleem S, Munir K. Multidrug resistance tuberculosis in Lahore. Pakistan J Med Res 2008; 47: 22-25.

7. Saleem S, Shabbir I, Iqbal R. Value of three sputum smears microscopy in diagnosis of pulmonary tuberculosis. Pakistan J Med Res 2007; 46: 94-97.

8. Shabbir I, Iqbal R, Chaudhary A. New strategy for transferred out patients to have better treatment outcome. ( Paper accepted for publication in Eastern Mediterranean Journal )

9. Shabbir I, Iqbal R, Khan SU. Analysis and correlation of sputum smear and X-Ray results in pulmonary tuberculosis patient admitted in Tertiary Care Hospital. Pakistan J Med Res 2007; 46: 67-69.

10. Iqbal R, Shabbir I, Tabassum MN. Extra pulmonary tuberculosis: An experience at Mayo Hospital Lahore. Pakistan J Med Res 2006; 45: 93-95.

11. Iqbal R, Information on Bird flu. Pakistan J Med Res 2006; 45: 1.

12. Iqbal R, Shabbir I, Khan SU. Patteren of drug resistance in tuberculosis. Pakistan J Med Res 2005; 44: 136-139.

13. Shabbir I, Mirza MN, Iqbal R. Clinico epidemiological profile of one hundred AFB smear positive cases of pulmonary TB. Pakistan Journal of Chest Medicine 2005; 11: 29-23.

14. Khan SU, Shabbir I, Iqbal R. Non-Compliance to treatment in tuberculosis patients. Pakistan Journal of Chest Medicine 2004; 10: 31-34.

15. Iqbal R, Shabbir I, Khan SU. TB drug resistance an update. Pakistan Journal of Chest Medicine 2004; 10: 15-17.

Completed Research Studies

1. Screening of tuberculosis in District Bagh an area of Azad Kashmir. (Project under taken after earth quake.)
2. 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.
3. Monitoring of Anti TB Drug resistance pattern 1000 case study.
4. Radiological diagnosis of smears positive pulmonary tuberculosis 300 case studies.
5. Value of ABF smears microscopy in the diagnosis of pulmonary tuberculosis. Screening of AFB in sputum of direct smear and concentration method.
6. An analysis of 2211 cases of extra pulmonary tuberculosis at PMRC TB Research Center.
7. Trends in Multi drugs resistance tuberculosis study based on 228 cases.
8. Colonization of Candida albicans in the women of childbearing age.
9. Study of anti tuberculosis Drugs Sensitivity pattern in separate form of drug and in fixed combination form (500 case study completed).
10. Study based on 240 cases showing the anti tuberculosis drug resistance pattern for the year 1999 completed.
11. Study based on 678 cases showing AFB culture positive were subjected to anti tuberculosis drug resistance pattern for the year 2000 to 2002 completed.
12. Capacity development for heath research in Pakistan evaluating a decade of efforts.
13. EMRO / TDR sponsored Health Research System Development and mapping of health research in Pakistan.

On Going Research Studies: (Future Strategy)

1. 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 multi and multiple drug resistance cases. (120 cases of MDR completed)
2. To study the factors responsible for failure to initiate tuberculosis treatment among smear positive tubercular patients.
3. Screening for latent tuberculosis with commitment to control the disease.
4. Multi drug resistance anti TB drugs monitoring on regular basis to furnish data on pattern of TB drug resistance.
5. Detection of Mycobacterium tuberculosis in extra pulmonary specimens using polymerase chain reaction.
6. Study of extrapulmonary specimens on LJ media verses PCR for the diagnosis of tuberculosis.
7. Development of PCR-SS CP for the detection of mutation in Isoniazid resistant mycobacterium study in collaboration with CEMB.
8. Molecular characterization of some Multi drug resistant genes of Mycobacterium tuberculosis isolates of Pakistan.

Submitted Research Studies

Screening for tuberculosis among the household contacts with the commitment to control the disease. PMRC multi centric study.

Detection of Mycobacterium tuberculosis in extra pulmonary specimens using polymerase chain reaction.

Services

• Microscopy of mycobacterium by concentration method.
• Pulmonary and extra pulmonary culture of mycobacterium on LJ Medium.
•Anti TB drug sensitivity of 1st and 2nd line by standard proportion method.

Key Aim of PMRC 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.