Recent research on genomic profiling of pancreatic ductal adenocarcinoma (PDAC) has identified many potentially actionable alterations. However, the feasibility of using genomic profiling to guide routine clinical decision making for PDAC patients remains unclear. We retrospectively reviewed PDAC patients between October 2013 and December 2017, who underwent treatment at the Johns Hopkins Hospital and had clinical tumor next-generation sequencing (NGS) through commercial resources. Ninety-two patients with 93 tumors tested were included. Forty-eight (52%) patients had potentially curative surgeries. The median time from the tissue available to the NGS testing ordered was 229 days (interquartile range 62–415). A total of three (3%) patients had matched targeted therapies based on genomic profiling results. Genomic profiling guided personalized treatment for PDAC patients is feasible, but the percentage of patients who receive targeted therapy is low. The main challenges are ordering NGS testing early in the clinical course of the disease and the limited evidence of using a targeted approach in these patients. A real-time department level genomic testing ordering system in combination with an evidence-based flagging system for potentially actionable alterations could help address these shortcomings.

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Aim: To find the characteristics and frequency of hepatitis C among children with β-Thalassemia. Methodology: It was a cross sectional type of study conducted in tertiary care hospital of Bahawalpur for a period of 6 months from from January 2021 to June 2021. Sample size was 51 patients. Patients suffering from β-Thalassemia and were undergoing blood transfusions in large amounts were included. Results: β-Thalassemia is more common in Males (67%) than females (33%) with most of the cases detected in the patients who were living in rural areas (61%). Moreover, with the increase in number of transfusions the threat of HCV increases. Conclusion: Blood transfusion is a lifesaving intervention. There is a need to pay an immediate attention towards the bio safety practice in both the public and private sector blood banks. There must be strict rules and regulations for safe blood transfusions in Pakistan. Keywords: Thalassemia; HCV; Blood transfusion; HB electrophoresis

Introduction: Pediatric bacterial meningitis is a life-threatening illness that results from bacterial infection of the meninges and leaves some survivors with significant sequelae. More than 2/3 cases of meningitis occur in the 1st 2 years of life, owing to decreased immunity and high vascularity of the brain.This study was conducted to determine the frequency of hemophilus influenzae type b, streptococcus pneumonia and neisseria meningitidis and outcome in culture proven meningitis in children 6 months to 24 months. Study Design: Case series. Setting: Paeds Unit 1, Bahawal Victoria Hospital, Bahawalpur and Paeds Unit of District Headquarter (DHQ) Teaching Hospital, Dera Ghazi Khan. Period: 1st April 2017 to 30th September 2018. Material and Methods: A total of 220 children (110 from each center) of either sex with culture proven meningitis, aged 6 months to 24 months, were included in the study. Demographics, duration of fever, history of seizures, weight of child, vaccination status and bacteria isolated from CSF and outcome were analyzed. The outcome in the form of mortality was noted during the first 10 days of hospital stay. Results: Amongst a total of 220 children, 123 (55.9%) were male. There were 130 (59.1%) children who were less than or equal to 1 year of age. There were 154 (70.0%) children who were having a weight of 7 to 10 kg. Vaccination status was, 111 (50.5%) were fully vaccinated, 59 (26.8%) partially vaccinated and 50 (22.7%) not vaccinated. Duration of fever was, 141 (64.1%) had fever for more than 5 days. There were 139 (63.2%) children who had a history of seizures.  Streptococcus pneumonia was the commonest bacteria found in 110 (50%) children followed by neisseria meningitides 53 (24.1%), H. Influenza 37 (16.8%). Overall mortality was noted in 34 (15.5%) children. Conclusion: In children with bacterial meningitis, mortality was high and most common bacteria were found to be s.pneumoniae followed by neisseria meningitidis and h.influenzae. Awareness about the empiric and directed antimicrobial therapy will help to lower the burden of morbidity and mortality related to bacterial meningitis.