Exploring the historical roots, advantages and efficacy of phage therapy in plant diseases management.

In the drug-resistance era, phage therapy has received considerable attention from worldwide researchers. Phage therapy has been given much attention in public health but is rarely applied to control plant diseases. Herein, we discuss phage therapy as a biocontrol approach against several plant diseases. The emergence of antibiotic resistance in agriculturally important pathogenic bacteria and the toxic nature of different synthetic compounds used to control microbes has driven researchers to rethink the century-old strategy of phage therapy''. Compared to other treatment strategies, phage therapy offers remarkable advantages such as high specificity, less chances of drug resistance, non-harmful nature, and benefit to soil microbial flora. The optimizations and protective formulations of phages are significant accomplishments; however, steps towards a better understanding of the physiologic characteristics of phages need to be preceded to commercialize their use. The future of phage therapy in the context of plant disease management is promising and could play a significant role in sustainable agriculture. Ongoing research will likely affirm the safety of phage therapy, ensuring that it does not harm non-target organisms, including beneficial soil microbes. Phage therapy could become vital in addressing global food security challenges, particularly in regions heavily impacted by plant bacterial diseases. Efforts to create formulations that enhance the stability and shelf-life of phages will be crucial, especially for their use in varied environmental conditions.

Audiological Outcomes of Type 1 Tympanoplasty Using Conchal Cartilage and Temporalis Fascia.

OBJECTIVE: To compare the efficacy of conchal cartilage graft and temporalis fascia graft in Type 1 tympanoplasty in terms of graft uptake and hearing improvement. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Department of Otolaryngology, Khyber Teaching Hospital, Peshawar, Pakistan, from January 2020 till December 2022. METHODOLOGY: Using quota sampling, 2 groups were made i.e. conchal cartilage group (Group A) and temporalis fascia group (Group B). Total of 124 records were selected with 62 records from each group. Graft uptake rate and audiological outcomes were compared between the groups. Moreover, postoperative complication rate was also noted for each group. RESULTS: The graft uptake rates between Group A and B at 3rd month were compared postoperatively (98.39%, 93.55%, p=0.36). The difference between preoperative mean air-bone gap (ABG, 28.05 ± 2.19dB, 28.68 ± 2.38 dB, p=0.12) and postoperative mean ABG (13.35 ± 3.45, 14.47 ± 3.29, p=0.69) was also statistically not significant. However, the differences regarding audiological success rate between cartilage and fascia groups (96.77%, 82.25%, p=0.01) and average operating time (51.8 ± 2.1 vs. 43.5 ± 3.2 minutes, p=0.009) were significantly different. CONCLUSION: In chronic otitis media (COM) patients with subtotal perforations, endoscopic tympanoplasty using conchal cartilage or temporalis fascia as graft yielded comparable outcomes in terms of graft uptake, hearing improvement, and postoperative complications. However, using conchal cartilage, the procedure showed better audiological success rate. With temporalis fascia as graft, the procedure was performed in a shorter time. KEY WORDS: Chronic otitis media, Tympanoplasty, Temporalis fascia, Conchal cartilage, Subtotal perforation.

Computational exploration of novel ROCK2 inhibitors for cardiovascular disease management; insights from high-throughput virtual screening, molecular docking, DFT and MD simulation.

Cardiovascular disorders are the world's major cause of death nowadays. To treat cardiovascular diseases especially coronary artery diseases and hypertension, researchers found potential ROCK2 (Rho-associated coiled-coil-containing protein kinase 2) target due to its substantial role in NO-cGMP and RhoA/ROCK pathway. Available drugs for ROCK2 are less effective and some of them depict side effects. Therefore, a set of novel compounds were screened that can potentially inhibit the activity of ROCK2 and help to treat cardiovascular diseases by employing In-silico techniques. In this study, we undertook ligand based virtual screening of 50 million compound's library, to that purpose shape and features (contain functional groups) based pharmacophore query was modelled and validated by Area Under Curve graph (AUC). 2000 best hits were screened for Lipinski's rule of 5 compliance. Subsequently, these selected compounds were docked into the binding site of ROCK2 to gain insights into the interactions between hit compounds and the target protein. Based on binding affinity and RMSD scores, a final cohort of 15 compounds were chosen which were further refined by pharmacokinetics, ADMET and bioactivity scores. 2 potential hits were screened using density functional theory, revealing remarkable biological and chemical activity. Potential inhibitors (F847-0007 and 9543495) underwent rigorous examination through MD Simulations and MMGBSA analysis, elucidating their stability and strong binding affinities. Results of current study unveil the potential of identified novel hits as promising lead compounds for ROCK2 associated with cardiovascular diseases. These findings will further investigate via In-vitro and In-vivo studies to develop novel druglike molecules against ROCK2.

Revolutionizing Diabetes Diagnosis: Machine Learning Techniques Unleashed.

The intricate and multifaceted nature of diabetes disrupts the body's crucial glucose processing mechanism, which serves as a fundamental energy source for the cells. This research aims to predict the occurrence of diabetes in individuals by harnessing the power of machine learning algorithms, utilizing the PIMA diabetes dataset. The selected algorithms employed in this study encompass Decision Tree, K-Nearest Neighbor, Random Forest, Logistic Regression, and Support Vector Machine. To execute the experiments, two software tools, namely Waikato Environment for Knowledge Analysis (WEKA) version 3.8.1 and Python version 3.10, were utilized. To evaluate the performance of the algorithms, several metrics were employed, including true positive rate, false positive rate, precision, recall, F-measure, Matthew's correlation coefficient, receiver operating characteristic area, and precision-recall curves area. Furthermore, various errors such as Mean Absolute Error, Root Mean Squared Error, Relative Absolute Error, and Root Relative Squared Error were examined to assess the accuracy of the models. Upon conducting the experiments, it was observed that Logistic Regression outperformed the other techniques, exhibiting the highest precision of 81 percent using Python and 80.43 percent using WEKA. These findings shed light on the efficacy of machine learning in predicting diabetes and highlight the potential of Logistic Regression as a valuable tool in this domain.

Multi-Method Analysis of Histopathological Image for Early Diagnosis of Oral Squamous Cell Carcinoma Using Deep Learning and Hybrid Techniques.

Oral cancer is a fatal disease and ranks seventh among the most common cancers throughout the whole globe. Oral cancer is a type of cancer that usually affects the head and neck. The current gold standard for diagnosis is histopathological investigation, however, the conventional approach is time-consuming and requires professional interpretation. Therefore, early diagnosis of Oral Squamous Cell Carcinoma (OSCC) is crucial for successful therapy, reducing the risk of mortality and morbidity, while improving the patient's chances of survival. Thus, we employed several artificial intelligence techniques to aid clinicians or physicians, thereby significantly reducing the workload of pathologists. This study aimed to develop hybrid methodologies based on fused features to generate better results for early diagnosis of OSCC. This study employed three different strategies, each using five distinct models. The first strategy is transfer learning using the Xception, Inceptionv3, InceptionResNetV2, NASNetLarge, and DenseNet201 models. The second strategy involves using a pre-trained art of CNN for feature extraction coupled with a Support Vector Machine (SVM) for classification. In particular, features were extracted using various pre-trained models, namely Xception, Inceptionv3, InceptionResNetV2, NASNetLarge, and DenseNet201, and were subsequently applied to the SVM algorithm to evaluate the classification accuracy. The final strategy employs a cutting-edge hybrid feature fusion technique, utilizing an art-of-CNN model to extract the deep features of the aforementioned models. These deep features underwent dimensionality reduction through principal component analysis (PCA). Subsequently, low-dimensionality features are combined with shape, color, and texture features extracted using a gray-level co-occurrence matrix (GLCM), Histogram of Oriented Gradient (HOG), and Local Binary Pattern (LBP) methods. Hybrid feature fusion was incorporated into the SVM to enhance the classification performance. The proposed system achieved promising results for rapid diagnosis of OSCC using histological images. The accuracy, precision, sensitivity, specificity, F-1 score, and area under the curve (AUC) of the support vector machine (SVM) algorithm based on the hybrid feature fusion of DenseNet201 with GLCM, HOG, and LBP features were 97.00%, 96.77%, 90.90%, 98.92%, 93.74%, and 96.80%, respectively.

Identification of Small Molecule Inhibitors of Human Cytomegalovirus pUL89 Endonuclease Using Integrated Computational Approaches.

Replication of Human Cytomegalovirus (HCMV) requires the presence of a metal-dependent endonuclease at the C-terminus of pUL89, in order to properly pack and cleave the viral genome. Therefore, pUL89 is an attractive target to design anti-CMV intervention. Herein, we used integrated structure-based and ligand-based virtual screening approaches in combination with MD simulation for the identification of potential metal binding small molecule antagonist of pUL89. In this regard, the essential chemical features needed for the inhibition of pUL89 endonuclease domain were defined and used as a 3D query to search chemical compounds from ZINC and ChEMBL database. Thereafter, the molecular docking and ligand-based shape screening were used to narrow down the compounds based on previously identified pUL89 antagonists. The selected virtual hits were further subjected to MD simulation to determine the intrinsic and ligand-induced flexibility of pUL89. The predicted binding modes showed that the compounds reside well in the binding site of endonuclease domain by chelating with the metal ions and crucial residues. Taken in concert, the in silico investigation led to the identification of potential pUL89 antagonists. This study provided promising starting point for further in vitro and in vivo studies.

Interleukins (Cytokines) as Biomarkers in Colorectal Cancer: Progression, Detection, and Monitoring.

Cancer is the primary cause of death in economically developed countries and the second leading cause in developing countries. Colorectal cancer (CRC) is the third most common cause of cancer-related deaths worldwide. Risk factors for CRC include obesity, a diet low in fruits and vegetables, physical inactivity, and smoking. CRC has a poor prognosis, and there is a critical need for new diagnostic and prognostic biomarkers to reduce related deaths. Recently, studies have focused more on molecular testing to guide targeted treatments for CRC patients. The most crucial feature of activated immune cells is the production and release of growth factors and cytokines that modulate the inflammatory conditions in tumor tissues. The cytokine network is valuable for the prognosis and pathogenesis of colorectal cancer as they can aid in the cost-effective and non-invasive detection of cancer. A large number of interleukins (IL) released by the immune system at various stages of CRC can act as "biomarkers". They play diverse functions in colorectal cancer, and include IL-4, IL-6, IL-8, IL-11, IL-17A, IL-22, IL-23, IL-33, TNF, TGF-ß, and vascular endothelial growth factor (VEGF), which are pro-tumorigenic genes. However, there are an inadequate number of studies in this area considering its correlation with cytokine profiles that are clinically useful in diagnosing cancer. A better understanding of cytokine levels to establish diagnostic pathways entails an understanding of cytokine interactions and the regulation of their various biochemical signaling pathways in healthy individuals. This review provides a comprehensive summary of some interleukins as immunological biomarkers of CRC.

Deciphering host-pathogen interaction during Streptomyces spp. infestation of potato.

Potato crop, currently, is the staple food crop of about 1.3 billion global population. Potato is attaining even more admiration globally day by day owing to its public acceptability. However, potato sustainable production is distinctly challenged by multiple factors like diseases, pests and climate change etc. Among diseases, common scab is one of the prime threats to potato crop due to its soil-borne nature and versatility in phytotoxins' secretion. Common scab is caused multiple number of phytopathogenic streptomyces strains. Despite extensive research programs, researchers are still unable to identify a significant solution to this threat that is proliferating exceptional rate across the globe. To develop feasible remedies, adequate information regarding host-pathogen interaction should be available. This review possesses insights on existing pathogenic species, the evolution of novel pathogenic streptomyces spp. and phytotoxins produced by the pathogenic strains. Furthermore, which type of physiological, biochemical and genetic activities occur during pathogen's infestation of the host are also canvassed.

Molecular Understanding of ACE-2 and HLA-Conferred Differential Susceptibility to COVID-19: Host-Directed Insights Opening New Windows in COVID-19 Therapeutics.

The genetic variants of HLAs (human leukocyte antigens) play a crucial role in the virus-host interaction and pathology of COVID-19. The genetic variants of HLAs not only influence T cell immune responses but also B cell immune responses by presenting a variety of peptide fragments of invading pathogens. Peptide cocktail vaccines produced by using various conserved HLA-A2 epitopes provoke substantial specific CD8+ T cell responses in experimental animals. The HLA profiles vary among individuals and trigger different T cell-mediated immune responses in COVID-19 infections. Those with HLA-C*01 and HLA-B*44 are highly susceptible to the disease. However, HLA-A*02:01, HLA-DR*03:01, and HLA-Cw*15:02 alleles show resistance to SARS infection. Understanding the genetic association of HLA with COVID-19 susceptibility and severity is important because it can help in studying the transmission of COVID-19 and its physiopathogenesis. The HLA-C*01 and B*44 allele pathways can be studied to gain insight into disease transmission and physiopathogenesis. Therefore, integrating HLA testing is suggested in the ongoing pandemic, which will help in the rapid identification of highly susceptible populations worldwide and possibly acclimate vaccine development. Therefore, understanding the correlation between HLA and SARS-CoV-2 is critical in opening new insights into COVID-19 therapeutics, based on previous studies conducted.

Energy, environmental degradation, and health status: evidence from South Asia.

Energy is considered a vital factor of economic growth that contributes to improve quality of life and health status. However, global warming, climate change, and environmental degradation are due primarily because of energy emissions, whereas environmental degradation is detrimental to health. Since one-fifth of the population lives in South Asia, it is necessary to analyze the impact of energy and environmental degradation on health status in this region. For this purpose, health status in South Asia is proxy with health expenditure, life expectancy, and infant mortality, and this study investigates the effect of energy intensity, income, and carbon emissions on health status, whereas urbanization is considered a control variable. The cointegration test indicates South Asia's long-term health status factors are energy intensity, income, carbon emissions, and urbanization. Long-run results suggest that energy intensity and income improve health status as these factors reduce health expenditure, improve life expectancy, and decrease infant mortality. Environmental degradation not only increases health expenditure but also hinders life expectancy and increases mortality. Moreover, an increase in income diminishes health expenditure and is responsible for high life expectancy and low mortality in South Asia.

Recent Progress on Synthesis, Characterization, and Performance of Energetic Cocrystals: A Review.

In the niche area of energetic materials, a balance between energy and safety is extremely important. To address this "energy-safety contradiction", energetic cocrystals have been introduced. The investigation of the synthesis methods, characteristics, and efficacy of energetic cocrystals is of the utmost importance for optimizing their design and development. This review covers (i) various synthesis methods for energetic cocrystals; (ii) discusses their characteristics such as structural properties, detonation performance, sensitivity analysis, thermal properties, and morphology mapping, along with other properties such as oxygen balance, solubility, and fluorescence; and (iii) performance with respect to energy contents (detonation velocity and pressure) and sensitivity. This is followed by concluding remarks together with future perspectives.

Monitoring land use land cover changes and its impacts on land surface temperature over Mardan and Charsadda Districts, Khyber Pakhtunkhwa (KP), Pakistan.

Land use/land cover (LULC) changes due to urban growth on the regional scale affect land surface temperature (LST). The present study aims to assess the LULC changes and their impact on LST over Mardan and Charsadda districts of Khyber Pakhtunkhwa (KP), Pakistan, in the period from 1990 to 2019. Landsat satellite (TM& ETM +) datasets in the period from 1990 to 2010 and Sentinel-2 images from 2016 to 2019 were used in this study. All the datasets were pre-processed and the LULC types were classified by maximum likelihood classification algorithm. The vegetation degradation was computed from normalized difference vegetation index (NDVI), and the LST was derived based on the LULC changes. The results showed that the overall accuracy of LULC classification was 87.84%. Dramatic LULC changes were observed during the last three decades, where the vegetation degradation area was decreased from 1307.8 (59.27%) to 1147.6 km2 (52.1%) and the barren land area increased from 816.6 (37.07%) to 961.4 km2 (42.64%). Similarly, the built-up area has also increased from 57.2 (2.5%) to 104.3 km2 (4.73%) in the years 1990 and 2019, respectively. These variations in LULC types have significantly influenced the LST from 1990 to 2019; specifically, the LST of built-up area, barren land, and vegetation cover increased from 20.1 to 32.1 °C, 21.5 to 35.5 °C, and 17.1 to 28.2 °C, respectively. The regression line plotted defines that the LST has a negative correlation with NDVI and a positive correlation with normalized difference of built-up index (NDBI). In particular, the vegetation and land covers dramatically transformed to barren land and/or to urban development over the study area in the period from 1990 to2019, which has severely affected the LST and the natural resources of the study area. Therefore, our study will be very helpful for managing the rapid environmental changes and urban planning.

Preparedness to Combat Determinants of Underweight-Based Child Malnutrition in Flood-Affected Areas of Pakistan.

AIMS: Floods badly impact the food and nutrition security in developing countries. The role of the government and the impact of floods on the underweight status of children in the affected areas is not clear. We aimed to find the determinants of underweight in flood-affected areas of Khyber Pakhtunkhwa, Pakistan. METHODS: We used a multistage sampling technique and selected 656 households during in the flood-affected areas of Pakistan. Data were collected in the three most affected districts. A validated questionnaire was used to find socioeconomic and demographic information, hygiene, and sanitation information. We used logistic regression to find the determinants of underweight, controlling for confounders. RESULTS: The prevalence of global malnutrition based on underweight was 25.2%. The prevalence of underweight was higher in young age mothers (40.6%), younger age children (71.4%), large family size (28.4%), joint family (27%), and no toilet facility (28.9%). District Nowshera was at high risk of underweight based undernutrition, followed by district Charsadda compared to children belonging to Dera Ismail Khan. The significant risk factor that causes underweight was child lower age (p < 0.01), young age of mothers (p < 0.01), children access to unimproved water sources (p < 0.01), and location (districts) due to environmental and constant flood consequences (p < 0.01). CONCLUSION: In conclusion, risk factors of underweight should be appropriately targeted in the flood-hit areas of Pakistan. Governments should preallocate budgetary resources and enhance the emergency preparedness levels to facilitate the communities with flooding incidents and their aftermath in the shape of child underweight-based malnutrition.

Nexus between export variety and carbon emissions in Pakistan: The role of FDI and technological development.

Carbon emissions constitute a large portion of greenhouse gases that are responsible for global warming and climate change. This study examines the impact of export variety on carbon emissions along with foreign direct investment (FDI) and technological development as determinants of environmental degradation in Pakistan. Moreover, this study is conducted in the context of the environmental Kuznets curve hypothesis (EKC). This study applies dynamic ordinary least squares and error correction models for long-term and short-term estimates, respectively. The results indicate that the EKC hypothesis is valid in the long term. This implies that Pakistan's economy reached the threshold level of income, after which an increase in income was not responsible for environmental degradation. Export variety restrains environmental degradation in the short term and is not a significant factor in the long term. Energy consumption has aggravated environmental degradation, while FDI and technological development are restraining environmental degradation. Policy measures are recommended to curb environmental degradation in Pakistan.

Laparoscopy offers better clinical outcomes and long-term survival in patients with right colon cancer: experience from national cancer center.

PURPOSE: Laparoscopic approach to colonic tumor requires skill set and resources to be established as routine standard of care in most centers around the world. It presents particular challenge in country like Pakistan due to economic constrain and lack of teaching and training opportunities available for surgeons to be trained to deliver such service. The aim of this study is to look into changing practice of our institution from conventional approach of open to laparoscopic surgery for right colon cancer. METHODS: Consecutive patients between January 2010 to December 2018 who presented to Shaukat Khanum Memorial Cancer Hospital and Research Centre with diagnosis of right colon (cecum, ascending and transverse colon) adenocarcinoma and underwent surgical resections were included in this study. RESULTS: A total of 230 patients with adenocarcinoma of the right colon underwent curative resections during the study period. Of these, 141 patients (61.3%) underwent laparoscopic surgery while open resection was performed in 89 patients (38.7%). Five-year disease-free survival (DFS) of patients with American Joint Committee on Cancer (AJCC) stage III (80.9% vs. 54.8%, P = 0.021) was significantly better if these patients underwent laparoscopic surgery while a trend toward better DFS (96.7% vs. 84.1%, P = 0.111) was also observed in AJCC stage II patients, although this difference was not significant. CONCLUSION: This study demonstrates the adoption of a laparoscopic approach for right colon cancer over 10 years. With a standardized approach and using the principle of oncological surgery, we incorporated this in our minimally invasive surgery practice at our institution.

Prevalence of Micronutrient Deficiencies among Preschool and School-Going Children in Flood-Hit Areas of Pakistan.

There is minimal literature regarding micronutrient deficiencies in flood-affected regions. In our study, we aimed to find the prevalence of micronutrient deficiencies (vitamin A, calcium, zinc, iron, and iodine) among preschool and school-age children in flood-hit areas of Khyber Pakhtunkhwa, Pakistan. In this cross-sectional study, a multi-stage sampling technique was used for the selection of 656 households. Serum micronutrient status was detected in the targeted population in the affected districts. The least significant difference test was used with analysis of variance to determine significant differences in nutrient contents in different areas. Of the total respondents, 90.8% of the children were calcium deficient, 88.3% were zinc deficient, 26.7% were iron deficient, 53.5% were vitamin A deficient, and 39.5% were had an iodine deficiency in flood-affected areas. A significant difference (P < 0.05) was found in different age groups of children for zinc (5.7-42.63 µg/dL) and urinary iodine (69.6-85.4 µg/L). The 10- to 12-year-old age group had a lower serum zinc concentration (5.7 µg/dL), whereas the 1- to 3-year-old age group had a lower urinary iodine concentration (69.6 µg/L) than other groups. There was no significant difference (P > 0.05) between male and female children and various age groups for calcium and iron status. Vitamin A levels were significantly (P < 0.05) different among different age groups (high in age group 4-6 years) and districts. Vitamin A concentration was lower in the Nowshera District, whereas serum iron and zinc were lower in the Dera Ismail Khan District. All the important micronutrients in the population of children were deficient in the flood-affected areas of Pakistan. Therefore, policymakers should implement potential prevention strategies, such as food security, school health nutrition, food fortification, nutrition in the first 1,000 golden days, nutrition knowledge, and awareness of the local population, to reduce the burden of micronutrients deficiencies in flood-affected areas.

An Early Presentation Of Supraglottic Laryngeal Paraganglioma: Case Report And Review Of Literature.

A thirty-year-old male presented with progressive hoarseness and dysphagia for solids. Fibre optic laryngoscopy showed a right supraglottic mass. Subsequent CT imaging showed the location and extent of the mass. Biopsy revealed a Paraganglioma with cytokeratin negative and chromogranin positive cells. The mass was subsequently removed without complications. Follow up also showed no complications. Hoarseness and dysphagia resolved following tumour excision.

Airway Management for Emergent Surgeries during COVID-19 Pandemic.

Aerosol generating procedures (AGPs) performed in the operating room during general anesthesia and surgery can contaminate the operation room environment putting the anesthetist, surgeons and paramedical staff at risk of infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The polymerase chain reaction (PCR) test for SARS-CoV-2 has low sensitivity and is time-bound. Emergent surgical cases might not give ample time for SARS-CoV-2 evaluation. These issues have called for adaptation of an anesthesia technique that can ensure safety measures regarding airway management in emergent cases; and can limit the chances of viral spread in case the patient is a carrier of coronavirus disease 2019 (COVID-19). In this communication, we summarised the modifications required in anesthesia technique during intubation and extubation of a patient's airway that would decrease the risk of virus transmission to the operation theatre staff. Key Words: COVID-19, SARS-CoV-2, Emergent surgeries, Anesthesia technique.

Airway Management for Emergent Surgeries during COVID-19 Pandemic.

Aerosol generating procedures (AGPs) performed in the operating room during general anesthesia and surgery can contaminate the operation room environment putting the anesthetist, surgeons and paramedical staff at risk of infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The polymerase chain reaction (PCR) test for SARS-CoV-2 has low sensitivity and is time-bound. Emergent surgical cases might not give ample time for SARS-CoV-2 evaluation. These issues have called for adaptation of an anesthesia technique that can ensure safety measures regarding airway management in emergent cases; and can limit the chances of viral spread in case the patient is a carrier of coronavirus disease 2019 (COVID-19). In this communication, we summarised the modifications required in anesthesia technique during intubation and extubation of a patient's airway that would decrease the risk of virus transmission to the operation theatre staff. Key Words: COVID-19, SARS-CoV-2, Emergent surgeries, Anesthesia technique.

Pancreaticoduodenectomy: Outcomes of a complex surgical procedure from a developing country.

BACKGROUND: Pancreaticoduodenectomy (PD) plays an integral part in the management of pancreatic, periampullary and duodenal cancers, along with a few other pathologies of this region. Despite advances in surgery PD continues to have significant morbidity and noteworthy mortality. The aim of this study is to provide an in-depth report on the patient characteristics, indications and the outcomes of PD) in a tertiary cancer hospital in Pakistan. MATERIALS AND METHODS: The study population included patients who underwent PD between January 1, 2014 and march 31, 2019, at Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH&RC) in Pakistan. The data was retrospectively analyzed from the Hospital Information System (HIS), which is a prospectively maintained patient electronic database of SKMCH&RC. Patient characteristics, procedural details and post-operative outcomes according to internationally accepted definitions were reported. RESULTS: A total of 161 patients underwent PD at our hospital in the study period at a median age of 53 years, ranging from 19 to 78 years. 62% of the patients were males while 37% were females. Jaundice was the most common presenting symptom (64.6%), followed by abdominal pain (26.7%). PD with pancreaticogastrostomy was performed in 110 patients (68.3%), while pancreaticojejunostomy was performed in the rest of the cohort. Surgical site infection (SSI) was observed in 64 patients (40%). The incidence of Pancreatic Fistula grade C based on the International Study Group on Pancreatic Fistula (ISGPF) definition was 7.45% (n = 12). The 30 days mortality rate was 3.1%. Median survival of the cohort was 21 ±1.13 months and disease-free survival was 16±2.62 months. CONCLUSION: PD can be performed with acceptable morbidity and mortality in a resource constrained country, as long as it is undertaken in a high-volume center. This is in keeping with data published from other well-reputed international centers.