Critical Care Research Group
- CCM Epidemiology
- Emerging Infections & Pandemic Preparedness
- Patient & Public Involvement & Engagement
- Antimicrobial Resistance and Stewardship
- Long-term outcomes of Critical Illness
- Genomics in Critical Care
- Trials Methodology
- Machine Learning
Prof. Madiha Hashmi
MBBS, FFARCSI
[email protected]
Landline # 021-35862937-39, Ext # 4460
Dr Madiha Hashmi is a Professor and Chair of the Department Critical Care Medicine at Ziauddin University, Karachi. She is also a Visiting Faculty at Aga Khan University Karachi Pakistan, an Honorary Physician, Mahidol Oxford Research Unit (MORU), Bangkok, Thailand and Secretary, Faculty of CCM at the College of Physicians and Surgeons Pakistan (CPSP).
- She conducted the first comprehensive National Survey of Critical Care Services in hospitals accredited for training in Pakistan.
- She leads the Pakistan Registry of Intensive CarE (PRICE) which is operational across all provinces of Pakistan in both public and private sector hospitals.
- She is a PI for REMAP-CAP, MegaRox, and GenOMICC in Pakistan
- She leads the South Asian ISARIC hub and is on the Executive Board of International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC). https://isaric.org/isaric-regional-hubs/
Dr. Ayesha Siddiqui
MBBS (Bachelor of Medicine, Bachelor of Surgery) Ziauddin University, Karachi.
[email protected]
Profile/Projects:
Dr. Ayesha Siddiqui is the National Coordinator and co-principal Investigator for the Genetics of Mortality in Critical Care (GenOMICC) project. She serves as an Information Specialist for the Critical Care in Asia and Africa (CCAA) James Lind Alliance (JLA) Priority Setting Partnership (PSP) from Pakistan. She is also currently engaged in the Clinical Trial Unit Maturity Metrics project in collaboration with WHO and University of Oxford. Her research focuses on critical care, antimicrobial resistance, and omics sciences.
Dr. Arishay Hussaini
MBBS (Bachelor of Medicine, Bachelor of Surgery), Ziauddin University, Karachi.
[email protected]
Dr. Arishay is the PPIE (Public and Patient Involvement and Engagement) co-leader from Pakistan for the Ziauddin University Clinical Trials Unit. She is the National Coordinator for the REMAP-CAP trial in Pakistan and the National Principal Investigator for the study “Application of PRECIS-2 to Three Clinical Trials in Pakistan and Nepal.” Additionally, she is leading a systematic review on the PRECIS tool in low- and middle-income countries (LMICs). Her research interests lie in public health and qualitative research.
Ms. Aasma Khan
Master in Biological Sciences, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology University (SZABIST), Karachi.
[email protected]
Ms. Aasma Khan is responsible for managing the planning, execution, and coordination of all clinical research projects within the Critical Care Reseach Group. Ms Khan also serves as the Clinical Research Coordinator for the Antimicrobial Resistance Surveillance Network for Healthcare-associated Infections (ACORN-HAI) and leading the Clinical Characterization Protocol (CCP) by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) and World Health Organization (WHO) at Ziauddin University. Her research interests include Critical Care Epidemiology, Antimicrobial Resistance, and Infectious diseases.
Dr. Priya Jarwar
Ph.D. in Biotechnology, University of Sindh, Jamshoro.
[email protected]
Dr. Priya specializes in molecular research and coordinates multiple studies, including the Genetics of Mortality in Critical Care (GenOMICC) and An observational study to follow-up patients with suspected or confirmed COVID-19. She is also the Co-Lead for the Dengue Prospective Surveillance in Ziauddin Group of Hospitals, where she plays a role in expanding the project to other institutes across Pakistan. Her research interest lies in identifying genetic aspects of Infectious diseases.
Mr. Ahmed Nayeem
Master in Data Science, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology University (SZABIST), Karachi.
[email protected]
Mr. Ahmed specialises in statistical modelling, machine learning, and big data analytics. With extensive experience in designing and implementing complex algorithms, he expertly analyses large datasets using Python, R, SQL, and advanced data visualisation tools. Ahmed has collaborated on numerous interdisciplinary projects, contributing to various publications. His research interests focus on applying data science methodologies to real-world problems, particularly in healthcare and neuroscience.
Dr Maham Jawaid Ahmed
MBBS (Bachelor of Medicine, Bachelor of Surgery), Ziauddin University, Karachi.
[email protected]
Dr. Maham is the lead for Dengue Prospective Surveillance at Ziauddin Group of Hospitals. She is actively engaged in various projects, including a systematic review on the PRECIS tool in low- and middle-income countries (LMICs) and MegaRox. Her interests lie in psychiatry and systematic reviews.
Mr. Faraz Ahmed Khan
Assistant Project Manager ISARIC
Bachelor of Commerce, University of Sindh, Jamshoro.
Profile/Projects:
Mr Faraz serves as Assistant Project Manager for the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) project, within the Critical Care Research Group at Ziauddin University. His role includes maintaining budgets, tracking invoices, coordinating and facilitating communication between departments for management of different clinical research projects.
Mr. Mohiuddin Shaikh
Mr. Mohiuddin serves as the Project Manager for the Pakistan Registry of Intensive Care (PRICE). He oversees data management, analytics, and the administration of various clinical trials.
Mr. Adnan Gul
ICU Technician Diploma
[email protected]
Mr. Adnan has been associated with Research Education and Critical Care Health (REACH) since 2021. He is designated to collect data for the Pakistan Registry of Intensive Care (PRICE) at Ziauddin Hospital Clifton Campus. In this role, he is responsible for collecting data for both national and international research projects. Additionally, he has completed a Nursing course from Ziauddin University.
Mr. Akash Thakrani
Currently pursuing Bachelor of Arts (BA) degree at Allama Iqbal Open University, Umerkot.
[email protected]
Mr. Akash has been associated with Research Education and Critical Care Health (REACH) since 2020. Mr. Akash is designated to collect data for the Pakistan Registry of Intensive CarE (PRICE) at Ziauddin Hospital North Campus and Remedial Hospital. In this role, he is responsible for gathering data for both national and international research projects.
Adjunct Faculty
Professor Dr. Nikhat Ahmed Siddiqui
Professor Nikhat is a neuroscientist, biochemist, and former Dean of Research at Ziauddin University. Her research career spans over 38 years and crosses the entire research spectrum, from laboratory experiments to clinical studies on diseases such as diabetes, dementia, and blindness. She also meaningfully contributes to research ethics, training, policy development, and strategic planning. Beyond conducting scientific research, Prof. Nikhat is passionate about building capacity to enable high- quality and patient-centered research in Pakistan
Dr. Timo Tolppa
Dr. Timo is a Ph.D. candidate based at the University of British Columbia in Canada and has worked as a regional clinical trial coordinator for several international intensive care trials across South Asia, including Malaysia, Nepal, and Pakistan. He is working collaboratively with researchers at Ziauddin University on making clinical trials more relevant for low-resource settings. Dr. Timo is focused on patient engagement, qualitative research, and health equity, and has a personal interest in the use of film to promote health and justice.
The Mega-ROX trial is a large-scale, multi-center, randomized clinical study investigating optimal oxygen therapy strategies for mechanically ventilated adults in intensive care. Embedded within PRICE, this study examines whether a conservative approach to oxygen therapy reduces mortality compared to a liberal approach, while also exploring whether liberal oxygen therapy may benefit certain groups, such as patients with acute brain pathologies (excluding hypoxic brain injuries) and those with sepsis. Ziauddin University contributes to this global effort with an enrollment number of 236 patients, as of July 2024, with Pakistan accounting for 20% of the total enrollments.
GenOMICC investigates the genetic factors influencing susceptibility to life-threatening infections and sterile injuries. In collaboration with the International Severe Acute Respiratory Infection Consortium (ISARIC) and the International Forum of Acute Care Trialists (InFACT), this study aims to establish a DNA resource for genome-wide discovery of host genetic variants that affect patient outcomes. By analyzing DNA samples from critically ill patients in Pakistan, the research seeks to identify key genetic mechanisms that could lead to new therapeutic targets for improving survival in severe infections and systemic injuries.
Ziauddin University is the coordinating center for other GenOMICC sites achieving 299 successful enrollments as of September 2024.
REMAP, is a Randomised, Embedded, Multifactorial, Adaptive Platform trial. The broad objective of this trial is, over time, to determine and continuously update the optimal set of treatments for community-acquired pneumonia. This trial is an innovative global research initiative designed to improve the treatment of community-acquired pneumonia (CAP) including COVID-19, particularly in severe cases that require admission to an Intensive Care Unit (ICU). REMAP-CAP uses an adaptive platform trial design that allows for the simultaneous testing of multiple treatments across different domains. The trial evolves by incorporating new treatment options and adjusting strategies based on real-time data.
Ziauddin University is the coordinating center for other REMAP-CAP sites and successfully enrolled patients in the Vitamin C, Ivermectin, Statin, and Oseltamivir domains. In the Ivermectin domain, 98% of enrollments are from Pakistan.
https://www.remapcap.org/participating-sites
The ISARIC-WHO Clinical Characterisation Protocol (CCP) is a standardized protocol for the
rapid, coordinated clinical investigation of severe or potentially severe illness caused by
emerging or high-consequence pathogens or other noxious exposures of public health interest.
It is an adaptable protocol depending on a site’s resources and works in a tiered approach:
○ Tier 0: Data collection
○ Tier 1: Data collection and on-admission samples
○ Tier 2 – 3: Data collection and serial sampling depending on resources
The following studies utilize CCP
● Characteristics and outcomes of patients with severe Dengue
A prospective observational study designed to analyze the clinical presentation, disease
progression, and outcomes of patients with severe dengue in intensive care units (ICUs) across
Pakistan. The project leverages ISARIC-WHO Clinical Characterisation Partnership (CCP)
framework which is designed to capture globally harmonized data on dengue and is publicly
accessible through;
https://isaric.org/research/dengue/dengue-clinical-characterisation-protocol/
● COVID-19 FOLLOW-UP
A multicenter, prospective and retrospective observational study to assess the long-term
impacts of COVID-19 on ICU survivors across Pakistan. This study examines the prevalence of
Long-COVID symptoms and monitors both physical and psychosocial outcomes in patients with
confirmed or suspected SARS-CoV-2 infection. Using the ISARIC-WHO COVID-19 follow-up
protocol, the study conducted retrospective follow-up on patients discharged between August
1, 2021, and January 31, 2022, and follows new ICU admissions at regular six-month intervals in
a prospective cohort.
https://isaric.org/research/covid-19-clinical-research-resources/covid-19-long-term-follow-up-study/
Five waves of COVID-19: Insights from the Pakistan Registry of Intensive CarE (PRICE)
This is a multicenter prospective observational study analyzing the demographics, clinical
characteristics, and outcomes of 9,102 patients with SARS-CoV-2 infection admitted to 69
PRICE-collaborating intensive care units (ICUs) across Pakistan from April 2020 to March 2022
during the five waves of the pandemic.
ACORN-HAI is a surveillance designed to address the growing threat of antimicrobial resistance (AMR) in healthcare-associated infections (HAIs) within Pakistan. This project focuses on severe infections, particularly in intensive care units (ICUs), surgical wards, and cancer care settings, where multidrug-resistant organisms (MDROs) are most prevalent. The study aims to monitor and document the incidence and prevalence of AMR in HAIs, specifically focusing on bloodstream infections (BSI) and ventilator-associated pneumonia (VAP).
Ziauddin University has successfully implemented the study across both North and Clifton campuses and has enrolled 212 patients as of October 2024.
The Pakistan Registry of Intensive CarE (PRICE) is a network of more than eighty intensive care units (ICUs) across Pakistan, including both public and private sector institutions. Established as a clinician-led initiative, PRICE aims to standardize and improve critical care practices throughout the country. The registry prospectively collects clinical and demographic data on consecutive adult ICU admissions, providing detailed information on the case mix, including presentation, diagnosis, comorbidities, severity of illness, organ support days, ICU mortality, and care processes. It provides a platform for evaluating the quality of care, implementing quality improvement initiatives, and facilitating registry-based research and platform trials within Pakistani ICUs.
Oxygen requirements and approaches to respiratory support in patients with COVID-19 in low- and middle-income countries (O2CoV2) was an observational study conducted by WHO between March – April 2022. The study aimed to characterise type and duration of different modalities of oxygen therapy delivered to patients; describe demographics and outcomes of hospitalised patients with COVID-19; and describe facility-level oxygen production and support. The study was implemented in 30 countries representing four LMICs from each of the six WHO regions. Pakistan successfully contributed 67 enrolments.
A multicenter, randomized trial conducted between May 2020 and March 2022. It aimed to assess whether medical masks provided non-inferior protection compared to N95 respirators in preventing COVID-19 among healthcare workers. Participants were randomly assigned to wear either medical masks or fit-tested N95 respirators for 10 weeks. The study was conducted across 29 healthcare facilities in Canada, Israel, Pakistan, and Egypt, involving 1,009 healthcare workers. Of these, 186 participants were from Pakistan.
Comprising patient caregivers and community representatives, the group has made meaningful contributions to the informed consent processes for international trials such as Mega-ROX and REMAP-CAP. Their input has helped make these processes more culturally appropriate, locally relevant, and accessible.
Through a series of workshops and regular meetings, the group has co-developed public-facing materials including infographics and videos to improve understanding of trial participation. They are also actively involved in developing strategies to disseminate REMAP-CAP trial results to patients and the wider community in ways that are easy to understand.
https://zu.edu.pk/ppie/
The ISARIC South Asian Hub, led by Dr Madiha Hashmi has been awarded funding under the ISARIC Clinical Characterisation Protocol (CCP) 3.0 initiative, supporting a five-year programme (2024–2029) aimed at enhancing clinical research capacity, outbreak response readiness, and equitable research leadership across South Asia. This initiative is part of the broader ISARIC 3.0 strategy, which builds on the consortium’s global mission to prevent outbreak-prone infectious diseases through collaborative, high-quality, and timely research. The South Asian Hub brings together regional partners to develop sustainable research infrastructure, implement harmonized protocols, and rapidly activate studies during public health emergencies.
The CCP 3.0 grant will support a wide range of activities, including prospective clinical studies, training and mentorship of investigators, data standardization, and the development of interoperable research systems. A particular emphasis is placed on empowering low- and middle-income countries (LMICs) through capacity sharing and by addressing long-standing disparities in global health research.
The South Asian Hub lead by Professor Hashmi has taken initiatives to improve patient care in Pakistan by standardising data collection processes, which has led to the identification of gaps in patient management and fostered an informed ‘community of healthcare professionals’ within the network. Expanding on ISARIC’s preparedness endeavours and leveraging established connections within the Pakistan Registry of Intensive Care (PRICE), the integration of the ISARIC WHO Case Report Form into the PRICE registry has significantly enhanced data gathering efforts across 80 ICUs. This pioneering approach, which embeds data collection mechanisms within existing registries, enabled the REMAP-CAP collaborative to carry out their trial for COVID. Regular reports on outcomes of COVID-19 patients admitted to ICUs empowered healthcare professionals with valuable insights to optimise patient care.
Additionally, the Karachi Hub established a comprehensive framework for follow-up studies, incorporating approaches involving patient communities, including implementing follow-up calls post-discharge with access to medical professionals, and designing concise, user-friendly questionnaires for telephone surveys.
The Critical Care Research Team has been awarded the prestigious WHO-SHQ-RFP-24-2020 grant for their proposal to create a globally applicable Clinical Trials Unit (CTU) maturity framework. The project will focus on developing standards and guidance for CTUs, ensuring their capacity to manage high-quality clinical trials in diverse settings. The framework will be piloted across multiple WHO regions, enhancing its global applicability and impact.
- Oxford University & ISARIC, UK (https://isaric.org/)
- University of Edinburgh, UK (https://www.ed.ac.uk/)
- Mahidol-Oxford Tropical Medicine Research Unit & CCAA, Thailand (https://www.tropmedres.ac/)
- MONASH University, Australia (monash.edu)
- Medical Research Institute New Zealand (MRINZ) (https://www.mrinz.ac.nz/)
- McMaster University, Canada (https://www.mcmaster.ca/)
- Pakistan Institute of Living & Learning, Pakistan (https://new.pill.org.pk/welcome/)
- South City Hospital, Karachi, Pakistan (https://southcityhospital.org/)
- North West General Hospital, Peshawar (https://www.nwgh.pk/)
- Abbasi Shaheed Hospital, karachi (https://kmdc.edu.pk/abbassi-shaheed-hospital/)
- Patel Hospital, Karachi (https://patel-hospital.org.pk/)
- Burns Unit, Civil Hospital, Karachi (https://chk.gov.pk/departments/burn_care.php)
Ziauddin University hosted the PRICE Retreat, an event led by Professor Dr. Madiha Hashmi, Chairperson Critical Care Medicine. The retreat brought together national and international experts in intensive care research, including esteemed faculty from Ziauddin University, PRICE collaborating investigators, and international collaborators. Attendees presented ongoing research and clinical trials under the PRICE umbrella.
This Open House event was organized by a MORU-funded PPIE group, led by Prof Madiha Hashmi (Ziauddin University) and coordinated by Dr Arishay Hussaini (Ziauddin University), Prof Nikhat Ahmed (public member,) and Critical Care Asia Research Coordinator Dr Timo Tolppa (University of British Columbia).
This international workshop was the first of its kind in Pakistan, bringing together participants from multiple countries and underscoring its global significance. Experts, Principal Investigators (PIs), and grant management professionals gathered to enhance their knowledge and skills in transparent, accountable, and efficient grant management to maximize project impact.
The workshop featured an esteemed team of facilitators from Oxford University, including Ms. Sarah Moore, and Ms. Genny Kiff, the former Chief Financial Officer (CFO) of the Wellcome Sanger Institute. Their expert insights provided attendees with essential tools and strategies to ensure financial transparency and governance excellence in their grant-related endeavors.
This transformative initiative was led by Pro-Chancellor Dr. Nida Hussain and organized by Dr. Zulfiqar Ali Umrani, Director of the Office of Research and Innovation and Commercialization (ORIC), and Dr. Madiha Hashmi, Chairperson Critical Care Medicine.
The three-day workshop included interactive sessions, group activities, and presentations focused on key areas such as clinical research during epidemics, data management, research planning, and risk communication. These activities helped participants apply their knowledge to real-life situations, improving their ability to respond to future health emergencies. On the final day, the group visited Khoj Beach Resort, where they worked together to develop research plans in a calm and natural setting. This retreat allowed participants to reflect on their learning and strengthen teamwork.
