On Tuesday, Debutant opener Fakhar Zaman and Sarfraz missed hundred by six runs each but still revived Pakistan on the first day, after Pakistan found themselves reeling at 57/5 having won the toss and chose to bat first.
The offspinner nearly had his head taken off by a shot which Fakhar blasted back at him but managed to get a hand up and take a remarkable reflex grab.
There is also an injury cloud hovering over Mitchell Starc, with the tearaway paceman not bowling in the day's final session, while spending time earlier in the day fielding in the slip cordon - a highly unusual spot for a strike bowler.
Fast bowler Mohammad Abbas had Usman Khawaja - who scored a fighting 141 to lead Australia's fightback for a draw in the first Test in Dubai last week - caught behind for his 50th Test wicket in 10 Tests.
Paine reviewed the not-out decision for lbw and replays showed the ball was hitting the stumps but Azhar was too far down the pitch to overturn the umpire's call.
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Messonnier said some patients diagnosed with AFM have recovered quickly while others continue to struggle with paralysis. No geographic clustering has been found and there is no other "unifying factor to explain the peaks", she added.
Pakistan were reeling on 5-57 part way through the morning session, their top order decimated by Lyon (4-78) in the space of six deliveries as he took four wickets for no runs.
The rookie was at the non-striker's end when Starc hit a hard return that shot back into legspinner Yasir Shah then clattered into the stumps.
Abbas removed Shaun Marsh (3) in the fourth over of the day before dismissing Travis Head (14).
Aaron Finch fought a lone hand in just his second test before falling for 39 with none of Head, Mitch Marsh or Paine able to go the distance.
After his Ashes heroics last summer, veteran Sean Marsh hasn't reached 50 in 11 Test innings since the start of the tour of South Africa earlier this year, making just 157 runs.
This one will feel especially frustrating after Lyon snared four wickets in six balls on day one to hand his side a dream start.