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Myocardial infarction is among the related events in acute coronary syndrome, which also comprise unstable angina pectoris, ST-segment elevation myocardial infarction, and non-ST-segment elevation myocardial infarction. Objective: To determine the prevalence of multi-vessel coronary artery disease in non-ST-segment elevation myocardial infarction with observably increased troponin T concentrations. Methods: There were 284 patients participated in this research. Patients with cardiac troponin T concentrations above 500 ng/l (the recommended limit is 14 ng/l) who had previously had heart problems, tiredness, or other angina-related indications, regardless of gender, between the ages of 30 and 60, were also included in the research. Results: The study group consisted of 95 (33.46%) non-smokers and 189 (66.54%) smokers. Electrocardiogram alterations were detected in 179 (63.02%) participants, whereas no changes were detected in 105 (36.97%) individuals. Additionally, 113 individuals (39.78%) had multi-vessel coronary artery disease, compared to 171 (60.22%) who did not. Conclusion: We come to the conclusion that almost any person with elevated troponin T levels, despite the apparent absence of ST-segment elevation, may undergo cardiac catheterization to ascertain the diagnosis of multi-vessel coronary artery disease.

Introduction: Since plasma microRNAs (miRNAs) are stable in the circulatory system and are associated with a number of disorders, including coronary artery disease (CAD), the primary worldwide source of mortality and morbidity, they have been found in these conditions. Objective: This study aimed to define the functions of miRNAs in lipoprotein and lipid metabolism with a focus on the conceivable participation in the onset and development of atherosclerosis. Methods: This study was carried out at Hayatabad Medical Complex from November 2021 to March 2022. 85 patients (25 females and 60 males) diagnosed with the coronary angiography (CAG) were included because they were suspected of having CAD. Results: The results showed that patients with CAD exhibited down-regulated expression of miRNA-199a-5`, miRNA-135a-3`, miR17-5`, and miRNA-222-3` and up-regulated expression of miRNA-144-3`, miRNA-185-5`, miRNA-133a-5`, and miRNA-222-5` in comparison to the control group. Individuals with CAD and the group that didn't take statins both had significantly higher levels of miRNA-144-3` than the control group (p=0.040 and p=0.018, respectively). Both the statin and non-statin groups significantly outperformed the control group in terms of plasma level of miRNA-133a-5` (p=0.037 and p=0.011, respectively). Conclusion: The current study's findings revealed that CAD patients' expression levels of the miRNAs HSA miRNA-144-3`, HSA miRNA-222-5`, and HSA miRNA-133a-5` are significantly different from controls. Keywords: microRNAs, lipid metabolism, atherosclerosis, treatment

Introduction: South Asian communities vary from western cultures in terms of their genetic make-up, culture, and predisposition to develop coronary artery disease (CAD). Percutaneous coronary intervention (PCI) has shown remarkable effectiveness over the last three decades. To decrease hospital outcomes, thrombus aspiration and pre ballooning are often employed during angiography. Objectives: To evaluate the angiographic and hospital results between PCI using a thrombuster and PCI using pre-ballooning. Methodology: This research was conducted at Hayatabad Medical Complex, Peshawar from March 2022 to September 2022. 188 patients who came in for primary PCI at the catheterization lab were included and divided into two groups: the “thrombuster group (n=96)”and the “balloon group (n=92)”. In the thrombuster group, manual thrombus aspiration was carried out with the use of a thrombuster, whereas in the balloon group, patients had primary PCI with customary pre-dilatation using a balloon and had their TIMI flow evaluated and graded again. Throughout their hospital stays, all patients were monitored, and study outcomes, such as death and post-procedure problems, were noted. The statistical study made use of SPSS (v.25), and p value less than 0.05 was established as the threshold for significant. Results: 54 participants (26.72%) were women and 134 (71.72%) were men. A statistical study reveals a significant relationship (p=0.027) between gender. With a larger percentage of male patients (36.70%), the balloon group's demographics (n=92; 48.93%) differed from those of the thrombuster group (n=96; 51.06%). In balloon groups, a greater mean age (56.89 10.3) was discovered. With the exception of smoking, all clinical risk factors were greater in balloon groups than in thrombuster patients [17 (9.04%) vs. 12 (6.38%); p=0.007]. When compared to the balloon group (7/92), the Thrombuster groups' in-hospital mortality rate was much lower (2/96). Overall complications were also substantially greater with balloon than with thrombuster. Conclusion: Thrombus aspiration rather than ballooning should be performed using a large lumen guiding catheter in a deep-seated position. Keywords: angiography, coronary artery disease, thromboses, ballooning, angiography

Objective: The aim of current study was to evaluate effectiveness of moxifloxacin 4th generation quinolones against patients of H-pylori infection admitted in a tertiary care hospital Peshawar. Study Design:Observational study Place and Duration: This study was carried out at Khyber Teaching Hospital, Peshawar from December 2021 to February 2022 Methods: There were 180 patients of both genders had age 18-55 years with H-pylori infection were included. After obtaining informed written consent detailed demographics of all cases were recorded. Patients were equally divided in two groups. Group I received 400mg moxifloxacin for 6-days and group II received moxifloxacin for 12-days. All the patients received 1000mg amoxicillin and lansoprazole 30 mg twice day. Posttreatment results were compared in terms of eradication rate and complications among both groups. Results:We found that 105 (58.3%) patients were males and 75 (41.7%) patients were females. Mean age of the patients was 47.6±11.74 years and had mean BMI 25.8±12.34 kg/m2. Majority of the patients 98 (54.4%) were smokers. Most common comorbidity was hypertension found in 62 (34.4%) cases, diabetes mellitus in 42 (23.3%) cases, chronic pulmonary disease in 28 (15.6%) and ischemic heart disease in 13 (7.2%) cases. We found that eradication rate among cases of group I was lower found in 59 (65.6%) cases compared to group II found in 80 (88.9%) cases with p value

Background: Major public health risk was ‘Dengue infection’ initial discovery is critical to improving the existence in serious infection of dengue. Our objective in this study was to investigate the serum ferritin level to suppose biomarker in the diagnosis of dengue fever. Method: An observational and prospective study was conducted in the Hayatabad Medical Complex and it included one hundred nineteen cases related to dengue was diagnosed by using NSI Test antigen or serology test related to specific dengue that internment “ELISA”. At the time of diagnosis, serum ferritin was measured. Monitoring the clinical and platelets counts was done on daily bases, it also classified into two groups such as non-severe and severe groups by allowing WHO criteria in 2009. Result: Five out of 119 cases of dengue were severe, dengue patients had lower platelets when they are in severe condition, count the number of platelets (p less than 0.0001); Ferritin level almost high (p=0.02) and the value of hospital longer time period (p less than 0.0001) mostly in severe group as compare to non-severe group of dengue. Platelets count had negative value with age factor almost Positive correlations with ferritin levels (p=0.08 or r= 0.16) and a longer hospital stay (r= -0.427 and p 0.0001) were also found (r= 0.26, p= 0.004). These values indicate the severe risk of dengue infection/ disease. Negative value of serum ferritin that are related to the value of platelets (r=0.51 and p< 0.001). On day 4 of clinical infections, an elevated value of ferritin is seen in severe cases. Conclusion: In Clinical practice, a biomarker for determining the severity of dengue infection is increased serum ferritin concentrations. Keywords: Biomarkers, Serum ferritin, Severity, Dengue infection, Predicators

Objective: The purpose of this research is to ascertain the frequency of deeper sections and the diagnostic utility of these sections in non-cutaneous tiny biopsies obtained from a hospital setting. Study Design: Cross-sectional study Place and Duration: This study was carried out at Shaukat Khanum Memorial Hospital Peshawar, Jan 2022 to April 2022 Methods: In this study, there were a total of 100 patients, ranging in age from 16 to 50 years old. Patients who were hospitalized to the oral and maxillofacial department and who had deeper section procedures were considered for inclusion. Following the acquisition of informed and written consent, complete demographic information was obtained. The locations of organs and the levels at which leaks were found were documented for each and every instance. The mean, standard deviation, frequency, and percentages were the metrics that were used to evaluate the categorical variables. All of the data was analysed with SPSS version 22.0. Results: Among the deeper sections, we discovered that cervix cases accounted for 50%, stomach cases accounted for 25%, endometrial cases accounted for 15%, and colorectal cases accounted for 10%. Twenty-six instances 26%, had a deeper section done, with level 4 being the most prevalent. Although in most cases a diagnosis could be determined from the initial slide, in 55 of these cases (55%), further slides were reviewed to look for additional histological features. The goal was to either confirm the diagnosis obtained from the initial slide or raise confidence in that diagnosis. In 55 cases, 39 (70.9%) showed new pathological abnormalities in deeper sections, whereas 16 (29.1%) showed no change in histological features. Conclusion: A more in-depth examination is typically required in order to arrive at a certain diagnosis. Because of this, it is recommended that, regardless of the extent of the lesion, deeper sections be conducted on samples that cannot be consistently detected on ordinary levels, and this approach need to be standardized everywhere in the globe. Keywords: Histopathology, Deeper Sections, Non-cutaneous, Biopsy

Syphilis is not common, although HIV-infected people are far more likely to be infected than the general population. This may be caused by weakened cellular immunity due to HIV infection. This study aimed to find out the correlation between CD4 concentration and T. Pallidum occurrence. Methods: A assessment of a single institution identified ten patients with secondary syphilis diagnosed through a skin biopsy, positive syphilis serology, and high CD4 levels. There were 14 samples obtained from 13 individuals. Immunohistochemistry (IHC) was used to detect the presence of treponemes and CD4 levels in skin samples. These findings have also been compared with results obtained from detecting T. Pallidum by IHC in silver stain sections (Warthin-Starry). A comparison of the histological characteristics of each sample has also been made. IHC was used to determine the number of treponemes on the samples. Results: Silver stain had a sensitivity of 9 percent whereas IHC detected the treponemes at 64 percent. (p-value of 0.04). Spirochetes high incidence found only in people with less than 250 cells/ml of CD4 (>100 per 10 HPF). Conclusions: The utmost persistent histological outcome was low to highlympho-plasmocytic infiltration. However, this research did show that a high spirochete count is associated with a low CD4 count (less than 250 cells/ml). In comparison to Warthin-Starry staining results, IHC staining for T. palidum has shown superior results.

Background: The use of xylene as a cleaning agent is required for hematoxylin and eosin staining. On the other hand, there is cause for concern when it comes to the dangers of xylene exposure. Xylene has been replaced with a variety of solutions, including essential oils, during tissue processing. The objective of this research was to see whether Cedarwood oil, an essential oil, could be utilised as a substitute for Xylene in Hematoxylin and Eosin staining. Materials and Methods: The study was carried out in the Histopathology and Microbiology Department. The department's archives yielded thirty blocks of paraffin from the regular biopsy material. For my diffuser combination, I purchased cedar wood oil from an organic and natural goods store in my neighbourhood. The 30 tissue samples that were processed, each of the 30 tissue samples that was processed was washed with an essential oil (utilised 8 percent cedarwood oil) or xylene before being sliced into four-micron-thick slices and stained with E and H stain. They were rated based on the uniformity, clarity, and transparency of the stained sections. Results: The three staining quality indicators tested showed a strong link between cedarwood oil and xylene. Conclusions: It is our opinion that cedarwood oil may be used as a xylene substitute in the histopathology laboratory. Keywords: H and E stain, xylene, histo-techniques

In this study, we evaluated the immunohistochemical and micromorphological techniques for analyzing small intestinal biopsies from adults suspected of celiac disease. Methods: The study was carried out at the Department of Histopathology, Lady Reading Hospital, Peshawar, from December 2018 to August 2019. Fifty (50) specimens of small intestinal mucosal biopsies were examined in adult celiac disease patients over the age of 14 years. Modified Marsh Criteria were used to record their histomorphology data. Immunohistochemistry was used to determine the kind of intraepithelial lymphocytes. H&E staining and CD3 and CD20 immunostaining were used to count intraepithelial lymphocytes. Results: Seventin (34%) of patients were between the ages of 21 and 30 years, and 22% were between the ages of 41 and 50. Out of total 50 cases, males were 42 (84%). Thirteen (26%) of the cases had focal villous atrophy, 32 (64% of the cases) had partial villous atrophy, and 5 (10%) had total villous atrophy. Antibody to tissue transglutaminase was found to be positive in 21 (42%) of the patients. In all 50 cases, the CD3 immunomarker indicated intraepithelial lymphocytes, while the CD20 immunomarker showed localized positivity in lymphoid follicle development. On both H&E stain and immunostaining CD3 and CD20, the number of intraepithelial lymphocytes was determined to be nearly identical (with a difference of 3 - 4 lymphocytes). Conclusion: Males between the ages of 21 and 30 were the most affected. Partial villous atrophy and lymphocytic enteritis were the most common histological changes. All intraepithelial lymphocytes were distributed in a crescendo-like manner.

Background: Diabetes mellitus is a chronic illness that needs continuous monitoring and treatment. In order to avoid diabetic foot issues, there has to be more awareness and understanding of the signs of diabetic foot, risk factors, and early screenings. Objective: Aim of the current study was level of awareness about risk factors associated with diabetic foot in Type 2 diabetic patients Methodology: This cross sectional study was carried out at the Medicine Department, Khyber Teaching Hospital, Peshawar for duration of one year from January 2021 to December 2021. Data was collected from all diabetic type 2 patients by using pre-designed questionnaire. A total of 350 subjects were included in the study. Data analysis was performed by employing SPSS version 21. Results: In our study, based on level of awareness about risk factors of diabetic foot, 133 (38%) subjects have poor awareness, 91 (26%) have average awareness whereas 126 (36%) patients have good level of awareness about risk factors of diabetic foot. Conclusion: Our study concludes that on the basis of current diabetic foot care guidelines, the level of awareness of diabetic type 2 patients about diabetic foot was sub-optimal. Patients with diabetes mellitus should be aware of the medications and lifestyle changes that may help them better manage their blood sugar levels and avoid complications. Keywords: Level of awareness; Risk factors; Diabetic foot; Type 2 diabetes

Background: Erythropoietin, a hormone produced by the kidney, activates the bone marrow upon demand. Recombinant erythropoietin can be subcutaneously injected to maintain red blood cell counts in chronic renal failure patients. Some time being recognized as foreign antigens, the patient occasionally produces antibodies against erythropoietin. Objective of current study was to investigate the existence of Anti-Erythropoietin Antibodies in Chronic Renal Failure (CRF) affected individuals during hemodialysis. Methods: The current study was performed at the Pathology Department, Khyber Teaching Hospital, Peshawar, Pakistan. After the assent of ethical committee, data collection was initiated to carry out the study. All the patients filled the informed consent proforma. The blood sample was collected in two EDTA and Gel tubes for complete blood count and for anti-EPO-antibodies respectively. ELISA tests for anti-EPO antibodies were performed on all patients who were classified into two groups based on whether antibodies were present or not. The data was analyzed using SPSS version 25.0. Results: In this study, 150 patients suffering from Chronic Kidney Disease on dialysis were included in which 79 (52.7%) were males. Moreover, age-wise group 41-60 years (n=93, 62%) were more suffering as compared to age group 21-40 years (n=24, 16%). In our study, hypertension was found to be a leading cause of death for 65(43.3%), diabetes 32(21.3%), hypertension and diabetes mellitus 10(6.7%), and miscellaneous accounted for 28.7%. There were 56(37.3%) patients who received dialysis twice a week, and 94 patients (62.6%) received it three times a week. Patients had transfusion history were 136(90.7%), while 92 (61.3%) patients were found to have anti-EPO antibodies. Conclusion: Anti-EPO antibodies are frequently demonstrated in patients with CKD undergoing hemodialysis. Due to the lack of correlation between antibody levels and Hb or reticulocyte counts, these antibodies might not be neutralizing antibodies. Keywords: Anti-EPO antibodies, Chronic Renal Failure, Hypertension, Peshawar.

The cytologicalPapanicolaou test and primary human papilloma virus screening are often performed to detect cervical carcinomas and pre-carcinomic lesions, that is critical for cervical cancer restriction and therapy. ASCUS or LSIL patients should be continuously followed since some may develop CIN2+. Women who test positive for HPV may develop cervical dysplasia, reversible precancerous lesions, and, in the worst-case scenario, invasive cervical cancer. As a consequence, an effective biomarker must be developed to distinguish distinct individuals based on early screening findings. Cell growth is shown by Ki-67, whereas cell cycle arrest is induced by p16, a cell cycle regulator.They couldn't co-express in the identical cervical epithelial cells under normal circumstances. HR-HPV infection has disrupted the cell cycle, predisposing to the formation of high-grade cervical epithelial lesions, according to the co-expression of these two indicators. There's growing evidence that p16/Ki-67 dual staining cytology might be employed as an substitute biomarker for detecting high-grade CIN and cervical cancer with excellent sensitivity and specificity. The current research discusses the benefits of p16/Ki-67 dual staining, as well as how it may be used to screen for cervical cancer and precancerous lesions. Keywords: human papilloma virus, cytology, Peshawar, cervical cancer screening, CIN, p16/Ki-67 dual-staining

Background: Gastrointestinal stromal tumours (GISTS) are uncommon gastrointestinal tumours. The prognosis is heavily influenced by the histopathologic features of resection specimens, which have not been investigated extensively in our community. Objective of the current study was to assess the histopathologic features of GISTs in our community, as well as how they affect their prognosis, based on what we found. Methodology: In this study, 60 cases of GISTs were included that were found and treated at Peshawar's Khyber Teaching Hospital from Jan, 2018 to December, 2020. Results: The patients' ages varied from 18 to 71 years. The stomach was the most common location for primary GISTs, accounting for 57.7% of cases.75% of the patients had spindle cell morphology, and 53.8 percent of them had a poor prognosis. It was shown that intestinal GISTs had a higher grade (70%) and were more likely to be in the elevated-risk prognosis groups than stomach gastrointestinal stromal tumor,(43 percent). However, there is no statistical difference found. Although GISTs are rare gastro-intestinal tumors, initial discovery and recognition of unfavorable histology properties are important for effective treatment. In stomach the GISTs is prevalent. However, intestinal gastrointestinal stromal tumors are shown to be more prevalent and more likely to be linked to poor prognostic factors. Moreover, further large-scale investigations are needed to confirm this conclusion. Keywords: Intestinal-GISTs, Stomach-GISTs, Peshawar, Gastrointestinal stromal tumors

Worldwide Oral carcinomas considerable problem. It is crucial to know the molecular incidences of molecular carcinogenesis, as it has a significant association with tobacco in Pakistani population. So, this study aimed to screen out the savage high risk of papilloma virus 16/18 and p16 in oral premalignant lesion and oral squamous cell carcinoma. Moreover, the p16 correlation between HPV and OPL and OSCC was also analyzed. Method: A total of 150 samples from the oral cavity were taken from the Hayatabad Medical complex (50 samples of OPL and 100 samples of OSCC).In this study we used immunohistochemistry to look for p16 in OPL and OSCC, and we used polymerase chain reaction to find HPV. SPSS 21 was used to input and evaluate the data. The relationship between HPVandp16withdifferentvariables was determined using Chi-square and Fisher exact tests. Results:For p16, 14% of 50 oral premalignant lesions were found positive and 86% were negative. Moreover, while screening for the OSCC, the 18 percent individuals were found positive for OSCC, while the remaining (82%) screened out negative. HPV was diagnosed in 6% of 50 OPL. The co-occurrence of HPV with p16 was found in all the 15 (100%) individual’s with a p value of 0.001. However, three of the 18 cases with p16 expression did not have HPV infection. Conclusion: The current research supports the use of p16 as a unique marker for human papilloma virus in oral squamous cell carcinomas. Furthermore, a chemical carcinogen like cigarettes is thought to be one of the main risk factors for p16 and HPV infection, as well as other things.

Aim: This study aimed to find out rhabdomyosarcoma’s (RMS) histopathological and immunohistochemical features. Settings: The current study was carried out at the Department of Pathology, Section of Histopathology, Khyber Teaching Hospital Peshawar. The study duration was between from 1st January 2015 to 30th of December 2020. Results: In the current study, all the 300 occurrences were found to be relevant. The most prevalent rhabdomyosarcoma was embryonal rhabdomyosarcoma (ERMS) (87.4%), followed by alveolar rhabdomyosarcoma (ARMS) (9.4%). In the current study we found that embryonal rhabdomyosarcomas was most frequent in males (64%). ERMS were 16.1 percent found in the genitourinary system followed by neck and head region (46.7%). Most samples displayed positive Desmin and MyoD1 immunohistochemistry staining. Conclusions: It is consistent with previously published rhabdomyosarcoma data from all across the globe that our patients' epidemiologic information and microscopic findings are consistent with one other.

Objective: The primary aim of this research was to study the molecular history of fibroblast growth factor 21 (FGF21) as well as its physiological and pathological functions. Study Design: Observational study Place and Duration: This study was carried out at Hayatabad Medical Complex from December 2021 to April 2022 Methods: There were 77 patients of non-alcoholic fatty disease had age 20-65 years were presented in this study. After obtaining informed written consent details demographics were recorded. Diseases of all the patients were recorded and their relation with the FGF21 levels was observed. SPSS 23.0 was used to analyze all data. Mean standard deviation was use for categorical variables. Results: There were 42 (54.5%) males and 35 (45.5%) females among all cases. Mean age of the patients was 40.11±8.74 years and had mean BMI 27.8±11.34 kg/m2. Majority of the patients 31 (40.3%) had diabetes mellitus, 24 (31.2%) cases had renal failure, 20 (25.97%) cases had cardiovascular disease, mitochondrial disease in 17 (22.1%) cases, energy metabolism disorder in 15 (19.5%), lipid metabolism disorder in 13 (16.9%) and frequency of stroke was 9 (11.7%). We found significantly increased volume of FGF21 among diabetic obese cases which were resistant to insulin with p value

Objective: The purpose of this study was to determine how common uncontrolled HTN is among medicated hypertensive individuals in Pakistan. Study Design: Cross-sectional study Place and Duration: This study was carried out at Hayatabad Medical Complex from Jan 2022 to April 2022 Methods: Total 165 hypertensive patients of both genders were presented. Enrolled cases were aged between 18-80 years. Baseline detailed demographics included age, sex, body mass index and socio economic status were recorded. Frequency of anti-hypertensive medications and uncontrolled hypertension among all cases were assessed. SPSS 24.0 was used to analyze all data. Result: Majority of the patients 95 (57.6%) were females and 70 (42.4%) were males. Mean age of the patients was 60.4±9.30 years and had mean BMI 30.3±17.85 kg/m2. 101 (61.2%) patients had poor socio-economic status. Frequency of married patients was 130 (78.8%) cases and 105 (63.6%) cases were non-educated. Mean duration of hypertension was 5.8±6.20 years. Most frequently used antihypertensive drug was combination therapy. Frequency of uncontrolled hypertension was found in 82 (49.7%) cases. Males, people older than 60, and smokers were more likely to experience uncontrolled hypternsion. Obesity, hyperlipidemia, diabetes, anaemia, malignancy, and reflex or gastric reflux disease were all associated with an increased risk of uncontrolled hypternsion in individuals with comorbid illnesses (P

Objective: The primary emphasis of our research is on people with hematologic malignancies, and we want to learn more about the features of clinical and environmental Aspergillus isolates by doing so. Study Design: Prospective study Place and Duration: This study was carried out at Department of Pathology, Mardan Medical Complex from October 2021 to March 2022 Methods: There were 160 patients of both genders included in this study. Included patients were aged between 18-80 years. Patients with hematologic malignancy were included. Invasive aspergiluus isolates from all patients in which 80 were clinical and 80 were environmental. . With the help of SPSS 22.0, clinical data were analyzed and Aspergillus species-level cryptic identification, antifungal susceptibilities, and cyp51 gene sequencing were all carried out. Results: Among 160 included patients, majority of the cases 95 (59.4%) were males and 65 (40.6%) patients were females. We found that 75 (46.9%) cases had age >50 years. Most common diagnostic criteria were probable IA found in 140 (87.5%) cases. Co-morbidities were pulmonary disease, neurological disease, autoimmune disease, cardiac disease and burns. Cryptic Aspergillus species composed 37.5% of environmental and clinical isolates. Section Nigri had a significant value (70.5%) of cryptic species, mostly among A. awamori and A. tubingensis the former was prevalent in ambient samples and the latter in clinical isolates (P 0.003). Twelve (7.5%) of 80 A. fumigatus isolates were azole resistant. At 90 days, A.fumigatus was 100% responsible for all deaths by resistant to azoles. Conclusion: Comparing clinical and environmental isolates, this study reveals a large proportion of cryptic Aspergillus species, highlights the clinical consequences of azole resistance. Keywords: Hematologic Malignancy, Drug Resistance Mechanisms, Aspergillus, Environmental Microbiology, Azoles

Background: Throughout all countries, obesity and overweight are the most significant health issues, and they are becoming more and more common. Numerous studies have demonstrated the link of obesity with a wide variety of illnesses, including hyperlipidemia, type 2 diabetes, coronary heart disease, hypertension and breast cancer. In 1300 pupils, this study sought to know about the knowledge, attitude and practices (KAP) of obesity. Methods: In order to conduct a cross-sectional study, measurements of waist circumference, height, hip circumference and weight were taken. FFQ, or 24-hour dietary survey, was completed. In order to evaluate obesity and overweight, BMI were utilized. Data was examined using SPSS 19's statistical tool. Results: The average age of students was 21.5 +/- 2.2, with 850 (65.38%) of all pupils being female. According to BMI, 429 pupils (33%) and 52 pupils (04%) are overweight and obese respectively. Among these overweight and obese students 228 and 42 (53%& 81%) were female respectively. Conclusions: Overweight and obesity rates were substantially higher in female students than in male. The intermediate to high frequency of overweight and obesity among students at Pakistani Institute highlights the significance of over eating, lack of physical activities and substantially little knowledge about dieting and balance diet. Keywords: Obesity, body mass index, Pakistan

Insulin resistance (IR) is a state characterized by the inability of tissues to utilize blood glucose particularly liver, muscle, and adipose tissues resulting in hyperglycemia and hyperinsulinemia. A close relationship exists between IR and the development of type 2 diabetes (T2D). Therefore, therapeutic approaches to treat IR also improve T2D simultaneously. Scientific evidence has highlighted the major role of inflammatory cytokines, reactive oxygen species (ROS), environmental & genetic factors, and auto‐immune disorders in the pathophysiology of IR. Among therapeutic remedies, nutraceuticals like polyphenols are being used widely to ameliorate IR due to their safer nature compared to pharmaceutics. Stilbenes are considered important metabolically active polyphenols currently under the limelight of research to cope with IR. In this review, efforts are made to elucidate cellular and subcellular mechanisms influenced by stilbenes including modulating insulin signaling cascade, correcting glucose transport pathways, lowering postprandial glucose levels, and protecting β‐cell damage and its effects on the hyperactive immune system and proinflammatory cytokines to attenuate IR. Furthermore, future directions to further the research in stilbenes as a strong candidate against IR are included so that concrete recommendation for their use in humans is made., In this review, efforts are made to elucidate cellular and subcellular mechanisms influenced by stilbenes including modulating insulin signaling cascade, correcting glucose transport pathways, lowering postprandial glucose levels, and protecting β‐cell damage and its effects on the hyperactive immune system and proinflammatory cytokines to attenuate IR. Furthermore, future directions to further the research in stilbenes as a strong candidate against IR are included so that concrete recommendation for their use in humans is made.

This project was designed to explore the xanthine oxidase (XO) inhibitory mechanism of eight structurally diverse phenolic compounds [quercetin: C1, quercetin-3-rhamnoside: C2, 4, 5-O-dicaffeoylquinic acid: C3, 3, 5-O-dicaffeoylquinic acid: C4, 3, 4-O-di-caffeoylquinic acid: C5, 4-O-caffeoylquinic acid (C6), 3-O-caffeoylquinic acid: C7, and caffeic acid: C8]. For this purpose, in-vitro and different computational methods were applied to determine the xanthine oxidase (XO) inhibitory potential of eight structurally diverse phenolic compounds. The results revealed that phenolic compounds (C1–C8) possess strong to weak XO inhibitory activity. These results were further confirmed by atomic force microscopy (AFM) and 1H NMR analysis. Furthermore, computational study results revealed that phenolic compounds (C1–C8) bind with the surrounding amino acids of XO at the molybdenum (MO) site. These in-vitro and in-silico results divulge that phenolic compounds have a strong potential to lower uric acid levels via interacting with the XO enzyme and can be used to combat hyperuricemia.

Objective: Prostate needle biopsy samples from cancer patients at a tertiary care hospital were analysed for the presence of the potential screening indicator alpha-methylacyl-COA RACEMES. Material and Methods: This was a Cross-sectional study carried out at Department of Histopathology, Lady Reading Hospital Peshawar from June, 2021 to December, 2021.Regardless of the patient's age, tumour grade, or histological type, all adenocarcinoma prostate specimens diagnosed at the Lady Reading Hospital Peshawar on the basis of immunohistochemistry and routine histology were examined. Standard and mean deviation were computed for quantitative factors of patient like age and frequencies, percentages were calculated for qualitative factors like AMACR expressions. Results: Outof 90 cases, AMACR positivity was found in 68 (85%), while negativity was seen in 22 (15%). Nine (11.3%) of the negative cases had one staining (weak, non-circumferential) and three cases (3%) had no stainings (No cytoplasmic staining). Conclusion: Positive AMACR staining on prostate needle core necropsies may be utilised to support a cancer diagnosis when the focus at issue is 1 mm in highest diameter. Basic hematoxylin and eosin standards for malice require analysis of cell-specific markers like P63 or 34E12. AMACR labelling must be interpreted in the context of other labels that can be used to find out more. Keywords: Adenocarcinoma of the prostate, Alphamethylacyl-CoA racemase (AMACR), Immunohistochemistry.

Type 2 Diabetes causes learning and memory deficits that might be mediated by hippocampus neuron apoptosis. Studies found that taurine might improve cognitive deficits under diabetic condition because of its ability to prevent hippocampus neuron apoptosis. However, the effect and mechanism is not clear. In this study, we explore the effect and mechanism of taurine on inhibiting hippocampus neuron apoptosis. Sixty male Sprague-Dawley rats were randomly divided into control, T2D, taurine treatment (giving 0.5%, 1%, and 2% taurine in drinking water) groups. Streptozotocin was used to establish the diabetes model. HT-22 cell (hippocampus neurons line) was used for in vitro experiments. Morris Water Maze test was used to check the learning and memory ability, TUNEL assay was used to measure apoptosis and nerve growth factor (NGF); Akt/Bad pathway relevant protein was detected by western blot. Taurine improved learning and memory ability and significantly decreased apoptosis of the hippocampus neurons in T2D rats. Moreover, taurine supplement also inhibited high glucose-induced apoptosis in HT-22 cell in vitro. Mechanistically, taurine increased the expression of NGF, phosphorylation of Trka, Akt, and Bad, as well as reduced cytochrome c release from mitochondria to cytosol. However, beneficial effects of taurine were blocked in the presence of anti-NGF antibody or Akt inhibitor. Taurine could inhibit hippocampus neuron apoptosis via NGF-Akt/Bad pathway. These results provide some clues that taurine might be efficient and feasible candidate for improvement of learning and memory ability in T2D rats.

Affiliations of authors Muhammad Shahbaz and Shahid Alam were incorrect in the published book. This has now been corrected as below.

It was reported that apoptosis of Schwann cells could increase in the diabetic rats. The studies showed that taurine inhibited apoptosis in a variety of cells. However, there were few reports on studying the protection of taurine against apoptosis of Schwann cells induced by high glucose (HG) and the underlying mechanism. In our study, the cells were divided into five groups: Control: the normal medium; HG group: 50 mM high glucose; T1: 50 mM high glucose+Taurine (10 mM) group; T2: 50 mM high glucose+Taurine (20 mM) group; T3: 50 mM high glucose+Taurine (40 mM) group. We used MTT and Tunel assays to measure the cell viability and apoptosis, respectively. Then, we also used western blotting to detect the protein levels of apoptosis-related protein. The results demonstrate that taurine promoted cell viability and decreased apoptosis in RSC96 cells exposed to HG. Furthermore, taurine markedly improved imbalance of Bax and Bcl-2, inhibited the translocation of Cytochrome C (Cyt C) from mitochondria to cytosol and reduced caspase-3 activity in HG-induced RSC96 cells. Our results indicate that taurine protect against apoptosis of Schwann cells induced by HG via inhibiting mitochondria-dependent caspase-3 pathway.

Taurine protect against diabetic neuropathy. However, the protective mechanism of taurine has been poorly understood. It has been demonstrated that microRNAs (miRNAs) are involved in regulating gene expression. Therefore, it is interested in whether taurine affects miRNAs expression profile in peripheral nerve tissue of diabetic neuropathy. In the present study, rats were treated as three group: (1) control (Con) group, (2) diabetic mellitus (DM) group and (3) taurine treatment (Tau) group. Sciatic nerve tissue was harvested and miRNA expression was determined using sequencing. The results showed that 80 miRNAs showed significant difference in DM group compared to Con group, of which 20 miRNAs showed up-regulating, as well as, 60 miRNAs showed down-regulating. On the other hand, 215 differential miRNAs were found between DM and Tau groups. Moreover, the numbers of up-regulated and down-regulated miRNAs were 1 and 214, respectively. Twelve specific miRNAs were screened out and the target genes were obtained by target analysis software. GO and KEGG enrichment analyses showed that these potential target genes for the miRNAs might be involved in axon guidance, generation of neurons, nervous system development and neurogenesis. Our results provided a miRNA profile for further exploring protective mechanisms of taurine against diabetic peripheral neuropathy.

Diabetic neuropathy (DN) is the most common chronic complication of DM and its major pathological changes show axonal dysfunction, atrophy and loss. However, there are few reports that taurine promotes neurite growth of dorsal root ganglion (DRG) cells. In current study, DRG neurons were exposed to high glucose (HG) with or without taurine. The neurite outgrowth of DRG neurons was observed by fluorescent immunohistochemistry method. Expression of Gap-43, Akt, phosphorylated Akt, mTOR and phosphorylated mTOR was determined by Western blot assay. Our results showed that HG significantly decreased the neurite outgrowth and expression of Gap-43 in DRG neurons. Moreover, phosphorylated levels of Akt and mTOR were downregulated in DRG neurons exposed to HG. On the contrary, taurine supplementation significantly reversed the decreased neurite outgrowth and Gap-43 expression, and the downregulated phosphorylated levels of Akt and mTOR. However, the protective effects of taurine were blocked in the presence of PI3K antagonists LY294002 or Akt antagonists Perifosine. These results indicate that taurine promotes neurite outgrowth of DRG neurons exposed to HG via activating Akt/mTOR signal pathway.

Diabetic peripheral neuropathy is a common complications of Type 2 Diabetes and its main pathological feature is myelin sheath damage of peripheral nerve that was induced by Schwann cells (SCs) apoptosis. Increasing evidence suggested that taurine might play a role in improving DPN because of its ability to prevent SCs apoptosis. In this study, we explore the effect of taurine on preventing SCs apoptosis and its underlying mechanism. Sprague Dawley rats were treated with streptozotocin to establish the diabetes model. Rats were randomly divided into control, diabetes, taurine treatment (as giving 0.5%, 1% and 2% taurine in drinking water) groups. RSC96 cell (a rat SCs line) was used for intervention experiments in vitro. Results showed that taurine significantly corrected morphology of damaged myelin sheath and inhibited SCs apoptosis in sciatic nerve of diabetic rats. Moreover, taurine prevented apoptosis of RSC96 cells exposed to high glucose. Mechanistically, taurine up-regulated NGF expression and phosphorylation levels of Akt and GSK3β, while, blocking activation of NGF and phosphorylation of Akt and GSK3β increased apoptosis of high glucose-exposed RSC96 cells with taurine supplement. These results revealed taurine improved the myelin sheath damage of sciatic nerve in diabetic rats by controlling SCs apoptosis via NGF/Akt/GSK3β signaling pathways, which provides some clues that taurine might be effective and feasible candidate for the treatment of DPN.

Diabetes mellitus (DM) is a condition characterized by chronic hyperglycemia, which leads to diabetic neuropathy and apoptosis in the spinal cord. Taurine has been found to ameliorate the diabetic neuropathy and control apoptosis in various tissues. However, there are few reports that discuss the direct relationship between spinal cord and anti-apoptotic effect of taurine. In this study, DM was induced in male SD rats with STZ @ 25 mg/Kg of body weight in combination with high fat diet. After 2 weeks, they were divided into four groups as DM: diabetic rats, T1 (0.5%), T2 (1%) and T3 (2%) taurine solution, while control group was non-diabetic rats (no treatment). The results showed that DM increased apoptosis, decreased phosphorylated Akt and Bad. DM decreased expression of Bcl-2 and increased the Bax. Moreover, the release of cytochrome c into cytosol was increased in DM and activation of caspase-3 was also increased. However, taurine reversed all these abnormal changes in a dose dependent manner. Our results suggested the involvement of Akt/Bad signaling pathway and mitochondrial apoptosis pathway in protective effect of taurine against apoptosis in the spinal cord of diabetic rats. Therefore, taurine may be a potential medicine against diabetic neuropathy by controlling apoptosis.

Taurine protect against diabetic neuropathy. However, the protective mechanism of taurine has been poorly understood. It has been demonstrated that microRNAs (miRNAs) are involved in regulating gene expression. Therefore, it is interested in whether taurine affects miRNAs expression profile in peripheral nerve tissue of diabetic neuropathy. In the present study, rats were treated as three group: (1) control (Con) group, (2) diabetic mellitus (DM) group and (3) taurine treatment (Tau) group. Sciatic nerve tissue was harvested and miRNA expression was determined using sequencing. The results showed that 80 miRNAs showed significant difference in DM group compared to Con group, of which 20 miRNAs showed up-regulating, as well as, 60 miRNAs showed down-regulating. On the other hand, 215 differential miRNAs were found between DM and Tau groups. Moreover, the numbers of up-regulated and down-regulated miRNAs were 1 and 214, respectively. Twelve specific miRNAs were screened out and the target genes were obtained by target analysis software. GO and KEGG enrichment analyses showed that these potential target genes for the miRNAs might be involved in axon guidance, generation of neurons, nervous system development and neurogenesis. Our results provided a miRNA profile for further exploring protective mechanisms of taurine against diabetic peripheral neuropathy.

Diabetic neuropathy (DN) is the most common chronic complication of DM and its major pathological changes show axonal dysfunction, atrophy and loss. However, there are few reports that taurine promotes neurite growth of dorsal root ganglion (DRG) cells. In current study, DRG neurons were exposed to high glucose (HG) with or without taurine. The neurite outgrowth of DRG neurons was observed by fluorescent immunohistochemistry method. Expression of Gap-43, Akt, phosphorylated Akt, mTOR and phosphorylated mTOR was determined by Western blot assay. Our results showed that HG significantly decreased the neurite outgrowth and expression of Gap-43 in DRG neurons. Moreover, phosphorylated levels of Akt and mTOR were downregulated in DRG neurons exposed to HG. On the contrary, taurine supplementation significantly reversed the decreased neurite outgrowth and Gap-43 expression, and the downregulated phosphorylated levels of Akt and mTOR. However, the protective effects of taurine were blocked in the presence of PI3K antagonists LY294002 or Akt antagonists Perifosine. These results indicate that taurine promotes neurite outgrowth of DRG neurons exposed to HG via activating Akt/mTOR signal pathway.

It was reported that apoptosis of Schwann cells could increase in the diabetic rats. The studies showed that taurine inhibited apoptosis in a variety of cells. However, there were few reports on studying the protection of taurine against apoptosis of Schwann cells induced by high glucose (HG) and the underlying mechanism. In our study, the cells were divided into five groups: Control: the normal medium; HG group: 50 mM high glucose; T1: 50 mM high glucose+Taurine (10 mM) group; T2: 50 mM high glucose+Taurine (20 mM) group; T3: 50 mM high glucose+Taurine (40 mM) group. We used MTT and Tunel assays to measure the cell viability and apoptosis, respectively. Then, we also used western blotting to detect the protein levels of apoptosis-related protein. The results demonstrate that taurine promoted cell viability and decreased apoptosis in RSC96 cells exposed to HG. Furthermore, taurine markedly improved imbalance of Bax and Bcl-2, inhibited the translocation of Cytochrome C (Cyt C) from mitochondria to cytosol and reduced caspase-3 activity in HG-induced RSC96 cells. Our results indicate that taurine protect against apoptosis of Schwann cells induced by HG via inhibiting mitochondria-dependent caspase-3 pathway.