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Excessive consumption of tea and coffee has been linked with dietary iron deficiency in many clinical trials. People who consume tea or coffee with meal are at higher risk of developing dietary iron deficiency. Objective: The aim of this study was to assess the prevalence of iron deficiency in relation with tea or coffee among female university students. Methods: 150 female students at University of Lahore selected randomly. All participants were willing to participate in this survey. Questionnaires (on the base of 25 iron deficiency related question) were used for the collection of data to assess the relation between consumption of tea and iron deficiency. Results: 88 participants reported experiencing headache when not taking tea or coffee for long time. 41 desire to consume it all the time. 49 participants experience fatigue when not consumed tea or coffee. 31 participants consume tea or coffee with meal. 27 participants experience symptoms of anemia. 68 participants consume tea or coffee for mind relaxation. 54 participants take tea or coffee for better sleep. 83 participants consume for weight management. About 91 participants take dietary supplement for iron less than 1-2 times a day. Conclusions: This study shows that all the participants consume tea or coffee on daily basis while majority of them take with meal. The participants revealed to have symptoms of iron deficiency. Consumption of tea or coffee with meal is one of the reasons of dietary iron deficiency as chelates present in tea and coffee hinders the absorption of iron from food.

Consuming excessive amounts of tea and coffee can have negative effects on your health, including increased anxiety, disrupted sleep patterns, and digestive issues. Objective: The objective of this study was to assess trigger factors after consuming tea or coffee. Methods: A random sample of 150 female students from the University of Lahore willingly participated in a survey aimed at evaluating the link between tea consumption and its trigger factors. Data was collected using questionnaires comprising questions related to excessive tea or coffee consumption. Results: Results showed that participants felt anxiety, insomnia, digestive issues, caffeine addiction, rapid heart rate, fatigue, headache and other symptoms after excessive tea or coffee consumption. There was an association between excessive consumption of tea or coffee as the chi-square value is significant (p= 0.025) whereas irregular menstrual cycle also shows a significant association with excessive consumption of tea or coffee (p=0.000). Conclusions: The findings show a significant association between excessive tea or coffee consumption and the trigger factors studied, including irregular menstrual cycles. This study could be used to inform public health campaigns aimed at promoting healthy beverage consumption habits.

Introduction: Rectal cancer is a common malignancy affecting millions of individuals worldwide. Surgery is the primary treatment modality, and for many patients, the creation of a temporary ileostomy is required to protect the anastomosis and allow for healing. Objectives: The main objective of the study is to find the safety and feasibility of early ileostomy closure within four to eight weeks of the initial surgery compared to traditional closure time frames of six to twelve months and to examine the potential benefits of early ileostomy closure, including reductions in morbidity, improved quality of life, and decreased healthcare costs. Material and methods: This multicenter study was conducted in Surgical Department Lady Reading hospital Peshawar during 1st January 2020 to 30th June 2020. Data on patient demographics, medical history, surgical procedures, and postoperative outcomes were collected using medical records and standardized data collection forms. Patient-reported outcomes, such as quality of life and stoma-related complications, may also have been assessed using validated instruments. Results: Demographic data of the 60 patients included in the study showed a median age of 62 years (range: 42-84 years) and a male-to-female ratio of 1:1.3. The majority of patients (70%) had an American Society of Anesthesiologists (ASA) physical status of 2 or 3, indicating mild to moderate systemic disease. The median body mass index (BMI) was 25 kg/m² (range: 18-35 kg/m²), with 30% of patients classified as overweight (BMI 25-29.9 kg/m²) and 13% classified as obese (BMI ≥ 30 kg/m²). Practical implication: This article will helps to support the safety and efficacy of early closure of temporary ileostomy in patients with rectal cancer. Conclusion: In conclusion, this study provides evidence to support the safety and efficacy of early closure of temporary ileostomy in patients with rectal cancer. The results indicate that there were no significant differences in the incidence of complications between early closure and traditional closure groups. Keywords: Temporary, Ileostomy, Patients, Rectal, Cancer

Introduction: Worldwide most common malignancy in females is breast carcinoma and accounts for almost one-third of all women cancers. In developing countries of Asia like in Pakistan, breast carcinoma has the highest incidence. With an age-standardised incidence rate (ASR) of 51.7, and the rate of the new cases of breast cancer is on the rise similar to the Western population. Objectives: The main objective of the study is to analyse the stage wise presentation of breast carcinoma in patients aged 40 years. Material and methods: This cross sectional study was conducted in Khyber teaching Hospital Peshawar from 2017 to 2020. The data was collected from 200 female patients who were suffering from breast cancer at different stages. The data was collected through a systematically prepared questionnaire after taking consent. Results: The data was collected from 200 female breast cancer patients. Out of which 68 patients were < 40 years and 132 patients were >40 years of age. Majority of patients 90 presented in 41—50 years, followed by 50 cases in 51—60 years and least cases observed in 21—30 years of age. Stage III was the commonest stage in younger patients followed by stage II while in older patients stage ii was common than stage iii. 82 patients presented in stage iii while 70 patients in stage ii. Least cases presented in stage i. 82 patients out of 200 patients presented with stage iii. Overall ductal carcinoma is the most common type of breast carcinoma. Left breast carcinoma is more than right breast carcinoma. Conclusion: It is concluded that breast cancer is more common in older age as compared to young age. In young patients stage iii is more common than stage ii while in old patient’s stage ii is more than stage iii, however overall stage iii has the highest frequency. Keywords: Breast, Cancer, TNM, Factors, Patients

With the outbreak of a global pandemic, people were faced with many difficulties such as financial and health issues, including psychological problems. There was a sharp rise in mental health issues as people were advised to observe social distancing resulting in social isolation. The present study examined three measures of psychological distress among the undergraduate student population: depression, anxiety, and stress. It also sought to study differences in academic years and gender on measures of psychological distress. A convenient and snowball sample of 1032 undergraduate students, aged between 17 and 25 years (M=21.81, SD = 1.99), filled out a survey. DASS – 21 was used to collect data on depression, anxiety, and stress among students. Descriptive statistics showed mild to normal levels of stress (M = 9.64), anxiety (M = 8.17) and depression (M = 9.05). Independent t-tests revealed significantly higher levels of psychological distress among women compared to men. Further, a one-way ANOVA and post hoc analyses showed that only juniors had significantly higher levels of stress compared to freshmen. Factors such as social support and religion have been discussed as possible explanations for lower levels of psychological distress in the overall student population. This research highlights resilience among students and future research should focus on investigating the factors which can help in dealing with difficult situations.

Introduction: Globally, over 2 million colorectal cancer cases were diagnosed. It is the second most common cause of cancer fatalities, causing 1 million deaths annually. The current study aimed to compare surgery and chemoradiotherapy treatment outcomes in colorectal cancer recurrence. Method: The current study was conducted using a randomized clinical trial design. The study was carried out at Hayatabad Medical Complex, Peshawar. A total of 74 patients previously treated for colorectal cancer, were selected. The patients who showed recurrence, based on radiology results, were selected for the current study. Survival from the commencement of chemoradiotherapy/surgery to death from any cause or censoring at the final follow-up was defined as overall survival (OS). OS were calculated using the Kaplan–Meier technique and compared with the log-rank test. All analyses were conducted using SPSS v25 and Jamovi. Result: A total of 21 patient included in the final analysis. The mean age in the surgery group was quite higher than the chemoradiotherapy group (p = 0.31). The male to female ratio in each group was 12/4, 8/3 respectively. The timer size was quite higher than the chemoradiotherapy group (p = 0.20). Two patients were died in the chemoradiotherapy group while one patient was died in surgery group. The survival rate of the surgery was quite good as compared to the chemoradiotherapy group. In the chemoradiotherapy group the patients survived up to 30 months, however, the patient treats with surgery showed the longest survival. Conclusion: The current study compared the surgery and Chemo-radio therapy in locally recurrent colorectal cancer. Two patients in the chemoradiotherapy group and one in the surgery group was died. Compared to those who had chemoradiation, surgical patients had a much higher chance of survival. In the chemoradiotherapy group, patients lived up to 30 months; nevertheless, the surgical group had the longest survival rate.

Background: Bleeding is common during pregnancy and it is quite normal during first trimester. As the first bleed indicates, implantation of fertilized egg in the lining of uterus. It is common complication of almost 16-25% of pregnancies. 20% of the women experience light or spotted bleeding. Half of these pregnancies survive while the rest lead towards miscarriage. The first trimester bleed can be because of different pathological conditions mainly: miscarriage, cervical bleeding, infection and ectopic pregnancy. Methodology: Women with bleeding or pain or both in pregnancy, without any conclusive analysis from December 2020 to December 2021 were presented to Gynecology ward, of DHQ Hospital, Timergara and Khyber Teaching Hospital, Peshawar. Evaluation was done with history and physical examination counting ultrasonography, pelvic examination, an HCG level and cervical cultures. 60 gravid females with less than 20 weeks of gestational age that presented with substantial per vaginal bleeding were recruited into the study population. Patients were properly counseled and each patient was given informed oral consent before being recruited for the research. Information about these prenatal, obstetric, and puerperal patients was recorded in an organized obstetric data sheet. SPSS version 16.0 was used for analysis of data. The chi-square test was used to evaluate relationships among groups. Results: The mothers mean age in the study and group of control was 24.7 ± 3.2 years and 23.93 ± 3.3 years, correspondingly (P> 0.05). The study group has mean parity of 1.9 ± 1.3 and in the control group 2.1 ± 1.4 (P> 0.05). At the time of presentation; mean gestational age for bleeding in the study group was 12.3 ± 1.68 weeks and for control group, it was 12.4 ± 1.39 weeks (P> 0.05). The comparison in both groups was accomplished but no significant differences in relations of birth history, gestational age and age was noted. Conclusion: The study found that recurrent episodes of bleeding per vaginal in late gestation and bleeding per vaginal in early gestation were related with premature delivery, low birth weight and miscarriage. Keywords: Apgar scores, Abruptio placentae, placenta praevia, low birth weight.

Hundreds of women die daily due to preventable causes related to pregnancy and childbirth. Multiple programs have been developed to support efforts to reduce maternal mortality. However, no synthesis has been conducted to date that reviews the design, delivery, and impact of these initiatives in Pakistan. After conducting a systematic literature search, we found 23 articles describing interventions. We analyzed these articles for intervention characteristics. In this scoping review the authors identify the characteristics of interventions to improve maternal health services in Pakistan and priorities for future programs and research. Recommendations include multi-level interventions, stakeholder engagement, and rigorous evaluations of existing interventions.

Among noble gases, Helium and Neon have smaller size, high ionization potential and low polarizability due to which these two gases exhibit weak binding affinities toward any surface. Bartlet's discovery and subsequent similar successful discoveries of stable complexes of noble gases opened new avenues for the storage of noble gases particularly on the new surfaces and their interactions for the storage of these gases. Here, we report the adsorption of light noble gases on polycationic clusters. Our current work not only investigates the interaction behavior of He and Ne with (Sb7Te8)

Among noble gases, Helium and Neon have smaller size, high ionization potential and low polarizability due to which these two gases exhibit weak binding affinities toward any surface. Bartlet’s discovery and subsequent similar successful discoveries of stable complexes of noble gases opened new avenues for the storage of noble gases particularly on the new surfaces and their interactions for the storage of these gases. Here, we report the adsorption of light noble gases on polycationic clusters. Our current work not only investigates the interaction behavior of He and Ne with (Sb7Te8)5+ cluster but also explores the saturation limit of the cluster for He and Ne. Stability of various complexes of He and Ne with cationic surfaces is determined by the calculation of their interaction energies which reveal that the adsorption of single and multiple atoms of noble gases at faces of double cubic cluster is comparatively more favorable than at the bond lengths. Electronic properties such as HOMO-LUMO gaps show that complexes of He and Ne are more stable electronically than that of pure cluster, because HOMO-LUMO gap of complexes are higher than the bare polycationic cluster. NCI analysis of iso-surfaces and RDG maps confirms the presence of van der Waals forces between light noble gases and polycationic clusters. Saturation studies reveal that cluster can adsorb eleven He and/or ten Ne atoms with no or minimum distortion in the geometry of cluster. The results showed that Ne has greater tendency to interact with polycationic clusters due to the large electronic cloud and polarizability value than He.

Purpose of the study: The objectives were to investigate and correlate the learning environment of students and the performance of students at the university level. Methodology: The study was descriptive. The study population consisted of the students currently studying at GC Women University Faisalabad. The data were computed using descriptive as well as inferential statistics. The selfdeveloped instrument, Learning Environment and Performance Survey [LEPS], was used. Main Findings: When the learning environment improves the performance of the students also increases strongly. The result showed the weak positive relationship of the learning environment with the performance of urban areas students. On the other hand, there were strong positive relationships of the learning environment with the performance of rural students. Applications of this study: The study may be applied to investigate and improve the students' learning environment. Novelty/Originality of this study: The female students had a better learning environment and significantly improved their achievement scores. Rural students had an insignificant difference in their learning environment and performance. &nbsp

The research was conducted to explore the situation of religious minorities in acquiring job opportunities, difficulties face by them at worship places and in accessing health facilities. Objectives of the study are to analyze how Christians, Hindus, Ahmadis and Sikhs are marginalized in the society; to explore the issues face by religious minorities at worship places; and to document their perceptions about provision of health care facilities. For data collection, snowball sampling and purposive sampling technique were used. A sample size of thirty respondents comprising of, ten Christians, eight Ahmadis, six Hindus and six Sikhs were interviewed. In order to collect the data, in-depth interviews was used as research technique. Interview guide was used as a tool for data collection. Data was analyzed by using thematic analysis. It is found in the research that religious minorities in Lahore, Pakistan were in a grimy condition. They face negligence from state institutions; exploited by extremist groups and general public show hatred towards them. The research reveals that people of this society socially exclude the religious minorities from mainstream of society just because of their religion. They have no equal opportunity in jobs. People limit their interaction with religious minorities because people label them untouchable. The government has least priority to provide security to religious minorities. This research also found that they are also facing marginalization in provision of health care facilities.