Objective: Prevalence of pre-high blood pressure and hypertension in early adolescent children between 12-14years old age. Study Design: Cross-section studyPlace and Duration of Study: This study was conducted at the schools of intermediate public in Al-Diwaniyah Governorate, Iraq from 1st January 2023 to 15th April 2023. Methods: This cross-section study was done in schools of intermediate public in Al-Diwaniyah Governorate, Iraq. The participants were carried out on 200 (100 males and 100 females) early adolescent children aged 12-14 years. Results: There were79% of normal blood pressure values, and 13% of them were in pre hypertension state with 4:5 male to female rate, 2% of them were in hypertension stage 1 with 3:1 male to female rate, 1% were stage 2 all females, 1.5% were isolated systolic hypertension with 1:2 male to female rate, 2% were isolated diastolic hypertension with 1:3 male to female rate, and the remainder were white coat hypertension. Conclusion: The increasing prevalence of hypertension in childhood were carrying problem of global health, demands early recognition with good treatment, a guide in a specific direction evolve progress with raise awareness of this subject shall be predicted, where early prevention could resolute before all measures.

Objective: To evaluate the effectiveness of a nurse-led preventive intervention on refining quality of life, disease- related knowledge, and complication lessening among patients with prolonged liver illness associated with hepatitis B, C, and Non-alcoholic fatty liver disease. Study Design: Quasi-experimental pre–post studyPlace and Duration of Study: This study was conducted at the Allama Iqbal Teaching Hospital, Dera Ghazi Khan from 1st July 2025 to 30th September 2025. Methods: The link between the nurse led preventive education and health improvement was assessed among patients. A total of 24 chronic liver disease patients aged 28–55 years were registered. The data were collected using the Prolonged Liver Illness Questionnaire, the SF-36 Quality of Life Scale, and the HCC Knowledge Assessment Scale. Results: Males are more with chronic liver disease than females which indicates that they are more exposed to the disease, mostly married. 83.3% improvement was seen among patients' symptoms due to following the preventive intervention. Mean difference has been reduced from 14.72 to 3.60. The systemic domain showed the highest mean difference (3.35). Fifteen (62.5%) have a good knowledge level, 8(33.3%) participants have a fair knowledge level, and only 1(4.2%) has a poor knowledge level. A Pearson correlation analysis was performed to check the association between the SF-36 Items. Mean and CLDQ 6 items Mean in which All SF-36 subscales correlated significantly with all scores of CLDQ subscales (p< 0.05). Conclusion: Nurse-led preventive education has a significant influence on patients' chronic health conditions. Organized patient education is a key policy within hepatology facilities to improve long-term predictive markers and avoid the onset of hepatocellular carcinoma.

Objective: The objective of this study was to determine whether the Platelet-Albumin-Bilirubin (PALBI) score outperformed the traditional Child-Pugh classification in predicting outcomes, such as deaths in hospitals andsubsequent bleeding, in cirrhotic patients presenting with an acute variceal bleed.Study Design: A cross-sectional studyPlace and Duration of Study: This study was conducted at the Gastroenterology Department, Holy Family Hospital, Rawalpindi from 1 July to 31 December 2021. Methods: 68 cirrhosis patients who were admitted due to acute variceal bleeding were among them. Serum albumin, bilirubin, and platelet count were used to compute the PALBI score, and the Child-Pugh classification was also evaluated. The two main outcomes were re bleeding within four weeks and in-hospital death. Each scoring system's predictive accuracy was calculated using the Area Under the Receiver Operating Characteristic Curve (AUC). Results: A total of 68 patients were enrolled in the study, with mean age 54.32 years. 63.2% (43) were male and 36.8% (25) were female. According to Child–Pugh classification, 5.9% were Class A, 27.9% Class B, and 66.2%Class C. while 14.7% were Grade 1, 38.2% Grade 2, and 47.1% Grade 3 PALBI score. Overall, in-hospital mortality was 16.17%, occurring only in Child–Pugh Classes B (5.26%) and C (22.22%), and in PALBI Grades 2 (7.69%) and3 (28.13%). No deaths were observed in Child–Pugh A or PALBI Grade 1. Rebleeding occurred in 5.26% of Class B and 57.78% of Class C patients, and in 15.38% of PALBI Grade 2 and 71.88% of Grade 3 patients; no rebleedingoccurred in Class A or PALBI Grade 1. PALBI grade showed a strong association with both mortality and rebleeding (p < 0.001). For predicting rebleeding, PALBI demonstrated high sensitivity (85.19%) and specificity(100%), with an excellent AUC of 0.926. Although not statistically superior to Child–Pugh (AUC difference 0.0944; p = 0.0722), PALBI showed better overall performance. Conclusion: When predicting rebleeding and early mortality in individuals with acute variceal hemorrhage, the PALBI score is a trustworthy method.

Objective: Stroke is still one of the most common causes of death in the world. Inflammation is a significant factor in the mechanism and course of stroke. CRP, as a major inflammatory marker, has been widely reported incardiovascular diseases; however, its prevalence and significance in acute stroke among our local population are less clear. To characterise the frequency of elevated CRP levels in patients with acute stroke. Study Design: Cross-sectional descriptive studyPlace and Duration of Study: This study was conducted at the Department of Neurology, Bolan Medical Complex, Quetta Form June 2025 to August 2025. Methods: Consecutive sampling was done and 96 patients in the age range of 20-70 years who reported with clinical symptoms of acute stroke (duration 1.7 mg/dl. Results: Fifty-two (54.2%) of the 96 patients were shown to have elevated CRP levels. Patients mean age was 58.4 ± 9.1 (range, 30-72) years; there were more males than females (60.4%). Ischemic stroke (68.8%) was moreprevalent than hemorrhagic stroke (31.3%). The most common comorbidity was hypertension (72.9%). Elevated CRP was found more frequently in ischemic patients than in haemorrhagic (p=0.03). Conclusions: This study demonstrated high rate (54.2%) of raised CRP in acute stroke patients indicating the marked inflammatory response to the condition. The significantly higher frequency of elevated CRP in ischemicstroke compared to haemorrhagic stroke in our cohort provides a novel, clinically relevant insight for our local population. This suggests that the underlying inflammatory burden may differ by stroke aetiology even atpresentation, positioning CRP as a simple, cost-effective biomarker that could aid in initial diagnostic suspicion and inflammatory risk stratification in resource-limited settings like Pakistan.

Objective: To examine the relationship between vitamin D levels, glycemic control values, and lipid profiles of obese diabetic patients. Study Design: Descriptive studyPlace and Duration of Study: This study was conducted at the College of Nursing, University of Basrah, Iraq from 1st January 2025 to 31st March 2025. Methods: Ninety males of 60 diabetic patients and 30 healthy controls were enrolled. Serum levels of vitamin D, HbA1c, glucose, and the elements of the lipid profile (total cholesterol, triglycerides, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and very low-density lipoprotein-cholesterol) were measured in addition to anthropometric measurements. Results: The diabetic patients had significantly higher body mass index, Inflammation, immunology, the endocrine system, cardiovascular disease, and dyslipidemia. These are just a few of the numerous areas where vitamin D appears to play a regulatory function. Pearson correlation analysis revealed that the level of vitamin D had a significant negative relation with both HbA1c and glucose concentrations. Non-significant or weak correlations between vitamin D and lipid parameters were, however, found. Conclusion: The possibility of poor glycemic control in obese diabetics being a factor of deficiency of vitamin D and draw attention to the possible advantages of vitamin D monitoring and supplementation in the treatment of diabetes.

Objective: To analyze the demographic and hematological characteristics of adults presenting with anemia versus those without aplastic anemia and to support timely clinical recognition and management. Study Design: A Cross-sectional study.Place and Duration of Study: This study was conducted at the General Medicine Department, Sandeman Provincial Hospital / Bolan Medical Complex Hospital Quetta from June 2025 to August 2025. Methods: One hundred adult patients with anemia were enrolled in a cross-sectional study at a tertiary care hospital. These patients underwent a detailed assessment and laboratory testing, including a complete blood count, reticulocyte count, and peripheral blood smear. Patients with peripheral blood smears showing a reticulocyte count. We're working up with anemia and bone marrow aspirations. Aplastic anemia was diagnosed according to Camitta criteria. Data were collected, including demographics, hematological, and clinical variables. SPSS version 24 was used to perform statistical analyses of these variables, and inter-group differences in cases were assessed using chi- square tests and independent t-tests between aplastic and non-aplastic anemia. Results: The 100 participants (mean age 42.8 ± 13.6 years; 54% male), the incidence of aplastic anemia was 12%. Anemia was commonly accompanied with, fatigue (83% of cases), infections (58%), and bleeding (42%).Pancytopenia was significantly more prevalent in cases of aplastic anemia (92) compared to non-18 cases; (p <0.001). Hemoglobin levels (6.1 ± 0.9 g/dL vs. 8.4 ± 1.2 g/dL; p <0.001), and the count of platelets and neutrophilswas significantly lower within the aplastic group. When looking at the severity, 50% were categorized as severe, 33% fall into the very severe category, and 17% were indicated as non-severe. Conclusion: A significant proportion of adult anemia cases are due to aplastic anemia with severe cytopenias. This demonstrates the need for prompt diagnostic evaluations and timely bone marrow assessments.

Knee osteoarthritis (OA) is the most common d disease of degenerative nature leading to the pain, reduced mobility, and diminished quality of life. Currently, treatment options are conservative approaches and advanced therapies like mesenchymal stem cell (MSC) therapy and hyaluronic acid (HA) in the injectable form Current systematic review assesses the effectiveness, safety, and comparative outcomes of MSC therapy versus HA in managing knee OA. Methods: This systematic review and meta-analysis was conducted following PRISMA guidelines (PROSPERO registration: CRD42023473958). Literature searches across multiple databases identified randomized clinical trials (RCTs) comparing MSC therapy with HA in knee OA patients. Risk of bias was assessed using RoB 2.0, and meta-canalyses employed a random-effects model to aggregate data from eligible studies. Results: Four RCTs involving 120 patients were encompassed. Studies showed that MSC therapy, especially at higher doses, improved pain, function (WOMAC and VAS scores), and cartilage quality compared to HA. MSC- treated groups exhibited sustained benefits, including improved joint mobility and reduced inflammation, over long- term follow-ups. Meta-analysis indicated significant heterogeneity (I2 > 80%), limiting definitive conclusions on pooled results. No severe adverse events were considered for MSC therapy, underscoring its safety profile. Risk of bias ranged from low to intermediate across studies. Conclusion: MSC therapy shows promise in improving clinical outcomes for knee OA compared to HA. However, high heterogeneity in study outcomes and intermediate risk of bias warrant caution. Further large-scale, well- designed RCTs are necessary to verify these findings and optimize therapy protocols.

Objective: To evaluate the diagnostic accuracy of TI-RADS in differentiating benign and malignant thyroid nodules using histopathology as the benchmark standard. Study Design: Cross-sectional analytical studyPlace and Duration of Study: This study was conducted at the Watim Medical and Dental College, Rawalpindi from July 2024 to March 2025. Methods: This study was conducted on 195 patients with thyroid nodules who underwent ultrasound evaluation followed by fine-needle aspiration cytology (FNAC) or thyroidectomy for histopathological confirmation. Nodules were classified according to the American College of Radiology TI-RADS (TR2–TR5) based on their sonographic features. Histopathological results were considered the gold standard. Results: Of the 195 patients, 143 (73.3%) had benign and 52 (26.7%) had malignant nodules. The malignancy rate increased progressively with higher TI-RADS categories: 0% in TR2, 5.5% in TR3, 20.3% in TR4, and 80.8% in TR5. TI-RADS showed a sensitivity of 90.3%, specificity of 84.6%, PPV of 70.2%, NPV of 95.3%, and an overall diagnostic accuracy of 86.7%. Conclusion: It is concluded that TI-RADS is a highly effective and reliable tool for differentiating benign from malignant thyroid nodules. Its strong correlation with histopathological outcomes confirms its diagnostic value.Routine application of TI-RADS in thyroid ultrasound practice is recommended to enhance diagnostic accuracy, standardize reporting, and minimize unnecessary invasive procedures.

Objective: To evaluate the relative importance of pentraxin-3, procalcitonin, C-reactive protein, glycated hemoglobin and body mass index as well as identify any correlations between these parameters. Study Design: Case-control studyPlace and Duration of Study: This study was conducted at the University of Babylon, College of Medicine, Iraq from 18th June to 24th September 2024. Methods: Fifty participants with diabetic foot infection and fifty healthy individuals were among the one hundred people whose Pen-3, procalcitonin, C-reactive and glycated hemoglobin levels were estimated. The age range of patients and control subjects is 38 to 69 years. The sandwich-enzyme-linked immunosorbent assay kit and the colomeric technique were used to test the levels of pentraxin-3, procalcitonin and C-reactive protein in serum. The glycated hemoglobin kit was also used. Results: There was a substantial rise in serum levels of pentraxin-3, procalcitonin and C-reactive protein as well as a significantly elevated glycated hemoglobin (p<0.001). However, glycated hemoglobin was a major relationship between pentraxin-3 and procalcitonin. Conclusion: There is a substantial link between diabetic foot and variability, pentraxin-3 and procalcitonin among patients with diabetes.

Objective: To assess quality of life in women with breast cancer by examining their sociodemographic and health profiles and determining the relationship between these factors and quality of life. Study Design: Cross-sectional descriptive studyPlace and Duration of Study: This study was conducted at the Marjan Medical City’s Oncology Centre, Iraq from 1st April 2024 to 9th February 2025. Methods: This cross-sectional descriptive study was conducted at Marjan Medical City’s Oncology Centre, Iraq and 200 women with breast cancer were enrolled. Results: 26.5% women between 50-59 years of age, 76% women were married, 29% have bachelors degree, 61.5% were belonged to urban areas 69% women were unemployed. The majority of applicants lived with family (93%). 27.5% had a first-degree comparative with breast cancer, whereas 54.5% had no chronic diseases and 51.5% were overweight. 42% were spotted within the earlier 1-2 years and 51% were at phase II diseases. 59.5% women treated with radical mastectomy and 53% received both radiotherapy and chemotherapy and moderate perceived social support. No association were founded among quality of life and sociodemographic factors. However, health-related issues showed solid correlations, time since diagnosis (p=0.000), surgery type (p=0.002) and type of treatment(p=0.003) were all significantly accomplished to quality of life. Conclusion: The sociodemographic issues did not influence quality of life, health-related factors such as surgical intervention, diagnosis duration and type of treatment had a significant influence. Social support levels weremoderate among participants.