Khyber Pakhtunkhwa Research Articles

BRAF and RET polymorphism association with thyroid cancer risk, a preliminary study from Khyber Pakhtunkhwa population.

Thyroid cancer, originating in the neck's thyroid gland, encompasses various types. Genetic mutations, particularly in BRAF and RET genes are crucial in its development. This study investigates the association between BRAF (rs113488022) and RET (rs77709286) polymorphisms and thyroid cancer risk in the Khyber Pakhtunkhwa (KP) population. Blood samples from 100 thyroid cancer patients and 100 healthy controls were genotyped using ARMS-PCR followed by gel electrophoresis and statistical analysis. Analysis revealed a significant association between the minor allele T of BRAF (rs113488022) and thyroid cancer risk (P = 0.0001). Both genotypes of BRAF (rs113488022) showed significant associations with thyroid cancer risk (AT; P = 0.0012 and TT; P = 0.045). Conversely, the minor allele G of RET (rs77709286) exhibited a non-significant association with thyroid cancer risk (P = 0.2614), and neither genotype showed significant associations (CG; P = 0.317, GG; P = 0.651). Demographic and clinical parameters analysis using SPSS showed a non-significant association between BRAF and RET variants and age group (P = 0.878 and P = 0.536), gender (P = 0.587 and P = 0.21), tumor size (P = 0.796 and P = 0.765), or tumor localization (P = 0.689 and P = 0.727). In conclusion, this study emphasizes the significant association between BRAF polymorphism and thyroid cancer risk, while RET polymorphism showed a less pronounced impact. Further validation using larger and specific datasets is essential to establish conclusive results.

Epidemiology and phylogeny of Haemonchus contortus through internal transcribed spacer 2 gene in small ruminants

IntroductionHaemonchus contortus (H. contortus) is a blood-feeding nematode causing infectious disease haemonchosis in small ruminants of tropical and subtropical regions around the world. This study aimed to explore the prevalence and phylogeny of H. contortus in small ruminants using the internal transcribed spacer-2 (ITS-2) gene. In addition, a comprehensive review of the available literature on the status of H. contortus in Pakistan was conducted.MethodsFecal samples were collected from sheep and goats (n = 180). Microscopically positive samples were subjected to DNA extraction followed by PCR using species-specific primers.ResultsThe overall prevalence of H. contortus was 25.55% in small ruminants. The prevalence of H. contortus was significantly associated with months and area. The highest occurrence of haemonchosis was documented in July (38.70%), whereas the lowest occurred in December (11.11%), with significant difference. The prevalence was highest in the Ghamkol camp (29.4%) and lowest in the arid zone of the Small Ruminant Research Institute (17.5%) (p = 0.01). The results of the systematic review revealed the highest prevalence of haemonchosis (34.4%) in Khyber Pakhtunkhwa (p = 0.001).DiscussionPhylogenetic analysis revealed a close relationship between H. contortus and isolates from Asia (China, India, Iran, Bangladesh, Malaysia, and Mongolia) and European countries (Italy and the United Kingdom). It has been concluded that H. contortus is prevalent in small ruminants of Kohat district and all over Pakistan, which could be a potential threat to food-producing animals, farmers, dairy, and the meat industry. Phylogenetic analysis indicates that H. contortus isolates share close phylogenetic relationships with species from Asia and Europe.

Family Role in the Reintegration of Juvenile Delinquents: A Post Release Analysis in Dir Valley Pakistan

This research focuses on the reintegration of released juvenile offenders within Dir Valley in Khyber Pakhtunkhwa, Pakistan. Situated within a unique socio-cultural and legal context, this region face distinct challenges that impact the lives of juvenile offenders. This study aims to uncover the role of family dynamics in shaping successful reintegration and inform tailored interventions. Using a qualitative phenomenological approach, the study collected data through semi structured interviews with twenty released juvenile offenders and twenty family members. Thematic analysis revealed intricate patterns in family involvement that significantly influence the reintegration process. The family emerged as both a source of support and challenge for these juveniles. Challenges included absent key family members, strained relationships, and dysfunctional family environments, which hinderd reintegration efforts. Economic challenges, emotional support, and family criminal history were also found relevant factors in reintegration. The study’s conclusions offer policy implications, including family centered policies, tailored interventions, and holistic rehabilitation.

Intra-Familial Cases of Hepatitis B Virus and Their Associated Risk Factors of Transmission in District Mardan, Khyber Pakhtunkhwa, Pakistan

Introduction: Hepatitis - B Virus is a prevalent viral hepatitis, with high morbidity, and mortality worldwide. It affects 2 billion people, especially those with limited healthcare access and low socioeconomic status. It causes liver problems which may be acute or chronic. HBV is transmitted from mother to fetus during pregnancy (vertical transmission) and also transmitted from infected individuals to others (horizontal transmission). In our society, the family living system is a joint system, many people live in a single house which results in the sharing of different personal items. So, there are high chances of intra-familial cases of HBV. This study aimed to find out the intra-familial cases of HBV infections and their associated risk factors of transmission within a family in District Mardan. Methodology: This was a descriptive cross-sectional study conducted in the Department of Pathology, Mardan Medical Complex, District Mardan, Khyber Pakhtunkhwa Pakistan. After ethical approval and informed consent from participants a total of 36 positive families of HBV were taken by using a non-probability convenience sampling method. Data was collected from positive individuals with the help of a pre-designed questionnaire. That data was analyzed through SPSS version 22. Results: Out of 36 families, 50% had no HBV-positive members, while 50% had positive individuals. There were 18 households (50%) with only one member positive for HBV, 12 families (33.3%) with two members, 4 families (11.1%) with three individuals, and 2 families (5.6%) with four members. There were three major risk factors present, which resulted in intra-family HBV transmission. There were 7 (19.4%) families where Vertical transmission was the main risk factor. 7 were (19.4%) due to the use of personal hygiene goods, whereas 4 families (11.1%) were due to unsafe sexual intercourse among couples (husband/wife). Conclusion: There was an equal chance of the hepatitis B virus to affect only one member of a family or have transmission to other members within a family. Multiple risk factors are involved in the transmission of HBV in a family but most of the cases were due to vertical transmission, use of personal hygienic items, and unsafe sexual intercourse between (couples)wife and husband in district Mardan, Pakistan. Key words: Hepatitis-B virus, Intra-familial, vertical transmission, Mardan, Risk factor

Fetal Outcome in Younger Age Pregnant Female; A Tertiary Care Hospital

Background: The efficacy of Caesarean section in managing breech births surpasses that of a vaginal birth. Risk factors associated with breech presentation include prematurity,recurrent pregnancies, uterine anomalies, and fetal abnormalities. this study aimed toassess fetal outcomes in younger age pregnant female.Materials and Methods:This cross-sectional study was performed in Department of Obstetrics and Gynecology at Mardan Medical Complex, Mardan. The study conducted in 12 months duration from January to December 2020. All data including patients' history,and clinical tests were collected through designed proforma. All recruited patients and fetal were monitor. All data were analyzed through Microsoft excel 2016.Results: Fetal outcomes revealed that out of the total cases, 53.6% found in age group 18-25 years and 46.4% in age 26-33 years. Apgar scores found low in 17.8%, low birth weight fetus observed in 17.8%, birth asphyxia in 32.9%, brachial plexus in 12.5%, andfetal distress in 11.4%.Conclusion: This study highlights that fetal birth issues including low birth weight, birth asphyxia, brachial plexus, and detal distress are common here in our region. It is a crucial to take additional precautions, including vigilant labor monitoring and thorough preparation for infant resuscitation, to mitigate these issues within our local Khyber Pakhtunkhwa community. Awareness of the risks associated with each option can aid in personalized decision-making regarding breech delivery, adding value to the decision-making process. Therefore, the choice of delivery method for breech presentations should be informed by the findings of this study.

Effectiveness of Billion Trees Tsunami Afforestation Projects in restoration of forests in Pakistan

AbstractThe history of forest cover dynamics in Pakistan reveals an unsatisfactory environmental situation. In the past 5 decades, particularly during the period between 1990 and 2010, the country lost an average of 41,100 hectares of green cover with a deforestation rate of 1.6% per year. The factors behind that this high deforestation rate is numerous including socio-economic transformation after the major political change during the 1970s in the mountainous areas of Pakistan, demographic changes, accessibility improvements, and land use changes. Several social forestry campaigns have been launched over time to cope with this socioecological and environmental issue. However, most of them have not been very effective due to certain shortcomings. This study aims to evaluate the effectiveness of the most recent and history’s biggest forest restoration program initiated by the government of the Khyber Pakhtunkhwa Province called the Billion Trees Tsunami Afforestation Project (BTTAP). This project was announced in 2013 when a new political party, Pakistan Tehreek-e-Insaf, came into power. The study is focused on one of the main forest hubs of the country in the Hindukush Mountains spanning five districts. Forest cover in this study area decreased from 20 to 2% between 1990 and 2010. After the launch of the BTTAP, the forest cover increased considerably from 2 to 35% by the year 2021. This growth was achieved through planting new trees, banning forest cutting, practicing surveillance, and enhancing community participation. If the project continues and the protection measures are not suspended, it can play a historical role in forest restoration.

Path and cost optimization using genetic algorithm: an application perspective

Genetic Algorithm is an optimization technique inspired by nature. The technique has been used by scientists and engineers for real-life search and optimization problems. This work makes use of the genetic algorithm for the solution of the traveling salesman problem. This work focuses on real-time problems; the algorithm is used to find the optimum path for sales travelers inside the Khyber Pakhtunkhwa Province of Pakistan. The solution provides the shortest distance between the cities to be traveled and gives the optimal route. The coding is done in Python-3 and software is developed for the traveling salesmen, where the salesmen can select the cities, they want to travel, and the software will provide the optimal path and the distance.

Advanced floodplain mapping: HEC-RAS and ArcGIS pro application on Swat River

AbstractFloods stand out as one of the most devastating environmental threats worldwide resulting in the tragic loss of human lives and significant damage to our essential infrastructure. This study focuses on creating floodplain maps for the two important reaches of Swat River in the Khyber Pakhtunkhwa Province of Pakistan, namely, Kalam–Khwazakhela and Khwazakhela–Chakdara reaches. The Advanced Land Observing Satellite Phased Array Type L-band Synthetic Aperture Radar (ALOS PALSAR) 12.5 m Digital Elevation Model (DEM) data has been used for this purpose. Furthermore, the sensitivity of the flood model was assessed for the Flood 2022 event, considering simulated flood depth, extent, and velocity in relation to various terrains derived from the 12.5-m ALOS PALSAR data. To estimate extreme flows for different return periods (2, 5, 10, 25, 50, and 100 years), the Log Normal (LN), Log Pearson III (LP3), and Generalized Extreme Value (GEV) distributions were employed for the frequency analysis. The GEV distribution turned out to be the best fit for modeling the Swat River for both the Chakdara and Khwazakhela gauge stations. To predict flood levels for the peak floods identified through frequency analysis and for the specific return periods the Hydrologic Engineering Center's River Analysis System (HEC-RAS) 2D simulations were performed. Subsequently the outcomes of this model were used to create floodplain maps using Geographic Information System Professional (ArcGIS Pro) software customized for various return periods. The analysis revealed a linear increase in flood inundation area with longer return periods. The floodplain maps developed hold significant importance for the governing authorities of the Swat region. These maps serve as essential tools for implementing proactive measures against potential infrastructure damage, thereby protecting against economic losses and enhancing public safety. This research effectively combines hydrological modeling and geospatial technology offering practical solutions for managing flood risks. It serves as a valuable guide for making well-informed decisions and promoting sustainable development in flood-prone areas.

Religiosity-based behavioral study, Islamic finance users’ approach and selection standard: empirical evidence from Pakistan

Purpose Considering the speedy growth of Islamic finance and limited research work on Muslim behavior regarding Islamic Banking, this study aims to investigate to comprehend the stimulus of religiosity on customer’s behavior. Design/methodology/approach A conceptual model is developed on existing literature. The key dimensions of religiosity in the model include practice, knowledge, experience and consequences to capture the whole religiosity of customers. Model of the study investigates the impact of customer’s religiosity on their behavior in decision-making about selection of Islamic bank. Analysis of the study is based on the sample of 370 customers of Islamic banks from District Nowshera Khyber Pakhtunkhwa, Pakistan. The data for the study collected through random sampling by a comprehensive survey questionnaire. Binary logistic model is used to test the data for statistical analysis. Findings The key findings of the study suggest that religiosity influence customer behavior positively in decision-making regarding Islamic finance. Service standards of Islamic banking has also significant impact on customer perception, while the financial education of the customers has insignificant impact on customer behavior. Research limitations/implications This study mainly focused on the curiosity of the customer religious commitment, so religiosity is a vast phenomenon; there are deep sections in each dimension of religiosity, so further study is suggested for the comprehensive capture of each dimension of religiosity. Practical implications The results of the study have a great importance for the managers of Islamic finance industry to identify and detect the potential customers and divide the target market of banking industry on the base of religiosity. Furthermore, the study may bring significant managerial suggestions for marketing planners and can help them in market segmentation strategies. Originality/value The study examined the association between Muslim religiosity and Islamic banking customer’s selection behavior. This study spread the understanding of religiosity and its impact on Islamic banking customer’s behavior. Furthermore, the study is valuable to discover the level to which religiosity determines the inclinations of customers. This study helps marketing practitioners and researchers to grow their knowledge about customer’s motives in terms of religious commitment.

Medical Disorders in Pregnancy Among Inpatients at a Tertiary Level Hospital of Peshawar (Khyber Pakhtunkhwa)

OBJECTIVES This study aimed to determine the prevalence, type, and demographic makeup of pregnancy-related medical conditions among patients receiving treatment in a tertiary care facility. METHODOLOGY The Monocentric retrospective impact study was conducted in the Department of Obstetrics and Gynaecology of MTI, Hayatabad Medical Complex Peshawar, from January to December 2022. Case records of all pregnant women (n=1811) with previous or recently developed medical conditions treated during the study period were collected from the records / medical registers, and all the information was recorded in a pre-structured proforma. All women with previous or recently developed medical conditions treated during the study were included. All pregnant women without any medical conditions were excluded. Data was analyzed using simple statistical measures, and the results were presented as frequency percentages. Prior approval from the institution’s ethical committee was obtained to conduct the study. vRESULTSAmong 6327 antenatal admissions, 1811 (28.62%) women had medical disorders. The most common medical disorder was PIH, reported in 384 (21.20%) of the females, followed by RH incompatibility and Gestational Diabetes Mellitus (GDM) seen in 235 (12.98%) and 205 (11.32%) females, respectively. Other notable medical conditions include UTI in 170 (9.39%), Chronic HTN in 134 (7.40%), iron deficiency anemia in 122 (6.74%), and pre-eclampsia in 100 (5.52%) of women. CONCLUSION Pre-existing medical conditions in pregnancy are not uncommon. Early recognition of acute illness and treatment of chronic conditions in pregnancy is of clear benefit and needs to be managed to arrest any adversaries to the mother and fetus.

Translating and Validating PRISMA-7 Questionnaire in Urdu: A Screening Tool to Identify Frail Individuals.

Frailty is a condition in which the affected individual is more prone to both external and internal stressors and has a higher risk of succumbing to chronic diseases. The aim of this research was to translate and validate the PRISMA-7 questionnaire in the Urdu language. This is a validation study conducted in a hospital in Khyber Pakhtunkhwa, Pakistan. PRISMA-7 Questionnaire was translated into Urdu language using forward and backward translations and was then piloted on a sample of 151 subjects, aged 60 and above, and validated by applying reliability and validity statistics. Amongst the sampling population, frailty was found to be 63.26%. All the items in the questionnaire were significantly different from each other, however, the correlation between each was found to be low. Cronbach's alpha was found to be 0.322. Urdu translated version of PRISMA-7 is not a valid and reliable tool for screening frailty in the elderly population of Khyber Pakhtunkhwa, Pakistan. Key Words: Frailty, Validation, Translation, Frail elderly, Urdu.

Screening of Type 2 Diabetes Patients of Khyber Pakhtunkhwa for CDKAL1 Variant (rs10946398)

Diabetes Mellitus Type 2 (T2DM) is a metabolic disorder influenced by environmental and genetic factors, with varied genetic predispositions across populations. Research on T2DM's genetic risk factors in the Pakistani community is limited. Objective: To explore the association between the CDKAL1 gene variant (rs10946398) and T2DM in the Khyber Pakhtunkhwa population in Pakistan. Methods: The study involved 100 T2DM patients and 100 controls, matched by age and gender, following specific inclusion and exclusion criteria. Sociodemographic data were collected alongside 3ml of whole blood for DNA extraction. The CDKAL1 gene was analyzed using PCR-based Sequence Restriction Fragment Length Polymorphism (RFLP), and the data were processed with SPSS version 26.0s. Results: Findings showed that 47% of cases were aged 39 to 59, with 94% having a family history of T2DM and 85% leading a sedentary lifestyle. A significant association was observed between the CDKAL1 rs10946398 variant and T2DM. The GC variant was linked to a fourfold increase in risk (OR: 4.833, CI: 1.197-19.509, P=0.027), and the CC variant had a twofold association (OR: 2.788, CI: 1.545-5.033, P=0.001). These associations persisted after adjusting for family history, age, socioeconomic factors, exercise, and diet. Conclusions: The study identified a significant correlation between the CDKAL1 rs10946398 variants and T2DM susceptibility in the Khyber Pakhtunkhwa population, emphasizing the role of genetic factors in the disease's prevalence within this community.  

Investigating the Level of Attitude and Satisfaction among Nursing Instructors Regarding OSCE/OSPE at the Institutes of KPK

The Objective Structured Clinical Examination (OSCE) is a commonly utilized tool for evaluating clinical performance among students pursuing medical and health professions. The study was conducted with the aim of determining the level of attitude and satisfaction among nursing educators in Khyber Pakhtunkhwa, Pakistan. Methods: A cross sectional analytical study design was used to evaluate the level of attitude and satisfaction from nursing educators of Khyber Pakhtunkhwa from 181 participants using convenient sampling technique. The study was conducted from March to December 2023. A valid and reliable adopted questionnaire was used for collection. The study was approved by the ethical review board while informed consent from each participant was taken before data collection. Independent t-test, ANNOVA and chi-square test was applied through SPSS version 22.0 for data analysis. Results: In the present study, the number of males was higher (65%), age 25 to 35 was 89 (49.4%), and education post-RN BSN was 101 (56.1%) in majority. The maximum number of the participants, 132 (73.3%), attitude level was moderate, having a mean score of 46.79 ± 7.01, while the level of satisfaction of the higher number of participants, 141 (78.3%), was also moderate, with a mean score of 79.77 ± 10.53. There was significant difference in mean score of attitudes within the groups of qualification, and experience, while the satisfaction there were significant difference within the groups of age, qualification and experience. Conclusions: The study concluded that attitude is associated with age, qualification, and experience, while satisfaction was associated with qualification, the tool should be improved for acceptance and understanding.

Association of Plant Parasitic Nematodes with some Vegetables Crops of Khyber Pakhtun Khwa, Pakistan

Association of Plant Parasitic Nematodes with some Vegetables Crops of Khyber Pakhtun Khwa, Pakistan

The Role of Education in Fostering Political Empowerment among the Female School Teachers in Newly Merged Districts of Khyber Pakhtunkhwa

One of the fundamental institutions that exist in one form or another in every society on the planet is education. The present research focuses on how education supports women's political empowerment in Khyber Pakhtunkhwa's newly merged districts. The study's main goal was to determine how education contributes to the political empowerment of female teachers in the targeted community. In a similar vein, the study's goal was to ascertain how teachers in the research area support women's political empowerment. The research was quantitative in nature, and 225 sample size (female teachers) were chosen from the three districts of Bajawar, Kurram, and Mohmmand using the Sekran sample size determination table. The data were collected through structured questionnaires from (Primary, Middle, and High) school teachers, which were then analyzed using the Statistical Package for Social Sciences (SPSS) software. The analyzed data were then presented in the form of tables and frequencies. The researched data demonstrates that in Khyber Pakhtunkhwa's newly merged districts, education may promote women's political empowerment in the true sense. It is advised that training, seminars, and awareness-raising events on the value of education and how it gives women political power be required for both the general public and female teachers.

Harmonizing Progress: The Resounding Impact of Education on Women's Economic Empowerment

This study explores the transformative role of education in economically empowering women in District Dir Lower, Malakand Division, Khyber Pakhtunkhwa, Pakistan. The research delves into the correlation between women's education and economic well-being, emphasizing education as a gateway for women to compete in the labor market, strengthen earning possibilities, and gain control over resources. The methodology employs purposive sampling to engage with 20 educated and employed women, using open-ended questions in interviews to capture authentic narratives. Thematic analysis is applied to unravel insights, and ethical considerations ensure confidentiality and cultural sensitivity. The qualitative data analysis unveils a rich tapestry of themes, emphasizing education's impact on women's employment and productivity. Educated women emerge as pivotal contributors to family and national income, participating actively in legislation and policy-making. The study underlines the importance of women's education as a gateway to economic growth, with higher literacy rates correlating to stronger GDP and GNP. The symphony of women's education is portrayed as a transformative force, empowering nations and fostering a brighter, more inclusive future. The study calls for government prioritization of girls' education, implementation of skill development programs, and gender-responsive labor policies to foster gender equality and women's economic empowerment.

Effectiveness of In-Service Training Programs: A Narrative Approach of Teachers Professional Development at Girls Secondary Level

This research study aims to unravel the influence of in-service training programs on the teaching-learning process of secondary school teachers in Khyber Pakhtunkhwa, Pakistan. The study argues that teachers play a critical role in shaping the future of their students, and the quality of a nation's academic performance is linked to the quality of its teachers. Thus, it is essential to improve the quality of teacher education. Qualitative narrative research was employed in this study. The researcher selected five public girls' secondary schools through convenient sampling in district Mardan. The researcher selected ten secondary school teachers, and participants were selected using a random purposive technique. Semi-structured interviews were conducted following the saturation level of the interview questions. This research study furnished valuable findings with reference to in-service training that will assist in transforming teachers with sophisticated and constructivist teaching-learning processes. This research study accomplished recommendations at the teacher-educator level, policy level, teacher level, and student level. It's recommended that teachers should focus on reflective thinking and teacher group discussions in an attempt to make a more effective classroom. Teacher educators should empower teachers by reshaping their naive and traditional teaching practices. Realistic efforts need teachers' professional development with follow-up supervision by competent and dedicated trainers.

Instructional Leadership and School Effectiveness: A Correlational Study at Secondary Level Institutions in the Context of District Bannu

This study examines the correlation between instructional leadership and school effectiveness at secondary-level institutions in the context of district Bannu, Khyber Pakhtunkhwa, Pakistan. This study aimed to find out this relationship through a correlational research design. All 1511 teachers from 100 public sector secondary level schools constituted the population of this study. A close-ended 7-point Likert scale questionnaire comprising of 45 items was utilized by the researcher to obtain data from 306 teachers of 80 secondary-level institutions through a stratified random technique. The data that was obtained was analyzed through SPSS using Pearson’s R statistics. The findings reveal a strong, significant correlation between instructional leadership and school effectiveness. The study clearly confirmed that the explicit role of an instructional leader leads to successful school effectiveness.

Determinants of Green Energy Use: Household Level Comparative Analysis of Southern Khyber Pakhtunkhwa

In recent times, the utilization of renewable energy sources has gained significant traction and garnered widespread attention across diverse social segments. The prominent driver behind this surge in popularity is its cost-effectiveness and long-term durability. Notably, even individuals with limited financial means are increasingly drawn toward various forms of renewable energy. This research endeavor aims to draw comparisons between users and non-users of green energy and their corresponding household behaviors. Upon conducting a rigorous data analysis, the study will present a comprehensive and well-founded conclusion, along with offering pertinent recommendations. This study is slated to take place in the rural regions of Southern Khyber Pakhtunkhwa, Pakistan. The study employed random sampling to select a sample from the population and focused on examining the relationship between the utilization of green energy, its characteristics, conventional green energy use, and the quality of solar energy. The primary objective of the study was to explore the choices made by individual households concerning green energy consumption and the factors that influence this choice. The analysis was carried out using Ordinary Least Squares (OLS) regression. This research gap presents a significant opportunity for advancing the promotion and adoption of renewable energy sources.

Assessing tobacco-related ischemic stroke in Pakistan (1990-2019): Insights from the Global Burden of Disease Study.

This study analyzes the impact of active smoking and secondhand smoke on the ischemic stroke burden of Pakistan, 1990-2019. We used data from the Global Burden of Disease (GBD) database to conduct a comprehensive evaluation of ischemic stroke-related indicators in Pakistan, including the number of deaths, mortality rates, disability-adjusted life years (DALYs), DALY rates, and the estimated annual percentage change (EAPC). Joinpoint analysis was applied to assess sex-specific temporal trends in the burden of active smoking and secondhand smoke in Pakistan and regions of Pakistan. These assessments incorporated the Socio-Demographic Index (SDI) and we have made comparative analyses of epidemiological differences between active smoking and secondhand smoke exposure. The burden of ischemic stroke related to tobacco use is presented in terms of the age-standardized mortality rate (ASMR) and the age-standardized disability-adjusted life year rate (ASDR) per 100000 population. The results (ASMR/ASDR) for Pakistan were 6.04/130.81, in the middle SDI region 7.69/176.54, and low-middle SDI region 5.64/124.22. Pakistan's ASMR is higher than the global average of 5.85, while ASDR is lower than the global average of 140.23. From 1990 to 2019, a downward trend in both ASMR and ASDR was observed, indicating progress in controlling tobacco-related stroke burdens. Individuals aged ≥70 years experienced the highest rates of stroke (ASMR: 66.31; ASDR: 1091.20). Gender disparities were evident: men were more affected by active smoking (ASMR: 3.08; ASDR: 78.47) than women (ASMR: 0.79; ASDR: 20.76), while women faced a higher burden from secondhand smoke (ASMR: 0.66; ASDR: 16.33) compared to men (ASMR: 0.79; ASDR: 9.93). Regional differences within Pakistan show fluctuating death and DALY rates. Notably, an increasing trend in female ASDR due to secondhand smoke in the Khyber Pakhtunkhwa Region (annual percentage change, APC=0.17 from 2010 to 2019) calls for focused health interventions. The study finds ASMR for tobacco-related ischemic stroke in Pakistan exceeds global averages, with significant gender and age disparities in exposure to smoke, highlighting the need for targeted health interventions.