Objectives: To determine the frequency of elevated plasma homocysteine (Hcy) levels among type 2 diabetes mellitus (T2DM) patients. Study Design: Cross sectional study. Setting: Department of Medicine, Abbasi Shaheed Hospital, Karachi. Period: From 28 September 2012 to 26 March 2015. Material & Methods: Type 2 Diabetic patients fulfilling inclusion criteria were enrolled. Patients with conditions known to cause altered homocysteine levels were excluded. Patients’ HbA1c and fasting serum homocysteine levels were obtained. Level >15 μmol/L was labeled as elevated.  Data was collected with the help of Performa. Data was analyzed using SPSS version 21. Results: (90) ninety patients were enrolled in this study during study period with mean age of 61.5±7.3 years. Of (90) ninety patients, 45 (50%) were male and 45 (50%) were female with male to female ratio of 1:1. Mean duration of diabetes was 6.9±1.7 years. 40 (44.44%) cases were of controlled diabetes and 43 (47.7%) were on treatment. Of 90 patients 36 (40%) patients had Homocysteinemia. Homocysteine levels were found to be significantly raised in males 51.1% v/s 28.8% (p<0.03), older patients (>60 years of age) 55.5% v/s 16.6% (p<0.001), having diabetes for > 7 years, 59.2% v/s 17%(p<0.00004), in 21% v/s 57.4% cases who were and were not on treatment respectively (p<0.0004), in 22.5% patients with controlled diabetes and 54% patients with uncontrolled diabetes respectively (p<0.002). Conclusion: Hyperhomocystenemia is prevalent (40%) in type 2 diabetics with statistically significant raised levels in males, >60 years of age, non-compliant diabetics, have long duration diabetes, and uncontrolled disease.

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Background: Halitosis is a common human condition; however, the pathophysiological mechanism of halitosis is still unclear. Halitosis is mostly attributed with oral pathological conditions, in addition, halitosis resulting from gastrointestinal disorders is not rare either. Halitosis is often reported with symptoms related to Helicobacter pylori infection, epigastric pain and gastroesophageal reflux disease. Objective: Halitosis can stem from a number of gastric conditions and one of the most common causes of halitosis include the presence of a gastric infection with Helicobacter pylori. This study was conducted to evaluate the incidence ofhalitosis in patients presenting with Helicobacter pylori infection and epigastric pain. Additionally, to review whether there is a correlation between H pylori infection and halitosis; moreover, to determine whether halitosis is a valid indication for H pylori infection. Methods and Materials: This case control, comparative study was done at Medicine department of Isra University hospital and Civil hospital, Karachi during the period of January 2019 to December 2019. Participants were enrolled only after taking verbal and signed consent. Prior permission from the hospital management was taken as well. Result: Halitosis and H pylori are statistically significant with p value of 0.026. There was a clear correlation between halitosis and H pylori infection, and it may be a common contributor to halitosis.

Background: Timely diagnosis has become important because the safety and efficacy of acute cerebral ischemia depend on rapid and accurate assessment and treatment within a few hours of the onset of symptoms.The overall incidence of stroke is about 2.4 per thousand people, with a small geographical difference. Studies have shown that the echo MRI gradient is as accurate as CT within 6 hours of the onset of symptoms in patients with acute stroke. Methodology: This study is a one-time prospective comparison of CT and MRI in acute stroke assessment. The study was conducted from April 2020 to September 2020at the Hayatabad Medical Complex in Peshawar, with the ethical approval of the hospital ethical review committee. Regardless of the onset date, the severity of symptoms, or final clinical diagnosis, a series of patients suspected of further referral to a stroke staff at the hospital are eligible. Results: Results showed that out of 178 patients referred for clinical suspicion of stroke, acute stroke corresponds to almost two-thirds of the final clinical diagnosis. MRI found 92 out of 178 acute strokes and 29 out of 178 CT. According to study results, the MRI has a higher frequency for detecting any acute stroke (ischemic or hemorrhagic) compared with CT (p <0.0001). All four readers agreed that 143 patients with MRI and 103 patients with CT respectively, 143 patients (80%, 76–84%) had an acute stroke. Conclusion: MRI is better for detecting acute ischemia than CT and can detect both acute and chronic bleeding. This should therefore be the preferred test method for accurate diagnosis of patients with suspected acute stroke. Samples of patients cover a variety of diseases that may arise in an emergency with a suspected stroke so that the results can be applied immediately in the clinic. Keywords: Magnetic Resonance Imaging, Computed tomography, Acutestroke.

Objectives: The goal of this study is to assess the relative value of individual UGIB prognostic scores in predicting patient outcomes. Patients and Methods: This study was a descriptive cross-sectional analysis of data collected before. Included were patients admitted to the Al Tibri Medical college and hospital Malir Karachi Center and Fauji foundation Rawalpindi with upper GI bleeding and treated in the Gastroenterology Division. Analyses in this study compared the predictive power of five different prognostic scores (the Glasgow Coma Scale, modified Glasgow Coma Scale, coagulation risk score, and acute ischemic stroke severity score; together, these scores are known as GBS, mGBS, FRS, CRS, and AIMS65) for the occurrence of death and rebleeding within 42 days. ROC (Receiver Operating Characteristic) curves were used to compare the various scores. Results: A total of 314 individuals were enrolled in the study, with a male-to-female sex ratio of 2.48. In 70.94% of cases, fibroscopy revealed UGIB due to portal hypertension unrelated to peptic ulcer disease. The "FRS" score was the most reliable predictor of mortality or rebleeding for all patients. Compared to other scores, the "FRS" provided the best reliable forecast of whether or not patients would have spots. The "FRS" score was the most reliable one for predicting mortality. Patients deemed to be at low risk (below the threshold value) had a mortality rate of 2.2% according to the "FRS," 9.3% according to the "CRS," 0% according to the "GBS" (p = 0.565), 50% according to the "mGBS," and 11.42% according to the "AIMS65." The predictive value of UGIB scores was higher for incidental portal hypertension. Conclusion: Upper gastrointestinal hemorrhage cases can be accurately predicted using the "FRS" and "CRS" scores. But in the setting of portal hypertension, these scores did badly. UGIB Keywords: Prognostic Scores, Upper Gastrointestinal Bleeding, Rockall, Glasgow-Blatchford