Objective The aim of the study is to find out amount of physical stress among cardiovascular disease (CVD) patients and its relation with hypertension. Background Physical stress is defined as a pressure -force and strain a state of physical mental tension. Stress is among the mental factors that has for some time been recorded among the potential. Furthermore, essential hazard variables of hypertension and coronary illness. Methodology A cross-sectional study was conducted in the patients of department of Cardiology at tertiary hospitals, Karachi, from January 2014 to December 2014. Sadaf stress scale (SSS) 2.0 was used to find out the physical stress. Results It showed physical stress among CVD patients about n=39 (43.3%) have moderate physical stress. which was decreased over time after 5 year of illness as compared to the patient who have disease for less than 5 years. While systolic blood pressure among subjects with severe physical stress showed an average systolic B.P. of 147mmhg, moderate have 146mmhg and patients with mild physical stress have 135mmhg. Conclusion This report concluded moderate physical stress among CVD patients which was decrease over time due different coping mechanism and blood pressures are directly related to severity of physical stress mainly systolic which lead to hypertension.

Background: Biliary strictures(BS) possess challenging diagnosis, requiring a multidisciplinary approach. In gastrointestinal clinical practice, the occurrence of biliary strictures is quite common. Multiple diagnostic techniques are used to examine BS in which endoscopic management is considered comparatively effective and non-invasive intervention. Objective: The study aimed to observe the impact of the endoscopic management of unresectable malignant biliary strictures on the patients' quality of life (QoL). Methodology: This cross-sectional study was conducted at the Surgical Ward IV Civil Hospital Karachi, Pakistan. A total of 80 patients with diagnosed unresectable malignant stricture, aged between 18 to 70 years, those with disease duration of more than eight weeks and life expectancy > 1 month were included in the study. In addition to the baseline characteristics along with the pre and post-treatment quality of life was assessed, and the mean values were compared statistically using SPSS version 19.0. Results: The mean total score of QoL improved from 71.47 ± 0.88 at baseline to 84.12 ± 1.93 after 30 days of endoscopic management of unresectable malignant biliary strictures. Conclusion: There was a significant improvement in the patient's QoL after 30 days of endoscopic management of unresectable biliary stricture.