Aim: To assess the frequency and risk factors for genitourinary infections in people with type 2 diabetes who are using SGLT2 inhibitors. Study design: A retrospective study. Place and Duration: Jinnah Hospital Lahore from March 2021 to March 2022. Methodology: This study included 57 people with type 2 diabetes who were using SGLT2 inhibitors.The parameters linked to genitourinary infections were observed via the use of multiple logistic regression analyses. This study utilized patients' medical records for observation and analysis. At the beginning of SGLT2 inhibitor therapy, data on the patient's age, gender, height, weight, duration of diabetes, menopausal status, HbA1c, and creatinine levels were collected. Two independent teams of scientists looked through the results of the investigation before concluding the final hypothesis. Results: Genitourinary infection occurred at a rate of 2.37 percent in the first month and 21.78 percent in the second month of the therapy. Genitourinary infections are more likely in individuals with HbA1c values between 7.0 and 8.0% (OR=3.45, p=0.001), 8.0% to 9.0% (OR=8.56, p=0.0001), and 9.0% (OR=11.45, p=0.0001), as well as diabetes medications such as SUR (OR=4.13, p0.001) and insulin (OR=3.81, p0.001).

Ring enhancing lesions are a common neurological problem seen in eithergender and in all age groups. Objectives: To determine the clinical presentations and etiologicalfactors in patients with ring enhancing lesion on CT scan brain. Design: Case series study.Period: One year. Setting: Department of medicine, Liaquat University Hospital, Hyderabad.Patients and methods: Subjects of either sex ≥12 years of age, presented with seizures, fever,focal neurological signs and deficit, headache, weight loss and vomiting and had single ormultiple ring enhancing lesions on computed tomography (contrast CT brain film) were enrolledand entered in the study. CT scan brain was advised to evaluate any identified lesion and thencertain specific biochemical tests were also advised to detect the particular existence etiologicalfactor. The data was analyzed in SPSS 16 and the frequency and percentage was calculated.Results: During one year study period, total 50 subjects were detected as ring enhancing lesionon CT scan. The mean age ±SD of the over all population was 28.87±4.84 whereas the meanage ±SD of male and female population was 27.76±6.53 and 30.76±5.83 respectively. Ringenhancing lesions were right sided in 30 patients (60%), on the left side in 15 (30%) and bilaterallesions were identified in 6 subjects (10%) on brain imaging. Majority of the ring enhancinglesions were single 45 (90%) and the parietal lobe was observed as the commonest site. Theheadache, seizures, fever, pyramidal signs and papilledema was identified the common clinicalfeatures whereas the common etiological factors responsible for ring enhancing impression onbrain CT scan were tuberculoma 17(34%), brain tumor 12(24%), metastasis 05(10%) and brainabscess 04(08%). Conclusions: The male population was predominant while the seizure wasobserved as common clinical feature whereas the tuberculoma, brain tumour and metastasisare the common etiological factors responsible for ring enhancing lesion on brain imaging.

Objective: To determine the frequency of hepatocellular carcinoma in different Child-Pugh classes based on Alfa fetoprotein level. Study design: Case series study. Period: Six months Setting: Medical Unit-I of Liaquat University Hospital, Hyderabad Sindh Pakistan. Patients & Methods: A total of 100 patients admitted (inpatients) in Medical Unit I with the diagnosis of cirrhosis were enrolled in the study. Patients with cirrhosis of liver (more than six month duration) of either gender were included. If patients had metastatic lesion of the liver, liver abscess, or acute liver failure then they were excluded. Child-Pugh score was calculated which included ascites, encephalopathy, prothrombin time, albumin and serum bilirubin. The levels of α-fetoprotein were measured and HCC was diagnosed. The primary outcome variable was presence of HCC in cirrhotic patients. Results: The proportion of males (53%) was higher as compared to females (47%). The mean age of the study patients was 40.47 years with a standard deviation of 11.5. At the beginning patients were categorized according to Child Pugh Classes (A= up to 6, B=7-9 and C=10-11), age groups (15-30 years, 31-50 years and 51-70 years respectively). The mean Child Pugh score was 6.83 with ± 1.8 S.D. The majority of the cases of HCC (75.61%) occurred in the Child Class A, whereas 21.95% occurred in Child Class B and finally only one case of HCC (2.44%) was present in Child Class C. Conclusions: This study comprehensively demonstrated that hepatocellular carcinoma (HCC) is far more common in compensated cirrhosis (Child Pugh Class A) vs. decompensated cirrhosis (Child Pugh Class B and C).

Aim: The purpose of this study was to determine the frequency of constipation in people with diabetes seen at an outpatient endocrinology clinic. Study design: A cross-sectional study Place and Duration: This study was conducted at , People's University of Medical and Health Science for Women Nawabshah Pakistan between April 2020 to April 2021. Methodology: An outpatient endocrinology clinic conducted at our institute using questionnaire & Rome III criteria. According to Rome III, the following should be considered constipation symptoms: (1) fewer than three bowel movements per week, (2) an attempt to empty bowl, (3) hard or lumpy stools, (4) a belief that an evacuation is incomplete, (5) a belief that an evacuation is blocked, and (6) manual defecation procedures. Results: Constipation was shown to be common among diabetes individuals in 31.2 percent of the 372 participants studied. Females outnumbered males in the sample (72.8 percent), as well as in terms of constipation frequency (80.2 percent). The prevalence of type 2 diabetes was 97.3 percent, and 80.2 percent of the participants were above the age of 50 years. Constipation was linked to poor glycemic control (HgA1c 7) in 112 participants. Conclusion: In comparison to the general population, persons with diabetes mellitus who met the Rome III criteria had a higher rate of constipation. Inadequate glycemic control increases the incidence of constipation in people with diabetes mellitus, and further research is needed to prove this hypothesis. Keywords: diabetes mellitus, constipation, prevalence,

Chronic hyperglycemia in Type 2 Diabetes Mellitus (T2 DM) is associated with ongoing damage, dysfunction, and failure of many organs, particularly the eyes, kidneys, nerves, heart, lungs, blood vessels and the diabetic patients may have considerable reductions in lung functioning. Diabetes Mellitus, Peak Expiratory Flow, and Fasting Blood Sugar are some of the terms used in this study. One hundred T2 DM patients, ranging in age from 30-70 years old and of either gender, were submitted to spirometry, vital parameters were recorded, glycated hemoglobin (HbA1c) and fasting blood sugar (FBS) were evaluated, and healthy controls were a matched. Diabetics forced vital capacity (FVC) ranged from 1.51 to 4 (Liters) with a mean of 2.4 ±0.6SD, whereas controls' FVC ranged from 2.2 to 4.74 with a mean of 3.14 ±0.7SD and a significant P value. (P<0.001) diabetics peak expiratory flow rate (PEFR) ranged from 188 to 459 (liters per minute) with a mean of 288 ±70SD, whereas controls PEFR ranged from 243 to 571 with a mean of 373±74 and a significant P-value. When compared to male diabetics, the PEFR in female diabetics was 239 ±38SD with a significant P-value. Spirometric parameters in male diabetics were found to be insignificant when compared to healthy controls (P <0.001). In both sexes, HbA1c and FBS were shown to be extremely significant when compared to controls. Variable PEFR in healthy controls and in the lung function was found to be impaired in female diabetics, but male diabetics had a normal PEFR.