In the present study, 124 samples of milk and milk products were analyzed for the presence of aflatoxin M1 (AFM1), which were purchased from the central cities of Punjab, Pakistan. The analysis was carried out using reverse-phase liquid chromatography, which was equipped with a fluorescence detector. The results showed that 66 samples (53.8%) of raw milk and milk products were found to be contaminated with detectable levels of AFM1 above ≤50 ng/L, and 24.2% of the samples had levels of AFM1 higher than the permissible limit of the European Union (EU; 50 ng/kg). In total, 53.6% of the raw milk, 57.8% of the UHT (ultra-heat-temperature) milk, 45% of the powdered milk, 57.1% of the yogurt, 55.5% of the cheese, and 50% of the buttermilk samples had levels higher than the LOD, i.e., 4 ng/L. The highest mean of 82.4 ± 7.8 ng/kg of AFM1 was present in the positive samples of raw milk. The highest dietary intake of AFM1 was found in infants’ milk (5.35 ng/kg/day), UHT milk (1.80 ng/kg/day), powdered milk (5.25 ng/kg/day), and yogurt (1.11 ng/kg/day). However, no dietary intake was detected in the cheese and butter milk samples used for infants. The results from the undertaken work are beneficial for establishing rigorous limits for AFB1 in animal feed, especially considering the high prevalence rate of hepatitis cases in the central cities of Punjab, Pakistan.

Introduction The aim of this study was to compare epidemiological characteristics of breast cancer in young adolescent women (YAW) versus older women (OW). Methods This was a cross-sectional prospective observational study, conducted in Ward 3, Jinnah Postgraduate Medical Center, Karachi, Pakistan, from September 2021 to February 2022. A total of 120 female patients were recruited in this study from the Outpatient Department of Jinnah Postgraduate Medical Center, out of which 22 patients were below the age of 40 years and 98 were above 40 years. For breast cancer diagnosis, we used the triple assessment method involving clinical examination, radiology, and histopathology. Diagnosed patients were further evaluated for hormonal status and metastatic workup. Results were noted on a performa, and differences between both age groups were analyzed. Results Out of 120 patients, 22 were younger than 40 years and 98 were older than 40 years. YAW used to present late after the appearance of symptoms. Patients of both age groups mostly presented with breast lumps (68.18% in YAW and 81.6% in OW). YAW presented with larger sizes of lumps and with more nodal involvement as compared to OW. BI-RADS IV (Breast Imaging Reporting and Data System Category IV) was the most commonly observed (27.27% in YAW and 48.97% in OW) mammographic finding in both age groups. Invasive ductal carcinoma was the most common histological type in both age groups (72.73% in YAW and 76.53% in OW). The triple-negative disease was more commonly found in YAW than OW (40.91% in YAW vs 21.43% in OW). We found that usually YAW presented at advanced stages (stages III and IV, 54.55%) and higher grades (grade III, 63.63%). Conclusion Breast cancer in young patients is rare but more aggressive with higher grades, advanced stages, and poor prognostic features. Heredity is mainly the risk factor in young breast cancer patients. There should be proper screening programs for high-risk group for early diagnosis and prompt treatment. Other age-specific concerns such as psychological impact of disease should be addressed as well.

Background: Lactational breast abscess is attributed to higher morbidities among women, specifically from developing countries. Though many treatment options are available, still consensus regarding the modality yielding the best outcome is scarce. The study's objective was to compare the outcome of lactational breast abscess following incision & drainage (ID) versus ultrasound-guided needle aspiration (USGNA). Methodology: This prospective comparative investigation was carried upon a sample of 59 female patients with lactational breast abscess (chosen via non-probability, consecutive sampling), presenting to the Department of Surgery at Liaquat University Hospital, Hyderabad. The patients were divided into two groups, namely Group A (ID) and Group B (USGNA). Data was documented using a structured questionnaire, including inquiries related to sociodemographic details, disease specifics, and treatment outcomes (mainly abscess resolution, uninterrupted breastfeeding and fistula formation). Results: The results showed that 3 patients (5.08%) from group A developed mammary fistula, 26 (44.06%) with complete resolution, and only 1 (1.69%) patient attained uninterrupted breastfeeding. In group B, there was full resolution in 28 (47.45%) patients, and the abscess of 2 (3.38%) patients did not completely resolve, while 28 (47.45%) attained uninterrupted breastfeeding. Conclusion: It can be concluded that USGNA yields a better outcome in the treatment of lactational breast abscess in terms of lesser incidence of fistula development, the better probability of complete resolution and a significantly higher rate of attainments of the ability to breastfeed uninterruptedly.

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Objective: To observe the effects of hookah smoking on hematological and inflammatory parameters in chronic hookah smokers. Methods: A cross sectional observational study was conducted in the setting of Post Graduate Medical Institute, Lahore from March to September, 2021, on 30 male chronic hookah smokers, who had been smoking hookah for more than 5 years, in the age range of 30-60 years and a comparison of their hematological parameters was done with 30 subjects of the same age group and ethnic background with no history of hookah smoking. Fresh blood samples from antecubital vein were collected and tested for hemoglobin (Hb) content, red blood cells (RBC) count, packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC), platelet count, neutrophil count, lymphocyte count and neutrophil lymphocyte ratio (NLR). An automatic hematological analyzer was used to get results. High sensitivity CRP (hs-CRP) was measured using Elisa kit.  Data was analyzed using SPSS 21. Results: A statistically significant difference was found in Hb, PCV, MCV, MCH, MCHC, platelets, MPV (p ˂ 0.05). Inflammatory markers such as hs-CRP (p = 0.05), NLR (p = 0.03) were significantly higher in hookah smokers as compared to non-smoker. Conclusion: Hookah smokers have altered hematological and inflammatory parameters and are at higher risk of developing atherosclerosis, cardiovascular and pulmonary diseases associated with these alterations.