Background: Colorectal cancer is the largest cause of mortality in patients admitted to any Gastroenterology units. Diagnostic colonoscopy is a valuable tool for the disease’s diagnosis and proper treatment but its compliance has been historically low. Our main objective was to find out social, cultural, and psychological barriers among those patients who finally did not show up for their colonoscopy appointment and, make a comparative analysis with those who did. Methods: A cross-sectional study was conducted in the Lady Reading Hospital, Peshawar from October 2021 to March 2022, selecting 224 patients through consecutive sampling. Results: Out of the 224 patients included, males (48.2%) were more likely to show up for the procedure than females (51.8%) (p<0.05).  Overall, the most recurring barrier was a lack of knowledge with 116 (51.7%) for both the groups, but especially more for the non-compliant patients (p<0.05). Fear of results, fear of complications of the procedure, and affordability issues stood out as important differences between the compliant and non-compliant patients. Conclusion: For the country's healthcare to be able to overcome these problems, and enter an era where screening colonoscopy is a norm, mass education regarding the issue is imperative.

Objective: To evaluate clinical and demographic characteristics of guillian-barre syndrome. Material & Methods: Study Design: Descriptive, Cross-sectional study. Setting: Department of Neurology, Lady Reading Hospital, Peshawar. Period: December 2020 to March 2022. Results: The study identified 117 patients with GBS, and the mean age was 43.59 ± 17.39 years. There were 78 male (67%) and 39 female (33%) patients. The most common GBS subtype was AMAN (46.2%), followed by AMSAN (34.2%), AIDP (16.2%), and atypical (2.6%). The study found a significant difference in gender distribution between the two subtypes, with male patients being more likely to have axonal GBS. Regarding antecedent events, the study found that 61% of patients had a preceding illness, with gastrointestinal infection being the most common (50%). The clinical features of GBS varied by subtype, with patients with AMAN being more likely to have walking difficulty, symmetric ascending weakness, and numbness/tingling, while patients with AIDP were more likely to have a fever and respiratory distress. Conclusion: The study's findings are broadly consistent with previous research, highlighting the heterogeneity of GBS in terms of its presentation and antecedent events. However, other differentiating points that need to be taken into consideration have also been mentioned. Furthermore, work needs to be done to raise awareness among medical professionals in Nothern Pakistan regarding the salient features of the problem.

Vitamin D deficiency is often correlated with nervous system disorders like major depression, Parkinson’s disease and dementia. While much of the clinical literature suggests its association with clinical depression, very few studies have looked into the relationship between vitamin D levels and clinical depression severity. Objectives: To find out the association between vitamin D levels in patients suffering from different severities of clinical depression with the confounding socio-cultural factors of a third-world country i.e., Pakistan. Methods: The cross-sectional study was conducted in Lady Reading Hospital, Peshawar for five months with convenience sampling. Results: Overall, the study had 132 (36.57%) males and 229 (63.43%) females, and 236 diagnosed cases of Clinical Depression. In terms of Vitamin D levels, 242 (67.04%) had deficient, while 77 (21.33%) and 42 (11.63%) had insufficient and normal vitamin D levels, respectively. There was a statistically significant difference in the serum Vitamin D levels between at least two groups (F (3,232) = [38.64], p < 0.05). Conclusions: Vitamin D levels showed a dose-dependent, inverse relation with the severity of clinical depression in the Pakistani population

Objective: To investigate the frequency of Depression in Patients with Rheumatic and Musculoskeletal diseases with particular emphasis on gender and compliance to treatment. Study Design: Descriptive, Cross-sectional study. Setting: Department of Rheumatology at Lady Reading Hospital, Peshawar. Period: August 2020 to February 2021. Material & Methods: A total of 189 patients were assessed with their detailed history, examination, and lab data collected. Depressive symptomatology was evaluated using DSM – 4 criteria . SPSS 26 was utilised for data analysis, and a p-value of<0.05 was considered statistically significant. Results: 131 (69.3%) were female and 58 (31.7%) were male patients. Seropositive Rheumatoid Arthritis ranked the highest concerning the diagnosis with 128 cases (68.25%). Methotrexate was the most commonly used drug with 134 (70.9%) patients receiving it. A total of 169 (89.4%) patients had Depressive disorder, with females outnumbering males, a finding reaching statistical significance (p=0.04). Conclusion: Undiagnosed Depression is common in patients affected by Rheumatic and Musculoskeletal diseases, especially among the female population. Routine screening for depressive symptoms with subsequent referral to the mental health service may serve detection of this comorbidity and improve patient outcomes.