Breast cancer is a major cause of mortality among females, worldwide. The present study was intended to evaluate the significance in the management of carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) in patients with breast cancer. MethodologyA cohort study was conducted at the Jinnah Postgraduate Medical Center, Karachi, Pakistan from June 2020 to May 2021. All diagnosed cases of breast cancer who underwent surgical excision of tumor were eligible to partake. Patients who had metastatic breast cancer or had a recurrence were excluded. The patient's sociodemographic and clinical data were documented in a predefined pro forma. It included information about the age, sex, weight, as well as serum CEA and CA15-3. The CA15-3 and CEA levels for each patient were assessed by taking a 5ml blood sample and sending it to the laboratory for further workup. preoperatively on the second, seventh, and 28th postoperative days. ResultsA mean ± SD age of 52.6 ± 8.89 years was reported. Family history of breast cancer was positive in one-fourth of the patients. Nodal metastasis was negative in 114 (46.72%) patients. Three-fourth of patients had Stage II-IV with only a minority diagnosed with Stage I. The mean levels for CA15-3 in women with Stage I cancer was significantly lower on the seventh day and 28th postoperative day, compared to preoperative levels (p = 0.05). Similar associations were seen for stages II and III. Higher CEA levels were significantly associated with stage III breast cancer preoperatively (5.88 ng/ml, p = 0.05) compared to postoperative values. ConclusionThe current study revealed that preoperative values of serum CEA and CA15-3 significantly reduced postoperatively. Moreover, patients with advanced cancers had significantly higher levels of both tumor markers than those with less advanced diseases. The current study highlighted the importance of regular assessment of serum CEA and CA15-3 in breast cancer patients. Both these biomarkers are substantially elevated in breast cancer patients, preoperatively. Determining the levels of serum CEA and CA15-3 preand postoperatively may determine the prognosis and aid in forming the most optimal patient care regime with respect to the stage and subtype of cancer.

Objective: To determine the frequency of HIV infections in patients with pulmonary tuberculosis. Patients and methods: This cross-sectional study, was conducted at the Department of Medicine, Ghulam Muhammad Mehar Medical College, Sukkur, from October 2019 to 2020. All the patients had pulmonary TB of any duration; their ages ranged from 15 years to 45 years, and both genders were included. Sputum analysis for the patients with known pulmonary tuberculosis was done for AFB (Positive/Negative). Sputum was also sent for a GeneXpert test for the diagnosis of MDR TB. The patient's sputum culture and sensitivity were checked from the record and the XDR TB, if present in that record, was noted. In all patients with PTB, blood was taken and sent for serology. HIV was assessed by serology. All of the data was taken and recorded into the proforma at its completion, and was then analyzed by SPSS version 26 for the research purpose. RESULTS: The average age of the patients was 34.2±10.3 years, and the average duration of TB was 8.1±3.9 months. Out of all, 90 (64.3%) were males and 50 (35.7%) were females. In distribution for types of pulmonary tuberculosis, 1st line drug response was found in 41 (29.4%) patients, MDR TB in 60 (42.8%), while XDR TB was found in 39 (27.8%) patients. HIV infection serology was found to be positive in 53 (37.9%) patients. As per stratification, the HIV serological infection was significantly higher among males (p-0.004), while it was statistically insignificant according to the patients' age and disease status (p->0.05). CONCLUSION: It was to be concluded that the prevalence of HIV infection was documented as considerably high in patients with pulmonary tuberculosis. Therefore, all individuals having tuberculosis should be evaluated for HIV risk factors and advised to get tested. Keywords: HIV, Pulmonary Tuberculosis, Co-Infection

Objective: To determine the frequency of vitamin d deficiency and insufficiency among patients of diabetes mellitus type II presented at medicine OPD of tertiary care Hospital Methodology: This cross-sectional study was done at Medicine department of Peoples University of Medical and Health Sciences for women Nawabshah (SBA). Study was done during six months from April 2020 to September 2020. All patients of diabetes mellitus type II, age >40 years and of either were included. A 5ml sample was taken from each patient and was sent to the diagnostic laboratory to assess the HbA1c level and vitamin D status. The normal range for vitamin D (25-OHD) was 30–40 ng/ml. The value <20 ng/ml was defined as deficiency while insufficiency was ranged between 20.1- 29.9 ng/ml. All the data was collected by the self-made study proforma. Data analysis was done by using the SPSS version 26. Results: A total of 62 patients of diabetes mellitus were studied for vitamin D level; their average age was 49.51+12.65 years and average duration of diabetes was 10.25+5.22 years. Average HbA1c was 7.33+3.5 and the average vitamin D level was 27.21+21.98. 36(58.1%) were males and 26(41.9%) were females. Average BMI was 28.41+3.63 kg/m2. Out of all study participants 48.40% of the cases were observed with vitamin D deficiency. Vitamin D deficiency was statistically insignificant according to gender and socioeconomic status (p=>0.05). Conclusion: As per study conclusion the vitamin D deficiency and insufficiency was observed to be higher among patients of diabetes mellitus type II and vitamin D deficiency was insignificantly linked to gender, socioeconomic status and severity of diabetes. Keywords: Vitamin D, Type II diabetes mellitus

Objectives: To evaluate the frequency of different risk profiles and associated clinical parameters in patients with nonalcoholic fatty liver disease (NAFLD). Methodology: This cross-sectional study was conducted at the Gambat Institute Of Medical Sciences,Gambat District, Khairpur, between March 2019 to January 2020. A total of 345 patients participated in the study. Demographics, clinical features, investigations, and causative agents of NAFLD were noted in a document. Patients with raised ALT, fatty liver on imaging, aged between 18-75 years were a part of the study. Exclusion criteria included patients with overconsumption of alcohol, positive HBsAg, positive anti-HCV, and other underlying liver diseases with known origin. Patients’ blood samples were also tested for fasting blood sugar, random blood sugar, fasting cholesterol and fasting triglyceride levels.Levels of glucose, triglycerides and cholesterol were measured with an autoanalyzer; Photometer 4010; Beohrnger Mannheim; using the enzymatic-calorimetric methods. All data was analyzed using SPSS version 24. Results: The mean age of the patient was 48.4 ± 12.2 years and a mean body mass index of 30.2 The mean cholesterol was 199.4 ± 54.3 mg/dl. The majority i.e. > 60 percent were women with only 128 (37.1%) males (Table 1). The body mass index (BMI) was significantly higher in female patients as compared to males (p<0.001). The males had a significantly greater frequency of traits for metabolic syndrome as compared to women i.e. 111 (86.7%) vs. 145 (66.8%) (p=0.02). Obesity in patients was also significantly associated with female gender. We found a significant relationship of hypercholesterolemia in patients with DMT2 (p=0.04). Similarly, the majority of the patients i.e. 55 (47%) with DMT2 also had hypertriglyceridemia (p=0.002). Conclusion: The present study indicated that female gender, obesity, and diabetes mellitus were significantly associated with NAFLD. NAFLD places a significant burden on the healthcare system and is associated with poor quality of life of patients. Metabolic syndrome is another leading association that needs to be explored in further detail. Recognition of high-risk profile patients can help establish early diagnosis and hence treatment plans can be implemented at an early stage of disease. Keywords: fatty liver, chronic liver disease, non-alcoholic liver disease, NAFLD, obesity, diabetes mellitus, dyslipidemia

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,