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Background One of the main risk factors for coronary artery disease (CAD), which is a significant source of morbidity and death, is diabetes mellitus (DM), which also speeds up the disease's course and severity. This study aimed to compare the severity of CAD between diabetic and non-diabetic patients, providing insights to guide clinical decision-making and improve therapeutic outcomes. Methodology A prospective, observational study was conducted at the Sheikh Mohamed Bin Zayed Al Nahyan Institute of Cardiology, Quetta, from August 2018 to July 2019, involving 204 adult patients with CAD, consisting of 102 patients with diabetes and 102 without diabetes. Demographic, clinical, and laboratory data were collected, and coronary angiography was performed to assess the severity of CAD, which was defined as a binary outcome variable (1 = severe CAD, 0 = not severe CAD), based on criteria such as multi-vessel involvement and degree of stenosis. Statistical analysis was carried out using IBM SPSS Statistics for Windows, V. 25.0 (IBM Corp., Armonk, NY, USA), with chi-squared tests used for categorical variables (e.g., number of affected vessels, plaque distribution) and independent t-tests for continuous variables (e.g., fasting blood glucose, hemoglobin A1c(HbA1c) levels, lipid profiles). Logistic regression was employed to identify independent predictors of CAD severity, and odds ratios (ORs) with 95% confidence intervals (CI) were calculated, with statistical significance defined as a p-value of less than 0.05. Results Diabetic patients exhibited significantly higher rates of multi-vessel disease (70 (68.63%) vs. 52 (50.98%); p = 0.02), three-vessel involvement (37 (36.27%) vs. 25 (24.51%); p = 0.01), and severe stenosis (64 (62.75%) vs. 52 (50.98%); p = 0.019) compared to non-diabetic patients. Fasting blood glucose (158.21 ± 45.63 mg/dL vs. 98.31 ± 12.74 mg/dL; p < 0.001) and HbA1c (8.21 ± 1.34% vs. 5.62 ± 0.41%; p < 0.001) levels were significantly higher in diabetics. Multivariate regression analysis revealed that diabetes (OR = 2.12; 95% CI: 1.35-3.32; p = 0.001), hypertension (OR = 1.45; 95% CI: 1.01-2.08; p = 0.04), elevated glucose levels (fasting blood glucose OR = 1.04; 95% CI: 1.02-1.06; p < 0.001; HbA1c OR = 1.27; 95% CI: 1.15-1.41; p < 0.001), and age (OR = 1.03; 95% CI: 1.01-1.05; p = 0.02) were significant predictors of CAD severity, with each increase in fasting blood glucose, HbA1c, and age associated with higher odds of severe CAD. Other variables, such as gender, hyperlipidemia, smoking history, sedentary lifestyle, and regular exercise, did not show significant associations with CAD severity (p > 0.05). However, a family history of CAD was identified as a significant predictor (OR = 1.56; 95% CI: 1.06-2.31; p = 0.02), suggesting that those with a family history of CAD had 56% higher odds of experiencing severe CAD. Systolic blood pressure (OR = 1.18; 95% CI: 1.07-1.30; p = 0.002) was associated with CAD severity, with each 10 mmHg increase in systolic blood pressure increasing the odds of severe CAD.  Conclusion DM is linked to more severe CAD, with high blood pressure, HbA1c, and blood glucose levels contributing to increased severity, emphasizing the need for early detection and aggressive treatment to mitigate its impact on heart health, and further research, including long-term follow-up and therapeutic interventions, is needed to enhance management for diabetic CAD patients., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Sheikh Mohamed Bin Zayed Al Nahyan Institute of Cardiology Institutional Review Board issued approval 173/SMBZ-DOC/2018. The study was approved in July 2018. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2025, Arshad et al.)

Objective: To determine the frequency of E. coli resistance to ciprofloxacin and common factors leading to it among patients presenting with urinary tract infection., Study Design: Descriptive cross-sectional study., Place and Duration of Study: Department of Medicine, Ayub Teaching Hospital, Abbottabad, from December 2011 to June 2012., Methodology: A total of 166 patients, > 18 years of age of both gender, who presented with features of UTI and had urine culture positive for E.coli were included in the study. The urine samples were further tested for ciprofloxacin resistance and the patients were further checked for the common factors leading to E.coli resistance to ciprofloxacin., Results: Among 166 patients, 41 were male and 125 were female patients. Sixty-six (39.8%) E. coli isolates showed ciprofloxacin resistance. Male gender (p-value 0.001), previous history of recurrent UTI (p = 0.008, OR = 2.37), history of prior use of ciprofloxacin (p = 0.018, OR = 2.16) and history of catheterization (p = 0.005, OR = 4.80) were independent risk factors found in this study for the development of ciprofloxacin resistant UTIs., Conclusion: Ciprofloxacin resistance rates of E.coli were high at over 39.8%. The risk factors that affected the ciprofloxacin resistance rates of E.coli were prior use of ciprofloxacin, recurrent UTI, previous catheterization and male gender. Ciprofloxacin should be prescribed cautiously in patients with these risk factors and urine culture and sensitivity test should be performed for optimal treatment.

Background: Stroke is a common neurological disease that results in significant mortality and morbidity globally. Several risk factors have been identified for stroke among which hyperlipidaemia is one of the modifiable risk factors. Recent clinical trials have shown a reduction in ischemic stroke for patients taking lipid lowering medications. Therefore, the aim of this study was to find out the frequency of hypercholesterolemia in patients of ischemic stroke in Hazara region., Methods: This cross sectional study was carried out in the Medical Department of Ayub Teaching Hospital, Abbottabad. Ninety patients of stroke confirmed as ischemic by CT scan brain were enrolled in the study after informed consent. The frequency of hypercholesterolemia in patients was recorded., Results: There were 55 (61.1%) males. The mean age of patients was 64.4±11.5 years. The mean serum cholesterol in all patients was 4.16±1.1 mmol/l. The mean serum cholesterol of male patients was 4.3±1.2 mmol/l and 4.0±10.9 mmol/l in the case of females., Conclusions: Hypercholesterolemia could not be established as a major risk factor for stroke in our setup through this study that allude to the fact that other risk factors might be contributing more to the incidence of cerebrovascular accident in our population.

Kikuchi Fujimoto Disease (KFD) or histiocytic necrotizing lymphadenitis can present with unexplained fever and lymphadenopathy. It is often mistaken for more serious conditions like malignant lymphoma or tuberculosis. First case was described by Kikuchi in Japan, very few cases have been reported in Pakistan. A middle aged female presented with fever and body aches for one month. She was investigated extensively for pyrexia of unknown origin, all of which came out to be normal except a raised ESR. Anti-tuberculous drugs were started on clinical suspicion, with no improvement after a month. Later, a detailed physical examination revealed cervical lymphadenopathy. One of the lymph nodes was excised and biopsied. The histopathology suggested Kikuchi's disease. Oral Prednisolone was started showing improvement. Her fever subsided and lymph nodes disappeared at the follow-up visit. No relapse was encountered in the subsequent visits.

Hodgkin's lymphoma has been traditionally defined as a hematopoietic neoplasm composed of diagnostic Reed-Sternberg cells. More than 70% of the cases involve cervical or supraclavicular lymph nodes. Isolated sub-diaphragmatic lymphadenopathy or organ involvement is rare. We present the case of Hodgkin's lymphoma in a 51 years old female, who presented with obstructive jaundice and lymphadenopathy, empirically treated previously as a case of tuberculosis. Chemotherapy with modified ABVD protocol was given with dose modification according to LFT's. Her liver functions returned to normal levels after the first cycle. The main purpose of reporting the case is to stress definitive diagnosis of the disease before initiating treatment and the modified chemotherapy regimen used in this infrequent presentation of the disease.