Background: Khyber Pakhtoonkhwa and Afghanistan located in South Central Asia which is most prevalent area for childhood leukemia. In this region, no previous data or study was available on estimated cases per year of different types of childhood leukemia. The aim of the present study is to evaluate the frequency of different types of childhood leukemia in the children from different districts of Khyber Pakhtoonkhwa (KP) and Afghanistan presenting to Hayat Abad Medical Complex Hospital, Peshawar. Methods: This descriptive cross-sectional study was conducted in pathology department Hayat Abad Medical Complex hospital, Peshawar, Pakistan. Duration of the present study was, from January 2014 to December 2016. A total number of 605 children were enrolled up to 15 years of age, who were suspected to have leukemia, went through bone marrow examination. 3 ml blood was collected in EDTA tube (purple top) and complete blood count was prepared by hematology analyzer (Ruby cell dyne, Abbott, USA). By aseptic techniques bone marrow aspiration and bone marrow trephine biopsy samples were collected from all patients. Slides were papered from Bone marrow aspirates, fixed with methanol and stained with Giemsa, myeloperoxidase and periodic acid Schiff stain. Trephine biopsy slides were stained by Hematoxylene and Eosin and Reticulin stain. Immunohistochemistry was done after initially examining bone marrow aspirate slides. All data was documented and statistical analysis was performed by SPSS-20 software. Findings: Among 605 children suspected to have leukemia, 281 (46.5%) children were diagnosed with different types of childhood leukemia. Out of 281 diagnosed patients, 231(82.2%) were Pakistani children and rest of the 50 (17.8%) were Afghani children. The studied population consist of 173(61.6%) males and 108(38.4) females. Their age ranged from 3 months to 15 years with median age of 9.8 years. Out of 281 cases, 210 (74.73%) were diagnosed to have acute lymphoblastic leukemia and rest of the children were 62 (22.06%) acute myeloid leukemia, 7 (2.44%) chronic myeloid leukemia, 2 (0.71%) had Juvenile Chronic Myelomonocytic Leukemia (JMML) and 1 (0.35%) child was report with Chronic Myelomonocytic leukemia (CMML). There was no significant differences seen in prevalence among Afghan children and Pakistani children except ALL, which is more frequent in Afghan children compared to Pakistani children and no single case of CMML, were diagnosed in Afghan children. Conclusion: In the present study, acute lymphoblastic leukemia is most frequent leukemia in the children of Khyber Pakhtoonkhwa and Afghanistan. Juvenile chronic Myelomonocytic leukemia is found the less common leukemia in the present study.

Background: Fetal hemoglobin (HbF) has been reported to be associated with disease severity and treatment response to HbF-inducing therapies like Hydroxyurea and thalidomide in patients suffering from transfusion-dependent beta-thalassemia (TDT). However, the role of hemoglobin A2 (HbA2) remains less clear in TDT, therefore this study aims to determine the impact of both HbF and HbA2 levels on disease severity and treatment response. Methodology: A prospective observational study was conducted at the Peshawar Institute of Medical Sciences and Fatimid Foundation Peshawar from May 2023 to October 2023. A total of 232 TDT-diagnosed patients were enrolled using a convenient sampling technique, whereas coinheritance of beta-thalassemia with other hemoglobinopathies was excluded. Result: This study reveals a significant impact of HbF on disease severity (p0.05) between HbA2 levels and disease severity. Additionally, HbF and HbA2 levels exhibit association with treatment response categories in patients receiving HbF induction therapy, and various mutations do not significantly alter HbF and HbA2 levels or disease severity parameters in TDT patients. Conclusion: The study established a significant association between HbF and disease severity. However, regarding treatment response, neither HbF nor HbA2 levels impact response categories. Combinatorial treatment with hydroxyurea and thalidomide showed superior efficacy compared to monotherapy. A larger sample size and extended follow-up are recommended to further explore the impact of HbF, HbA2, and various mutations on disease severity and treatment response.

Background: There are various treatment options for breast cancer, but a delayed diagnosis at an advanced stage negatively affects overall survival. Our objective is to investigate the prognostic significance of the modified Glasgow Prognostic Score (mGPS) with different treatment modalities. Materials and methods: The study was a longitudinal cohort conducted in the Biochemistry laboratory of the Institute of Basic Medical Sciences at Khyber Medical University. Enrolling 121 patients with invasive breast carcinoma from November 2018 to February 2021, blood samples were collected at various stages. Data analysis utilized SPSS^® version 22, employing the Kaplan–Meier method for overall survival (OS) calculation. The log-rank test assessed P-values for OS, and the chi-square test analyzed the association of modified Glasgow Prognostic Score (mGPS) with different treatments. Statistical significance was considered for results with a P-value (p < 0.05). Results: The study results indicated that mGPS 2 was linked to lower overall survival, while mGPS 0 and 1 were associated with good overall survival. Chemo-endocrine therapy exhibited the highest median survival of 40.9 months compared to other treatment options. Conversely, chemoradiotherapy combined with targeted therapy demonstrated the lowest overall median survival of 22.5 months. Conclusion: The findings of the current research suggested that mGPS could be used as a prognostic screening tool in patients with breast cancers receiving different therapeutic modalities.