Hemophagocytic lymphohistiocytosis (HLH) or hemophagocytic syndrome is a very rare and life-threatening condition caused by an overactive and abnormal response of the immune system1. In HLH, the immune system reacts to a stimulus (most often an infection), but this response is both ineffective and abnormal. This ineffective and abnormal response leads to a variety of signs and symptoms, which, if left untreated, can potentially become life-threatening2.

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by challenges in social communication and repetitive and restricted activities and behavior. According to etiology it is a multifactorial disease that genetic and environmental factors are predominate. Pathogenesis of ASD involved disruption in neurotransmitter production, methylation of DNA, immune function, oxidation and antioxidant balance and vitamin D metabolism. In addition exposure to toxic chemicals as heavy metals and phthalates are the major environmental risk factors in ASD. Folate is a water soluble vitamin, involved in production of methyl group through methionine cycle. Methionine cycle produce methionine and metabolize homocysteine which is a neurotoxic substance, through transulfuration to cysteine. Cysteine is structural component of glutathione that is a crucial non enzymatic antioxidant. Method: This study is a literature review that summarizes results of research articles related to keywords, autism, folate, methionine cycle and homocysteine, and published in 2023 and 2024. All researches conducted on humans, written in English language and were available in full text are included in this review. Result: As a result of this literature review, abnormalities related to ASD pathogenesis are relevant to activity of folate as cofactor for pathways involved in production of neurotransmitter, metabolism of vitamin D and methionine production through methionine cycle. Conclusion: it can be concluded that folate is important for neurodevelopment and lowering incidence of ASD in children, because as vital cofactor, it has potential effect on methionine cycle, synthetic pathways related to neurotransmitter and vitamin D metabolism.

Abstract Background: Environmental gamma radiation of natural origin can cause the ionization of vital molecules such as DNA and pose a serious risk to human health. Measuring this radiation is particularly important because it increases the risk of various cancers. This study was conducted to measure the radiation dose, calculate the annual effective dose, and the risk of cancer caused by radiation in different regions of Kabul City in 2024. Materials and Methods: In this study, measurements were taken using a dosimeter (model PM1621A) in open and closed spaces in 6 districts of Kabul city (District 3, District 5, District 6, District 10, District 11, and District 15 of Kabul city) during three different seasons in the Spring, Summer and Autumn Seasons. Measurements were taken from five areas in each region and five random points in each region over three days in the Spring, Summer, and Autumn seasons. The annual effective dose and lifetime risk of radiation-induced cancer were also calculated. Results: The average annual dose in open and closed spaces was 1.292±0.163 and 1.4046±0.219 mSv/year, respectively. No statistically significant difference was observed between the average dose values of the Spring, Summer, and Autumn months and different regions of the districts. Also, the annual effective dose was calculated to be 0.93016 millisieverts and the excess lifetime risk of radiation-induced cancer was calculated to be: 2.7858292 ×〖10〗^(-3).

Abstract Introduction: Drug abuse involves the use of illicit substances, misused prescription drugs, and, in non-Islamic contexts, legal substances like alcohol, often resulting in addiction and adverse health outcomes. It is a major contributor to criminal activities, including theft, violence, and drug-related offenses. Socioeconomic factors, peer pressure, limited treatment access, and societal stigma exacerbate the issue. Effective prevention, rehabilitation, and legal strategies are essential to reduce drug-related crime and improve public safety. The objective of this study is to determine the prevalence and associated factors of drug abuse among incarcerated individuals in Pul-e-Charkhi Jail, located in Kabul, Afghanistan. Materials and Methods: This cross-sectional study included 254 inmates of Pul-e-Charkhi Jail, Central Prison. Data were collected using a structured questionnaire and a mixed sampling method (systematic random and convenience sampling) between November 15 and 30, 2024. Results: The study, conducted on 254 male inmates at Pul-e-Charkhi Jail, revealed a 30.7% prevalence of drug abuse, with the highest rate (41.7%) observed among individuals aged 50–64. No significant associations were identified with age, marital status, or education. Nonetheless, strong correlations emerged with criminal history prior incarceration (49.2% abuse rate, P = 0.000), connections with criminal associates (61.2%, P = 0.000), and involvement in drug-user networks (96.4%, OR = 184.44, P = 0.000). Drug abuse was most prevalent among those convicted of sexual offenses and drug trafficking. The majority of users-initiated drug use between the ages of 11 and 20, utilized drugs daily, and exhibited a preference for cannabis and smoking. Sources of funding for drug use comprised employment (48.7%) and theft (44.9%). Analysis highlighted criminal networks, previous incarceration, and associations with drug users as significant predictors.

Osteoarthritis (OA) is a chronic and degenerative disease which is mostly seen in adult population. It is common form of joint disability which negatively affect the quality of life of affected people. This study was conducted to review evidence on the use of platelet-rich-plasma (PRP) injection for treatment knee OA, evaluating its efficacy, limitations, and geographical disparities in research. . Methods: This review encompassed 39 eligible studies: 11 meta-analyses, 10 RCTs, seven systematic reviews, seven narrative reviews, and four observational studies. It examined key themes such as the comparative efficacy of PRP versus HA, CS, and placebo injection; protocol variability; and long-term outcomes. . Results: Applying PRP at early stages and in mid-term (6-12 months) demonstrates significant superiority over HA and steroids in pain reduction and functional improvement, particularly in early-to-moderate OA. However, structural benefits such as cartilage regeneration remain unproven, as well as evidence beyond 24 months is limited. Critical limitations include protocol heterogeneity as leukocyte content, centrifugation methods, statistical fragility in meta-analyses, and publication bias favoring small positive trials. Over 90% of studies originated from high-income countries particularly USA, China, and Europe, while people affected with severe OA and low income countries and regions with constrained resources remained underrepresented.

Background Measles is a highly contagious viral illness and continues to be a major cause of morbidity and mortality among children globally, particularly in low- and middle-income countries. Despite the widespread availability of a safe and effective vaccine, measles outbreaks remain common in regions with low immunization coverage. In Afghanistan, ongoing conflict, displacement, and limited access to healthcare services have contributed to suboptimal vaccination rates, placing children at increased risk. This study aimed to assess the prevalence of measles and examine associated factors—such as vaccination status, age distribution, and complications—among pediatric patients admitted to Maiwand Teaching Hospital in Kabul, Afghanistan. Methods A hospital-based cross-sectional study was conducted at Maiwand Teaching Hospital, affiliated with Kabul University of Medical Sciences, from January 1 to December 31, 2022. The study included all pediatric patients aged 1 month to 156 months (13 years) who were admitted with a clinical diagnosis of measles during the study period. Data were collected using structured forms and included patient demographics, measles vaccination status, clinical presentation, complications, and outcomes. Descriptive statistics were used to summarize patient characteristics, and inferential statistical analyses were performed to assess associations between variables. Data analysis was conducted using SPSS software, version 25. Results During the study period, a total of 3,850 children were hospitalized, of whom 998 (25.9%) were diagnosed with measles. The vast majority of affected children (88.7%) were under five years old, and 54.2% were male. A large proportion (86%) had not received any measles vaccination, while 7.6% had received a single dose and 6.4% had completed two doses. Complications were frequently observed, with pneumonia (79%), diarrhea (36.8%), and oral thrush (22%) being the most commonly reported. Nearly all patients (99.6%) recovered following appropriate medical care, though a small number with severe complications succumbed to the illness. Conclusions The study reveals a high prevalence of measles among pediatric inpatients at Maiwand Teaching Hospital, with a significant number of cases occurring in unvaccinated children. These findings highlight the urgent need to enhance immunization efforts and strengthen public health interventions to mitigate measles-associated illness and death in Afghanistan.

Background: Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer primarily linked to asbestos exposure. Diagnosis remains challenging, particularly in resource-limited settings where imaging and histopathology services are constrained. Case Presentation: A 60-year-old male presented to Ali Abad Teaching Hospital, Kabul, with a one-month history of progressive dyspnoea and cough. Initial evaluation revealed left-sided pleural effusion, initially managed as tuberculosis and bacterial infection due to nonspecific fluid analysis. Persistent effusion on follow-up prompted CT imaging, which identified a 5 cm pleural mass suspicious for MPM. Diagnostic limitations prevented confirmatory biopsy, leading to referral for specialized oncology care.

: Upper gastrointestinal (GI) bleeding is defined as hemorrhage from the mouth to the ligament of Treitz., In this study, we found 28 cases among a total of 700 patients who were admitted from March 20, 2024, to June 20, 2024, in Aliabad Teaching Hospital. The gastrointestinal bleeding may involve many distinctive situations. The reason for this variety is that bleeding can arise from multiple lesions and numerous internal situations in the upper gastrointestinal tract. Patients with significant upper GI bleeding often have hemodynamic compromise and are rapidly transported to the emergency department for resuscitation, stabilization, and hospitalization. This study aims to determine the prevalence of endoscopic findings in upper gastrointestinal bleeding. Methods: this study is in a descriptive cross-sectional design , which was carried out with the prescription of 28 patients in which 13 patients done endoscopy who were admitted to the inpatients service of Aliabad teaching hospital from 3 , 20 , 2024 till 6 , 20 , 2024 . The data collected from the patient's files were inserted into the SPSS program, and then all the calculations were performed in this software. Results: This result shows the prevalence of endoscopinc finding in UGIB patients 7, 692 % of them were below 30 years of age, followed by 15, 384% of the patients were between 31 - 40 years .and 7, 692% of the patients were in the ages among 41 -50 years and between the ages of 51-60 years there were 30,769 % of the participants in this study and 30, 769% of the participants were above 60 years of ages and in the ages 71 – 80 participants 7, 692%. In this study 53, 846%% of the patients were males 46, 153% of the patients were females. In this study 53 , 846% were from province and 46 , 135% were from capital of Afghanistan .

: Peri-implantitis is a situation that begins as gingival inflammation around a dental implant (peri-implant mucositis) and then extends to the bone that supports the dental implant. It causes bone loss at the coronal part of the fixture and can be determined by deep gingival pockets, bleeding, or discharge during investigation. Learning how to find, understand the etiology, assess the progress, find out its prevalence, and manage peri-implantitis is essential for both dental students and residents. Objectives: This study aimed to identify the different factors that stimulate the onset of peri-implantitis and to use this knowledge to support practical prevention techniques. Methods: A comprehensive survey of previous studies was done using two main online sources: PubMed and Google Scholar. PubMed showed 1,512 beneficial articles, while Google Scholar gave a much higher number, with 7,940 relevant findings. Results: Periodontal disease, inadequate supportive therapy, and cigarette smoking are recognized as significant systemic risk factors contributing to the development of peri-implantitis. Local factors such as poor plaque control, mucosal inflammation, Improperly designed implant crowns, residual submucosal cement, and a lack of keratinized mucosa surrounding the implant also play critical roles in increasing the risk of peri-implantitis. Effective management of both systemic and local risk factors is essential to prevent and control this condition.

Earthquakes, as devastating natural disasters, can have profound and long-term psychological consequences, particularly for children. The frequency of aftershocks following earthquakes has been shown to exacerbate these negative effects. This study aimed to investigate the prevalence of depression and anxiety levels among children exposed to the October 2023 earthquakes in Herat, Afghanistan. Methods: A community-based cross-sectional study was conducted in October and November 2023, involving 420 participants (227 boys and 193 girls). Sociodemographic data were collected using a 14-item questionnaire; the Patient Health Questionnaire-9 (PHQ-9) modified for adolescents and the Screen for Child Anxiety Related Emotional Disorders (SCARED) had been utilized to assess depression and anxiety levels, respectively. Data analysis was carried out using IBM SPSS Statistics version 27. Results: A high prevalence of depression among children (82.6%) was found among study participants. Additionally, the study identified significant rates of anxiety disorders, including panic disorder (67%), generalized anxiety disorder (27.1%), separation anxiety disorder (94.4%), social phobia (9.5%), and school avoidance (15%). Based on the sociodemographic data, gender and the presence of disturbing night dreams were significantly associated with both anxiety and depression. The loss of a first-degree family member due to the earthquake emerged as the sole factor significantly associated with depression.