International Journal of Life-Sciences Scientific Research, 2017
Importance of measurement of glycated hemoglobin (HbA1c) has been recommended for the diagnosis o... more Importance of measurement of glycated hemoglobin (HbA1c) has been recommended for the diagnosis of diabetes and pre-diabetes. However, various epidemiological studies conducted different parts of the universe have shown significant discordance between HbA1c and glucose-based tests. Glycated hemoglobin (HbA1c) is assumed to be the gold standard for monitoring glycemic control in patients with diabetes mellitus disorder. The Glycated hemoglobin (HbA1c) assay provided an accurate, precise measure of chronic glycemic levels, and associates with the risk of diabetes complications. Materials and Methods: This is a cross sectional prospective study. A total of 868 individuals attended to the medicine outpatient clinic at Lord Buddha Koshi Medical College, Saharsa, Bihar between Jan 2016 to Dec 2016 were selected for the study after screening a large cohort visited OPD. The results of FPG, OGTT, and HbA1c for 868 individual were analyzed as well as all grouped as diabetic patients, glucose intolerant (pre-diabetes) patients, and non-diabetic patients according to new ADA criteria for the diagnosis of diabetes. Results: Diagnostic sensitivity of all diabetic criteria were 80.33% for A1c; 75% for OGTT and only 41.87% for FPG respectively. Conclusion: The proposed A1c diagnostic criteria have greater diagnostic than FPG and 2-h OGTT regarding a diagnosis of diabetes mellitus disorder.
Objective: To assess leptin concentrations in different categories of Body Mass Index (BMI) in a ... more Objective: To assess leptin concentrations in different categories of Body Mass Index (BMI) in a sample of local population of Rawalpindi, Pakistan. Study design: Observational study. Place & Duration of Study: Armed Forces Institute of Pathology and Benazir Bhutto Shaheed Hospital, Rawalpindi, 2009-2010 (8 months). Materials and Methods: Fasting serum leptin concentrations were measured in 100 healthy obese, overweight and non-obese individuals aged 20-50 years, including both sexes. ELISA test was done for serum leptin assay. For each statistical analysis SPSS version 15 was used. The mean, standard deviation, ranges p-values and r-values. were calculated for statistical inference Results: Serum leptin concentrations were strongly associated with sex and the body mass index. Serum leptin level was found comparatively higher in women, in same category of BMI, (mean-64.4 ng/ml, obese group) than in men (mean-40.4 ng/ml, obese group). The mean serum leptin concentration in non-obese...
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2016
OBJECTIVE To determine the serum 25-hydroxycalciferol levels [25(OH)D] in adults with pre-diabete... more OBJECTIVE To determine the serum 25-hydroxycalciferol levels [25(OH)D] in adults with pre-diabetes and normoglycaemia to examine a possible association of vitamin D deficiency with pre-diabetes. STUDY DESIGN Case control study. PLACE AND DURATION OF STUDY Armed Forces Institute of Pathology, Rawalpindi, from November 2012 to July 2013. METHODOLOGY Atotal of 272 adults including 136 pre-diabetics and 136 normoglycaemics of either gender aged 20 years and above were consecutively inducted. Patients with diabetes mellitus, pregnancy, rickets and osteomalacia, ischemic heart disease, chronic kidney disease and chronic liver disease were excluded. Fasting Plasma Glucose (FPG) was estimated with hexokinase method on Modular p800 Roche chemistry analyzer while serum 25(OH)D was measured on Diasorin Liaison immunoassay analyzer using the chemiluminescent technique. Mean 25(OH)D levels in pre-diabetic and normoglycaemic groups were compared using Mann-Whitney U test. Spearman's correlati...
The study was conducted in the department of Plant Breeding and Genetics, University of Agricultu... more The study was conducted in the department of Plant Breeding and Genetics, University of Agriculture, Faisalabad. In total 226 genotypes were grown in polythene bags and drought stress was imposed using PEG-6000 (20%) and data were collected for shoot and root length, root shoot ratio, fresh weight and dry weight. The genotypes which showed good performance for all the parameters were selected (100 genotypes) and evaluated during the next two years 2013-14 and 2014-15 under both the normal and meiotic stage (pre-anthesis) drought stress conditions. The data for the following 14 traits were recorded, numbers of days to heading, numbers of days to maturity, plants height, peduncle length, spike length, leaf length, leaf width, leaf area, spikelets / spike, grains number / spike, grains weight / spike, tillers / plant, 1000 grain weight and with yield per plant. The significant results were shown by the genotypes, environment and (G x E) their interaction for almost all the parameters studied. The DNA of these 100 genotypes was extracted and 25 SSR markers were applied. It was concluded that about nine of the markers were linked with nine parameters studied and the level of probable was taken as one percent and phenotypic changes ranged between 14 to 32% under the water stress condition. And under the normal, irrigated conditions only 6 markers were found to be linked and the phenotypic variability ranged from 14 to 22%. The SSR marker CFA2086 showed significant association with 1000 grain weight under normal as well as under drought conditions. The 5 markers such as WMC382, CFA2086, CFA2121, CFA2263 and WMC2610 were associated with spikelets per spike which could be considered as trait specific MTA.
Objective: To derive the ethnic factor and validate the modified estimated Glomerular Filtration ... more Objective: To derive the ethnic factor and validate the modified estimated Glomerular Filtration Rate (eGFR) by Modification of Diet in Renal Disease (MDRD) equation for Chronic Kidney Disease (CKD) patients of Rawalpindi.
Objective: To compare the Friedewald and modified Friedewald formulae with direct homogeneous ass... more Objective: To compare the Friedewald and modified Friedewald formulae with direct homogeneous assay for serum lowdensity lipoprotein cholesterol (LDL-C) levels estimation. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Pathology, Rawalpindi, from June to December 2011. Methodology: Healthy subjects of either gender, from Rawalpindi, aged 18-75 years were included by consecutive sampling. Patients with diabetes mellitus, chronic liver disease, chronic kidney disease, those taking lipid lowering drugs and samples with triglyceride (TG) > 4.52 mmol/l were excluded from the study. Total cholesterol, high-density lipoprotein cholesterol, TG and LDL-C were measured on Hitachi 912 chemistry analyzer (Roche). LDL-C levels were also calculated by Friedewald formula (FF) and Vujovic modified formula (VMF). Paired sample t-test and scatter plots were used for statistical analysis. Results: Although both calculated methods showed good correlation ...
JPMA. The Journal of the Pakistan Medical Association, 1997
The reference values of common blood chemistry analytes in healthy population, aged newborn to 80... more The reference values of common blood chemistry analytes in healthy population, aged newborn to 80 years, of Rawalpindi Islamabad area were determined at AFIP, Rawalpindi. A total of 2115 healthy subjects, 1206 males and 909 females, were included in the study. Plasma glucose was analysed by GOD/POD, serum cholesterol by CHOD/PAP, triglycerides by GPO/PAP, urea by urease/GLDH, creatinine by Jaffe' rate reaction, uric acid by uricase, total bilirubin by Jendrassik and Grof, total protein by biuret, alanine transaminase (ALT) by optimized IFCC and alkaline phosphatase (AP) by optimized DGKC method. The between batch CVs of all the parameters were within acceptable quality goals. The reference values were calculated using 2.5 and 97.5 percentiles as lower and upper limits (95% CI). In healthy adult males the reference values were: fasting plasma glucose, 3.6-6.0 mmol/l; serum cholesterol; 3.2-6.6 mmol/l; triglycerides, 0.6-2.3 mmol/l; urea, 2.8-6.4 mmol/l; creatinine, 65-132 umol/l;...
JPMA. The Journal of the Pakistan Medical Association, 1994
In Pakistan, male infertility constitutes about 35% of all cases of infertility. The dysfunction ... more In Pakistan, male infertility constitutes about 35% of all cases of infertility. The dysfunction can be at the level of the central nervous system or somewhere in the male genital tract. A study was conducted to screen cases of male infertility using various biochemical parameters. A total of 81 cases were screened. Oligospermia was seen in 13 (16%) patients. They were divided into severe and mild to moderate oligospermia. In severe oligospermia, there was an increase in serum FSH level with decrease in seminal transferrin and carnitine suggesting damage to sertoli cells. In mild to moderate oligospermia, serum FSH were normal with levels a slight decrease in the levels of transferrin and carnitine in semen indicating that sertoli cells were not significantly defective and the dysfunction could be somewhere else.
Journal of Ayub Medical College, Abbottabad : JAMC
Several non-invasive markers are being used to assess the structural liver damage in patients wit... more Several non-invasive markers are being used to assess the structural liver damage in patients with chronic hepatitis C (CHC). We evaluated Aspartate aminotransferase (AST) to platelet ratio index (APRI) in comparison with Metavir scoring for assessing the severity of hepatic fibrosis in the CHC patients in district Rawalpindi. One hundred twenty CHC patients, naive for HCV treatment, underwent liver biopsy in tertiary care hospitals of district Rawalpindi, participated in the study. Liver biopsies were reviewed by Metavir scoring system. Serum AST was analyzed by IFCC method. Platelets were measured on a haematology Analyzer. Patients with mild fibrosis (F0, F1) were differentiated from significant fibrosis (F2, F3, F4) and those with mild/moderate fibrosis (F0, F1, F2) from advanced fibrosis (F3, F4) based on APRI score as compared to liver biopsy. Liver biopsies examination revealed that out of 120 patients 10 (8.3%) had no fibrosis (F0), 46 (38%) portal fibrosis (F1), 34 (28%) se...
International journal of clinical and experimental medicine, 2008
Tobacco is an important cash crop of Pakistan and tremendous amount of irrational pesticides are ... more Tobacco is an important cash crop of Pakistan and tremendous amount of irrational pesticides are being used to control insect growth. The frequency of plasma pesticide residues above acceptable daily intake (ADI) and its correlation with biochemical markers for assessment of adverse health effects in the tobacco farmers at district Sawabi, Pakistan was determined. Total 109 adult males consisting of 55 tobacco farmers exposed to pesticides and 54 controls were included. Pesticides residues in blood were analyzed on HPLC and GC-NPD. Plasma butyrylcholinesterase (BChE) was analyzed by Ellman's method. Biochemical markers including serum calcium, phosphorus, urea, creatinine, bilirubin and liver enzymes were measured on Selectra-E auto analyzer. The tobacco farmers had multiple pesticides residues above ADI in their blood consisting of 35 (63%) methomyl; 31 (56%) thiodicarb; 34(62%) cypermethrin; 27 (49%) Imidacloprid; 18 (32%) Methamidophos and 15 (27%) endosulfan. BChE activity w...
Journal of Ayub Medical College, Abbottabad : JAMC
Glycaemic control is critical for managing diabetes and related complications. Considering high p... more Glycaemic control is critical for managing diabetes and related complications. Considering high prevalence of Diabetes in Pakistan, our study aimed to assess the status of glycaemic control in Type-II Diabetics by measurement of HbA1c from 2005-2007 at Rawalpindi. We also evaluated changes in its trends in relation with sex and age. It was a retrospective analysis of data from Clinical Pathology Laboratory, Army Medical College, Rawalpindi during 2005-2007. A total of 2875 patients, aged 24-70 years, taking oral hypoglycaemic agents, were included. HbA1c was measured by using Human kit. International Diabetes Federation guidelines, < or = 6.5%, 6.6%-8.4% and > or = 8.5% were used to classify patients into good, fair and poor control categories. The number of patients (n = 2875) tested for HbA1c increased from 904,974 to 997 during 2005-2007. The patients had an age of 48 +/- 13 years and comprised of 54% males and 46% females. Improvement in patient's glycaemic control amo...
JPMA. The Journal of the Pakistan Medical Association, 2009
To determine total lead body burden by the Lead mobilization test (LMT) by measuring 4 hours urin... more To determine total lead body burden by the Lead mobilization test (LMT) by measuring 4 hours urinary lead excretion in the lead exposed as compared to unexposed industrial workers after administration of 10 mg/Kg of dimercaptosuccinic acid and correlate it with blood lead levels, at Wah district Rawalpindi. Total 149 males consisting of 87 lead exposed workers and 62 controls were included. Dimercaptosuccinic acid (DMSA), 10mg/kg body weight, was administered orally. Four hours urine specimens before and after DMSA administration were collected. Blood lead levels (BLL) were determined on 3010B ESA lead analyzer and urinary lead was measured on atomic absorption analyst 800 (Perkin Elmer). The lead exposed workers had high BLL median (range) 291 (90-611) ug/L as compared to controls 108 (10-310) ug/L (p=0.01). The occupational workers also revealed high DMSA-chelated urinary lead excretion (DMSA Pb-U) median (range) 28 (1.7-268) ug/4h as compared to controls 6 (1-27) ug/4h (p<0.01...
Journal of Ayub Medical College, Abbottabad : JAMC
Insulin resistance syndrome or metabolic syndrome is one of the major metabolic threats our recen... more Insulin resistance syndrome or metabolic syndrome is one of the major metabolic threats our recently urbanized society is going to face in near future. The management of this syndrome requires a very effective biochemical marker for screening. The objective of this cross sectional study were to compare various lipid and lipoprotein indices in human subjects with insulin resistance syndrome This study was carried out between April 2004 to January 2006 at the department of chemical pathology and endocrinology, Armed Forces Institute of Pathology, Rawalpindi. A total of forty-seven subjects with metabolic syndrome were selected as per the criteria of National Cholesterol Education Program, Adult Treatment Panel III (NCEP, ATP III) from a target population diagnosed to have impaired glucose regulation at AFIP. Forty-seven age and sex-matched healthy controls were also included in the study. Insulin resistance was calculated by the method of HOMA-IR, using the formula of Mathew's et ...
Journal of Ayub Medical College, Abbottabad : JAMC
Duchenne Muscular Dystrophy (DMD) is an X-linked recessive lethal, genetic disorder characterised... more Duchenne Muscular Dystrophy (DMD) is an X-linked recessive lethal, genetic disorder characterised by progressive weakness of skeletal muscles which is untreatable and transmitted to males by carrier females. Advances in laboratory techniques now focus direct mutational analysis as the most reliable and indirect analysis based on Short Tandem Repeats (STR) based linkage analysis as feasible, inexpensive, and efficient method for carrier detection and prenatal diagnosis. The objective of this study was to compare the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic efficiency of Serum Creatine Kinase (SCK) with Short Tandem Repeats (STR) based linkage analysis in carriers and affected children of Duchenne Muscular Dystrophy. The study was carried out from Dec 2006 to Dec 2007 in families having index clinical cases of DMD who were referred from different hospitals for evaluation/workup of DMD. SCK was done as a preliminary inves...
Journal of Ayub Medical College, Abbottabad : JAMC
Infertility affects about 15% of all couples in the world. Approximately 40% of all infertility c... more Infertility affects about 15% of all couples in the world. Approximately 40% of all infertility cases could be attributed entirely to male factors. Serum inhibin B has emerged as a sensitive marker of male fertility. Analysis of serum inhibin B reflects the relationship between inhibin B, Sertoli cell function and spermatogenesis. This validation study was conducted to calculate the sensitivity, specificity, positive and negative predictive value of serum inhibin B in diagnosis of male infertility, using semen analysis as the gold standard. One hundred and sixty men were included in the study, they reported for semen analysis for evaluation of male infertility. Sperm count was done per standard procedure. Serum inhibin B level was determined by ELISA. Serum inhibin B level > or = 80 pg/ml was regarded as a normal response. The serum inhibin B test had 75% sensitivity, 93.1% specificity, 80.5% PPV and 90.7% NPV. Serum inhibin B has a positive correlation with sperm counts and coul...
in the cardiac cycle in terms of retinal vessel diameter, therefore ECG gated retinal photography... more in the cardiac cycle in terms of retinal vessel diameter, therefore ECG gated retinal photography should be synchronized to mid systole to eliminate the pulsatile changes due to the cardiac cycle and improve the precision of the technique.
Albanian Journal of Trauma and Emergency Surgery, 2022
Introduction: Ascites is of Greek derivation (“askos”) and refers to a bag or sack. The word is a... more Introduction: Ascites is of Greek derivation (“askos”) and refers to a bag or sack. The word is a noun and describes pathologic fluid accumulation within the peritoneal cavity. Orientation in finding or excluding portal hypertension through examination of ascitic fluid is the first step towards an accurate diagnosis. Material and Methods: The aim of this study was to evaluate the role of SAAG (Serum Ascites Albumin Gradient) in the differential diagnosis between cirrhotic and malignant ascites. The SAAG is obtained by subtracting the value of serum albumin, the value of ascites albumin (from samples to be taken on the same day) and is a reflection of hepatic sinusoidal pressure. Result: All ascitic fluids were analyzed on the laboratory parameters of ascitic albumin values and at the same time serological albumin through the blood was taken for analysis on the same day as the diagnostic paracentesis. The value of SAAG was calculated for each patient between their two groups: 64 pati...
Objective: To compare insulin resistance between hypertensive and non-hypertensive subjects. Meth... more Objective: To compare insulin resistance between hypertensive and non-hypertensive subjects. Methodology: It is a comparative cross-sectional study which was carried out between April 2004 to March 2006 at department of chemical pathology and endocrinology, Armed Forces Institute of Pathology, Rawalpindi. A total of sixty-three subjects with metabolic syndrome were selected as per the criteria of National Cholesterol Education Program, Adult Treatment Panel III (NCEP, ATP III) from a target population diagnosed to have impaired glucose regulation at AFIP, along with forty-seven age and sex-matched controls. Insulin resistance was calculated by the method of HOMA-IR, using the formula of Mathew's et al. Blood pressure was measured as per recommendations of JNC7 report on prevention, detection, evaluation and treatment of high blood pressure. Results: The difference for hypertension for diastolic blood pressure between subjects with and without metabolic syndrome were found to be significant [Metabolic syndrome: 86.79 mm of Hg (95 % CI: 83.75-89.84), Age and sex matched controls: 80.21(95 % CI: 76.80-83.62) (p<0.05). However the difference for systolic blood pressure were not found to be significant between the two groups (p=0.860).Hypertensive individuals had higher HOMA-IR [(n=33): 2.87 (95 % CI: 2.37-3.05)] than non-hypertensive [(n=30): 1.76(95 % CI: 1.53-2.05)] (p<0.05).The effect of obesity as determined by waist circumference between patients with and without hypertension remained significant (p=< 0.05) Conclusion: Hypertensive individuals have higher insulin resistance than subjects without hypertension. Thus it is recommended that vigorous search be made to diagnose insulin resistance in subjects diagnosed to have hypertension, and to demonstrate other components of metabolic syndrome.
Journal of Interferon & Cytokine Research, 2011
Proinflammatory interleukin-18 (IL-18), high-sensitivity C-reactive protein (hS-CRP), tumor necro... more Proinflammatory interleukin-18 (IL-18), high-sensitivity C-reactive protein (hS-CRP), tumor necrosis factor-alpha (TNF-alpha), and anti-inflammatory IL-10 are involved in the pathogenesis of atherosclerosis. The aim of this study was to determine the imbalance between pro- and anti-inflammatory cytokines in premature coronary artery disease (PCAD) and their association with the degree of angiographic atherosclerotic blockade. A case-control study was carried out at the National Institute of Heart Diseases, Rawalpindi, Pakistan. Three hundred eighty-five stable coronary artery disease patients aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;45 years were screened. A total of 172 subjects participated in this study, comprising 98 PCAD patients and 74 angionegative controls. Serum IL-10, IL-18, and TNF-alpha were measured using enzyme-linked immunosorbent assay and hS-CRP was analyzed using Immulite 1000. The mean age of the patients was 40 ± 4.23 years (69 men and 9 women). Serum IL-18, TNF-alpha, hS-CRP, and IL-18/IL-10 ratio were significantly raised in PCAD patients (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01), whereas IL-10 was moderately increased (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05) when compared with controls. Serum IL-18 and hS-CRP were significantly raised in patients with 86%-100% stenosis (n=57) when compared with patients with 71%-85% stenosis (n=41) (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Serum IL-18, TNF-alpha, IL-18/IL-10 ratio, and hS-CRP significantly correlated (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01) with the degree of angiographic blockade. Pro/anti-inflammatory cytokines play a vital role in the pathogenesis of PCAD and have potential to identify the degree of atherosclerosis.
International Journal of Life-Sciences Scientific Research, 2017
Importance of measurement of glycated hemoglobin (HbA1c) has been recommended for the diagnosis o... more Importance of measurement of glycated hemoglobin (HbA1c) has been recommended for the diagnosis of diabetes and pre-diabetes. However, various epidemiological studies conducted different parts of the universe have shown significant discordance between HbA1c and glucose-based tests. Glycated hemoglobin (HbA1c) is assumed to be the gold standard for monitoring glycemic control in patients with diabetes mellitus disorder. The Glycated hemoglobin (HbA1c) assay provided an accurate, precise measure of chronic glycemic levels, and associates with the risk of diabetes complications. Materials and Methods: This is a cross sectional prospective study. A total of 868 individuals attended to the medicine outpatient clinic at Lord Buddha Koshi Medical College, Saharsa, Bihar between Jan 2016 to Dec 2016 were selected for the study after screening a large cohort visited OPD. The results of FPG, OGTT, and HbA1c for 868 individual were analyzed as well as all grouped as diabetic patients, glucose intolerant (pre-diabetes) patients, and non-diabetic patients according to new ADA criteria for the diagnosis of diabetes. Results: Diagnostic sensitivity of all diabetic criteria were 80.33% for A1c; 75% for OGTT and only 41.87% for FPG respectively. Conclusion: The proposed A1c diagnostic criteria have greater diagnostic than FPG and 2-h OGTT regarding a diagnosis of diabetes mellitus disorder.
Objective: To assess leptin concentrations in different categories of Body Mass Index (BMI) in a ... more Objective: To assess leptin concentrations in different categories of Body Mass Index (BMI) in a sample of local population of Rawalpindi, Pakistan. Study design: Observational study. Place & Duration of Study: Armed Forces Institute of Pathology and Benazir Bhutto Shaheed Hospital, Rawalpindi, 2009-2010 (8 months). Materials and Methods: Fasting serum leptin concentrations were measured in 100 healthy obese, overweight and non-obese individuals aged 20-50 years, including both sexes. ELISA test was done for serum leptin assay. For each statistical analysis SPSS version 15 was used. The mean, standard deviation, ranges p-values and r-values. were calculated for statistical inference Results: Serum leptin concentrations were strongly associated with sex and the body mass index. Serum leptin level was found comparatively higher in women, in same category of BMI, (mean-64.4 ng/ml, obese group) than in men (mean-40.4 ng/ml, obese group). The mean serum leptin concentration in non-obese...
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2016
OBJECTIVE To determine the serum 25-hydroxycalciferol levels [25(OH)D] in adults with pre-diabete... more OBJECTIVE To determine the serum 25-hydroxycalciferol levels [25(OH)D] in adults with pre-diabetes and normoglycaemia to examine a possible association of vitamin D deficiency with pre-diabetes. STUDY DESIGN Case control study. PLACE AND DURATION OF STUDY Armed Forces Institute of Pathology, Rawalpindi, from November 2012 to July 2013. METHODOLOGY Atotal of 272 adults including 136 pre-diabetics and 136 normoglycaemics of either gender aged 20 years and above were consecutively inducted. Patients with diabetes mellitus, pregnancy, rickets and osteomalacia, ischemic heart disease, chronic kidney disease and chronic liver disease were excluded. Fasting Plasma Glucose (FPG) was estimated with hexokinase method on Modular p800 Roche chemistry analyzer while serum 25(OH)D was measured on Diasorin Liaison immunoassay analyzer using the chemiluminescent technique. Mean 25(OH)D levels in pre-diabetic and normoglycaemic groups were compared using Mann-Whitney U test. Spearman's correlati...
The study was conducted in the department of Plant Breeding and Genetics, University of Agricultu... more The study was conducted in the department of Plant Breeding and Genetics, University of Agriculture, Faisalabad. In total 226 genotypes were grown in polythene bags and drought stress was imposed using PEG-6000 (20%) and data were collected for shoot and root length, root shoot ratio, fresh weight and dry weight. The genotypes which showed good performance for all the parameters were selected (100 genotypes) and evaluated during the next two years 2013-14 and 2014-15 under both the normal and meiotic stage (pre-anthesis) drought stress conditions. The data for the following 14 traits were recorded, numbers of days to heading, numbers of days to maturity, plants height, peduncle length, spike length, leaf length, leaf width, leaf area, spikelets / spike, grains number / spike, grains weight / spike, tillers / plant, 1000 grain weight and with yield per plant. The significant results were shown by the genotypes, environment and (G x E) their interaction for almost all the parameters studied. The DNA of these 100 genotypes was extracted and 25 SSR markers were applied. It was concluded that about nine of the markers were linked with nine parameters studied and the level of probable was taken as one percent and phenotypic changes ranged between 14 to 32% under the water stress condition. And under the normal, irrigated conditions only 6 markers were found to be linked and the phenotypic variability ranged from 14 to 22%. The SSR marker CFA2086 showed significant association with 1000 grain weight under normal as well as under drought conditions. The 5 markers such as WMC382, CFA2086, CFA2121, CFA2263 and WMC2610 were associated with spikelets per spike which could be considered as trait specific MTA.
Objective: To derive the ethnic factor and validate the modified estimated Glomerular Filtration ... more Objective: To derive the ethnic factor and validate the modified estimated Glomerular Filtration Rate (eGFR) by Modification of Diet in Renal Disease (MDRD) equation for Chronic Kidney Disease (CKD) patients of Rawalpindi.
Objective: To compare the Friedewald and modified Friedewald formulae with direct homogeneous ass... more Objective: To compare the Friedewald and modified Friedewald formulae with direct homogeneous assay for serum lowdensity lipoprotein cholesterol (LDL-C) levels estimation. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Pathology, Rawalpindi, from June to December 2011. Methodology: Healthy subjects of either gender, from Rawalpindi, aged 18-75 years were included by consecutive sampling. Patients with diabetes mellitus, chronic liver disease, chronic kidney disease, those taking lipid lowering drugs and samples with triglyceride (TG) > 4.52 mmol/l were excluded from the study. Total cholesterol, high-density lipoprotein cholesterol, TG and LDL-C were measured on Hitachi 912 chemistry analyzer (Roche). LDL-C levels were also calculated by Friedewald formula (FF) and Vujovic modified formula (VMF). Paired sample t-test and scatter plots were used for statistical analysis. Results: Although both calculated methods showed good correlation ...
JPMA. The Journal of the Pakistan Medical Association, 1997
The reference values of common blood chemistry analytes in healthy population, aged newborn to 80... more The reference values of common blood chemistry analytes in healthy population, aged newborn to 80 years, of Rawalpindi Islamabad area were determined at AFIP, Rawalpindi. A total of 2115 healthy subjects, 1206 males and 909 females, were included in the study. Plasma glucose was analysed by GOD/POD, serum cholesterol by CHOD/PAP, triglycerides by GPO/PAP, urea by urease/GLDH, creatinine by Jaffe' rate reaction, uric acid by uricase, total bilirubin by Jendrassik and Grof, total protein by biuret, alanine transaminase (ALT) by optimized IFCC and alkaline phosphatase (AP) by optimized DGKC method. The between batch CVs of all the parameters were within acceptable quality goals. The reference values were calculated using 2.5 and 97.5 percentiles as lower and upper limits (95% CI). In healthy adult males the reference values were: fasting plasma glucose, 3.6-6.0 mmol/l; serum cholesterol; 3.2-6.6 mmol/l; triglycerides, 0.6-2.3 mmol/l; urea, 2.8-6.4 mmol/l; creatinine, 65-132 umol/l;...
JPMA. The Journal of the Pakistan Medical Association, 1994
In Pakistan, male infertility constitutes about 35% of all cases of infertility. The dysfunction ... more In Pakistan, male infertility constitutes about 35% of all cases of infertility. The dysfunction can be at the level of the central nervous system or somewhere in the male genital tract. A study was conducted to screen cases of male infertility using various biochemical parameters. A total of 81 cases were screened. Oligospermia was seen in 13 (16%) patients. They were divided into severe and mild to moderate oligospermia. In severe oligospermia, there was an increase in serum FSH level with decrease in seminal transferrin and carnitine suggesting damage to sertoli cells. In mild to moderate oligospermia, serum FSH were normal with levels a slight decrease in the levels of transferrin and carnitine in semen indicating that sertoli cells were not significantly defective and the dysfunction could be somewhere else.
Journal of Ayub Medical College, Abbottabad : JAMC
Several non-invasive markers are being used to assess the structural liver damage in patients wit... more Several non-invasive markers are being used to assess the structural liver damage in patients with chronic hepatitis C (CHC). We evaluated Aspartate aminotransferase (AST) to platelet ratio index (APRI) in comparison with Metavir scoring for assessing the severity of hepatic fibrosis in the CHC patients in district Rawalpindi. One hundred twenty CHC patients, naive for HCV treatment, underwent liver biopsy in tertiary care hospitals of district Rawalpindi, participated in the study. Liver biopsies were reviewed by Metavir scoring system. Serum AST was analyzed by IFCC method. Platelets were measured on a haematology Analyzer. Patients with mild fibrosis (F0, F1) were differentiated from significant fibrosis (F2, F3, F4) and those with mild/moderate fibrosis (F0, F1, F2) from advanced fibrosis (F3, F4) based on APRI score as compared to liver biopsy. Liver biopsies examination revealed that out of 120 patients 10 (8.3%) had no fibrosis (F0), 46 (38%) portal fibrosis (F1), 34 (28%) se...
International journal of clinical and experimental medicine, 2008
Tobacco is an important cash crop of Pakistan and tremendous amount of irrational pesticides are ... more Tobacco is an important cash crop of Pakistan and tremendous amount of irrational pesticides are being used to control insect growth. The frequency of plasma pesticide residues above acceptable daily intake (ADI) and its correlation with biochemical markers for assessment of adverse health effects in the tobacco farmers at district Sawabi, Pakistan was determined. Total 109 adult males consisting of 55 tobacco farmers exposed to pesticides and 54 controls were included. Pesticides residues in blood were analyzed on HPLC and GC-NPD. Plasma butyrylcholinesterase (BChE) was analyzed by Ellman's method. Biochemical markers including serum calcium, phosphorus, urea, creatinine, bilirubin and liver enzymes were measured on Selectra-E auto analyzer. The tobacco farmers had multiple pesticides residues above ADI in their blood consisting of 35 (63%) methomyl; 31 (56%) thiodicarb; 34(62%) cypermethrin; 27 (49%) Imidacloprid; 18 (32%) Methamidophos and 15 (27%) endosulfan. BChE activity w...
Journal of Ayub Medical College, Abbottabad : JAMC
Glycaemic control is critical for managing diabetes and related complications. Considering high p... more Glycaemic control is critical for managing diabetes and related complications. Considering high prevalence of Diabetes in Pakistan, our study aimed to assess the status of glycaemic control in Type-II Diabetics by measurement of HbA1c from 2005-2007 at Rawalpindi. We also evaluated changes in its trends in relation with sex and age. It was a retrospective analysis of data from Clinical Pathology Laboratory, Army Medical College, Rawalpindi during 2005-2007. A total of 2875 patients, aged 24-70 years, taking oral hypoglycaemic agents, were included. HbA1c was measured by using Human kit. International Diabetes Federation guidelines, < or = 6.5%, 6.6%-8.4% and > or = 8.5% were used to classify patients into good, fair and poor control categories. The number of patients (n = 2875) tested for HbA1c increased from 904,974 to 997 during 2005-2007. The patients had an age of 48 +/- 13 years and comprised of 54% males and 46% females. Improvement in patient's glycaemic control amo...
JPMA. The Journal of the Pakistan Medical Association, 2009
To determine total lead body burden by the Lead mobilization test (LMT) by measuring 4 hours urin... more To determine total lead body burden by the Lead mobilization test (LMT) by measuring 4 hours urinary lead excretion in the lead exposed as compared to unexposed industrial workers after administration of 10 mg/Kg of dimercaptosuccinic acid and correlate it with blood lead levels, at Wah district Rawalpindi. Total 149 males consisting of 87 lead exposed workers and 62 controls were included. Dimercaptosuccinic acid (DMSA), 10mg/kg body weight, was administered orally. Four hours urine specimens before and after DMSA administration were collected. Blood lead levels (BLL) were determined on 3010B ESA lead analyzer and urinary lead was measured on atomic absorption analyst 800 (Perkin Elmer). The lead exposed workers had high BLL median (range) 291 (90-611) ug/L as compared to controls 108 (10-310) ug/L (p=0.01). The occupational workers also revealed high DMSA-chelated urinary lead excretion (DMSA Pb-U) median (range) 28 (1.7-268) ug/4h as compared to controls 6 (1-27) ug/4h (p<0.01...
Journal of Ayub Medical College, Abbottabad : JAMC
Insulin resistance syndrome or metabolic syndrome is one of the major metabolic threats our recen... more Insulin resistance syndrome or metabolic syndrome is one of the major metabolic threats our recently urbanized society is going to face in near future. The management of this syndrome requires a very effective biochemical marker for screening. The objective of this cross sectional study were to compare various lipid and lipoprotein indices in human subjects with insulin resistance syndrome This study was carried out between April 2004 to January 2006 at the department of chemical pathology and endocrinology, Armed Forces Institute of Pathology, Rawalpindi. A total of forty-seven subjects with metabolic syndrome were selected as per the criteria of National Cholesterol Education Program, Adult Treatment Panel III (NCEP, ATP III) from a target population diagnosed to have impaired glucose regulation at AFIP. Forty-seven age and sex-matched healthy controls were also included in the study. Insulin resistance was calculated by the method of HOMA-IR, using the formula of Mathew's et ...
Journal of Ayub Medical College, Abbottabad : JAMC
Duchenne Muscular Dystrophy (DMD) is an X-linked recessive lethal, genetic disorder characterised... more Duchenne Muscular Dystrophy (DMD) is an X-linked recessive lethal, genetic disorder characterised by progressive weakness of skeletal muscles which is untreatable and transmitted to males by carrier females. Advances in laboratory techniques now focus direct mutational analysis as the most reliable and indirect analysis based on Short Tandem Repeats (STR) based linkage analysis as feasible, inexpensive, and efficient method for carrier detection and prenatal diagnosis. The objective of this study was to compare the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic efficiency of Serum Creatine Kinase (SCK) with Short Tandem Repeats (STR) based linkage analysis in carriers and affected children of Duchenne Muscular Dystrophy. The study was carried out from Dec 2006 to Dec 2007 in families having index clinical cases of DMD who were referred from different hospitals for evaluation/workup of DMD. SCK was done as a preliminary inves...
Journal of Ayub Medical College, Abbottabad : JAMC
Infertility affects about 15% of all couples in the world. Approximately 40% of all infertility c... more Infertility affects about 15% of all couples in the world. Approximately 40% of all infertility cases could be attributed entirely to male factors. Serum inhibin B has emerged as a sensitive marker of male fertility. Analysis of serum inhibin B reflects the relationship between inhibin B, Sertoli cell function and spermatogenesis. This validation study was conducted to calculate the sensitivity, specificity, positive and negative predictive value of serum inhibin B in diagnosis of male infertility, using semen analysis as the gold standard. One hundred and sixty men were included in the study, they reported for semen analysis for evaluation of male infertility. Sperm count was done per standard procedure. Serum inhibin B level was determined by ELISA. Serum inhibin B level > or = 80 pg/ml was regarded as a normal response. The serum inhibin B test had 75% sensitivity, 93.1% specificity, 80.5% PPV and 90.7% NPV. Serum inhibin B has a positive correlation with sperm counts and coul...
in the cardiac cycle in terms of retinal vessel diameter, therefore ECG gated retinal photography... more in the cardiac cycle in terms of retinal vessel diameter, therefore ECG gated retinal photography should be synchronized to mid systole to eliminate the pulsatile changes due to the cardiac cycle and improve the precision of the technique.
Albanian Journal of Trauma and Emergency Surgery, 2022
Introduction: Ascites is of Greek derivation (“askos”) and refers to a bag or sack. The word is a... more Introduction: Ascites is of Greek derivation (“askos”) and refers to a bag or sack. The word is a noun and describes pathologic fluid accumulation within the peritoneal cavity. Orientation in finding or excluding portal hypertension through examination of ascitic fluid is the first step towards an accurate diagnosis. Material and Methods: The aim of this study was to evaluate the role of SAAG (Serum Ascites Albumin Gradient) in the differential diagnosis between cirrhotic and malignant ascites. The SAAG is obtained by subtracting the value of serum albumin, the value of ascites albumin (from samples to be taken on the same day) and is a reflection of hepatic sinusoidal pressure. Result: All ascitic fluids were analyzed on the laboratory parameters of ascitic albumin values and at the same time serological albumin through the blood was taken for analysis on the same day as the diagnostic paracentesis. The value of SAAG was calculated for each patient between their two groups: 64 pati...
Objective: To compare insulin resistance between hypertensive and non-hypertensive subjects. Meth... more Objective: To compare insulin resistance between hypertensive and non-hypertensive subjects. Methodology: It is a comparative cross-sectional study which was carried out between April 2004 to March 2006 at department of chemical pathology and endocrinology, Armed Forces Institute of Pathology, Rawalpindi. A total of sixty-three subjects with metabolic syndrome were selected as per the criteria of National Cholesterol Education Program, Adult Treatment Panel III (NCEP, ATP III) from a target population diagnosed to have impaired glucose regulation at AFIP, along with forty-seven age and sex-matched controls. Insulin resistance was calculated by the method of HOMA-IR, using the formula of Mathew's et al. Blood pressure was measured as per recommendations of JNC7 report on prevention, detection, evaluation and treatment of high blood pressure. Results: The difference for hypertension for diastolic blood pressure between subjects with and without metabolic syndrome were found to be significant [Metabolic syndrome: 86.79 mm of Hg (95 % CI: 83.75-89.84), Age and sex matched controls: 80.21(95 % CI: 76.80-83.62) (p<0.05). However the difference for systolic blood pressure were not found to be significant between the two groups (p=0.860).Hypertensive individuals had higher HOMA-IR [(n=33): 2.87 (95 % CI: 2.37-3.05)] than non-hypertensive [(n=30): 1.76(95 % CI: 1.53-2.05)] (p<0.05).The effect of obesity as determined by waist circumference between patients with and without hypertension remained significant (p=< 0.05) Conclusion: Hypertensive individuals have higher insulin resistance than subjects without hypertension. Thus it is recommended that vigorous search be made to diagnose insulin resistance in subjects diagnosed to have hypertension, and to demonstrate other components of metabolic syndrome.
Journal of Interferon & Cytokine Research, 2011
Proinflammatory interleukin-18 (IL-18), high-sensitivity C-reactive protein (hS-CRP), tumor necro... more Proinflammatory interleukin-18 (IL-18), high-sensitivity C-reactive protein (hS-CRP), tumor necrosis factor-alpha (TNF-alpha), and anti-inflammatory IL-10 are involved in the pathogenesis of atherosclerosis. The aim of this study was to determine the imbalance between pro- and anti-inflammatory cytokines in premature coronary artery disease (PCAD) and their association with the degree of angiographic atherosclerotic blockade. A case-control study was carried out at the National Institute of Heart Diseases, Rawalpindi, Pakistan. Three hundred eighty-five stable coronary artery disease patients aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;45 years were screened. A total of 172 subjects participated in this study, comprising 98 PCAD patients and 74 angionegative controls. Serum IL-10, IL-18, and TNF-alpha were measured using enzyme-linked immunosorbent assay and hS-CRP was analyzed using Immulite 1000. The mean age of the patients was 40 ± 4.23 years (69 men and 9 women). Serum IL-18, TNF-alpha, hS-CRP, and IL-18/IL-10 ratio were significantly raised in PCAD patients (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01), whereas IL-10 was moderately increased (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05) when compared with controls. Serum IL-18 and hS-CRP were significantly raised in patients with 86%-100% stenosis (n=57) when compared with patients with 71%-85% stenosis (n=41) (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Serum IL-18, TNF-alpha, IL-18/IL-10 ratio, and hS-CRP significantly correlated (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01) with the degree of angiographic blockade. Pro/anti-inflammatory cytokines play a vital role in the pathogenesis of PCAD and have potential to identify the degree of atherosclerosis.
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