Journal of Islamabad Medical & Dental College
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Changes in Lipid Profiles According to Body Mass Index in Individuals Coming to a Tertiary Care Hospital
Get PDFObjective: The aim of this study was to quantify dyslipidemia among people with different Body mass index. Patients and Methods: This cross-sectional study was performed in the Pathology Department of Pakistan Institute of Medical Sciences, Islamabad. A total of 198 participants were enrolled in the study. All the participants were above 20 years of age coming as caretakers to the patients coming to OPD and indoor departments. People under 20 years, with cardiac diseases and those reluctant to give consent were excluded from the study. The outcomes were measured in the form of quantification of dyslipidemia among different classes of Body mass index (BMI). Results: The mean age of the participants was 34.9 + 9.4 years with predominance of male participants, 141 (71.2%). The overall frequency of dyslipidemia was 56.1%. It was observed that 51 (42.5%) individuals with normal BMI also had dyslipidemia. Out of 38 overweight cases 32 (84.2%) were found to be associated with dyslipidemia (p-value = <0.001). Conclusion: From the above study, it was found that dyslipidemia is not only associated with obese or overweight individuals, but also in individuals with normal BMI. This shows that normal BMI individuals are also at risk of developing cardiovascular disorders and should be routinely screened for dyslipidemi
Frequency of Depression in Mothers of Learning-Disabled Children
Get PDFObjective: To determine the frequency of depression in mothers caring for learning-disabled children. Subjects and Methods: This cross-sectional study was conducted at Department of Psychiatry, Benazir Bhutto Hospital Rawalpindi from May 2011 till 14th January 2012. In total 96 mothers of Learning disabled children, were consecutively recruited, from out patient department of Institute of Psychiatry, Benazir Bhutto Hospital. After obtaining written informed consent, Beck Depression Inventory (BDI) Urdu version was administered to assess the severity of depression; rated as ‘mild’. ‘mild-moderate’, moderate- severe’ and ‘severe’ depression. The data were entered on SPSS version 10 for further analysis. Results: In total 89.6% of the mothers were found depressed. Among these 27.1% had mild- moderate depression, 26.4% had moderate-severe depression and 36.1% were found to have severe depression. Conclusion: A high frequency of depression was observed in mothers caring for learning disabled children; frequency steadily increasing with severity of depression. This issue thus needs immediate attention for better heath related quality of mothers and better childcare. Ke
Full Dose Steroid Responsiveness Within 8 Weeks in Initial Treatment of Childhood Nephrotic Syndrome
Get PDFObjective: To determine the steroid responsiveness within 8 weeks of the initial treatment of childhood nephrotic syndrome. Patients and Methods: This prospective study was conducted in Children Hospital, Pakistan Institute of Medical Sciences, Islamabad from January 2012 to June 2012. A total of 139 children aged 1 to 10 years of both genders diagnosed as nephrotic syndrome were included in the study. Those children who were already taking any form of therapy for Nephrotic syndrome were excluded from the study. These children were given prednisolone 60 mg/m2 of body surface area, divided into 3 doses for a period of 8 weeks and then switched over to 40 mg/m2 as a single morning dose on alternate days, in those children who showed a response. The primary outcome of the study was to see the response of steroid therapy at different occasions for up to 8 weeks. SPSS version 11.0 was used for data analysis. Mean and standard deviation were calculated for numerical variables and frequency and percentages were calculated for categorical variables. Results: In this study 16.5% of cases responded to steroids within 2 weeks, major bulk of patients (43.5%) showed response between 3-4 weeks, (20.1%) and (2.1%) patients responded between 5-6 weeks and 7-8 weeks respectively. Steroid resistant nephrotic syndrome was seen in 16% of the study cases. Conclusion: Steroids are first line treatment for the idiopathic nephrotic syndrome. The majority of the patients show a response within 8 weeks of their first presentation. Maximum number responds between 3-4 weeks
Comparison of Anti-Diabetic Activity of Berberis lycium Royle Stem bark (Barberry) and Pioglitazone in Type 2 Diabetes Induced Mice Model
Get PDFObjective: To compare the anti-diabetic activity of aqueous extract of stem bark of Berberis lycium Royle and Pioglitazone –a thiazolidinedione in a type 2 diabetes mellitus induced male mice model. Material and Methods: This Randomized control trial was carried out in the animal house of National Institute of Health (NIH), Islamabad for 10 weeks. Fifty albino Balb/C male mice were divided randomly into groups I-V (10 in each group). Group I served as normal control group. In rest of the forty mice from group II-V, type 2 diabetes mellitus was induced by administration of high fat diet (HFD) for two weeks followed by low dose (40 mg/kg) intra-peritoneal Streptozotocin (STZ) injections for four consecutive days. Group II served as the disease control group, group III received the aqueous extract of stem bark of Berberis lycium Royle in dose of 50 mg/kg body wt. while group IV received the aqueous extract of stem bark of Berberis lycium Royle in dose of 100 mg/kg body wt. Group V was administered Pioglitazone in a dose of 30mg/kg body wt. The herb extract and the drug was given orally once a day for six consecutive weeks. Samples were taken at the end of ten weeks. Results: The blood samples estimated for fasting blood glucose (FBG) & glycosylated hemoglobin (HbA1c %) levels showed that the aqueous extract of stem bark of Berberis lycium Royle in a high dose (100 mg/kg body wt.) maximally lowered the FBG and HbA1c% levels followed by its low dose (50 mg/kg body wt.) Pioglitazone also reduced the FBG and HbA1c% to normal limits but its extent was less than the aqueous extract of stem bark of Berberis lycium Royle. Conclusion: The aqueous extract of stem bark of Berberis lycium Royle lowers the FBG and HbA1c levels in a type 2 diabetes induced male mice in a dose dependent manner
Frequency of Candidiasis, Trichomoniasis and Pyogenic Infection Causing Pelvic Inflammatory Diseases
Get PDFObjective: To determine the frequency of Candida, Trichomonas and Pyogenic infection, in Pelvic inflammatory diseases (PID) Patients and Methods: This cross-sectional study was carried out in Gynecology OPD of Abbasi Shaheed Hospital Karachi and Baqai Hospital Karachi from November 2013 to January 2014. The study included 100 females of 20-40 years and above with history of vaginal discharge, low back pain, itching, bleeding. The subjects were divided on the basis of various socioeconomic status (poor, middle, rich) groups. Females who were pregnant or had recent history of abortion were excluded from the study. For assessment, Pap smear, wet preparation and high vagina swab was collected from cervix and vagina. Results: In our study Candida albican 35%, Trichomonas infection 30% and pyogenic infection 35% were seen in various age groups. Majority of the cases were between 20-40 years. It was also observed that trichomoniasis was observed in lower and middle class females and not in upper class females. Conclusion: Trichomonas, Candida and Pyogenic infections were found to be most commonly associated with pelvic inflammatory diseases. A relatively higher frequency of Candidiasis, and Pyogenic infections were observed in upper and middle class, whereas high frequency of trichomoniasis was found in lower and middle class women. 
Comparison of Effect of Losartan with Pioglitazone on β-Cell Function in a Rat Model of Type 2 Diabetes Mellitus
Get PDFObjective: To find out the effect of losartan in comparison with pioglitazone on β-Cell function in a type 2 diabetic rat model. Patients and Methods: This was a randomized control trial study and was carried out at Postgraduate Medical Institute (PGMI), Lahore from June to August 2011. In this study 45 Sprague-Dawley rats of 5 weeks of age were randomized into three groups. All the rats were fed with a high fat and sucrose diet. Pioglitazone or losartan were given along with this diet to the rats in-group HFD-PIO and HFD-LOS respectively, while group HFD was kept under control. Body weight and fasting blood glucose levels were determined weekly. At the end of 12 weeks, blood glucose and serum insulin levels were determined. A marker of β-cell function, HOMA-β, was also calculated. Results: At the end of study period, body weight, fasting blood glucose, serum insulin, and HOMA-β levels were significantly lower in the HFD-PIO and HFD-LOS groups as compared to the control HFD group. The difference in these parameters between the HFD-PIO and HFD-LOS groups was not significant. Conclusion: Losartan is significantly comparable to Pioglitazone in improving β-cell function
Pathologist-Clinician Collaboration and Patient Care
Get PDFIn this era of personalized medicine Pathology plays a pivotal role and pathologists are at the forefront of establishing a correct diagnosis, on the basis of which further management of any disease is carried out. Infect the glorification of modern medicine and understanding of human body owes a lot to advances in pathology. A practicing physician or a surgeon is stranded without the help of a diagnostic pathology laboratory and guidelines from pathologist. Clinician suspects a disease and advises a battery of laboratory tests encompassing all the differential diagnosis and quite often, the confirmation requires a microscopic examination or more sophisticated tests involving molecular or genetic studies. It is believed that 70% of clinical decisions are based upon laboratory tests. Collaboration between the pathologist and clinician has been found to be indispensable in improving the quality of patient care especially in, but not limited to, the areas of cancer management and care.1 Knowledge about the sample collection, the right container used and proper documentation can minimize the pre-analytic errors. Laboratory request form is the first contact between the patient and laboratory and inadequately completed laboratory request forms or illegible clinical information provided limits pathologists advice to clinician and may contribute to medical errors. Majority of laboratory errors occur in pre-analytic phase of laboratory workflow and inadequately completed forms have been described as a contributory pre-analytic error.2 Awareness about the limitations and interpretation of different test results is an essential component of patient care
Testicular Germ Cell Tumor with a Rare Combination of Seminomatous and Nonseminomatous Components
Get PDFTesticular neoplasms constitute 1% of all tumors in men. With new therapeutic regimens, the cure rate in testicular germ cell tumors is more than 90%. Accurate histologic typing of the neoplasm plays a pivotal role in planning treatment in each case. Most testicular germ cell tumors (GCT) are of mixed type. Various combinations can be present but the occurrence of seminomatous component in mixed germ cell tumor is unusual. We report a case of a 26 years old man who presented with painless enlargement of testis. Histological examination revealed a mixed GCT of seminoma with syncytiotrophoblast cells, immature teratoma and embryonal carcinoma
Role of Probiotics in Prevention of Necrotizing Enterocolitis in Preterm Infants
Get PDFObjective: To compare the efficacy of prophylactic enteral probiotic administration versus placebo in the prevention of necrotizing enterocolitis in preterm infants. Patients and Methods: This randomized control trial was carried out at Paediatric Department of Holy Family Hospital, Rawalpindi. A total of 154 preterm infants, 28-33 weeks’ gestational age and <2500 grams at birth were enrolled after informed parental consent a donation of for 6 months. They were randomized in to 2 groups with 77 in each group. The infants in the study group were given BILUS (B.bifidus & L.acidophilus) with breast milk twice a day. The infants in the control group were given breast milk alone. Physical and radiological signs of Necrotizing Enterocolitis (NEC) were observed and NEC was staged according to Modified Bell’s criterion. Results: The frequency of Necrotizing Enterocolitis was lower in the study group as compared to the control group; 4 of 77 (5.2%) versus 6 of 77(7.8%) but the results were not statistically significant (p value = 0.25
Y Chromosome Microdeletions in Pakistani Infertile Men
Get PDFObjective: To determine the prevalence of Y chromosome microdeletions in Pakistani idiopathic infertile men, using multiplex polymerase chain reaction. Patients and Methods: A case control study was conducted on the infertile male patients attending OPD’s of Aziz Medical Hospital and National Center for Fertility Control, Jinnah Post Graduate Medical Center (JPMC), Karachi. A total of 220 primary infertile men, of which 150 (68.2%) had azoospermia, 40 (18.2%) had severe oligozoospermia and 30 (13.6%) had oligozoospermia and 220 fertile men as control group were studied. Six sequence-tagged sites: sY84 and sY86 for AZFa, sY127 and sY134 for AZFb, and sY254 and sY255 for AZFc were used for amplification of the azoospermia factor region of Y chromosome according to the recommendations of European Academy of Andrology and the European Quality Monitoring Network Group. Results: Yq microdeletions were found in (12) 5.45% cases, while none in the control group (p =<0.007). All the microdeletions were found in azoospermics 12/150 (8.0%). Among patients with microdeletions, the AZFa region was found to be deleted in 1 (8.33%), AZFb in 2 (16.67%), AZFc in 6 (50%), AZFb+c in 2 (16.67%) and complete AZF deletions in 1 (8.33%) patients. Identification of Y chromosome microdeletions in Pakistani infertile males was found to have significant diagnostic and prognostic value and provides useful information for genetic counseling in patients choosing assisted reproductive treatment