Biological activities of three medicinal plants from district Mirpur, AJK, Pakistan

Present research work was aimed to investigate the biological activities i.e. antibacterial, antifungal, antioxidant, cytotoxic and antitumor activities of crude methanolic extract of Anagallis arvensis L., Butea monosperma [Lam.] Kuntze and Coronopus didymus [L.] Pers. against Gram positive strains [Bacillus subtilis, Staphylococcus aureus] and gram negative strains [Vibrio cholera, Enterobacter aerogenes, Klebsiella pneumonia, Agrobacterium tumefaciens, Escherichia coli] were screened. Best activity was observed against K. pneumonia and S. aureus by A. arvensis compared with other strains. Butea monosperma exhibited considerable activity against S. aureus, V. cholera, E. aerogenes and K. pneumonia compared with other strains. Methanolic extract of A. arvensis L. inhibited fungal growth against A. niger up to 30.2%. B. monosperma inhibited the growth of A. niger up to 43.5% and against A. fumigatus 27.3%. C. didymus inhibited the A. fumigates up to 27.3% and against A. niger, it inhibited 48%. Brine shrimps lethality bioassay was used to evaluate the cytotoxic activity and LD50 value was calculated by using probit analysis. Potato disc bioassay was designed to screen antitumor activity and data was analyzed by one way ANOVA

Controlled release matrix tablets of glipizide: influence of different grades of ethocel and Co-excipient on drug release

The aim of the current study was to formulate and evaluate glipizide controlled release matrix tablets by means of different grades of polymer Ethoceland different co-excipients in order to evaluate their effect on drug release profiles during in vitro dissolution studies. Type II diabetes mellitus is usually treated with Glipizide. Glipizide belongs to sulfonylurea group. Gastric disturbance and severe hypoglycemia has been observed after taking glipizide orally. To overcome these problems, controlled release matrices were developed using different grades of ethyl cellulose polymer with a drug-polymer ratio of 1: 3by the direct compression method. The effect on drug release of partial replacement of lactose by different co-excipients, HPMC K100M, starch and CMC, were also studied. Diameter, thickness, hardness, friability, weight variations, drug contents of formulations were tested, these properties were within prescribed limits. Co-excipients and polymer containing formulations were compared to the without co-excipients and polymer containing formulations with respect to their release profile. After a 24-hour release study, ethyl cellulose polymer containing formulation exhibited prolonged release for 5-16 hours; however the polymer Ethocel standard FP 7 Premium without co-excipient containing formulation exhibited controlled release for 24 hours. Incompatibility was investigated between drugs, co-excipient DSC and polymer study was performed and any type of interaction was not found. Different kinetic models were used to study the release mechanism. An enhanced release rate was observed in case of excipients containing formulations

Increased Body Mass Index may lead to hyperferritinemia irrespective of body Iron stores

Objective: Obesity causes subclinical inflammation which results in the secretion of various bioactive peptides that are key players in metabolic regulation of iron homeostasis. We sought to establish correlation of one such peptide [ferritin] with marker of subclinical inflammation [CRP] in various BMI

Methods: Total 150 subjects between the ages of 20-60 years were included in the cross-sectional study conducted at Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre, Karachi, Pakistan. Body Mass Index [BMI] was calculated by weight [kg] /height [m[2]]. The given values were used as reference for Group A: normal weight [18.0-22.9 kg/m2], Group B: overweight [23.0-24.9 kg/m2], Group C: obese [>25.0 kg/m2] according to South Asian criteria. Serum Iron, Total Iron Binding Capacity, serum Transferrin Saturation, serum Ferritin and C-reactive protein were measured by commercially available kits. ANNOVA with Tukey's minimum significant difference and Spearman Rho correlation were used considering p<0.05 significant

Results: The results identified an increased serum Ferritin and CRP in obese versus lean subjects [p < 0.001]. BMI showed significantly positive correlation with serum CRP [r = 0.815; p-value < 0.01] and Ferritin [r = 0.584; p-value < 0.01]. However, serum Iron levels and Transferrin saturation decreased in obese versus normal weight individuals [p < 0.001]

Conclusion: This integrated new data reveals that individuals with high BMI had high levels of Serum Ferritin despite low levels of iron with high levels of C- reactive protein.This might be caused due to inflammatory conditions prevailing in the presence of increased adipose tissue

Clinical indications and adverse reactions of platelet apheresis

To determine the clinical indications and adverse reactions of platelet apheresis procedure. Cross-sectional, observational study. Blood Bank of Pakistan Atomic Energy Commission General Hospital, Islamabad, from January 2010 to December 2014. Indications and adverse reaction verified for 200 consecutive platelet apheresis donations performed for 125 patients was included in this study. Data was analysed for descriptive variables using SPSS version 16. Donor deferral rate in the study was 63.83%. All the donors were males [100%] and replacement donors. Most prevalent blood type was B-positive [n=63, 31.5%], followed by O-positive [n=59, 29.5%]. Rh negative groups constituted 13.5% [n=27] of all the donors. Average age of platelet apheresis donors was 28.56 +/- 5.77 years. Maximum numbers of donors were in age range 20 - 30 years. Average weight of the donors was 73.96 +/- 11.96 kg. Mean pre-procedure platelet count of donors was 268,000/microL. The postprocedure average platelet count was approximately 200,000/microL. The mean duration of a platelet apheresis session was 78.27 +/- 26.07 minutes. Average volume of the final product was 412.53 +/- 45.33 ml. Average volume of anti-coagulant acid citrate dextrose used per procedure was 300 +/- 40 ml, 245 ml returned to donor along with returned blood while 55 ml used as anticoagulant in final concentrate. Of total 200, two [1%] final products were contaminated with red cells. Three [1.5%] products were not issued and finally expired. Of the 125 patients for which plateletpheresis procedures were performed, 54 [43.2%] patients were males and 71 [56.8%] were females [M: F=0.76:1]. Six donors [3%] had adverse events: three donors [1.5%] had mild reactions, two [1%] moderate reaction, and one donor [0.5%] developing hematoma. None had severe or life-threatening reactions. Plateletpheresis procedure is relatively safe and forms an important adjuvant to blood bank inventory

Natural history and comorbidities of subjects with subclinical hyperthyroidism: analysis at a tertiary hospital setting

<p><b>INTRODUCTION</b>Subclinical hyperthyroidism (SH, grade 1, thyrotropin (TSH) ≥0.1 mU/L and grade 2, TSH <0.1 mU/L) is a common disorder with increased prevalence in older subjects. There is evidence for increased morbidities in SH, such as atrial fibrillation and osteoporosis. We aim to study the natural history and comorbidities of SH from patients referred to a tertiary endocrine clinic in Singapore as they are currently unknown.</p><p><b>MATERIALS AND METHODS</b>Retrospective evaluation of SH subjects for natural progression and comorbidities.</p><p><b>RESULTS</b>One hundred and thirteen SH subjects (male/female: 24/89, mean age: 67.2 years, grade 1/grade 2: 60/53) were identified from the endocrine clinic. The aetiology of SH include 52 multinodular goitre, 15 Graves' disease, 7 toxic adenoma and 39 unclassified. A minority of SH patients (5.3 %) progressed to overt hyperthyroidism while 13% remitted to euthyroid state (1 to 3 years with a mean follow-up of 18 months) in the total cohort. Most of the patients remained in SH state during follow-up (50/60 in grade 1 SH and 42/53 in grade SH). However, no single predictive factor could be identified for progression or remission of SH. The prevalence of morbidities in SH subjects include ischaemic heart disease (16.8%), heart failure (8.9%), tachyarrhythmias (13.3%), any cardiovascular disease (28%), cerebrovascular disease (28%), osteoporosis (28%), and any fracture (15.9%).</p><p><b>CONCLUSION</b>Most of SH cases in our cohort remain in subclinical state with very few progressing to overt hyperthyroidism. Significant proportion of SH subjects have vascular disease, but this association needs to be confirmed in prospective controlled studies.</p>

Study to compare serum beta crosslaps levels between premenopausal and postmenopausal women

Osteoporosis is a progressive systemic disease of the bone causing significant reduction in bone mineral density and microarchitecture of bone tissue .All women experience slow bone loss with age . In Pakistan accelerated bone loss at menopause in women is about 75.3% increasing upto 97%with age thus making osteoporosis a major health problem.At the time of menopause, serum automated beta-Crosslaps increases by 86% a pattern consistent with accelerated bone loss within the first few years following menopause .we therefore hypothesized that estimation and comparsion beta-Crosslaps levels in Premenopausal and Postmenopausal women may be use as a diagnostic and screening marker for prevention of postmenopausal osteoporosis. A cross sectional comparative study. This study was conducted in department of Physiology, BMSI in collaboration with Karachi gymkhana through a medical campaign in September 2011. A total of 94 subjects [premenopausal and postmenopausal] were included in this study that was performed in the urban area of Karachi city in 2011. Data was collected from all subjects through a questionnaire including questions regarding their age, menstrual history, menopausal and medical history. Blood samples from all these subjects were collected for the determination of bone turnover marker beta crosslaps. Bone mineral density [BMD] of the heel bone was done by single x-ray absorptiometry. The results of our study showed that the levels of serum beta-Crosslaps in postmenopausal women were significantly higher as compared to premenopausal women p<0.01.There was a significant rise in the beta-Crosslaps levels with the increasing age among the postmenopausal women p<0.01.BMD [bone mineral density] value have negative correlation the beta-crosslaps levels p<0.01 i.e with the increasing age there was decrease in BMD value and increase in beta-crosslaps values. Serum beta-crosslaps levels in postmenopausal women can provide valuable information regarding the decreasing bone density and hence may be considered a cost effective diagnostic as well as screening marker for the prevention of postmenopausal osteoporosis

Comparison of effects of short term [12 weeks] low, moderate and high intensity exercises on lipids and lipoproteins levels in young hyperlipidemic adults

To study and compare the effects of light, moderate and vigorous intensity exercise on serum total cholesterol [TC], triglycerides [TGs], low density lipoprotein cholesterol [LDL-c] and high density lipoprotein cholesterol [HDL-c] levels in hyperlipidemic adults. To evaluate the level of minimum physical activity required to keep the lipid profile under the desirable limits in hyperlipidemic adults in local population. The effects of increased physical activity is related to reduce risk of cardiovascular disease, possibly due to improvement in the lipoprotein profile. Case control study. This study was conducted in the Department of Physiology, BMSI, JPMC, Karachi from January 2012 to April 2012. Total of 120 volunteers moderately active, young hyperlipidemic adults, aged 30 to 50 years, thirty for each A [control], B, C and D for low, moderate and high intensity exercise respectively were assigned to participate for 12 weeks exercise program without restricted caloric diet at pre-identified track of specific time. Lipids profile and age, sex, BMI and lab investigations like serum TC, TG, LDL, HDL, of each participant were recorded at baseline and similarly on day 30, 60 and day 90. There was a beneficial effect of exercise by lowering the level of lipid and lipoproteins variables, seen most clearly in moderate and high intensity of exercise with increasing the level of HDL but no significant effects were observed with the low intensity exercise. These results indicate that the low intensity exercise has no beneficial effects in lowering the lipid and lipoproteins levels in hyperlipidemic adults but moderate and high intensity exercise has lipid and lipoproteins lowering effects with increasing the level of HDL significantly in hyperlipidemic young adults

Association of anxiety and depression with acne: evaluation of pathoplastic effect of adolescence on this comorbidity

To see the association of anxiety and depression with acne and to observe pathoplastic effect of adolescence on this comorbidity. This cross-sectional study was conducted in the out-patients of department of Dermatology, Bahawal-Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur, from January 01, 2011 to June 30, 2011. After taking written informed consent from each patient, we enrolled 101 patients of acne diagnosed by consultant dermatologist .The severity of acne was determined according to the Global Acne Grading System. The patients of both sexes of the age ranging from 10-39 years were included in the study and divided into three groups [I=10-19y, II=20-29y, III=30-39y] to examine the effect of age on the disease .The patients with concomitant dermatological, psychiatric diseases and on systemic isotretinoin were excluded. The patients fulfilling inclusion criteria were administered Urdu version of Hospital Anxiety and Depression Scale by senior psychiatrist assisted by his team. The score obtained from each patient was used to categorize non-caseness [0-7], mild anxiety and mild depression [8-10], moderate anxiety and moderate depression [11-15] and severe anxiety and severe depression [16-21]. Out of 101 patients studied, 35.6% were males and 64.4% females with M: F ratio of I: I.8. 81.18% of the acne patients were having anxiety, 70.29% depression and 18-29% had no psychiatric complication. The large majorities of the enrolled patients were suffering from mild anxiety [76.8%] and mild depression [83.1%]. Only the patients with moderate acne had severe anxiety [2.4%] and severe depression [1.4%]. 88.1% of the acne patients had duration of illness less than 5 year against 11.9% with duration more than 5 years [p<0.05]. We found continuous decrease in the frequency of anxiety and depression as the acne patients' age progressed without going into severe psychological handicap. There is high association of anxiety and depression with acne. But no linear relationship between the severities of anxiety and depression with those of acne is found. High frequency of mild anxiety and mild depression in adolescence decreases as the age progresses, which may be due to the pathoplastic effect of the younger age

Thrombomodulin, a protective marker against coronary artery disease

1] To compare the serum thrombomodulin levels between apparently healthy subjects and patients with myocardial infarction and unstable angina 2] To assess, whether it may be identified as a protective marker for determining the incidence of coronary artery disease The controls and patients were taken by convenient sampling. A total of 32 control [healthy] subjects were compared with 32 consecutive patients with history of myocardial infarction, [M.I.] and 32consecutive patients with history of unstable angina [U.A.] respectively. The diagnosis of myocardial infarction [M.I.] and unstable angina was made on the basis of history, E.C.G. and Trop. I levels. Serum thrombomodulin and serum lipid profile of each subject were determined by ELISA Kit methods. One way analysis of variance [ANOVA] was conducted for comparison of serum thrombomodulin level among healthy, Myocardial infarction [M.I.] and unstable angina [U.A.] patients. Serum Thrombomodulin levels were significantly higher in controls when compared to patients of myocardial infarction and unstable angina. Serum L.D.L. cholesterol and total cholesterol levels were significantly higher in diseased group in comparison with control Incur study healthy population had increased Thrombomodulin levels as compared to patients of coronary artery disease [C.A.D.]

increase in pulse pressure in the early age post menopause women in local population as a marker of preclinical cardiovascular disease

To determine the post menopausal changes of pulse pressure in the early age menopause women. A cross sectional and comparative study, was performed at the department of Physiology B.M.S.I., J.P.M.C., Karachi in collaboration with the Abbassi Shaheed Hospital and National Institute for Cardiovascular Diseases, Karachi. This study included a total of 100 women, 50 with early age post menopause and 50 with normal age post menopause. For the statistical analysis, the degree of probability was computed by comparing the calculated value of "t" with tabulated value in the table of "t" distribution against the degree of freedom. Pulse pressure was found to be significantly increased with a P-value of <0.001 in the early age post menopause women. This suggests that an early age post menopause is more likely to develop a marker of preclinical cardiovascular disease such as increased pulse pressure

investigate the association between the development of coronary heart disease and serum levels of adiponectin

To investigate the association between the development of coronary heart disease and serum levels of Adiponectin. It was a case control study done at the Department of Physiology Basic Medical Sciences Institute [BMSI] Jinnah Post Graduate Medical Centre [JPMC] in colaboration with Abassi Shaheed Hospital Karachi. The study included total 100 subjects, 50 subjects with angiographically confirmed coronary heart disease and 50 normal healthy age and gender matched controls. All the subjects were breifed about the the nature of the study and an informed concent were taken from all the recruits. Adiponectin serum concentration was found [7.1microL] in coronary disease patients, and the serum concentration of adiponectin in control subjects was [11.98 microL]

Frequency of depression and somatic symptoms in patients on interferon alpha/ribavirin for chronic Hepatitis C

Large numbers of patients suffering from Chronic Hepatitis C [HCV] are seeking treatment with interferon alpha [IFN] because of significant advances in overall improvement in the course of HCV and its complications. Objectives were to estimate the frequency of depression and somatic symptoms in patients on interferon alpha/ribavirin treatment for chronic hepatitis C. It was an observational study conducted in the out-patient Department of Gastroenterology Shaikh Zayed Hospital, Lahore during a period of three months, i.e., from September to November 2008. One hundred consecutive patients undergoing interferon alpha/ribavirin treatment for chronic HCV were included in the study. All patients, irrespective of age, sex or duration of treatment were administered with a check list of common physical complaints and DSM-IV symptoms for Major Depressive Episode. Out of a total of 100 subjects 37 were male and 63 were female. In all, 39 [39%] patients fulfilled the diagnostic criteria of DSMIV for Major Depressive Episode. Major Depression was more common in female 28 [44.4%] as compared to male 11 [28.7%] patients. Somatic symptoms were common in all the patients but they were reported more frequently by patients with Major Depression compared to those without Major Depression. Myalgias, headache, joint pain, nausea/vomiting, abdominal pain and palpitation were the most common physical symptoms. Major Depression and somatic complaints are a common consequence of interferon alpha/ribavirin treatment for chronic hepatitis C. All patients receiving this treatment should be periodically assessed for the detection of these side effects to promptly address relevant treatment options

mucin content a prognostic indicator in colorectal carcinoma?

To evaluate the mucin profile ofcolorectal adenocarcinoma by means of a histochemical study and to correlate mucin content and histological grade vis-a-vis prognosis. Descriptive study. Jinnah Postgraduate Medical Centre Karachi, from August 2004 to August 2007. Seventy patients who underwent surgical resection of sporadic colorectal adenocarcinoma over a 3-year period were evaluated for histological classification as to mucinous [MUC] or a non-mucinous [nMUC] subtype. They were further divided by histological differentiation into low-grade and high-grade tumors. The two groups were compared in terms of mucin content by histochemical techniques. Relationship between mucin content and histological grade was also analyzed. On the basis of mucin content all cases were divided into mucinous [MUC; n = 14; 20%] and non- mucinous [nMUC; n = 56; 80%] adenocarcinomas. The predominant mucin on histochemistry ofcolorectal adenocarcinoma [nMUC and MUC] was sialomucin. Tumors were further graded historically into low-grade [85.71%] and high-grade [14.28%]. MUC adenocarcinoms showed a higher proportion of high grade tumors. Both MUC and nMUC are distinct histological subtypes of colorectal adenocarcinoma. No relationship could be established between pattern of mucin secretion and histological differentiation, however there is a definite relationship between mucin content and histological grade. It could be concluded from this study that mucin content vis-a-vis histologic grade have an influence on prognosis. Further elucidation and follow-up is needed

Frequency and distribution of different types of breast carcinoma

Background: To find out frequency and distribution of different types of breast carcinoma in mastectomy specimens

Subjects and Methods: It was an observational study conducted in the Department of Histopathology, Shaikh Zayed Hospital, Lahore. The study comprised of a convenient sample of 30 female patients above 30 years of age undergoing modified radical mastectomy for carcinoma during a period of six months from December 2004 to May 2005

Results: A total of 30 mastectomy specimens of 30 female patients of age 30-79 years were included. A slightly greater proportion of patients [56.67%] had the tumour on the right side while [43.30%] had it in upper outer quadrant. Out of these thirty carcinomas, 25 cases were ductal in type whereas 4 were lobular

Conclusion: Majority of the patients in our study were in the fifth and fourth decade of life. Slightly greater proportion of patients had the carcinoma in the upper outer quadrant of right breast. Infiltrating ductal carcinoma was the commonest type

Interferon alfa and ribavirin induced hair changes

Combination therapy of lnterferon alfa and ribavirin in chronic hepatitis C has well documented cutaneous adverse effects. Most interesting of these has been reported on hair physiology. This study was conducted to determine the frequency and pattern of adverse effects involving hair in patients receiving combination of interferon alfa 2a and ribavirin for chronic hepatitis C. The study was conducted in Department of Dermatology, Division of Medicine Shaikh Zayed Hospital. Thirty Eight patients who completed treatment with interferon alfa 3 MIU subcutaneously thrice weekly] and 1200 mg ribavirin daily for 24 weeks were enrolled in this single-center study. The patient's response and examination finding particularly regarding involvement of hair was noted on a Pro forma. Thirty Two out of thirty eight [84%] patients noted adverse effects involving hair. The most frequent was diffuse hair loss and occurred in 27 patients [71 %]. Hypertrichosis of eyelashes [trichomegaly] and eyebrows [synophyrs] was observed in 18 [47%] and 16 [42%] patients respectively. Graying of hair was noted in 4 patients [11 %], while discoloration of moustache hair was seen in 2 patients [5%]. Epilation at the site of subcutaneous injection was noted in 10 patients [26%]. Alopecia areata was reported in 2 patients [5%]. It is concluded that adverse effects involving hair are frequent and varied [hair loss to excess hair growth] during combination therapy with Interferon alfa-2a and Ribavirin for chronic hepatitis C

Extra intestinal manifestations of irritable bowel syndrome

Objectives: This study was done to assess the frequency of extra intestinal features present in patients with irritable bowel syndrome

Design and place of study: It was an observational study conducted in out-patient Department of Medicine, Shaikh Zayed Hospital, Lahore affiliated with Federal Postgraduate Medical Institute, over a period of two years from January 2005 to December 2006

Subject and methods: The patients fulfilling the Rome II criteria of IBS were included in the study. A check list of extra intestinal symptoms was administered to all the patients

Results: A total of 63 patients were included in the study. There were 41 men and 22 women [male to female ratio of 1.86: I] with the age range from 18 to 61 years [mean of 33 .09 +/- 8.5 SD]. The mean duration of disease was 2.78 years. Urinary symptoms like frequency and urgency were present in almost one third of patients. These symptoms were more frequent in men [47%] than in women [33%]. The most common non-specific pain was chronic headache [62%] followed by fibromyalgia [43%] and non-specific chest pain [37%] of all cases. All of these non-specific pain symptoms were more common in women. Dysmenorrhoea [45%] was the commonest genitourinary symptom in women while impotence and premature ejaculation each were seen in 7% of men. As a group sexual and genital symptoms were more common in women than men

Conclusion: Majority of the IBS patients along with intestinal symptoms also suffers from extra intestinal complaints. Therefore, these patients should be actively screened for the presence of these extra intestinal complaints so that a timely multidisciplinary intervention may prevent further prolongation of their misery

Frequency of posttraumatic stress disorder symptoms in earthquake survivors

Objectives: This study was done to assess the frequency of symptoms of Posttraumatic Stress Disorder in earthquake survivors

Design and place of study: It was an observational study conducted on in-patient survivors of Oct 8. 2005 earthquake, admitted in different departments of Shaikh Zayed Hospital, Lahore affiliated with Federal Postgraduate Medical Institute

Subject and methods: The patients who had received different physical injuries and their surviving attendants were administered with a check-list of symptoms of Posttraumatic Stress Disorder [PTSD] diagnostic criteria of DSM-IV

Results: A total of 124 survivors [85 patients and 39 attendants] were identified and administered with the check-list. In all 52 [41.94%] of the survivors, 38 [44.77%] of patients and 14 [35.90%] of the attendants fulfilled the entire DSM-IV symptom criteria for PTSD. Among the patients more females i.e. 27 [52.94%] as compared to males i.e. 11 [32.32%] fulfilled the symptom criteria for PTSD

Conclusion: Posttraumatic Stress Disorder symptoms are very common in the survivors of an earthquake, an evidence to sensitize health care providers to organize and implement timely psychosocial assessment and interventions

Co-morbidity of personality disorders and other psychiatric disorders

To estimate the frequency of co-morbid personality disorders in psychiatric patients. Design: An institution based observational study. Place and duration: This study was conducted at the Academic Department of Psychiatry and Behavioral Sciences, Mayo Hospital, Lahore during September, 1997 and March, 1998. Patients and methods: A total sample of 231 psychiatric patients comprised of 106 outpatients, 105 inpatients and 20 patients with mental and behavioral disorders due to psychoactive substance use admitted for detoxification and rehabilitation. Clinical diagnoses of psychiatric disorders and personality disorders were made according to the ICD-10 diagnostic criteria after evaluating symptoms from history, mental state examination and The Present State Examination. The Personality Assessment Schedule was administered to all the patients and their informants for the diagnosis of personality disorders. Results: Out of 231 patients, 40 [17.3%] were diagnosed as suffering from ICD-10 personality d is order and 76 [32.9%] had personality disorder according to The Personality Assessment Schedule. Inpatients had slightly higher rate of personality disorders, 36 [34.3%] vs. 30 [28.3%] of outpatients. Out of 20 inpatients with substance use disorders, 5 [25%] had ICD-10 and 10 [50%] PAS personality disorder. The most common personality disorder diagnosis was passive-dependent in 11 [5%] cases closely followed by sociopathic and paranoid in 10 [4.5%] cases each and anankastic in 8 [3.6%] of patients. The dysthymic personality disorder was diagnosed in 6 [2.7%] cases whereas explosive, histrionic and avoidant in 5 [2.3%] cases each, followed by anxious and schizoid in 4 [1.8%] cases each and sensitive-aggressive in 3 [1.3%] of the patients. Conclusion: Co-morbid personality disorders are quite common in psychiatric patients as 1 out of every 3 patients is estimated to have a personality disorder. Assessment of pre-morbid personality is expected to promote an individualized approach to the management

Pulmonary alveolar microlithiasis

We report a patient with pulmonary alveolar microlithiasis who was admitted to King Abdul-Aziz Hospital, Makkah, Kingdom of Saudi Arabia with chest pain, shortness of breath, dry cough and swelling of lower limbs. The patient underwent chest radiographs and CT scan showing multiple diffuse, almost symmetrical bilateral micronodular opacities of calcific density. The diagnosis was confirmed after percutaneous lung biopsy from the patient. Cardiokinetics, diuretics and oxygen were administered with slight improvement

Characteristic features of 50 NAFLD patients

Objective: To note characteristic features of patients with nonalcoholic fatty liver disease [NAFLD] diagnosed on ultrasound basis

Design: Descriptive

Place and duration of study DHQ Teaching Hospital, Rawalpindi, from January to June 2003

Materials and Methods: Fifty NAFLD patients diagnosed on ultrasonographic findings were inducted consecutively. Patients with conditions associated with secondary NAFLD were excluded. Clinical and laboratory evaluation of each patient was done to note presence or absence of obesity, hepatomegaly, cholesterol and triglyceride levels, and diabetes mellitus. Obtained data was analyzed using statistical program, SPSS version 10

Results: Of the 50, 54% were female and 46% male. Mean patient age was 42.78 +/- 12.29 years. 66% patients were obese, 56% had hepatomegaly, 28% had elevated cholesterol, 72% had hypertriglycedemia, and 44% were diabetic. All of these features except for hypercholesterolemia were common in females

Conclusion: Obesity, hepatomegaly, diabetes, and hypertriglycedemia are characteristic features of our NAFLD patients that are more common in females