Correlation of CRP levels in third trimester with fetal birth weight in preeclamptic and normotensive pregnant women

To evaluate the levels of C-reactive protein, an inflammatory marker in preeclamptic and normotensive pregnant women and to determine its correlation with fetal birth weight. Cross-sectional analytical study. Unit of Obstetrics and Gynaecology, Shaikh Zayed Hospital and Gynaecological Unit II of Jinnah Hospital, Lahore, from December 2011 to May 2012. The participants included 60 cases with preeclampsia and 60 normotensive pregnant women, all in their third trimester. All the participants were in the age group of 20 - 40 years and had a BMI range of 18 - 25. High sensitive C-reactive protein [hsCRP] levels were measured by Enzyme Link Immunosorbent Assay. Statistical analysis was done using SPSS [version 15]. The values were considered significant at 0.05 level of significance. C-reactive protein levels were significantly high [p < 0.001] in the preeclamptic group with a median value of 8.8 [0.3 - 25.5] as compared to 5.4 [0.24 - 9.8] mg/l in the normotensive women. The birth weight of babies was also significantly low in the preeclamptic group. The high CRP levels were negatively correlated with fetal birth weight in preeclamptic group. Elevated C-reactive protein levels in the preeclamptic pregnant women is a part of an exaggerated maternal systemic inflammatory response, and correlates with low fetal birth weight

Vitamin D deficiency in pregnant women and their new born

Background: Vitamin D deficiency may affect the mother and its new born health

Objective: To detect the frequency of vitamin D deficiency in pregnant women and their newborn of Karachi at tertiary care hospitals, and correlating maternal vitamin D with cord blood

Patients and Methods: This cross-sectional study was conducted on 50 women in labor presenting with a singleton term pregnancy at tertiary centers in Karachi. Data was recorded on a special proforma, maternal blood was taken before delivery and cord blood was taken at delivery. All blood samples were analyzed for 25-hydroxy vitamin D levels

Results: The mean vitamin D levels were 24 ng/mL for the mothers and 20 ng/mL for the newborns. Vitamin D sufficiency was noted in 11[22%], insufficiency in 16 [32%], and deficiency in 23 [46%] of the 50 mothers whereas sufficiency and deficiency, were noted in 6 [12%] and 44 [88%] of the newborns respectively. There was a positive correlation between the vitamin D levels in maternal and cord blood [r = 0.03; P=0.003]. Maternal vitamin D levels were significantly affected by sunlight exposure [P =0.007] and quality of diet [P=0.01]

Conclusion: Vitamin D deficiency is high among pregnant urban Pakistani women and their newborns. This public health problem needs urgent attention

Familial, hereditary and sporadic characterization of prostate cancer and impact on diagnostic modalities

Background: A family history of prostate cancer has been associated with increased risk of prostate cancer development, but the risks were inconsistent in terms of the affected family members and the data on prostate cancer characterization with respect to family history of disease among Pakistani men is limited

Objective: To characterize prostate cancer based on family history into familial including hereditary and sporadic cases and to investigate the association with diagnostic modalities; age of patient at diagnosis and pathological tumor grade

Methods: A self-administered written questionnaire was forwarded to 100 patients diagnosed with prostate adenocarcinoma, containing questions about age at diagnosis and cases of prostate cancer in family. The information regarding age of patient at diagnosis, cases of prostate cancer in relative, pathological tumor grade and age at death for all relatives affected by prostate cancer was acquired. The data was validated through the biopsy report of patient and medical records of relative affected by prostate cancer, provided by patient respectively. Patients were then divided into three groups according to their family history: familial prostate cancer [FPC], hereditary prostate cancer [HPC] and sporadic prostate cancer [SPC] groups

Results: 17% of the patients were categorized in the FPC group, of which 2% were identified as having HPC and 81% were assigned SPC group. Overall, there was no significant statistical difference between groups and study variables

Conclusion: We found no difference in age and pathological tumor grade, in patients diagnosed with adenocarcinoma of prostate following TURP. These results are consistent with previous studies except that patients with HPC in previous studies were significantly younger at diagnosis

Detection of xenotropic murine leukemia virus-related virus in prostate biopsy samples

To determine the association of Xenotropic murine leukemia virus related virus [XMRV] infection with prostate cancer and compare it with benign prostate hyperplasia. Case control study. Department of Histopathology and Molecular Pathology, Dow University of Health Sciences, Karachi, from January 2009 to December 2012. XMRV was screened in 50 prostate cancer and 50 benign prostatic hyperplasia biopsies using conventional end-point PCR. Other studied variables were family history of prostate cancer, patients age and Gleason score. XMRV was detected in 4 [8%] of the 50 prostate cancer biopsy specimens compared to none in biopsies with benign prostatic hyperplasia. However, there was no significant statistical association of XMRV infection with the other variables. A low frequency of XMRV infection was found in this case-control study. Men, who harbor XMRV infection, may be at increased risk of prostate cancer but this needs to be investigated further at a larger scale

Field cancerization of oral lichen planus and prognostic aspects of oral squamous cell carcinoma occuring on its background

Lichen Planus first described by Erasmus Wilson in 1869 has moved from being regarded as an innocuous benign condition to being considered as a potentially malignant disorder by the World Health Organization and is now defined as an idiopathic immune mediated mucocutaneous chronic inflammatory disease that affects the stratified squamous epithelia and the appendices. Oral lichen planus carries a very small probability of becoming malignant. The objective of the present study was to assess the long term prognostic aspects of oral squamous cell carcinoma/dysplasia and field cancerization occurring on the background of oral lichen planus in a retrospective analysis of 51 OLP patients [mean age=54 years; female, n=35; male, n=16] who between 2001 to middle of 2010 were diagnosed with OLP-related OSCC at the Department of Oral Medicine, Eastman Dental Institute and one major Head and Neck Cancer unit, University College London Hospital, United Kingdom. 1500 OLP patients were analyzed by using a computerized data base [CDR, Clinical Data Repository] and case files of Eastman Dental Institute and UCLHNHS Trust, out of which 53 patients were found to have at least one neoplastic event [intraepithelial neoplasia and/or invasive OSCC]. 2patients were excluded from the study as the case files or CDR did not have sufficient data regarding the histopathological and clinical features of oral lichen planus and/or subsequent neoplastic events. The results of the present study suggest that 3.5% [5311500] of patients with OSCC have a previous history of OLP. The mean interval between the histological diagnosis of OLP and OSCC development was 4.5 years. The observation period following the detection of the first oral malignancy was at least 2.2 years for the majority of patients. 51 oral lichen planus patients suffered a total of 137 neoplastic events [OSCC I dysplasia]. Patients with OLP and subsequent development of dysplasia I oral squamous cell carcinoma are at risk of having multiple and multifocal neoplastic events of the oral cavity and therefore worse prognosis

C-reactive protein as a prognostic indicator of oral squamous cell carcinoma-a retrospective study

The objective was to determine Serum C-Reactive protein as a prognostic indicator for Oral Squamous Cell Carcinoma. It was a retrospective cross sectional study, conducted in the Department of Oral Medicine, Eastman Dental Institute, University College London. The medical records of the patients were reviewed by using NHS CDR [National Health Service Clinical Data Repository] and studying their hospital notes of the year 2005. All the patients who had histopathologically proven OSCC, being treated with surgery as primary treatment modality and had pre-operative CRP values were included in the study. Data collection included the pre-operative serum CRP values, treatment modalities, disease severity, out comes, complications and the survival time period of the patients. Thirty one patients with OSSC treated primarily with surgery were included in this study. Twenty four patients had elevated pre-operative serum CRP levels while seven patients had normal value of serum CRP. 12 were males and 19 females with male and female ratio of 1:1.6. The age of the patients ranged from 46-92 years with the mean age of 64.87+14.25 years. The pre-operative serum CRP levels ranged from 4-57.2 mg/L with the mean value of 35.94+19.68 mg/L. Higher values of CRP corresponded with higher TNM staging and poor overall 5-year survival. The study showed that patients with elevated pre-operative serum CRP levels showed the worst prognosis and almost all of them died within five years while the patients with normal CRP were alive even after 5 years of surgical resection. Hence, it can be concluded that elevated pre-operative CRP levels are prognostic indicators in patients with OSCC

Acetylator phenotyping of sulfadimidine in a randomly mixed population

The world populations are classified into slow and fast acetylator phenotypes based on their genetic Lineage. Though some genetic intermixing exists in most populations, trend in genetic phenotypes in randomly mixed populations have not been reported. The population occupying the northwestern part of the Indian subcontinent [now Pakistan] is a unique example of prolonged and random mixing of divergent races. This study reports the genetic phenotyping in this randomly mixed populations and concludes that divergent phenotyes, randomly mixed, yield a perfect 50% distribution of slow and fast acetylators. The metabolic acetylation status in the subject population was studied using Sulfadimidine as the marker at a dose of 3 mg/kg. The pharmacokinetics of Sulfadimidine and its acetylated metabolite were studied. The acetylation of Sulfadimidine was found to be bimodal with equal distribution between rapid and slow acetylators. The pharmacokinetics parameters of sulfadimidine and its acetylated metabolite, except renal clearance, differed significantly between the rapid and slow acetylators