ABSTRACT
Background: Pakistan is a big victim of breast cancer and vitamin D deficiency. Interestingly, bones are the common site of breast cancer metastasis and vitamin D deficiency makes this condition more worst. The present study designed to estimate bone markers and minerals in different BMI groups of newly diagnosed breast cancer patients. Materials & Methods: diagnosed breast cancer females were approached and their characteristics including age, marital status, menstrual & family history, receptor status, tumor grade & type and presence of metastasis were noted from their medical reports. Whereas bone markers and minerals viz., alkaline phosphatase (ALP), bone specific ALP (BALP), vitamin D, carboxyl terminal collagen crosslinks (CTX), human epidermal growth factor 2 receptor (Her2) protein, albumin, calcium (Ca), phosphorus (P) and magnesium (Mg) were estimated plus body mass index (BMI) measured. Results: Most of the recruited females found aged less than 50 yrs, wedded, belonged to plump to obese BMI groups, had invasive ductal carcinoma, expressed triple positive receptor status and tumor grade II. Very few had metastasis and family history of breast cancer. Patients in all BMI groups showed insufficient level of vitamin D but normal levels of ALP, Ca, Mg, P, albumin, Her2 protein and CTX. Whereas Ca and BALP found slightly low in underfed BMI group patients. Conclusion: The results concluded and recommended that vitamin D levels must be monitored in breast cancer patients before and after treatment otherwise it will decrease more and may affect other bone markers.
ABSTRACT
Objectives: To facilitate early detection of chronic kidney disease, many organizations now recommend reflex reporting of estimated glomerular filtration rate (eGFR) whenever serum creatinine (Cr) is measured. To compare two widespread eGFR equations with creatinine clearance (CrCl) calculated through a timed urine collection. Methodology: Laboratory data of subjects’ ≥ 18 years tested for CrCl from October 2010 to December 2010 was retrieved from laboratory information system of Aga Khan University Hospital. Statistical comparison of eGFR using Cockcroft Gault (CG) and 4- variable Modification of Diet in Renal Disease (MDRD) formulae with CrCl was performed. Results: Six hundred and seventy subjects with CrCl were studied. Mean age of the group was 51 ±15 years, 55.7 % being males. Mean glomerular filtration rate using CrCl, MDRD and CG were 57.1 (±35.9), 57.8 (±33.6) and 68.7 (±41.5) ml/min respectively. Deming regression analysis generated MDRD = 5.23 + 0.92 (CrCl) and CG = 0.23 + 1.2 (CrCl) for comparison of CrCl results with those of MDRD and CG respectively. Comparing MDRD and CrCl, Bland Altman revealed acceptable agreement with a minimal bias of 0.65 ml/min. Conclusion: We suggest that automatic reporting of eGFR using MDRD can be implemented in clinical laboratories when serum Cr is reported.