CRP, an inflammatory biomarker in type 2 diabetes mellitus

To find out hs-CRP levels in type 2 diabetic patients with and without CHD and to further evaluate association of hs-CRP with glycosylated hemoglobin and lipid profile. A cross- sectional / analytical study was conducted. Group A comprised of 100 type 2 diabetic patients without CHD and Group B comprised of 100 type 2 diabetic patients with CHD. All the patients were randomly selected from Khyber teaching hospital [KTH] and Hyatabad Medical Complex [HMC]. Blood Glucose, Glycosylated Hemoglobin, Lipid profile and hs-CRP levels were assessed. The mean hs-CRP, FBS and glycosylated hemoglobin values were significantly [P< 0.05] high in type 2 diabetic patients having CHD than type 2 diabetic patients without CHD. Moreover, hs-CRP also showed a significant [P< 0.05] positive association with FBS and HbAlc and negative association with HDL-C [P< 0.05]. Raised levels of plasma hs-CRP in type 2 diabetic patients may contribute to ongoing atherosclerotic processes leading to the development of coronary heart disease in these patients and this can be used as a marker of development of atherosclerosis in patients with diabetes mellitus

Endothelial dysfunction and deranged level of asymmetric dimethyl arginine in patients with type 2 diabetes mellitus

Objective: to determine the serum Asymmetric dimethyl arginine [ADMA] level, association of various biochemical parameters with plasma ADMA level in type 2 diabetic patients and also to compare with normal healthy individuals

Methodology: analytical cross sectional study was conducted at Medical and Cardiology Departments of Khyber Teaching Hospital [KTH] and Hayatabad Medical Complex [HMC], Peshawar for a period of one year. A total of 140 participants with age range of 35-65 years, were divided into two groups. Blood was obtained from each participant for biochemical analysis. All data obtained was entered in SPSS version 15. A P-value of < 0.05 was considered as statistically significant

Results: an elevated ADMA was noted group B. In group A significant positive correlation was observed between serum ADMA with TC and TG level and a non-significant correlation was observed between ADMA and HDL level. In case of group B a significant strong positive linear relationship was seen between ADMA level and different parameters like FBG, HbA1c, LDL and no significant correlation was seen between ADMA with TG and TC

Conclusion: our study reveals increased serum ADMA levels in the patients suffering from type 2 diabetes mellitus without CAD when compared with the control group. Also a significant positive correlation was seen between serum ADMA level and FBS, HbA1c, TC, HDL-C and TG levels among the subjects of group B

Atherogenic index of plasma in normotensive adults with type 1 diabetes mellitus

Type 1 diabetes is an organ specific autoimmune disease characterized by a progressive cell-mediated destruction of beta cells of the pancreas which leads to an absolute dependence on insulin for survival and maintenance of health. The present study was designed to look at the levels of atherogenic index of plasma [AIP] in normotensive adults with type 1 diabetes mellitus. The study was also intended to look for the difference, if any, in AIP levels between type 1 diabetics and the control healthy group. Observational and comparative study. This study was conducted at Department of Biochemistry and Clinical Chemistry, Khyber Medical College, Peshawar from July 2006 to December 2006. This study was conducted at Department of Biochemistry and Clinical Chemistry, Khyber Medical College, Peshawar from July 2006 to December 2006. In this study 30 patients with Normotensive Type 1 Diabetes Mellitus and 30 healthy control individuals were included. Blood samples of patients and control individuals were collected and analyzed for flucose, lipid profile and AIP was evaluated. The age and the body mass index [BMI] were having no significant statistical difference between the patient and the control group. Blood glucose, lipid profile and AIP were found to be significantly higher in normotensive type 1 diabetic patients when compared with control subjects. The study emphasizes that the determination of Atherogenic index of plasma as a routine measure can be used as an early predictor of atherosclerotic complications in diabetes mellitus

Assessment of male reproductive health by conventional method of semen analysis

Data available over the past twenty years reveal that in approximately 30% of cases of infertility, pathology is found in man alone, and in another 20% both man and woman are abnormal. Therefore, the male factor is at least partly responsible in about 50% of infertile couples. The longer a couple remains sub fertile, the worse is their chance for an effective cure. This study was planned to analyse the complete semen picture of infertile men for assigning the specific cause to male infertility related to concentration, motility and morphology and to know the distribution and pattern of male infertility in the various subclasses in Pakistani population. It was a prospective descriptive analytical study conducted at Department of Reproductive Physiology/ Health, Public Health Divisions, National Institute of Health [NIH], Islamabad. One thousand five hundred twenty-one [1,521] infertile male patients, and 97 proven fathers, taken as a control. Conventional semen analysis was performed on all samples. Out of 1,521 infertile men, 13.3% were azoospermic, 23.2% oligozoospermic, 0.9% polyzoospermic, 14.5% normozoospermic, 35.2% asthenozoospermic 10.5% oligoasthenozoospermic and 2.4% teratozoospermic. Sperm concentration and active motility of proven fathers, was significantly higher [p<0.05] than the normal concentration group. Least liquefaction time was recorded in case of polyzoospermic subjects, and highest for azoospermic cases. Although, the liquefaction time of azoospermic and oligozoospermic subjects varied non-significantly [p>0.05] with the proven fathers. Normal forms were significantly higher [p<0.05] among the proven fathers and polyzoospermic cases, in comparison with the other groups. Head defects were more in teratozoospermic group, followed by oligoasthenozoospermic and oligozoospermic patients. Neck defects were more profound in oligoasthenozoospermic and oligozoospermic patients, while, tail defect showed significant increase in teratozoospermic and asthenozoospermic cases only. Head and neck defect varied significantly [p<0.05] with proven fathers in all groups, while tail defect varied significantly [p<0.05] in oligozoospermic, asthenozoospermic and teratozoospermic groups only when compared with proven fathers. Complete semen analysis which provides important information about the quality and quantity of the sperm, should be performed before reaching a final conclusion

Effect of chemotherapy on serum lactate levels in malignant neoplasia

The present study was designed to look at the levels of serum lactate in various malignancies and to observe the effect of chemotherapy on serum lactate concentration in malignant neoplasia as a whole. The study was also intended to look for the difference, if any, in this effect for haematopoietic and non-haematopoietic neoplasias, so as to see whether evaluation of lactate levels could represent an additional and useful parameter in determining the clinical and prognostic aspect of the disease Observational and comparative study. This study was conducted at Radiotherapy Department, Jinnah Postgraduate Medical Centre, Karachi In this study 131 patients of Malignant Neoplasia were taken from the out-door patients in which 56 patients of haematopoietic group and 75 patients of non- haematopoietic group. Blood samples of 131 patients suffering from haematopoietic and non-haematopoietic neoplasia and 20 healthy control subjects were collected and analyzed for lactate, pyruvate and the NADH/NAD ratio. Blood lactate, Pyruvate levels and NADH/NAD* ratio were significantly higher in all groups of neoplasia before chemotherapy when compared with control subjects. The NADH/NAD+ ratio and the levels of blood lactate and Pyruvate decreased significantly with chemotherapy in all groups of patients suffering from neoplasia. Observation of low levels of these parameters, particularly that of serum lactate, after the course of chemotherapy can be used as an indicator of prognosis and also considered helpful in assessing the effectiveness of chemotherapy in malignancies

Effect of race, gender and age on thyroid and thyroid stimulating hormone levels in north west frontier province, Pakistan

Thyroid is one of the ductless endocrine gland, which is located immediately below the larynx on either side of and anterior to the trachea. The principal hormones of thyroid gland are thyroxine [T[4]] and triiodothyronine [T[3]]. The current study was carried out to investigate the impact of race, gender and area on the levels of Thyroxine [T[4]], Triiodothyronine [T[3]] and Thyroid Stimulating Hormone [TSH] in normal healthy individuals. Serum levels of T[4], T[3] and TSH in 498 normal healthy individuals belonging to different districts of North West Frontier Province, Pakistan, were examined. Serum T[4] and T[3] were analysed by Radio Immuno Assay [RIA] method whereas TSH was estimated by Immunoradiometric assay [IRMA] method. Levels of T[4], T[3] and TSH ranged from 53 to 167 eta mol/L, 0.6 to 3.1 eta mol/L and 0.3-4.8 micro IU/L respectively. The levels of these hormones show significant change from the reference values that are used in clinical laboratories as well as in Institute of Radiotherapy and Nuclear Medicine [IRNUM], Peshawar, Pakistan. It is concluded that the age, gender, race and area, all have an appreciable effect on the levels T[4], T[3] and TSH

Antioxidant vitamin status in type 1 Diabetes Mellitus patients

The study was designed to determine and compare the levels of both water soluble and fat soluble naturally occurring antioxidant vitamins, in order to know the antioxidant vitamin status of the type 1 diabetic and non-diabetic healthy individuals. Material and This case control study was conducted at Department of Chemistry, University of Peshawar from November 2004 to August 2005. Blood glucose, triglycerides, total cholesterol, HDL-c, LDL-c, VLDL-c and antioxidant vitamins [beta-Carotene, A, E, and C] levels were determined in 30 Type 1 diabetic and 30 healthy subjects. Values of blood glucose and lipid parameters were observed to be significantly increased [P 0.001] with exception of HDL-c, which was significantly decreased [P 0.001] in Type 1 diabetic patients. The concentration of antioxidant vitamins [b-carotene, E and C] were found to be significantly low in Type 1 diabetics when compared with normal healthy controls. Observation of low levels of antioxidant vitamins suggests possibly significant defects in antioxidant protection in Type 1 diabetes mellitus patients

Effect of folic acid supplementation on homocysteine level in postmenopausal women

Hyperhomocysteinemia is an independent risk factor for atherosclerotic diseases including Ischaemic heart disease, stroke and peripheral vascular disease. Homocysteine [Hcy] is an intermediate formed during the catabolism of essential sulphur containing amino acid methionine, increased Hcy is associated with endothelial dysfunctions in healthy human. Plasma Hcy is significantly lower in premenopausal women than young men but after menopause basal homocysteinemia increases significantly in women approaching those in men. Several studies showed that hyperhomocysteinemia to be stronger risk factor for CHD [Coronary Heart Disease] in women than men. It seems likely that altered hormonal status and age related low folate intake are responsible for this. The present study was designed to evaluate the effect of folic acid supplements for six months, on Hcy level in postmenopausal women. Hcy was estimated by Flourescence Polarization Immunoassay [FPIA]. There was a significant [p < 0.001] decrease in Hcy level after six months of folic acid supplements. Hcy is an independent risk factor for atherosclerotic disease, this study favours the view that after menopause Hcy level increases significantly and a simple non Toxic and relatively inexpensive vitamin [folic acid] intervention might be useful in primary cardiovascular prevention in this high risk group because Hcy is a stronger risk factor for CHD in postmenopausal women than men

Diabetes mellitus and its concomitant disorders in Afghan refugees residing in Peshawar, Pakistan

To determine the frequency of diabetes mellitus and its concomitant disorders in Afghan Refugees. Material and This study was carried out to see the prevalence of a number of diseases in Afghan Refugees attending different dispensaries and hospitals under Red Cross control, located in Peshawar, Pakistan. The diseases that were looked for were diabetes mellitus, hepatitis, nephritis, hyperlipidemia, and diabetes mellitus with concomitant disorders like hepatitis, nephritis and hyperlipidemia. A total of 456 Afghan patients were seen with non-insulin-dependent diabetes mellitus, hepatitis, nephritis, hyperlipidemia, and diabetes mellitus with concomitant disorders like hepatitis, nephritis and hyperlipidemia, attending different dispensaries and hospitals under Red Cross control, located in Peshawar, Pakistan, during a two year study period. Blood glucose, total lipids, cholesterol, triglycerides, total and direct bilirubin, urea, creatinine, uric acid, aspartate aminotransferase [AST], alanine aminotransferase [ALT], and alkaline phosphatase [ALP] were determined by colorimetric method. Four hundred and fifty-six patients examined during the study period included 255 patients suffering from diabetes mellitus [NIDDM], 80 with hepatitis, 69 with nephritis, and 52 with hyperlipidemia. Out of 255 diabetic patients, 45 diabetics had hyperlipidemia, 37 had nephritis, and 22 had hepatitis, whereas the remaining 151 diabetic patients were not having any other concomitant disorder. The patients were divided into adult age group [18 ' 50 years] and old age group [51 ' 80 years]. The level of total and direct bilirubin was found significantly higher [P < 0.01] in adult male when compared to the old age male patients with hepatitis, whereas the level of serum AST and ALT were found significantly increased [P < 0.05] in old age patients as compared to adult age group patients with hepatitis. Adult male patients had significantly increased levels of cholesterol as compared to the old age male patients with hyperlipidemia. Blood urea levels in old age female group showed a significant difference [P < 0.05] when compared to adult age female patients with nephritis. The rest of the parameters were found statistically indifferent in both sexes in adult and old age patients with nephritis. In female diabetic patients with nephritis the blood uric acid levels were found to be significantly lower in old age patients as compared to the adult age group patients. The frequency of non-insulin dependent diabetes mellitus was found to be very high in Afghan refugees in Peshawar then the rest of the diseases and the percentage of male patients in all groups of diseased subjects is higher than the female

Magnitude of lipoprotein [a] in diabetes mellitus

One hundred and three patients, 76 with diabetes mellitus alone [48- Non-Insulin dependent diabetes and 28 Insulin dependent diabetes] and 27 diabetics having coronary heart disease [CHD] and 27 normal control subjects were included in this study. All the 27 diabetics with CHD were Non-Insulin dependent. The patients and the controls were investigated for serum Lp [a], triglycerides, cholesterol, VLDL-C, LDL-C, HDL-C, apo A1 and apo B. The objective was to assess and compare the level of lipoproteins, especially the lipoprotein [a], in diabetic and non-diabetic subjects and to compare the level of the aforementioned parameters in diabetics with and without CHD. The Lp [a] and other lipid parameters were significantly raised [P < 0.001] except HDL-C and apo A1 that were significantly decreased [P < 0.001] both in diabetic patients with and without CHD, as compared to the control group. The diabetics with CHD showed significantly elevated [P < 0.001] Lp [a] and lipid profile, and significantly low [P < 0.001] HDL-C and apo A1 levels as compared to the patients having diabetes alone. No significant difference was observed in the levels of the above parameters when NIDDM patients were compared with IDDM group. In both NIDDM and IDDM patients significantly low [P < 0.001] HDL-C level and significantly high [P < 0.001] Lp [a] level along with the aforementioned lipid parameters was observed as compared to control group. Elevated levels of Lp [a] and lipid profile in diabetic subjects suggest their involvement in atherogenesis and subsequent development of CHD