Q192R paraoxonase1 polymorphism is a risk factor for cataract in Pakistani population

Cataract, the lens opacity, is among major causes of blindness in Pakistani population. In recent past, oxidative stress is suggested to play crucial role in loss of transparency. Along with other antioxidants, Paraoxonase 1 [PON1] has also shown decreased activity in patients suffering from cataract. The aim of current study was to examine the possible association of PON polymorphism with predisposition of cataract formation in local population. The study was conducted on 51 cataract patients and 50 control subjects considering all ethical issues. DNA was extracted from whole blood and PON1 polymorphism was identified using tetra primer ARMS-PCR method for both positions L55M and Q192R. Tetra primer ARMS-PCR results revealed that association between L55M polymorphism and cataract was insignificant while 192R genotype PON1 frequency was higher among the people suffering from cataract [78.4%] as compared to control subjects [56%], [odds ratio=2.857, confidence interval=1.197-6.820]. Hence, R allele is likely to be a risk factor for cataract with allele frequency [82.3%] and [odds ratio=4.552, confidence interval=1.716-12.073, p-value=0.002]. PON1 Q192R polymorphism is likely to be a risk factor for cataract development in Pakistani population while PON1 L55M was not found to be associated with cataract

Effect of pioglitazone on serum high density lipoprotein [HDL] levels of type-2 diabetics

Objective: To study effect of Pioglitazone on serum high density lipoprotein levels in patients with type 2 diabetes mellitus

Study Design: Single blind randomized controlled trial

Place and Duration of Study: Department of medicine, Combined Military Hospital Multan from 1[st] Feb 2011 to 30[th] July 2012

Material and Methods: A total of 276 already diagnosed patients of diabetes mellitus type 2 between age of 30-80 years, presenting to the outpatient department of Combined Military Hospital Multan were selected. Type 2 diabetic patients were allocated group A or B using random allocation. Base line blood sugar fasting [BSF], glycosylated hemoglobin [HbAlc], high density lipoprotein [HDL] levels were taken. Group A was treated with Pioglitazone along with other hypoglycemic agents while group B was treated with only hypoglycemic agents and multivitamin tablets were added as placebo.After 12 weeks of treatment, serum HDL levels were measured to analyze effect of pioglitazone on serum HDL levels

Results: Pioglitazone group showed significant improvement in the serum HDL levels from baseline HDL 46.38 + 6.44mmol/L to 49.80+ 5.86 mmol/L after 12 weeks of therapy, [p = 0.001]

Conclusion: Pioglitazone when used in combination with other oral hypoglycemic agents has a beneficial effect on the serum HDL levels of the diabetics

Heart and kidney patients; correlational patterns of social support with coping strategies and subjective well-being

The prevalence of chronic diseases is exceptionally high [37.9%] among the adult population of Pakistan. Social support could play a significant role in shaping the coping strategies and determining the subjective wellbeing of chronically ill patients. This research documents the correlation patterns of social support with coping strategies and subjective well-being among Heart and Kidney Patients. The primary data was collected from four major hospitals in Lahore by using purposive sampling method. For the collection of quantitative data, a hospital-based, cross-sectional survey was conducted with 275 admitted patients [131-heart and 144-kidney]184 male and 91 female [20 to 110 years of age] by using a structured interview schedule. Pearson Product-moment Correlation and Multiple Regression Analysis were performed on the data set. Strongest correlation was found between emotional and informational social support [r=.853]. Instrumental social support also indicates strong relationship with the emotional social support [r=.838]. There was a moderate positive correlation [r=.339] between behavioral coping, emotional social support and informational social support [r=.424]. Data show a negative relationship between physical coping and subjective well-being [r=.381]. Results of the study suggest that emotional [beta=.230] and informational [beta=.217] social support affect the patients' ability to actively engage in behavioral and physical coping for the subjective well-being; however, physical coping indicated negative effects [beta =-.225] on the subjective feelings of well-being. A strong correlations among four types of social support exists and behavioral coping has the strongest impact on the subjective well-being [beta=.629]

Coping strategies during chronic illness: a comparative study of cardiac and renal failure patients

Pakistan is a developing country where the majority of the population belongs to the lower socioeconomic class. Chronic diseases such as cardiovascular and kidney diseases are increasing day by day in Pakistan. Individuals suffering from chronic illnesses are at a greater risk of problems as compared to the un-sick. Their vulnerable situation and the stress of the event creates a lot of changes, changing the meaning of individual lives altogether. To understand the dynamics of chronic illnesses, it is important to find out what coping strategies were used by the cardiac and renal failure patients? The researchers tried to find out whether cardiac and renal failure patients differ in their coping strategies. Quantitative cross sectional study. August 2014. The data was collected from the Dialysis Units of Mayo Hospital, Jinnah Hospital, Lahore General Hospital and all admitted patients of Punjab Institute of Cardiology, Lahore. These four hospitals have good turn-over of the patients. Purposive sampling method was used in this study. For the collection of quantitative data, a hospital-based survey was conducted by using a structured interview schedule. 275 patients [131-cardiac and 144-renal failure] including 184 males and 91 females between age of 20 to 110 years were interviewed. Mean age was 44 years [S.D = 15.338]. T-Test for independent groups and Pearson's correlation tests were carried out to compare cardiac and renal failure patients coping strategies along with descriptive statistics. Results indicate that renal failure patients used more physical coping [M = 11.23], t [df = 273] = -1.235, p<.01 that cardiac patients [M = 10.83], t[df = 273] = -1.242, p<.01. Cardiac patients used more psychological [M = 28.69], t[df = 273] = 1.511,p<.01and behavioral coping [M = 17.37], t[df = 273] = 3.977,p<.01 than renal failure patients psychological[M = 27.97], t[df = 273] = -1.517,p<.01 and behavioral coping[M = 15.43], t[df = 273] = 3.980,p<.01. F = 11.800.1.882, and 0.623 which are greater [i.e., p<.05]. Pearson's Product-moment correlation coefficient show strong correlation exists between behavioral and psychological coping [r = .428]. Study found significant differences between the cardiac and renal failure patients coping strategies. Renal failure patients used physical coping strategies more whereas cardiac patients used more psychological and behavioral coping strategies

Effectiveness of dengue fever prevention campaigns; a study of knowledge and practices in urban/semi-urban communities of Lahore

Dengue fever badly hits Pakistan in 2011. A large number of people died due to dengue fever. To control the alarming situation, other than treatment, work had been started at all levels. Department of Social Welfare and Bait-ul-Maal, Punjab was involved by the City District Government to work for the awareness among public for the preventive measures and practices to reduce the spread of the epidemic. Anti-dengue awareness campaigns were organized at the community level with the help of non-government organizations. A survey was conducted with the following objectives to evaluate the effectiveness of anti-dengue awareness activities: [1] Public knowledge of Dengue fever. [2] Anti-mosquito Preventive Practices. A cross sectional household survey. Out of ten towns of Lahore city, Samanabad Town was selected. Januarys to March 2014. A structured interview schedule of three sections was designed. Interviews were conducted from urban/semi-urban communities. By using multistage random sampling, Out of ten towns of Lahore city, Samanabad Town was selected. Samanabad Town is consisted of 24 union councils with a population of 17 million. Three union councils: 86, 104 and 112 were randomly selected. 400 household were randomly selected from these union councils for interview to ensure representativeness of the sample. Males/Females aged 15-65 and above lived in the households of Samanabad Town were the respondents. One respondent was selected from each household. In this cross-sectional study, by using Taro Yamni Formula, 400 interviews were successfully conducted with a response rate of 100%. Other than demographics, 17-items questionnaire measured knowledge and practices about awareness and dengue prevention. Descriptive statistics and Pearson Correlation coefficient was used for the analysis of the data. Data was analyzed by using SPSS 20. Maturity of the community members' 76 - 92% was aware and had knowledge of preventive measures. 66 - 83% practicing regularly in the households. Data analysis indicated a positive and significant association between knowledge about dengue prevention and practices about dengue eradication [r = 0.000, p < .005]. Consistent awareness campaigns for dengue fever prevention and control enhances public knowledge and motivates individuals to adopt preventive practices in day to day routine life. To foster and maintain public interest, attractive beneficial public friendly practical economical practices need to be publicized to motivate young ones in communities. Orientation training programs of community paid health workers will be helpful to improve skills to assert effective dengue fever preventive measures and control activities to reduce the breeding sites of mosquitoes

Dietary patterns; precursor of health behaviors during chronic illness

In order to promote healthful trends, insight is needed in the behavioral determinants of nutrition behaviors. Most research on behavioral determinants has been linked with individuals' physical health and socio-economic factors. However, health behavior is influenced by individual physical health and abilities. Multiple dynamics of chronic illnesses within human body influenced the dietary patterns. For disease prognosis, doctors advised patients to observe preventive measures. The researchers tried to identify the changes in the dietary patterns protective effects of food consumption such as mutton, chicken, beef, snacks and sweets on chronic illnesses that reduce the risk factors and contribute in the patients' health behaviors. The empirical data was collected from three Dialysis Units: Mayo Hospital, Jinnah Hospital, Lahore General Hospital and all admitted patients of Punjab Institute of Cardiology, Lahore. These four hospitals have good turn-over of the patients should in this exploratory study, purposive sampling method was used. For the collection of quantitative data, a hospital-based survey was conducted by using a structured interview schedule. 275 patients [131-cardiac and 144-renal failure] including 184 males [67%] and 91 females [33%] between age of 20 to 110 years were interviewed. Age mean +/- standard deviation was 44 years; S.D = 15.338. Descriptive statistics [frequencies, percentages] and multiple response tables were deployed to find out the research goals across heart and kidney diseases. Results indicates that before illness, majority 238 [86.5%] of the patients took three meals. After illness, 34% patients changed the food consumption. In two meals, 96.7% patients used vegetables, 86.2% used pulses along with chapatti, and 98.5% used tap water to drink. In other drinks, 87.6% used tea, 50.5% used milk, and 52% used to drink lassi. A high proportion [65%] of patients for first treatment consults with GP's. 10.6% changed their food consumption on the advice of hakeem/homeopathic and 10.6% changed on the advices of others. 78% were unable to perform their daily activities and need help; 89% patients changed food choices; and 86% patients follow doctors' advices. Change in diet is a contributing factor towards health and well-being during illness. It reduces risk factors and a good indicator of patients' health behaviors to cope with the disease

Haemoperitoneum post colonoscopy in a continuous ambulatory peritoneal dialysis patient

We present the case of a patient on peritoneal dialysis [PD] who had an uneventful oesophagogastroduodenoscopy and colonoscopy. His peritoneal dialysis after colonoscopy had bright red peritoneal dialysate. The patient was completely asymptomatic and a CT scan was performed which did not reveal any retroperitoneal haematoma and showed no signs of perforation or splenic tear. His PD dialysate cleared up with time. We do not find any such case in the literature in which a patient has had haemoperitoneum after a colonoscopy without any obvious cause to account for it. Our patient was unique due to his CAPD in combination with his immunosuppression for his kidney transplant which may have predisposed him to the intraperitoneal bleed after colonoscopy or it may just have been a normal phenomenon after colonoscopy. More studies need to be done as the realisation of its pathology can prevent unnecessary testing and avoid patient and healthcare worker's anxiety