Attitude of Pakistani doctors towards euthanasia and assisted suicide

To determine the attitude of junior and senior Pakistani physicians towards euthanasia and assisted suicide. A descriptive study. The study was carried out at Shifa International Hospital Islamabad in 2006 [January to November]. Shifa International Hospital Islamabad is a 500 bed tertiary care hospital with 400 resident staff and 140 specialists. An anonymous enclosed questionnaire on the respondent's opinion of euthanasia / assisted suicide was distributed to the doctors who were requested to rate according to degree of agreement, willingness to participate in these practices, and safeguard or restrictions needed if the practices were legalized. The total response rate was 66% and male to female ratio was 7:1. Most of the respondents were Muslims and had familiarity with the subject. Seventy seven percent believe that the practice of euthanasia and assisted suicide was not ethically justified, while 9% were in its favor. Pakistani doctors oppose euthanasia and assisted suicide

C-reactive protein in patients with acute coronary syndrome: association with coronary markers, lipid profile and markers of coagulation

To determine levels of C-reactive protein [CRP] and its association with coronary markers, lipid profile and markers of coagulation in patients of acute coronary syndrome [ACS]. Case control study. The study was conducted at Shifa college of Medicine and Shifa international hospital for a period of one year [November 2005-December 2006]. Sixty nine age matched controls and 133 consecutive patients of ACS were included in the study. CRP were measured by immunoturbidometric method, MB fraction of creatine kinase [CK-MB] and Troponin-I by micro-particle enzyme immunoassay, lipid levels by Colorimetric Enzymatic methods, platelets by celldyn and coagulation markers were measured by CA-50 Sysmax. At admission mean CRP levels, cardiac biomarkers, lipid profile and coagulation markers were significantly increased in patients of ACS versus controls. Within the patients of ACS the mean levels of CRP, CK-MB, Trop I, prothrombin time [PT] and activated partial thromboplastin time [APTT] were significantly raised in patients with ST-elevation myocardial infarction [STEMI] and non STEMI [NSTEMI] versus patients of unstable angina [UA]. Association between CRP levels and coronary markers, coagulation markers and lipid profile was found to be non significant. The CRP levels were increased in patients with ACS as compared to controls. The CRP levels were insignificantly correlated with coronary markers [CK-MB, Trop I], coagulation markers [platelet count, PT, APTT], and lipid profile [cholesterol, triglyceride, HDL and LDL cholesterol] in patients with ACS

Deregulation of serum leptin levels in acute coronary syndrome

To test whether leptin is a risk factor for acute myocardial infraction. A case control study. The study was carried out at Shifa International Hospital Islamabad for one year. Serum leptin levels of 86 patients of acute coronary syndrome [ACS] were compared with 86 age and sex matched controls. Leptin levels were measured by enzyme linked immunosorbent assay [ELISA] technique. Our study indicated that patients of ACS have higher body mass index [BMI], systolic and diastolic blood pressure and blood sugar levels as compared to the controls [normal subjects free of any cardiac disease]. Moreover serum leptin levels were also significantly higher in the patients of ACS [47.87 +/- 6.16 ng/ml] as compared to the control group [14.97+ 1.90ng/ml]. Smoking, higher systolic and diastolic blood pressure, blood sugar and leptin levels were significant risk factors for ACS in univariate analysis. Whereas smoking, higher systolic blood pressure, blood sugar and leptin levels also remained significant risk factors for ACS in the multivariate model. Multivariate analysis indicated that increased leptin levels lead to 7.9% increase in the odds ratio of ACS. The current study has indicated that patients of ACS have significantly higher leptin levels as compared to controls, and this leads to 7% increase in the odds ratio of ACS. This study showed that in addition to the traditional risk factors like diabetes mellitus, smoking and hypertension, increased leptin levels is also an important link in the development of cardiovascular disease. Therefore development of therapeutic agents primarily directed against increased leptin levels could contribute in reducing the mortality and morbidity associated with CAD

Synergistic interaction of adenosine diphosphate-epinephrine and epinephrine - collagen in aggregation of human platelets

Efficient hemostasis in human body depends on a complicated series of events which actively involve blood platelets. Platelets exhibit diverse responses in a variety of agonists. In vivo, most of the agonists act in synergism, causing aggregation of platelets. In this study, the synergism between ADP ' Epinephrine and Epinephrine ' Collagen has been determined by means of turbidometric method, which measures changes in optical density of platelet suspension. The study was carried out at the department of Hematology, Armed Forces Institute of Pathology, Rawalpindi. The subthreshold concentrations of each of the agonists were established with the help of dose response curve. By adding these agonists in subthreshold concentrations, the synergism between ADP ' Epinephrine and Epinephrine ' Collagen was determined. The combinations of these agonists in subthreshold levels showed the synergistic responses in causing platelet aggregation. These findings indicate that the optimal platelet aggregation does occur between the above mentioned pairs of agonists even when each of the agonist is added to the other in subthreshold doses