Interleukin-10 as a marker of disease progression in Dengue hemorrhagic fever

Objective: To evaluate the plasma interleukin-10 [IL-10] levels in patients suffering from dengue hemorrhagic fever between 4 to 7 days of onset of disease and 24 hours after the first sample, to find out the association of plasma IL-10 levels with the outcome. Study Design: Analytical study. Place and Duration of Study: All major hospitals of Lahore, Pakistan, from August to November 2012

Methodology: Participants included 50 registered patients of dengue hemorrhagic fever [DHF] aged between 15 - 50 years. Plasma IL-10 concentrations were measured on above stated day. Outcome was described as recovery and shock. Platelet count and hematocrit percentages were also recorded. Statistical analyses were done using SPSS version 19. A p-value

Results: Plasma IL-10 levels were found to be raised in DHF patients and were associated with fatal outcome [p=0.004]. In recovered DHF patients, plasma IL-10 levels decreased after 24 hours [mean 26.54 +/- 16.03 pg/ml] as compared to admission time [mean 74.39 +/- 61.69 pg/ml] but in case of DHF patients suffering from shock, plasma IL-10 was found to be higher after 24 hours [mean 87.69 +/- 7.77 pg/ml] as compared to levels at admission time [mean 42.56 +/- 28.09 pg/ml]. ROC curve analysis revealed a change [30 units pg/ml] of plasma IL-10 concentration, within 24 hours of admission, raised from the base line to be 105 times more critical for shock in DHF patients [100% sensitivity and 71.4% specificity, p < 0.001]

Conclusion: Elevated plasma IL-10 is a potential predictor of disease severity and fatal outcome in DHF patients

Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes: Effect on Diabetic Control and Lipid Profile

Objective: To determine the frequency of non-alcoholic fatty liver disease in patients with type 2 diabetes and to compare the diabetic control and dyslipidemia in diabetic patients with and without non-alcoholic fatty liver disease

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted in Outpatient Department of Medicine, Jinnah Hospital, Lahore from 31[st] August 2013 to 28[th] February 2014

Materials and Methods: Both male and female with age ranging from 30-60 years having type 2 diabetes for more than 5 years duration were included. Two hundred and sixty diagnosed diabetes patients presenting to outpatient department were enrolled. Screening was done for NAFLD on the basis of ultrasonography. Sampling for HbAlC and lipid profile was done. Data was analyzed using SPSS 17

Results: Proportion of NAFLD was quite high i.e. 70%. Seventy five patients [28.8%] had abnormal triglyceride level and 72 patients [27.7%] had raised serum cholesterol. Low density lipoprotein was abnormally high in all individuals and high density lipoprotein was low in all individuals. One hundred and six [40.8%] diabetics patients had good control while rest has poor control and 135 patients [51.1%] were obese

Conclusion: Proportion of NAFLD was quite high in diabetic patients. We should screen every patient for NAFLD as it may reduce the co morbidity

Frequency of prediabetes and its association with lipid profile in patients with non- alcoholic fatty liver disease

Objective: To determine the frequency of prediabetes in patients with non-alcoholic fatty liver disease and to compare the mean values of cholesterol, triglycerides, low density lipoproteins and high density lipoproteins in patients of non-alcoholic fatty liver disease with and without prediabetes

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted at Medical Outpatient Department, Sharif Medical City Hospital, Lahore from 30[th] December 20 1 3 to 29[th] June 20 14

Materials and Methods: Three hundred twenty five patients with ultrasonic diagnosis of NAFLD were included

All the patients with other causes like alcohol, viral hepatitis, toxins and drugs were excluded. All patients were screened by Glucose tolerance test [GTT] and if post GTT, blood sugar level came out greater than mg/dl, it was labeled prediabetes. Lipid profile was compared in both groups

Results: Frequency of the pre-Diabetes is quite high in our population with nonalcoholic fatty liver disease i.e.82.2% and means values of cholesterol, triglyceride low density of lipoprotein and high density lipoprotein in patients of non-alcoholic fatty liver disease are equally distributed patients with and without pre-diabetes

These mean values are, mean value of cholesterols patients with pre-diabetes was 1.86.8 +/- 2.3 mg/dl while without pre- diabetes it was 193.4 +/- 40.8 mg/dl while mean triglyceride level in patients with pre-diabetes was 180.5 +/- 37.2 mg/dl while without pre-diabetes patients it was with 180.7 +/- 40.4 mg/dl. Similarly the mean LDL level was 157.8 +/- 19.4 mg/dl and with pre-diabetes and 156.8 +/- 19.8 mg/dl in patients of NAFLD without pre-diabetes

Conclusion: It is concluded that frequency of prediabetes and dyslipidemia is quite high so we should screen all patients of NAFLD for glucose intolerance

Serum 25-hydroxy vitamin D level in preeclamptic and normotensive pregnancies

Objective: to compare serum 25-hydroxy vitamin D level between preeclamptic and normotensive pregnancies

Study Design: cross-sectional analytical study

Place and Duration of Study: department of Physiology, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital, Lahore, in collaboration with Sir Ganga Ram Hospital and Lady Willingdon Hospital, Lahore, from March 2012 to April 2012

Methodology: thirty registered preeclamptic patients with systolic and diastolic blood pressure > 140/90 mm Hg on more than two occasions, 6 hours apart, and proteinuria at least 300 mg in 24-hour urine collection; and 30 normotensive uncomplicated pregnant women matched for age, gestational age, parity and BMI were included by convenient sampling technique. Vitamin D levels of less than 50 n mol/l [< 20 ng/ml] were the cutoff point. Spearman's rank correlation of vitamin D with systolic blood pressure and arterial pressure in both preeclamptic and normotensive pregnant women was presented in a tabulated form

Results: vitamin D deficiency was found in 95% of preeclamptic and normotensive pregnant women. The difference of vitamin D level between the two groups was not found significant. Although there was an inverse correlation between serum vitamin D and systolic blood pressure and arterial pressure in preeclamptic group, but this was not statistically significant

Conclusion: vitamin D deficiency does not seem to be affected by the state of preeclamptic and normotensive pregnancy. The correlation of systolic blood pressure and arterial pressure and vitamin D needs to be explored further by increasing the sample size