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Objective: In this study our main goal is to evaluate thehearing level among the workers of cement industry.Methodology: This Cross-sectional observational study wasconducted at Department of Physiology, Chittagong MedicalCollege, Chittagong and Heidelbargh Cement Bangladesh Ltd.East Halishar, Chittagong, One year (January 2011 toDecember 2011). Where total number of 800 (Eight hundred)subjects were included. During the study, all subjects wereselected purposively on the basis of noise exposure studyprocedure. After selection and proper counseling, the aim,objective and procedure of the study was explained in detailsto all subjects, in the cement industry.Results: During the study highest frequency of hearing losswas found in 30-40 years age group. Most of the patientsworked in production area for 5-10 years. most of the patientsexposed to 70-80dB, 41.4%.51.6% patients exposed >8 hoursdaily and 65.5% patients exposed 42-48 hours weekly.Conclusion: From our study we can conclude that the studyclearly demonstrated that noise is a serious health hazard inthe cement industry. Hearing threshold for the subjectsexposed to noise increase with the progress of age andduration of employment. Further study is needed for betteroutcome.
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Objective: In this study our main objective is to evaluate therelationship between Oesophageal varices, Portal veindiameter and splenic length (antero-posterior).Methodology: This Cross-sectional comparative studyconducted at the Department of Hepatology, BangabandhuSheikh Mujib Medical University (BSMMU) from Jan 2010 toDec 2011 where 50 Patients with cirrhosis of liver attending thedepartment of Hepatology, BSMMU were included as apopulation in this study.All the data was checked and edited after collection. It wasexpressed as Mean and SD. Data has been analyzed byANOVA. p value of less than 0.05 was considered statisticallysignificant. Statistical analysis was done by using SPSS-15(Statistical package for social sciences) win version 15software programme.Results: During the study, the mean age was43.12±15.68years. The highest frequency of cirrhosis patientswas found in 41-50 years age groups (Frequency 12). Leadingcause was HBV (68%) followed by HCV (12%), NBNC (12%),Wilson’s disease (6%) and both HVB& HCV (2%). Also,grade-3 mean portal Vein diameter was found 12.67±2.47 mmwhereas; mean splenic length (antero-post.) was 13.82±2.12cm.Conclusion: Splenic antero-posterior measurement is not areliable predictor for sizes of oesophageal varices. Furtherstudy is needed for better outcome.
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Objective: This study was conducted to determine the frequency and indications of caesarian section [CS] at Combined Military Hospital [CMH] Abbottabad. Study Design: Descriptive cross sectional study. Place and Duration of Study: Obstetrics and Gynecology Department, CMH Abbottabad, from Sep 2016 to Mar 2017
Material and Methods: A total of 2, 340 females delivered during the study duration were enrolled in study. Medical records of all the patients were analyzed retrospectively to determine the CS rate. Patient's demographic data, obstetric history, and indications and type of CS were recorded. Data were entered, coded and analyzed in IBM SPSS Statistics 20 software. Descriptive statistics were produced
Results: Of 2340 births, 1093 [46.7%] were via CS with about 50.9% being emergency CS. Mean age of the patient who underwent CS was 26.7 years. The most frequently noted indication was previous CS [59.4%], followed by poor progression of labor [32.2%], and fetal distress [26.9%]. More than half of the women [57.7%] who underwent CS fell into Robson Group 5 i.e. were multiparous with at least one previous CS and had a single cephalic pregnancy at term
Conclusion: CS rate at our setting was comparable to rates at similar tertiary care hospitals in Pakistan. The most common indication was previous scar, the most frequently observed indication in literature
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Objective: This study was conducted to determine the effectiveness of Foley catheter balloon tamponade in postpartum haemorrhage at Combined Military Hospital [CMH] Abbottabad. Study Design: Descriptive study. Place and Duration of Study: Obstetrics and Gynaecology Department CMH Abbottabad, from Sep 2016 to Mar 2017
Material and Methods: Patients who developed postpartum haemorrhage after caesarean section [CS] and were treated with intrauterine balloon tamponade [IUBT] using a Foley catheter were identified by review of medical records. Patient's demographic data, obstetric history, type of CS, cause of haemorrhage and transfusion history were extracted. Data was entered, coded and analyzed in IBM SPSS Statistics software. Descriptive statistics were produced
Results: A total of 26 patients were included with mean age of 29.2 +/- 5.23 years. More than two-thirds of the patients were multi-gravida and around three-quarters were at full term. The most frequent cause for postpartum haemorrhage [PPH] was placenta previa major. In 25 of the 26 [96.1%] patients the procedure was successful in stopping bleeding. There were no adverse effects related to the procedure
Conclusion: We found that IUBT with an inexpensive Foley catheter is likely to be effective in most cases of PPH associated with caesarean section, without causing additional adverse events
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Garlic and coriander play an obligatory role in the metabolism of lipids leading to the reduction of CVD development. We hypothesized that garlic, coriander and their mixture improves the lipid profile, BMI and blood pressure of CVD patients. Eighty patients were partitioned into 4 groups, each group consisting of twenty patients. The groups were randomly assigned to three supplements i.e. garlic powder [GP], coriander seed powder [CSP] and mixture [1:1 dry weight basis] of GP and CSP at a dose rate of 2 g/day. The fourth group was kept as placebo. The patients were examined for serum lipid profile, BMI and blood pressure at the start [0 day], 20, 40 and 60th day of supplementation. The initial 40 days were the intervention period whereas the last 20 days were the follow up period. The results indicated that all the supplements significantly [p<0.05] influenced the BMI, HDL, total cholesterol, triglycerides, LDL and systolic blood pressure of the patients. Among the supplements, GP had the highest influenced on BMI, TC, LDL and HDL whereas the impact of GP-CSP and CSP was more pronounced on TGL and blood pressure of the patients, respectively. All the parameters decreased with supplementation except HDL, which increased with the consumption of supplements. It was concluded that consumption of garlic, coriander and their mixture at a dose rate of 2 g/day is improving the lipid parameters of the patients
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Inflammation affects the reliability of ferritin. The serum level of transferrin receptor protein [sTfR] represents true demand of iron in the body. This study attempts to identify levels of sTfR and correlate the trends of sTfR/ferritin index with BMI in the population of Karachi. 132 gender matched volunteers between the ages of 20-60 years were recruited for this cross-sectional study. BMI was calculated using the formula: [weight in kg / height in m2]. Following groups were made according to South Asian criteria of BMI; Group A: normal weight [18.0-22.9 kg/m[2]], Group B: overweight [23.0-24.9 kg/m[2]], Group C: obese [>25.0 kg/m[2]]. Serum ferritin, sTfR and CRP levels were determined using ELISA kits. Statistical comparisons were performed using Mann Whitney U and Spearman's rank correlation, where p<0.05 was considered significant. The results identified increased in TIBC, sTfR, ferritin and CRP in obese as compared to normal weight individuals [p<0.001]. sTfR/ferritin ratio was 0.822 which signifies increased risk of acute myocardial infarction in group C. Serum iron [r=-0.359,p=0.004] showed negative correlation with BMI while serum ferritin [r=0.237,p< 0.001] and sTfR [r=0.263,p= 0.036] levels were positively associated to BMI. This study highlights a novel finding that sTfR is most likely a better clinical measure of iron status in inflammatory conditions as its expression is effected by erythropoiesis and not by inflammation. Risk of Acute myocardial infarction can also be predicted by increased sTfR/ferritin ratio
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Background: Kisspeptin [KP] is a neuropeptide that causes the release of the gonadotropin releasing hormone, which controls hypothalamo pituitary ovarian axis and exerts a number of peripheral effects on reproductive organs. The primary objective of this study was to compare baseline KP levels in females with different types of infertility and identify possible correlations with risk of failure to conceive, preclinical abortion and pregnancy after intracytoplasmic sperm injection [ICSI]
Materials and Methods: A longitudinal cohort study was carried out from August 2014 until May 2015 by recruiting 124 female patients undergoing ICSI, after obtaining ethical approval from the Australian Concept Infertility Medical Center. Cause of infertility due to male, female and unexplained factors was at a frequency of 32 [24%], 33 [31%] and 59 [45%] among the individuals respectively. KP levels were measured by ELISA assay before the initiation of the ICSI treatment protocol. Outcome of ICSI was categorized into three groups of non-pregnant with beta-human chorionic gonadotropin [beta-hCG]<5-25 mIU/ml, preclinical abortion with beta-hCG>25 mIU/ml and no cardiac activity, and clinical pregnancy declared upon confirmation of cardiac activity. Results based on cause of infertility and outcome groups were analyzed by one-way ANOVA
Results: Females with unexplained infertility had significantly lower levels of KP when compared with those with male factor infertility [176.69 +/- 5.03 vs. 397.6 +/- 58.2, P=0.001]. Clinical pregnancy was observed in 28 [23%] females of which 17 [71%] had a female cause of infertility. In the non-pregnant group of 66 [53%] females, common cause of infertility was unexplained 56[85%]. A weak positive correlation of KP levels with fertilized oocytes and endometrial thickness was observed [P=0.04 and 0.01 respectively]
Conclusion: Deficiency of KP in females with unexplained infertility was associated with reduced chances of implantation after ICSI
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Background and Objective: Genetic studies on gestational diabetes [GDM] are relatively scarce; moreover, limited data is available for KCNQ1 polymorphism in Pakistani pregnant women. We aimed to determine the frequency of KCNQ1 rs2237895 in GDM and normal pregnant controls and its association with GDMrelated phenotypes
Methods: A total of 637 pregnant females [429 controls and 208 cases] in their second trimester were classified according to the International Association of the Diabetes and Pregnancy Study criteria in this study. Their blood samples were genotyped for KCNQ1 SNP rs2237895 using PCR-RFLP method and sequencing. Fasting and two hour-post glucose load blood levels, serum HbA1c, insulin, and anthropometric assessment was performed. Pearson's Chi Square test, Mann- Whitney U test, and regression analyses were performed. A p-value of <0.05 was considered significant
Results: The variant genotyped was in Hardy-Weinberg equilibrium [p>0.05]. The rs2237895 showed an association with GDM [OR 2.281; 1.388-3.746: p <0.001] and remained significant after multiple adjustments for age and body mass index [OR 2.068; 1.430-2.997: p=0.005]. The C allele showed positive association with insulin level, and HOMA-IR in study subjects
Conclusions: This study identifies that KCNQ1 rs2237895 polymorphisms might be associated with risk of GDM in Pakistani population and that it is related to higher glucose levels and insulin resistance. Further large scale studies are required to consolidate on the functional aspect of this polymorphism
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Background and Objectives: Hypertensive disorder in pregnancy is the significant disease that badly affects the maternal and fetal prognosis and lead to higher mortality and morbidity in the prenatal period. Visfatin, potentially a new adipokine has emerged having high contribution in pathogenesis of preeclampsia. The objective of the study was to find the level of Visfatin in pregnancy induced hypertension and normal pregnant women
Methods: This study was carried out in tertiary care hospitals, Peshawar from March-October 2014. A total of 234 pregnant women [gestational age >20 weeks] were included in the study with distribution as Preeclampsia [PE=86], Eclampsia [E=74] and control [N=74]. Blood was taken for measuring Visfatin level by Enzyme Linked Immunosorbent Assay [ELISA] technique. SPSS version 19 was used for statistical analysis. Student's t test was performed to evaluate the mean differences in patients and control
Results: Serum level of visfatin was significantly higher in pregnancy induced hypertension when compared with control [P value <0.001]. Comparisons of mean value of visfatin with age group of 21-40 years, body mass index [BMI], primary parous and parity 2-4, gestational age of >36 weeks and both systolic and diastolic blood pressure were highly significant in pregnancy induced hypertension when compared with control [p value <0.001]
Conclusion: Pregnancy induced hypertensive women showed increased level of serum Visfatin than normal pregnant women
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Objective: Anti Mullerian hormone [AMH] is gaining place as ovarian marker, chiefly in infertility assistance
We explored its correlation with oocytes retrieval after long GnRH agonist protocol for stimulation, in younger and older infertile population
Methods: This retrospective analysis compiled data of 166 females, receiving ICSI treatment from June 2014 to March 2015. Serum FSH, LH, Estadiol, AMH and antral follicle count were assessed. Outcomes were measured as good [5 to 19 oocytes] and bad responders
Results: Higher discriminatory power of AMH [AUROC; 0.771; p < 0.05] was seen in comparison to FSH [0.692; p < 0.05] and AFC [0.690; p < 0.01]. AMH reported strongest association with oocyte retrieved [odds ratio of 15.06]
Subgroup analysis reported 68.6 % risk of bad response with AMH levels of less than 1.37ng/ ml. This association was observed more significant in young infertile patients <35 year of age [=0.245; p=0.012] versus older population >35 year [r=0.169; p>0.05
Conclusion: Our study reaffirms that serum AMH correlates well with oocytes retrieved, particularly in females younger than 35 years. We suggest incorporation of AMH in baseline assessment of infertile females, who are falsely advised to postpone interventions based on their age and normal FSH levels
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Objective: To assess educational environment in Aga Khan University Medical College [AKUMC] by Dundee Ready Educational Environmental Measure [DREEM] scale
Methods: A cross-sectional survey of students at the AKUMC with simple random sampling was carried out from June 2014 till March 2015. Responses in five subscales were used to calculate DREEM scores
Results: The average DREEM score was 125.77 +/- 16.8 with a reliability of 91.3%. With regards to subscales, on the 12-item students' perceptions of learning [PoL] subscale, the maximum score was 48; 11 items of students' perceptions of teachers [PoT] had a maximum score of 44; students' academic self-perceptions [ASP] identified by 8 items showed maximum score of 32; students' perceptions of atmosphere [PoA] with 12 items obtained maximum score 48 and students' social self-perceptions [SSP] subscale of 7 items had a maximum score of 28
Conclusion: Students perceived a positive learning environment at AKUMC Karachi
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Background: Successful ICSI depends on ovarian response to stimulation and maturation of oocytes retrieved
Objective: To identify predictors of number of retrieved oocytes during intra cytoplasmic sperm injection [ICSI]
Methods: A cross sectional study carried out at Islamabad Clinic Serving Infertile Couples @ Saudi Pak Tower from January 2011 till December 2012. Female subjects [n= 282] aged 20 -40 years had base line estimation of follicle stimulating hormone, estradiol, antral follicle count and ovarian volume on the second day of cycle. Down regulation of ovaries was followed by controlled ovarian stimulation for 12 +/- 2days. On the day of ovulation induction by intramuscular injection of human chorionic gonadotropin, pre-ovulatory follicle count [PFC] was measured by trans vaginal scan and serum estradiol, progesterone and interleukin I- beta were estimated. Data was expressed as mean +/- standard deviation and median with interquartile range. Correlation coefficient was measured to study degree of association of demographic and clinical factors with NRO. Univariate regression of NRO as dependent variable with predictors was confirmed by multivariate regression
Results: Retrieved oocytes had strongest correlation with PFC [r = 0.98]. Multivariable analysis stipulated that in the presence of other variables PFC had similar strongest effect on oocytes. AFC showed significant but negative effect on NRO by multiple regressions. Progesterone, E2, IL-I beta, FSH and injections used for stimulation had insignificant effect in the presence of other variables
Results: PFC measured at the time of ovulation induction is strongest predictor of oocytes which are obtained during oocyte pick up procedure of ICSI
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Objective: Obesity causes subclinical inflammation which results in the secretion of various bioactive peptides that are key players in metabolic regulation of iron homeostasis. We sought to establish correlation of one such peptide [ferritin] with marker of subclinical inflammation [CRP] in various BMI
Methods: Total 150 subjects between the ages of 20-60 years were included in the cross-sectional study conducted at Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre, Karachi, Pakistan. Body Mass Index [BMI] was calculated by weight [kg] /height [m[2]]. The given values were used as reference for Group A: normal weight [18.0-22.9 kg/m2], Group B: overweight [23.0-24.9 kg/m2], Group C: obese [>25.0 kg/m2] according to South Asian criteria. Serum Iron, Total Iron Binding Capacity, serum Transferrin Saturation, serum Ferritin and C-reactive protein were measured by commercially available kits. ANNOVA with Tukey's minimum significant difference and Spearman Rho correlation were used considering p<0.05 significant
Results: The results identified an increased serum Ferritin and CRP in obese versus lean subjects [p < 0.001]. BMI showed significantly positive correlation with serum CRP [r = 0.815; p-value < 0.01] and Ferritin [r = 0.584; p-value < 0.01]. However, serum Iron levels and Transferrin saturation decreased in obese versus normal weight individuals [p < 0.001]
Conclusion: This integrated new data reveals that individuals with high BMI had high levels of Serum Ferritin despite low levels of iron with high levels of C- reactive protein.This might be caused due to inflammatory conditions prevailing in the presence of increased adipose tissue
Subject(s)
Humans , Male , Female , Middle Aged , Adult , Body Mass Index , Ferritins/blood , C-Reactive Protein , Peptide Fragments , Cross-Sectional Studies , Iron/blood , InflammationABSTRACT
Intracytoplasmic sperm injection [ICSI] is an advanced technique employed in assisted reproductive clinics for treatment of infertile couples. The reproductive endocrinologists try their level best to identify factors that enhance success rate after ICSI. To compare estradiol progesterone ratio on ovulation induction day amongst pregnancy outcome groups following ICSI. A cross sectional study was conducted on 323 couples of Assisted Reproductive Clinic in Islamabad from June 2010 till August 2011. Down regulation of females aged 18-40 years with gonadotrophin releasing hormone agonist was followed by calculated stimulation with gonadotrophin injections [COS]. Oocytes pickup was done 36 hours after ovulation induction by 16G adapter and double lumen oocyte aspiration needle under general anesthesia. Oocytes were fertilized in vitro, graded and only blastocysts were transferred seven days after ovulation induction. Serum estradiol and progesterone were measured by enzyme linked immuno sorbent assay on ovulation induction day, ratio was compared in three groups of females; no conception with betahCG 5-25 mIU/ml, preclinical abortion with betahCG >25 mIU/ml and no cardiac activity on transvaginal scan and clinical pregnancy with betahCG >25mIU/ml and cardiac activity on transvaginal scan. Females having high estradiol/ progesterone ratio were able to achieve clinical pregnancy shown by a positive betahCG and cardiac activity on transvaginal scan. These females also had significantly high number of oocytes, endometrial thickness and implantation rate. A high estradiol/progesterone ratio on the day of ovulation induction predicts the success of intra cytoplasmic sperm injection
Subject(s)
Humans , Female , Estradiol , Progesterone , Pregnancy Outcome , Sperm Injections, Intracytoplasmic , Cross-Sectional StudiesABSTRACT
Osteoporosis is a progressive systemic disease of the bone causing significant reduction in bone mineral density and microarchitecture of bone tissue .All women experience slow bone loss with age . In Pakistan accelerated bone loss at menopause in women is about 75.3% increasing upto 97%with age thus making osteoporosis a major health problem.At the time of menopause, serum automated beta-Crosslaps increases by 86% a pattern consistent with accelerated bone loss within the first few years following menopause .we therefore hypothesized that estimation and comparsion beta-Crosslaps levels in Premenopausal and Postmenopausal women may be use as a diagnostic and screening marker for prevention of postmenopausal osteoporosis. A cross sectional comparative study. This study was conducted in department of Physiology, BMSI in collaboration with Karachi gymkhana through a medical campaign in September 2011. A total of 94 subjects [premenopausal and postmenopausal] were included in this study that was performed in the urban area of Karachi city in 2011. Data was collected from all subjects through a questionnaire including questions regarding their age, menstrual history, menopausal and medical history. Blood samples from all these subjects were collected for the determination of bone turnover marker beta crosslaps. Bone mineral density [BMD] of the heel bone was done by single x-ray absorptiometry. The results of our study showed that the levels of serum beta-Crosslaps in postmenopausal women were significantly higher as compared to premenopausal women p<0.01.There was a significant rise in the beta-Crosslaps levels with the increasing age among the postmenopausal women p<0.01.BMD [bone mineral density] value have negative correlation the beta-crosslaps levels p<0.01 i.e with the increasing age there was decrease in BMD value and increase in beta-crosslaps values. Serum beta-crosslaps levels in postmenopausal women can provide valuable information regarding the decreasing bone density and hence may be considered a cost effective diagnostic as well as screening marker for the prevention of postmenopausal osteoporosis
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There has been an increase in number of obese infertile females booked for advanced infertility treatment procedures like in vitro fertilization [IVF] and intra cytoplasmic sperm injection [ICSI]. The knowledge of impact of body mass index [BMI] on reproductive outcome can help to counsel these patients. To compare reproductive outcome in females of different BMI after ICSI. Cross-sectional study of 323 females was conducted from June 2010 till August 2011. Females were grouped on the basis of BMI; underweight, [BMI <18 kg/m[2]], normal weight, [BMI 18-22.9 kg/m[2]] overweight [BMI 23-25.9 kg/m[2]] and obese [BMI >/= 26 kg/m[2]]. The procedure involved down regulation of ovaries, controlled ovarian stimulation, ovulation induction by hCG, oocyte pickup, in vitro fertilization and embryo transfer of blastocysts. The oocyte yield and embryological data of all BMI groups was compared by ANOVA [analysis of variance]. Pregnancy outcome of these was categorized as; no conception betahCG <5 m IU/ml, preclinical abortion with betahCG >5 m IU/ml, no cardiac activity on trans vaginal scan [TVS] and clinical pregnancy with betahCG >5mIU/ml and cardiac activity on trans vaginal scan. Females with BMI 23-25.99 kg/m[2] had maximum oocyte retrieval, fertilization, implantation and clinical pregnancy rates in comparison to obese females with BMI >/= 26 kg/m[2]. A BMI cut off value of above 26 kg/m[2] in our study population is associated with a negative impact on pregnancy outcome
Subject(s)
Humans , Female , Pregnancy Outcome , Body Weight , Body Mass Index , Cross-Sectional Studies , Embryo Transfer , Ovulation InductionABSTRACT
To evaluate the frequency of daily life trends in known hypertensive patients attending a hypertensive clinic regularly. Cross sectional study. Jinnah Medical and Dental College Hospital Korangi, Karachi from July 2007 to August 2007. A total of 100 known hypertensive patients were administered questionnaire comprising sections on personal information, medical history, tobacco, caffeine, salt consumption, physical activity and sleep pattern. Single blood pressure reading, weight and height were recorded and BMI were calculated. It was observed that hypertensive patients were obese, had reduced physical activity with preference of salt intake. The detection of common habits that might be correlated with hypertension and avoiding them may improve awareness and lead to its prevention