Increased Body Mass Index may lead to hyperferritinemia irrespective of body Iron stores

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

Study to compare serum beta crosslaps levels between premenopausal and postmenopausal women

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

Comparison of effects of short term [12 weeks] low, moderate and high intensity exercises on lipids and lipoproteins levels in young hyperlipidemic adults

To study and compare the effects of light, moderate and vigorous intensity exercise on serum total cholesterol [TC], triglycerides [TGs], low density lipoprotein cholesterol [LDL-c] and high density lipoprotein cholesterol [HDL-c] levels in hyperlipidemic adults. To evaluate the level of minimum physical activity required to keep the lipid profile under the desirable limits in hyperlipidemic adults in local population. The effects of increased physical activity is related to reduce risk of cardiovascular disease, possibly due to improvement in the lipoprotein profile. Case control study. This study was conducted in the Department of Physiology, BMSI, JPMC, Karachi from January 2012 to April 2012. Total of 120 volunteers moderately active, young hyperlipidemic adults, aged 30 to 50 years, thirty for each A [control], B, C and D for low, moderate and high intensity exercise respectively were assigned to participate for 12 weeks exercise program without restricted caloric diet at pre-identified track of specific time. Lipids profile and age, sex, BMI and lab investigations like serum TC, TG, LDL, HDL, of each participant were recorded at baseline and similarly on day 30, 60 and day 90. There was a beneficial effect of exercise by lowering the level of lipid and lipoproteins variables, seen most clearly in moderate and high intensity of exercise with increasing the level of HDL but no significant effects were observed with the low intensity exercise. These results indicate that the low intensity exercise has no beneficial effects in lowering the lipid and lipoproteins levels in hyperlipidemic adults but moderate and high intensity exercise has lipid and lipoproteins lowering effects with increasing the level of HDL significantly in hyperlipidemic young adults

Thrombomodulin, a protective marker against coronary artery disease

1] To compare the serum thrombomodulin levels between apparently healthy subjects and patients with myocardial infarction and unstable angina 2] To assess, whether it may be identified as a protective marker for determining the incidence of coronary artery disease The controls and patients were taken by convenient sampling. A total of 32 control [healthy] subjects were compared with 32 consecutive patients with history of myocardial infarction, [M.I.] and 32consecutive patients with history of unstable angina [U.A.] respectively. The diagnosis of myocardial infarction [M.I.] and unstable angina was made on the basis of history, E.C.G. and Trop. I levels. Serum thrombomodulin and serum lipid profile of each subject were determined by ELISA Kit methods. One way analysis of variance [ANOVA] was conducted for comparison of serum thrombomodulin level among healthy, Myocardial infarction [M.I.] and unstable angina [U.A.] patients. Serum Thrombomodulin levels were significantly higher in controls when compared to patients of myocardial infarction and unstable angina. Serum L.D.L. cholesterol and total cholesterol levels were significantly higher in diseased group in comparison with control Incur study healthy population had increased Thrombomodulin levels as compared to patients of coronary artery disease [C.A.D.]

increase in pulse pressure in the early age post menopause women in local population as a marker of preclinical cardiovascular disease

To determine the post menopausal changes of pulse pressure in the early age menopause women. A cross sectional and comparative study, was performed at the department of Physiology B.M.S.I., J.P.M.C., Karachi in collaboration with the Abbassi Shaheed Hospital and National Institute for Cardiovascular Diseases, Karachi. This study included a total of 100 women, 50 with early age post menopause and 50 with normal age post menopause. For the statistical analysis, the degree of probability was computed by comparing the calculated value of "t" with tabulated value in the table of "t" distribution against the degree of freedom. Pulse pressure was found to be significantly increased with a P-value of <0.001 in the early age post menopause women. This suggests that an early age post menopause is more likely to develop a marker of preclinical cardiovascular disease such as increased pulse pressure

investigate the association between the development of coronary heart disease and serum levels of adiponectin

To investigate the association between the development of coronary heart disease and serum levels of Adiponectin. It was a case control study done at the Department of Physiology Basic Medical Sciences Institute [BMSI] Jinnah Post Graduate Medical Centre [JPMC] in colaboration with Abassi Shaheed Hospital Karachi. The study included total 100 subjects, 50 subjects with angiographically confirmed coronary heart disease and 50 normal healthy age and gender matched controls. All the subjects were breifed about the the nature of the study and an informed concent were taken from all the recruits. Adiponectin serum concentration was found [7.1microL] in coronary disease patients, and the serum concentration of adiponectin in control subjects was [11.98 microL]

Comparison of gamma glutamyltransferase in normal and in type 2 diabetics

Comparison of gamma glutamyltransferase in normal and type 2 diabetics. In a cross-sectional study, 100 apparently normal healthy subjects and, 47 type 2 diabetic subjects were selected from either sex with ages between 18-65 years.Subjects were measured for waist/hip ratio, BMI and serum levels of ALT, AST.Alk Phosphatase and Glutamyl Transferase [GGT]. The study excluded by screening for AntiHCV, HBsAg and patients with aspartate amino transferase [SGOT], alanine amino transferase [SGPT], GGT levels more than three times the normal and subject with a total leukocyte count more than 10,000/microl. The levels of GGT levels were found to be most significant among all the liver enzymes [P = 0.001]. The levels of GGT compared with type 2 diabetics was found to be significantly increased when compared with BMI, waist/circumference, cholesterol, triglycerides [TG], High Density Lipoprotein [HDL], Low density Lipoprotein [LDL], fasting blood sugar level and blood pressure [P = 0.001]. The pearson regression analysis showed a positive relation with systolic, diastolic blood pressure and fasting blood sugar. These results indicate that levels of GGT were raised with increased waist girth, BMI, blood pressure TG and low HDL, all of these are the features of metabolic syndrome according to ATP III criteria. Hence, serum GGT may be an important investigation for diabetes and metabolic syndrome

Ultrasound as a reliable guidance system for percutaneous nephrostomy

To determine the effectiveness and safety of ultrasound as a reliable guidance system for percutaneous nephrostomy [PCN]. Quasi-experimental. Jinnah Postgraduate Medical Center, Karachi, Pakistan, from January 1997 to July 2005. One hundred and fifty-three PCN were performed in 140 patients, referred from the Department of Urology and Transplantation, JPMC. Out of 140 patients, 137 had obstructive uropathy [>1 cm dilated pelvicalyceal system] of different etiologies. Three patients with ureteral rupture [non dilated pelvicalyceal system] underwent PCN for urinary diversion in the surgical ICU. The technique involved a pre procedural scan, initial renal puncture, placement of a guide wire, tract dilation and placement of 8-12 F Nephrostomy tube, entirely under ultrasound guidance. The machine used was "Just vision" or "Eccocee" with 3.5 MHz variable frequency convex transducer. Effectiveness in terms of successful tube placement and safety in terms of complications were observed. Out of 153 patients there were 78 males and 62 females. The minimum age of patient was 13 years while maximum age was 68 years, all [100%] patients had successful placement of PCN. Minor complications like transient gross hematuria and small perinephric collection occurred in 13 cases [8.5%] but was dealt with effectively by conservative measures. No major complications like hemorrhage, sepsis or periorgan damage were encountered in any of the patients. Ultrasound was found to be a rapid, effective, radiation-free, portable and safe imaging modality with minimum rate of complications that could be used as a reliable guidance system for critical interventions like percutaneous nephrostomies without using fluoroscopic units

Ultrasound guided percutaneous drainage of pancreatic pseudocysts using P.O. catheter

Objective: The purpose of the study is to report the drainage of pancreatic pseudocysts by percutaneous insertion of P.O. catheter under US guidance

Patients and Methods: Between January 1999 and December 2003, 44 patients [28 male, 16 female] with abdominal fluid collection from complicated acute pancreatitis underwent percutaneous ultrasound guided drainage using adult [12 F] or pediatric [10 F] peritoneal drainage catheter

Results: Simple cysts found in 07 patients, haemorrhagic in 20 and infected in 17 patients. Etiology varied from trauma in 09 patients, gallstone in 19 patients, post ERCP 05 patients, biliary ascariasis in 03 and alcohol consumption in 01 patient to idiopathic 07 patients. The tube was kept for drainage from 2 weeks to 11 weeks. The success rate was 84% whereas 12% patients did not improve and required open drainage and lavage. No major complications occurred

Conclusion: The study shows that complicated peripancreatic fluid collections can be safely and effectively treated in most patients with percutaneous P.D. catheter insertion under real time US guidance