ABSTRACT
Background: About 50% cases of recurrent miscarriages are idiopathic. The association of fibrinolytic defects with recurrent pregnancy failure is a novel research avenue and was first recommended in early 1990s. High Plasminogen activator inhibitor-1 [PAI-1] levels are found to be associated with recurrent miscarriage in various studies. The association of Plasminogen activator inhibitor -1 with recurrent pregnancy loss and its various variables are detrermined
Methods: This study was conducted at Ziauddin University Hospital Karachi, from Feb 2014 to Nov 2014. All non pregnant and non-obese women with history of consecutive two or more miscarriages, with no co-morbid diseases, visiting a gynecologist were included. Studied variables included were age, BMI, no. of miscarriages, time of miscarriage and plasma PAI-1 levels. The data was expressed in terms of median and percentages with a confidence interval of 95%. Analysis was done on SPSS version 20
Results: The median age of females was found to be 27.34+/- 5.09 years. Out of seventy five females with history of recurrent miscarriages, [81.3%] [n=61] women had Plasma PAI-1 levels within normal range whereas [18.7%] [n=14] had value greater than normal. The median plasma PAI-1 was found to be 29.6+/-22.16 ng/ml
Conclusion: PAI-1 was not found to be a risk factor for recurrent miscarriages in a local population of Karachi. Furthermore, studies on a large sample size need to be undertaken to assess the role of PAI-1in our population
ABSTRACT
Background: Currently most of the medical schools are incorporating innovative medical curricula in their bachelor programs. Most of the institutions are moving towards a more student centered approach to learning and assessment. Physiology being one of the mandatory basic science disciplines is also experiencing these changes. Student learning is always related to the teaching methodologies being used. Student's perception of the various teaching methodologies is useful in improving the quality of learning in medical education and to evaluate the student perception of different learning modalities in physiology in an integrated curriculum
Methods: Study was conducted on 100 medical students of 1st and 2nd Year. Participating students were explained the purpose of study. Based on the teaching methods practiced in the department of Physiology at Ziauddin Medical College, a survey questionnaire was prepared and given to the participants. The questionnaire consisted of questions enquiring about the preference of different learning/ teaching methods and the reason for the preference
Results: Majority of the students of 1st and 2nd year MBBS selected Problem based learning [PBL] 48% lecture 40% and small group session 7 % and other teaching method 5%
Conclusion: Problem based learning was found to be the preferred learning modality to study physiology and lecture was the most helpful method in preparing for exams
ABSTRACT
Background: The ABO Blood group system has been evaluated many a times for increased risk of vascular accidents and heart diseases. This study aims to prove that the reason behind the decreased risk of thrombosis in O blood group population could be the decreased levels of clotting factors in its plasma compared to other blood groups
Objective: To assess the levels of clotting factors VII, VIII, IX and X in all blood groups to determine whether blood group O has the lowest levels of all clotting factors in its plasma
Methods: This is a Descriptive Cross sectional study, conducted at Dr. Ziauddin Hospital Karachi and Dow University of Health Sciences over a period of six months. The study involves 16 plasma units divided into four of each blood group. On the day of testing plasma was thawed and assays of factor VII, VIII, IX and X were performed on all blood groups and results noted
Results: Levels of Factor VIII, IX and X were found to be highest in blood group AB and lowest in blood group O. Factor VII levels varied from others
Conclusion: Our results showed that factor VII levels vary in different blood groups, may be due to its short half-life. Thus we could not establish a link between ABO blood groups and clotting factor levels
ABSTRACT
Recurrent pregnancy loss [RPL], a very distressing situation for the patient and physician, occurs in 1-5% of women who conceive. The cause of recurrent miscarriage is multifactorial, it may be caused by thrombotic, fibrinolytic, genetic, infectious, chromosomal, anatomic, endocrine, or immune abnormalities, but more than 33% of cases remain unexplained. Thrombophilic and fibrinolytic defects are raising issues regarding the cause of RPL. Fibrinolysis is a novel research avenue in the recurrent miscarriage field. A systematic review to explore the risk factors of recurrent pregnancy loss was done. Articles that contained population based, epidemiological and prospective studies were selected and data concerned with prevalence, possible etiology and future directions of RPL was compiled. The objective of this review is to appraise and explore the latest research in the field of different causes of recurrent miscarriage especially fibrinolysis, a new area of research, which needs to be explored by randomized studies, meta-analysis and systematic reviews. Well designed multicentre research trials with large sample size are necessary to produce strong evidence-based medicine
ABSTRACT
According to regulatory guidelines, Fresh Frozen Plasma expires within 24 hours of thawing. Therefore, if transfusions are delayed or cancelled, FFPs are often wasted. The coagulation factor activity of thawed plasma was extensively researched and it was determined that most of the factor activity maintained its efficacy for four days after thawing making it usable with equivalent clinical results. Although derived from FFP, the composition of this product differs slightly and so, the AABB introduced this product as a separate entity called Thawed Plasma. In the US, many blood banks have been using Thawed Plasma interchangeably with FFPs. This not only increases the inventory of plasma products but also eliminates thawing time, providing faster patient care. There are still some concerns regarding transfusing neonates and liver failure patients, but for the majority of surgical patients or those with elevated INRs, Thawed Plasma is an acceptable alternate to FFP. This manuscript reviews attributes and benefits of thawed plasma and its approval by various recognized authorities
ABSTRACT
Exercise is one of the most common precipitant of acute asthma encountered in clinical practice. To determine frequency of Exercise-induced Bronchospasm [EIB] in male athletes, who had represented or were aspiring to represent at national and/or international level. Athletes of different departments and institutes, district, provincial and national squad who were residing, practicing and attending training camps at Karachi during November 2000 to January 2002 were included. It's an observational study on the frequency of EIB in athletes. A 21-item structured and pre-tested questionnaire was given for personal, biological and environmental information and an acquaintance session was conducted with each athlete to explain the procedure. Six minutes of competitive field free running Peak expiratory flow [PEF] rate, pulse rate and oxygen saturation were measured at 5-min, 15-min and 30-min. A player was considered EIB positive based on a post exercise decrement in PEF rate 15% at any defined point of time. The mean age of participating athletes was 27+6 years. Out of the one hundred and seventy-nine [n=179] athletes who participated in the study, 13 [7%] were found to be EIB positive. Our findings indicate that a significant number of our athletes suffer from EIB. It is suggested that either the department or national sports body should take the responsibility of screening for EIB making it a part of their training sessions
Subject(s)
Humans , Male , Asthma/etiology , Exercise , SportsABSTRACT
To observe the systolic blood pressure response to Valsalva maneuver in cases of chronic obstructive pulmonary disease [COPD]. To correlate the Valsalva responses with left ventricular ejection fraction [LVEF]. In all subjects the standard Valsalva maneuver was performed in the supine position and systolic blood pressure responses were characterized as a [a] Sinusoidal [Normal] [b] Absent over shoot and [c] Square wave [Abnormal]. LVEF was performed in all COPD subjects. Setting: Physiology Department BMSI, Medical Department, Chest Medicine Department J.P.M.C. and NICVD Karachi. A total of 95 male subjects were included, during the course of present study, out of which 30 subjects were healthy controls and 65 subjects were COPD with and without Cardiac failure. The Valsalva responses were strongly correlated with LVEF. Sinusoidal response was observed in all [100%] healthy control subjects, 21 [60%] of the 35 COPD subjects without cardiac failure and only 1 [3.33%] of 30 COPD subjects with cardiac failure, Absent overshoot was observed in 14 [40%] of the 35 COPD Subjects without Cardiac failure and 5 [16.67%] of the 30 COPD subjects with cardiac failure, square wave response was only observed in 24 [80%] of the 30 COPD subjects with cardiac failure. LVEF of 22 sinusoidal responses is 74.36 [ +/- 1.30], while 19 absent over shoot responses is 46.47 [ +/- 2.67] and 24 square wave responses is 29.67 [ +/- 1.69]. It is concluded that in the presence of physician systolic blood pressure response to Valsalva maneuver is a simple, safe and non-invasive technique than the more sophisticated test LVEF in early detection of cardiac failure