C-reactive protein as a predictor of adverse outcome in patients with acute coronary syndrome

The acute-phase reactant C-reactive protein [CRP] has been shown to reflect systemic and vascular inflammation and to predict future cardiovascular events. The objective of this study was to evaluate the prognostic value of CRP in predicting cardiovascular outcome in patients presenting with acute coronary syndromes. This prospective, single-centered study was carried out by the Department of Pathology in collaboration with the Department of Cardiology, Bolan Medical College Complex Quetta, Balochistan, Pakistan from January 2009 to December 2009. We studied 963 consecutive patients presenting with chest pain to Accident and Emergency Department. Patients were divided into four groups. Group-1 comprised patients with unstable angina; group-2 included patients with acute ST elevation myocardial infarction [STEMI]; group-3 comprised patients with Non-ST elevation myocardial infarction [Non-STEMI] and group-4 was the control group. All four groups were followed-up for 90 days for occurrence of cardiovascular events. The CRP was elevated [>3 mg/L] among 27.6% patients in Group-1; 70.9% in group- 2; 77.9% in group-3 and 5.3% in the control group. Among cases with elevated CRP, 92.1% had a cardiac event compared to 34.3% among patients with CRP œ3 mg/L [P < 0.0001]. The mortality was significantly higher [P < 0.0001] in group-2 [8.9%] and group-3 [11.9%] as compared to group-1 [2.1%]. There was no cardiac event or mortality in Group-4. Elevated CRP is a predictor of adverse outcome in patients with acute coronary syndromes and helps in identifying patients who may be at risk of cardiovascular complications

correlation of serum inhibin with sperm count and sperm motility in fertile and infertile males

Inhibin is produced by Sertoli cells of the testis, provides negative feedback on FSH secretion, and may prove to be an important marker for the functioning of seminiferous tubules. The purpose of this study was to examine the relationship between the spermatogenic function of the tests of subfertile men and the plasma concentrations of inhibin. The study was carried out on twenty infertile [or subfertile] males and ten age-matched control subjects with proven fertility. Infertile subjects were subdivided into oligospermie, normospermie and azoospermic on the basis of their sperm count. In infertile subjects mean serum inhibin concentration [30.4 +/- 22.2 pg/ml] was higher as compared to fertile subjects [25.2 +/- 8.5 pg/ml], although the difference was not statistically significant [p > 0.05]. Among the subgroups of infertile subjects mean serum inhibin level in azoospermics, who showed testicular atrophy on biopsy, was 8.2. +/- 1.1 pg/ml, which was significantly lower [p < 0.002] than fertile subject. The mean sperm count of infertile subjects way significantly lower than fertile subjects [p < 0.01]. The mean percentage of progressively active sperm was significantly lower in infertile than fertile subject [p > 0.001] while mean percentage of immotile sperms was significantly higher in infertile than fertile subjects [p < 0.001]. Sluggishly motile sperms did not show a significant difference between two groups. No significant correlation of serum inhibin with either sperm count or sperm motility was observed in both, fertile as well as infertile subjects. These results indicate that serum inhibin concentration is decreased in case of damage to the seminiferous tubules, however absence of any correlation of serum inhibin with sperm count and sperm motility questions its validity in place of traditional parameters used, for assessment of male infertility

value of fine needles aspiration cytology in the diagonsis of lymphodenopathy

A study of one hundred and five patients of lymphadenopathy was carried out to determine the diagnostic role of Fine needle aspiration cytology [FNA] and to see the pattern of diseases with which patients presented. The commonest lesion encountered was tuberculosis [55.238%] followed by reactive hyperplasia [28.571%], malignant lymphoma [7.169%] and metastatic carcinoma [5.714%]. Biopsy results were compared with cytological findings which revealed an accuracy of 95%. As the sensitivity of FNAC in cases of tuberculosis and malignancy is 100% and specificity 98% in the present study, it is recommended that this highly useful technique should be routinely adopted

Evaluation of the relationship of maternal nutritional status with that of the newborn

To evaluate and see the relationship of maternal nutritional status with that of the newborns. Design: This was a prospective observational study. Place and Duration of Study: The research was carried out on mothers between the age of 20 to 40 years in the Lady Willingdon and Ittefaq Hospital. Patients and The study was carried out on 30 mothers, divided in two groups, comprising 15 in each. 15 mothers belonging to the low socio-economic class whose income was < Rs 6000/month, and 15 to those belonging high socio-economic class with an average monthly income Rs > 20000 / month. Anthropometrics indexes of the infants from Lady Willingdon Hospital indicated that all the infants were of low birth weight [<2500gm]. Low hemoglobin [<10gm/dl] were found in many women though the ferritin stores were satisfactory. Similarly half of the infants had low hemoglobin levels [11-13 gm/dl] with an adequate ferritin stores. It was also found that high maternal hemoglobin levels [>11 gm/dl] were positively correlated with higher infant hemoglobin, serum ferritin, weight, height and head circumference measures. It was thus concluded that maternal nutritional status is directly related with that of newborn

Prevalence of methicillin resistant staphylococcus aureus [mrsa] infection laboratory study at mayo hospital lahore

To study the prevalence of methicillin resistant Staphylococcus aureus [MRSA] so that recommendation can be made for their prevention and control. Design: 350 Staphylococcus MINUS strains were isolated from Swvab/pus and other specimens randomly. Place and Duration: The samples were processed in the Department of pathology King Edward Medical Lahore College, during June 2000 to December 2000. Subject/The specimens from various types of infection sites suspected on clinical ground were processed by Standard methods and antibiotic susceptibility testing of all the isolates was done by using modified Kirby Bauer Disc diffusion technique. Result: Of these 350 positive cultures for Staphylococcus aureus, 135 were found to be methicillin resistant [38.5%]. This study shows a high prevalence of MRSA, which is of serious concern in Pakistan, In addition to the economic burden for antibiotic treatment MRSA Infections are serious threat to patients and a challenge for doctors

Experience with permanent pacemaker implantation at Mayo Hospital, Lahore

Permanent pacemaker implantation procedure was started at Mayo Hospital, Lahore in March, 1978. Till December 31st 1998 nine hundred and sixty six permanent pacemakers had been implanted in this institution. 53% patients were males and 47% patients were females. 55% patients were between 50-70 years old. The youngest patient was only six months old while maximum age of the patients implanted with permanent pacemaker was ninety nine years old. 92% patients had fist implant while 6% patient had second implant and 2% patient had third implant. 84% patients had complete heart block, 5.5% patients had sick sinus syndrome, 2.7% patients had symptomatic second degree heart block, 2.6% patients had congenital heart block