Effects of Gestational Diabetes and Other Metabolic Syndromes on Stemness Properties of Adult Mesenchymal Stem Cells

Stem cells are an auspicious contrivance for different therapeutic intermediation. Their inimitable properties include self-renewal, multilineage differentiation, and immunomodulation. These properties have enticed the attention and consideration of researchers and worldwide physicians to use these properties in treatment of different diseases. Stem cells can be classified as embryonic stem cells, fetal stem cells and adult stem cells, Mesenchymal stem cells (MSCs) and hematopoietic stem cells. Mesenchymal stem cells (MSCs) or mesenchymal stromal cells are myofibroblast-like cells, can be derived from different sources like bone marrow, adipose tissue, dental pulp, amniotic fluid, Wharton’s jelly, umbilical cord blood, and cord tissue. Literature reports that Gestational diabetes mellitus (GDM) and other metabolic syndromes have an effect on cellular and transcriptomic processes of stem cells derived from different sources. The effect can be in the form of alteration in proliferation, differentiation and many other properties of MSCs. Current investigation shows metabolic disorders are not only responsible for genetic problems and certain disease risk factors in adult life but also have adverse effects on perinatal environment. Keeping all these factors in mind the purpose of this review would be beneficial to all those who would like to explore how the stem cells are affected from perinatal environment problems, like gestational diabetes, Type 2 diabetes preeclampsia and many more. The most important factor is that this can provide insight on utilization of stem cells after conditioning and later can be used in regenerative medicine.

Association between 25-hydroxy vitamin D and volumetric breast density via a fully automated software Volpara[Trade Mark] in the reproductive age group

Objective: To determine the association between serum 25 hydroxyvitamin D levels and percent breast density among asymptomatic premenopausal women

Methods:Hundred asymptomatic, pre-menopausal women who visited the General Surgery Breast Clinic, Patel Hospital, Karachi, Pakistan between 3rd March and 10th November, 2015 were included in this study. The serum 25 [OH]D and calcium levels were measured and mammographic density [MD] was assessed using automated volumetric breast density software, Volpara Research [algorithm version 1.5.1, Volpara solutions Ltd, Wellington, NZ] on the same day. The volumetric breast density [VBD] was categorized as; VG1: 0% - 4.5 %; VG2: 4.6% - 7.5%; VG3: 7.6% - 15.5% and VG4 >15.5%. Mean serum 25[OH]D and calcium levels were compared across the four volumetric breast density categories. The percent volumetric density was also correlated with anthropometric measurements and other related variables

Results:No significant difference was found in mean serum 25 [OH]D level across the four groups [15.87 Vs. 12.40 Vs. 8.99 Vs. 9.68; p-value = 0.106]. The percent VBD were found significantly negatively correlated with age [r = - 0.365; p-value = 0.001], weight [r = - 0.575; p-value = 0.001], height [r = - 0.197; p-value = 0.049], and BMI [r = - 0.519; p-value = 0.001]. The serum Vitamin D, and calcium levels were not found significantly correlated with percent VBD [p-value > 0.05]

Conclusion:No significant association exists between serum 25[OH]D level and breast density

Effect of polycystic ovaries on the morphology of uterus and ovaries

Background: The presence of around 12 or more follicles in one or both ovaries with diameter ranging from 2-9mm is known as polycystic ovaries [PCO]. This condition is associated with hyperandrogenemia and is one of the most common causes of infertility. Due to increase in use of ultrasonography as a diagnostic tool, more cases of PCOs are being timely reported. This has also lead to diagnosis of PCO in younger age group

Objective: To measure the effect of age on ovarian and uterine morphology in infertile women with polycystic ovaries [PCO]

Methods: The cross sectional study was conducted in Karsaz Hospital, Karachi from January 2010 to March 2011. One hundred infertile women with PCOs were subdivided into age groups [years] 20-30 [group I] and 31- 40 [group II]. The ovarian volume [OV], follicles count [FC] and size [FS], uterine area [UA] and endometrial thickness [Endo] were determined by ultrasonography. Unpaired t-test was applied to analyze the result

Results: The ovarian morphology showed a significant decrease in group II; the OV transabdominally was 14.26 +/- 2.42 vs 10.56 +/- 1.0 [0.00] and transvaginally 14.93 +/- 2.55 vs 11.75 +/- 1.06 [0.00]. The FC was 14.00 +/- 1.60 vs 12.3 +/- 0.78 [0.023] and FS was 8.23 +/- 8.9vs 3.29 +/- 6.9 [0.00]. The uterine morphology however showed a significant increase in group II. The UA was 87.79 +/- 5.83 vs 118.71 +/- 22.83 [0.00] and endo was 0.46 +/- 0.10 vs 0.57 +/- 0.12 [0.00]

Conclusion: Ovarian morphology variables include OV, FC and FS decrease in the older infertile group of women with PCOs but the uterine morphology variables showed an increase in area with thickening of endometrium in the older group. The association of endometrium and PCOs has not been reported in this part of the world and the study is an attempt to fill this gap and prevent misdiagnosis of endometrial cancer

Correlation between vitamin D deficiency and breast tissue changes during child bearing age

Background: The role of vitamin D, a steroid hormone that exerts most of its biological activities by binding to the vitamin D receptor, in health and disease is far from understood and the literature is full of contradictory findings. Still, evidence that vitamin D is capable of modulating several features of cancer exist

Objective: To correlate changes in breast tissue with low serum levels of Vitamin D[Vit D] in females during their reproductive years

Methods: This study was conducted in the department of Anatomy, Ziauddin Medical College, Karachi and data collected from the department of surgery, Patel Hospital, Karachi in patients undergoing biopsy of the breast lump, between February 2012 and February 2013. 90 patients with diagnosis of breast lump, between 25-40 years of age, with parity varying from 1-5 were divided into 2 groups, those with serum Vit D levels in the normal Range[group A] and those having marked deficiency of serum Vit D levels[group B]. Detailed histological study of the biopsy specimen was conducted in all the patients

Results: Patients who had a marked deficiency of serum vitamin D levels, had more proliferation of stromal connective tissue in group B whereas in group A patients, minimal proliferation of connective tissue was observed in H and E stained slides under the light microscope

Conclusion: It seems clear that Breast Cancer prevention includes maintaining adequate Vitamin D levels by using oral vitamin D supplementation and with prudent exposure to sunlight

Vitamin E ameliorates renal damage in streptozotocin induced diabetes in albino rats

This study was designed to find out the role of Vitamin E on serum glucose and Creatinine concentrations of male albino rats made diabetic by streptozotocin. Prospective study. This study was conducted at the Department of Physiology; Basic Medical Sciences Institutes [BMSI], Jinnah post Graduate Medical Center [JPMC], Karachi from Feb. 2010 to March 2010. In a 4 weeks study, 45 male albino rats were divided into 3 groups containing 15 animals each. Group A was treated as control, Group B and Group C received 45 mg/kg STZ once at the start of the experiment whereas Group C additionally received 600 mg/kg Vitamin E Intramuscularly 3 times weekly. Serum glucose and Creatinine concentrations were measured at the beginning of the experiment and once weekly. Serum glucose and Creatinine levels were significantly elevated in Group B as compared to control. In Group C, blood glucose was elevated but the levels of serum Creatinine were significantly reduced, when compared to group B. our findings conclude that Vitamin E supplementation may have protective effects against deterioration of renal function brought about by free radical toxicity in diabetes mellitus

Age and gender related frequency of cancer in chronic cholelithiasis

To find out age and gender related frequency of cancer of the gall bladder in patients with chronic cholelithiasis. Descriptive case series. PNS Shifa Hospital Karachi for a period of 12 months. A total of 153 patients were inducted in the study who were suffering from chronic cholelithiasis and carcinoma [Ca] gall bladder. The diagnosis was confirmed by various laboratory and radiological methods. After surgical intervention the positive cases were referred to the oncologist who monitored and assessed them accordingly. Twenty-four patients had Ca Gall bladder. The youngest patient was 40 years of age and oldest of 70 years with an average of 54.8 years. The male to female ratio was 1:2. Preoperative diagnosis was made only in 4 patients. Frequency of carcinoma gall bladder peaked after 60 years in males while in females it peaked after 40 years. Although chronic cholelithiasis is predominantly a female disease but if present in males then chances of cancer is higher especially after the age of 60 years