Thyroid dysfunction; during combined peg-interferon Alpha-2a and Ribavirin therapy in patients with chronic hepatitis C

Hepatitis C is a burning issue. Prevalence of hepatitis C virus reported in Pakistan is 5% with areas of high infection in different cities and subsets of population. To find out the frequency of thyroid related dysfunctions in chronic hepatitis C patients on Peg- Interferon Alpha-2a and Ribavirin therapy. A prospective cohort study. Hepatitis Center DHQ teaching hospital Sahiwal from July 2013 to June 2014. We studied 100 patients of chronic HCV infection with baseline level of TSH,T3 and T4. Baseline serum ALT and serum AST were also measured. Patients were put on Peg-Interferon Alpha-2a [180 ug] weekly and Ribavirin [800 to 1000 mg/d] for 24weeks. All patients were followed up for thyroid dysfunction at weeks 0, 12, 18 and 24. Out of 100 treated patients 65 were female and 35 were male. Fifteen [15%] patients developed thyroid dysfunction and out of these 15 patients [11 female [73.3%] and 4 male [26.7%]]. Ten [66.6%] out of 15 patients developed hypothyroidism and 5[33.3%] out of 15 patients developed hyperthyroidism. Seven [70%] out of 10 patients who developed hypothyroidism needed levothyroxine therapy. Two [40%] out of 5 patients who developed hyperthyroidism needed carbimazol therapy for their symptoms and disease control. All patients completed hepatitis C treatment with combined Peg-Interferon Alpha-2a and Ribavirin therapy

Dermatoglyphics: in health and disease - a review.

Dermatoglyphics is the study of finger print patterns and the term was coined by Harold Cummins in 1926. Finger prints are imprints of epidermal ridges, which are formed in early embryonic life, during 10th to 16th week of intrauterine life and remain permanent during whole life. Dermatoglyphic patterns have polygenic inheritance and are affected by environmental factors in the uterus. Finger print patterns are mainly of three types: arches whorls and loops; though there are more than 100 ridge characteristics, called Galton’s details, in a single rolled finger print. Dermatoglyphics is not only used in the identification of an individual but also serves as a mirror of one’s potential and talent. In this review, we will be discussing Dermatoglyphics and its important role in the diagnosis of chromosomal disorders and other diseases which have some genetic bases.

Haemoglobin Sickle D Punjab: - A Case Report

Haemoglobin S D-Punjab is a rare compound heterozygous haemoglobinopathy characterised by the presence of two β globin gene variants: β6(GAG→GTG) and β121(GAA→CAA). These patients’ clinical and haematological features mimic haemoglobin S disease. We describe the first case of doubly heterozygous HbSD-Punjab from Malaysia managed with regular blood transfusion at the age of one. This case highlights the propensity for occurrence of rare phenotypes within our multi-ethnic population and emphasises the importance of accurate genotyping to avoid erroneous counselling, and to plan an effective patient management strategy before complication evolves.

Association of HIV with drug dependence; socio-demographic characteristics of substance abusers inclusive of HIV positive admitted in model drug abuse and treatment center, DHQ hospital, Faisalabad, Pakistan

This study was undertaken with an objective of collecting basic data to assess the extent and variety of drug abuse in patients presenting to the model drug abuse and treatment center, DHQ hospital, Fsd as per social and demographic circumstances. cross sectional study. The study was conducted in the indoor Department of Model Drug Abuse Treatment Center of Department of Psychiatry and Behavioral Sciences, DHQ Hospital, Faisalabad from Jan-2014 to March-2014. 80 patients dependent on different drugs participated in this study through purposive convenient sampling technique. Personal, Social, and Demographic variables were recorded on a demographic sheet. The results were obtained by using SPSS 17. Descriptive statistics showed that 31 patients [38.8%] were HIV positive. Most of the patients were males [97.5 %], between 30 to 35 years of age [28.8%], married [61.3%], lived in urban areas [55%], illiterate [32.5%], had primary level education [21.3%], or middle level education [22.5%]. 51.3 % patients were laborers. As illiteracy, low education, unemployment, labor as profession, and peer pressure are the key features of drug abusers. So, parents, health professionals, and state personals should take these as risk factors and focus upon these population segments to spread awareness and take measures of control to minimize the incidence of substance abuse

Plasma protein glycation status in Pakistan type 2 diabetic patients with or without nephropathy.

Background: Amadori-modified glycated plasma proteins play an important role in diabetic microangiopathy. Many of the pathogenic changes that occur in diabetic nephropathy (DN) may be induced by non-enzymatic glycation (NEG). Objective: The aim of this study was to determine prevalence of DN and non-enzymatic glycation levels in diabetic population. Methodology: One hundred patients with type 2 diabetes and forty healthy control subjects were recruited after consent. Case participants were further divided into two groups as type 2 diabetics with nephropathy (n = 22) and type 2 diabetics without nephropathy (n = 78). Non-fasting plasma glucose (Trinder GOD-PAP method), total plasma proteins (biuret method), Erythrocyte sedimentation rate (Westergren’s method), HbA1c (glycohemoglobin spectrophotometry A1c Kit) and non-enzymatic glycation (TBA colorimetric technique) were assayed. Results: Diabetic patients with nephropathy had higher ESR (55.33 ± 24.68 mm/1st hour vs. 46.88 ± 23.95 mm/1st hour vs.12.73 ± 2.34 mm/1st hour), total proteins (15.71 ± 4 g/dL vs.14.01 ± 4 g/dL vs 6.18 ± 1.16 g/dL) and non-enzymatic glycation (1.73 ± 0.48 mol./mol. vs.1.47 ± 0.58 mol./mol. vs. 0.48 ± 0.18 mol./mol.) measurements as compared to those without any similar renal complications and controls. Appreciable correlation existed between hyperglycemia and non-enzymatic glycation. Conclusion: Although the clinical consequences of NEG of circulating proteins remain ambiguous. In diabetic patients, however, extensively glycated species could exhibit significant alterations in function. Present study suggests DN as a frequently prevalent secondary complication of diabetes with a potential link with elevated NEG and glycemic control.

Dermatological disorders; psychiatric co-morbidity

The study aimed to determine the prevalence and risk factors of Depression and Anxiety in indoor Patients of Dermatology Department. cross sectional study. The study was conducted at in door Department of Dermatology, D.H.Q Hospital Faisalabad from August 2006 to October 2006. A total of 77 diagnosed dermatological patients, [21 males and 56 females] were selected by using non-probability convenient sampling. Hospital Anxiety and Depression Scale and DSM -IV-TR criteria for depression and anxiety were used to evaluate the patients. QOL-BREF was administered. Results were also correlated with patient's demographics. Out of 77 Patients who were enrolled in a study, 52% of subjects reported psychiatric co-morbidity regarding anxiety and depression according to DSM-IV-TR, HADS, anxiety and depression score was 12.75 [ +/- 4.33] and 11.18 [ +/- 4.51] respectively. A strong co-relation of HADS anxiety and HADS depression was found with the DSM-IV- TR diagnosis respectively. The strong negative association was found with the education, monthly income and socio-economic status respectively. The study shows high Prevalence of Depression and Anxiety in Patients having dermatological disorder. The findings also highlight the importance of recognizing dermatological disease related psychiatric problems. Through training, dermatologists can identify psychiatry morbidity and play their role in early detection, management and referrals of complicated cases of these co- morbid conditions. In this way better quality of care can be assured

Stratospheric ozone in the perspectives of exploratory data analysis for Pakistan atmospheric regions

In order to study physical behavior of Stratospheric ozone in Pakistan's atmospheric regions [PARs], the Exploratory Data Analysis [EDA] is performed. Using this analysis Probabilistic and mean deviation models are developed to study the ozone layer depletion for Pakistan Atmospheric Regions. These models provided a comprehensive description of the underlying process. The information attained from these forecasts by analyzing these models, can be further employed to vary possible parameters and variables in the physical system to achieve an optimal performance. Such an approach is well explained within the likelihood of computational analysis. The models presented in this paper along with their physical interpretations are very useful for public and private sector organizations

Biliary stones: an atypical cause of abdominal pain in paediatric age group

To identify Paediatric patients with biliary stone disease presenting to a tertiary care hospital in order to determine the etiology, presentation and management. Retrospective study of all cases of ultrasonographically proven biliary stones under the age of 15 years from January 1988 to December 2008. Data included their risk factors, complications, management and outcome. Total 32 patients were identified with biliary stones, treated in the hospital. Mean age at presentation was 8.25 +/- 3.33 years. Sixteen patients underwent cholecystectomy. Paediatric cholelithiasis is an atypical and under-diagnosed cause of abdominal pain in childhood. True prevalence of the disease may be higher than reported. Appropriate surgical intervention is required in patients with symptomatic and complicated biliary lithiasis

Trace elements status in type 2 diabetes.

Background: The metabolism of several trace elements has been reported to alter in diabetes mellitus and these elements might have specific roles in the pathogenesis and progress of this disease. Objective: The aim of the present study was to investigate serum levels of copper, zinc, chromium, magnesium and manganese in type 2 diabetic patients and their possible association with age, glycemic status and duration of diabetes. Methodology: The comparative study included 116 type 2 diabetic patients and 40 non-diabetic subjects. Fasting plasma glucose and HbA1c were determined by the glucose oxidase method and affinity chromatography respectively. The element concentrations were measured by means of an atomic absorption spectrophotometer after microwave-induced acid digestion. Results: Mean (±SD) Mg and Zn levels were significantly reduced in blood samples of diabetic patients as compared to control subjects (p<0.0001-<0.05). The alterations observed in serum levels of copper and manganese was not significant among diabetic and normal subjects. Glycemic status, duration of diabetes and age did not effect the trace elements concentrations. Conclusion: The results confirm that deficiency and efficiency of some essential trace metals may play a role in the development of diabetes mellitus.

Synthesis and evaluation of novel phenacyl based carboxamide derivatives of piperidine as antihypertensive agents

The research in the field of piperidine has generally been related to the synthesis of useful medicinal drugs. In view of the pharmacological and medicinal importance of piperidine derivatives in different disciplines of medicines the present study has been carried out. A series of newly synthesized N-substituted phenacyl piperidine derivatives [II-VII and XIII-XIV] has been evaluated for hypotensive activity in normotensive anesthetized rats at the doses of 0.5 micro g/kg taking acetylcholine and noradrenaline [1 micro g/kg] as control. Mean arterial blood pressure and heart rate were compared to its respective control values obtained immediately before the administration of test compounds and expressed as percent change. The compounds II, III and XIV showed mild hypertensive activity while compound V, VII and XIII were found inactive at that dose level. However, compound IV showed more hypotensive effect than the starting molecule [I]. None of these derivatives affected the heart rate at the same dose. It was also revealed that the carboxamide group has no considerable effects on arterial blood pressure and plays no important role in the increase or decrease of blood pressure

Antibacterial activity of 1-methyl-7-methoxy-B-carboline and its phenacyl and coumarine analogues

Antibacterial activity of 1-methyl-7-methoxy-pound]-carboline [harmaline] and its phenacyl and coumarine analogues 1-[3-nitro-phenyl]-[2-[7-Methoxy-1-methyl-1,3,4,9-tetrahydro-pound]-carbolin-2-yl]-ethanone[II], 1-[3,4-Dihydroxy-phe-nyl]-2-[7-methoxy-1-methyl-1,3,4,9-tetrahydro-pound]-carbolin-2-yl]-ethanone[III] 7-[methoxy-pound]-carboline],15-24, de-hydro[19,20-dimethoxy]coumarine [IV], 7-[methoxy-pound]-carboline]15-24,dehydro[20-methoxy]coumarine [V] were studied by disc diffusion method. All compounds were tested against three Gram positive and four Gram-negative bacteria. Parent compound showed good activity. All compounds revealed better results against Gram positive as compared to Gram-negative bacteria. 1-[3,4-dihydroxy-phenyl]-2-[7-methoxy-1-methyl-1,3,4,9-tetrahydro-pound]-carbolin-2-yl]-ethanone [III] was found most potent compound showing broad spectrum activity when compared with all synthesized analogues. Coumarine analogues showed more or less same activity indicating that number and position of methoxy groups are not important regarding antimicrobial activity

Reduction in the prevalence of antibody to hepatitis A virus among young Saudi adults: implications for hepatitis a vaccine

Viral etiology was investigated in 133 Saudi patients with acute hepatitis seen in King Khalid University Hospital, Riyadh. Between July 1993-May 1994. Out of the 133 patients. 51[38.3%] were diagnosed as having acute hepatitis due to hepatitis A virus [HAV]. Hepatitis C virus [HCV] was the second most common etiological agent [20.3%]. There were 35 patients with acute hepatitis [26.3%] in whom no viral marker for HAV, HBV, HCV, CMV or Epstein-Barr virus [EBV] was detected. Among the 51 patients with acute hepatitis due to HAV, the majority [882%] were children [1-12 years] and only 6[11.8%] were adults [15-24years]. This is in contrast to patients with HCV or HBV infection where the majority were adults: 74.1% and 82.3% respectively. The diagnosis of acute hepatitis due to HAV in Saudi adults, an observation not seen earlier, indicated a change in the epidemiological pattern of HAV infection in the Saudi population. This change was confirmed by the significant reduction in the prevalence of anti-HAV in 630 Saudi subjects [1-30 years old] [50.2%] investigated in 1994 compared to that of587 subjects of the same age group investigated in 1986[76.5%] [P < 0.005]. In the light of these results, a nation-wide survey is recommended to confirm this pattern in other areas. It is important that high-risk Saudi groups be identified and evaluated for their anti-HAV status as these groups are candidates for HAV vaccination

Effect of some newly synthesized compounds and comparison with the clofibrate on total serum cholesterol in experimentally induced hypercholesterolemic rabbits

Nicotinic acid such as 2, 4 - dimethoxy phenacyl nicotinium bromide, 2, 5 - dimethoxy phenacyl nicotinium bromide and 2,4 6 - tribrome, 3,5 - dimethoxy phenacyl nicotinium bromide and clofibrate showed an excellent anti - cholesterolemic effect on rabbits serum, when cholesterol and butter riched diet was given for 120 days. The effect of 2, 5 - dimethoxy phenacyl nicotinium bromide was found more interesting than other. In our previous studies the effect of some nicotinic acid derivatives and aspirin were observed as potential hypocholesterolemic agent [Saify et al; 1985] and on hyperlipoproteinemic rabbits [saifty et al; 1987] methoxy phenacyl nicotinium bromide on total lipid, phospholipid, triglyceride [Arif et al; 1990], total serum cholesterol and serum transaminases were observed on male rabbits and published [Arif et al; 1991]. The effect of some other synthesized nicotinic acid compound p - dibromo acetophenone nicotinate on total lipids and phospholipids were also observed on male rabbits and published [Arif et al; 1991]

Predisposition to respiratory distress syndrome: Difference between Pakistani and English infants

All 6201 newborn delivered over one year in Jinnah Postgraduate Medical Centre, Karachi [Pakistan] and Birch Hill Hospital, Rochdale [England] were carefully observed from birth for Idiopathic Respiratory Distress Syndrome. It occurred in 1.5% of the low birth weight and 1.13% of the preterm infants in Karachi. In Rochdale, it occurred in 4.2% of the low birth weight and 5.2% of the preterm infants. Thus, it was significantly more frequent among the low birth weight [p<0.02], as well as among the preterm [p<0.001] in Rochdale. Among the low birth weight in Rochdale, none of the 56 LBW Asian infants developed IRDS as against 8 [6%] of the European infants. It is concluded that Pakistani infants are less prone to develop Idiopathic Respiratory Distress Syndrome

Age specific markers to hepatitis B and hepatitis D viruses in the Saudi population: prevalence and epidemiological significance

An age-specific prevalence of hepatitis B [HBV] markers was studied in 1,497 Saudis [775 males and 721 females], including 170 children less than 9 years of age. The overall prevalence of HBsAg was 5.7% for males and 3.9% for females. Serologic evidence of HBV infection was present in more than one-third of the population studied [37.4% in males and 34.5% in females] with peak values in people in the 20-29 year group of both sexes [48.5% in males and 40.9% in females]. The relatively high prevalence of HBV markers in children less than 9 years of age [14.1% to 15.2%] indicates that exposure to HBV infection is early in life and in both sexes. In contrast, hepatitis D virus [HDV] infection seems to be infrequent in infants but is mainly acquired after the second decade of life. Horizontal intrafamilial and perhaps perinatal transmission may play a role in the transmission of HBV in the Saudi population while HDV infection seems to be mainly associated with non-parenteral spread. Vaccinating young children, and perhaps newborns, is an option worth considering in combating HBV as well as HDV infection in areas which are endemic for these two viruses