Serum levels of androgens in acne and their role in acne severity

Objectives: To correlate acne severity with elevated androgen levels and to compare androgen levels between cases and controls

Methods: This case-control study was carried out in the Department of Dermatology, Mayo Hospital, Lahore from March 2016 - March 2017. Two hundred and seventy patients and eighty age and gender-matched controls were recruited after ethical approval and informed consent and categorized into mild, moderate and severe acne. Severity was correlated with serum Testosterone, Dihydrotestoststerone and Dihydroepiandrosterone Sulphate levels. Quantitative variables were expressed as median and percentiles, comparisons done by Mann-Whitney and correlations by Spearman correlation. P-value of <0.05 was considered statistically significant

Results: There were 142 [41%] males and 208 [59%] females. Ninety-Seven patients had mild, 108 moderate and 65 had severe disease. Median hormonal levels were 3.5ng/ml, 184pg/ml and 0.82ug/dl for Testosterone, Dihydrotestosterone and Dihydroepiandrosterone Sulphate respectively which differed significantly between cases and controls. There was no correlation with severity but the levels differed significantly between the different grades in case of Testosterone and DHEAS

Conclusion: Androgens are not directly correlated with acne severity, but affect acne severity as seen in difference between their levels in different grades of acne. Anti-androgens may be initiated early in acne resistant to conventional therapy

Estimation of serum matrix metalloproteinases among patients of oral squamous cell carcinoma

Objective: To estimate the serum levels of matrix metalloproteinases in oral squamous cell carcinoma patients and in healthy subjects

Methods: In this observational study, biopsy diagnosed oral squamous cell carcinoma patients [n= 38] were recruited from Mayo Hospital, Lahore during 2016 to 2017. Age and gender matched Controls [n= 38] were also included. Venous blood sample of each participant was drawn, serum separated and the levels of matrix metalloproteinases were measured by multiplex ELISA

Results: Serum levels of MMP-1, -8, -10, -12 and -13 in OSCC patients showed statistically significant increase as compared to control group [p < 0.01]. The MMP-12 predicted the presence of OSCC with highest AUC of 0.836 [95% CI [0.733 to 0.911]] for sensitivity and specificity of 80% and 78.9%, respectively for a cut-off value of 16.13 pg/ml

Conclusions: MMP-12 has been found to have significant sensitivity and specificity to qualify as a diagnostic biomarker

Comparison of apoptotic effect of withania coagulans in Hela 1, viro and BHK cancer cell lines

Objectives: cancer is the second leading cause of death and has a complex etiology. Efforts are being made to target different components for its treatment. Developments in the field of molecular biology have led the researchers to target apoptotic pathway. This study has been designed to assess the apoptotic effect of the extract of withaniacoagulans on different cancer cell lines

Methodology: this study was designed to check the anticancer activity of withaniacoagulans and to compare it in different cancer cell lines

Results: the extract of withaniacoagulans proved to be equally effective in hela, vero and bhk cell lines even at concentration of 1 O[micro]g/ml

Conclusions: the extract has a potential to act as apoptotic compound. Study can be elaborated by isolating different components and assessing their role as apoptotic molecules on individual basis

Sexually transmitted infections [syphilis] in long distance truck drivers

To find out the frequency of sexually transmitted infections [Syphilis] in long distance truck drivers [LDTDs]. This study was conducted in the department of Microbiology Shaikh Zayed Hospital Lahore on 199 long distance truck drivers. Presence of syphilis was detected by rapid plasma reagin and enzyme link immunosorbent assay for treponema pallidum syphilis. 10.5% long distance truck drivers showed syphilis positive by enzyme link immunosorbent assay and 20.1% by rapid plasma reagin. Number of cases missed by rapid plasma regain were 03 [1.5%]. Sensitivity, specificity, positive predictive value and negative predictive value of rapid plasma reagin compared with enzyme link immunosorbent assay were 85%, 87%, 42% and 98% respectively. Enzyme Link immunosorbent assay syphilis is more accurate for diagnosis of syphilis than rapid plasma reagin.

Impact of pesticides of renal function tests in collaboration with liver function tests among workers of pesticide formulation and packing plants in Pakistan

Objective: to evaluate the impact of pesticides on renal function tests in collaboration with liver function tests among workers of pesticide formulation and packing plants in Pakistan

Material and Methods: one hundred workers, 20-50 years of age, working at different pesticide formulation and packing units for at least one year were included in this study. One hundred healthy age and sex matched industrial workers were taken as controls. Renal function tests i.e. blood urea nitrogen, serum creatinine and liver function tests i.e. alkaline phosphatase, alanine transaminase, aspartate transaminase, gamma glut amyl transferase, total bilirubin, and direct bilirubin, were performed. Screening for hepatitis Band C virus was also done to confirm that all the samples included in current study were negative for Hepatitis Band C virus

Results: in current study, mean blood urea nitrogen value for 100 control subjects was 8.37 mg/di while that of 100 pesticide industrial workers was 12. 70 mg/di. Mean serum creatinine value of 100 controls was 0.65 mg/di and that of patient population were 0.98 mg/di. These results revealed that all the hundred pesticide industrial workers had normal blood urea nitrogen and serum creatinine levels but on the higher side as compared to control subjects. P value was significantly high. The results of liver function tests in serum samples of control subjects were within normal range. Liver function tests of 80 pesticides industrial workers out of 100 were within normal range whereas 20 workers had abnormally raised levels

Conclusion: pesticide exposure among workers of pesticide plants might cause liver toxicity

Changing haematological parameters in dengue viral infections

Dengue Fever is the most common arboviral disease in the world, and presents cyclically in tropical and subtropical regions of the world. The four serotypes of dengue virus, 1, 2, 3, and 4, form an antigenic subgroup of the flaviviruses [Group B arboviruses]. Transmission to humans of any of these serotypes initiates a spectrum of host responses, from in apparent to severe and sometimes lethal infections. Complete Blood count [CBC] is an important part of the diagnostic workup of patients. Comparison of various finding in CBC including peripheral smear can help the physician in better management of the patient. This cross sectional study was carried out on a series of suspected patients of Dengue viral infection reporting in Ittefaq Hospital [Trust]. All were investigated for serological markers of acute infection. Out of 341 acute cases 166 [48.7%] were confirmed by IgM against Dengue virus. IgG anti-dengue was used on 200 suspected re-infected patients. Seventy-one [39.5%] were positive and 118 [59%] were negative. Among 245 confirmed dengue fever patients 43 [17.6%] were considered having dengue hemorrhagic fever on the basis of lab and clinical findings. Raised haematocrit, Leukopenia with relative Lymphocytosis and presence atypical lymphocytes along with plasmacytoid cells was consistent finding at presentation in both the patterns of disease, i.e., Dengue Haemorrhagic fever [DHF] and Dengue fever [DF]. Changes in relative percentage of cells appear with improvement in the symptoms and recovery from the disease. These findings indicate that in the course of the disease, there are major shifts within cellular component of blood.

Diagnostic evaluation of pancytopenia

Objective: the aim of this study is to evaluate pancytopenia and to know frequency of diseases presenting as pancytopenia

Methods: this is a retrospective study. Seventy six patients irrespective of age and sex were included in this study from August 2008 to June 2011. Patients on chemotherapy and radiotherapy were excluded from study. Blood counts on hematology analyzer, peripheral smear examination, bone marrow aspiration and trephine biopsies of all patients were performed according to standard protocols

Results: diseases leading to pancytopenia in this study in descending order of frequency were aplastic anemia 29[38%], hypersplenism 20[26.3%]. megaloblastic anemia 15[19.7%],myelodysplastic syndrome[MDS] 10[13 .15% ], acute leukemia 1 [1.3%] and granuloma formation in bone marrow 1 [1.3%]

Conclusions: aplastic anemia, hypersplenism and megaloblastic anemia were common causes of pancytopenia in this study

Impact of pesticides on liver enzymes in workers of pesticide formulation and packing plants in Pakistan

To evaluate the impact of pesticides on Gamma Glutamyl Transferase [GTT], Alkaline Phosphatase [ALP], Alanine Transaminase [ALT] and Aspartate Transaminase [AST] in workers of pesticide formulation and packing plants in Pakistan. One hundred workers in the age group of 20-50 years working at different pesticide formulation and packing units for at least one year were included in this study. One hundred healthy workers from other than pesticides industry, with no history of exposure to pesticides and matching age, sex and social status were taken as controls.Biochemical tests for GGT, ALP, ALT, and AST, were carried out employing Chemistry Auto analyzer. In current study, serum of one hundred control subjects indicated mean GGT value 37.19+8.07U/L. Mean GGT value for one hundred pesticide industrial workers was found to be 30.08_10.63U/L. These results revealed that all the hundred pesticide industrial workers had normal GGT levels, but on the lower side as compared to control subjects. P value was significant. Data of hundred pesticides industrial workers was taken and it was found that ALP, ALT, AST of eighty workers was within the normal range whereas the remaining twenty workers had raised level of ALP, ALT, and AST. Data of the control group showed that ALP, ALT, and ASTof all one hundred workers were within the normal range. All Pesticide industrial workers had normal GGT levels. High or upper normal levels of ALP, ALT, and AST were observed in serum of pesticide industrial workers

Relapsing fever, a rare disease in Saudi Arabia

Background: relapsing fever is an acute febrile illness caused by blood spirochetes belonging to genus borrelia. This spirochete can be acquired through the bite of an infected soft tick [Ornithodoros species] or contact with an infected louse [Pediculus humanus] and thus constituting two types of relapsing fever [RF] depending upon the responsible vector i.e. Tick borne relapsing fever [TBRF] and Louse-borne relapsing fever [LBRF]. It is characterized by recurrent cycles of pyrexia which are separated by intervals of apparent recovery. During pyrexia, organisms are found in blood. While during afebrile period, organisms hide themselves in spleen, liver and even central nervous system

Methods: one hundred and thirteen patients presenting with high grade fever were studied for disease pattern. They underwent routine and special investigations for meningitis, malaria, dengue, enteric fever, HBV, HCV and HIV on quality control maintained analyzers by standard methods

Results: all the 113 patients after diagnosis were classified as enteric fever [41], malaria [37], meningitis [20], dengue fever [14] and a patient of relapsing fever i.e. Borrelia recurrentis. This patient was brought in unconscious state, looked jaundiced, dehydrated, had hepatosplenomegaly. His CBC showed WBC 10. 7X1 0A9/L, Hb 10.5g/dl, Platelet count 35x10"9/1. Giemsa stained blood film showed multiple number of spiral shaped organisms- borrelia recurrentis. He had signs of splenic rupture; he underwent splenectomy. Histopathology of spleen for spirochetes confirmed spiral shaped organisms [borrelia recurrentis]

Conclusions: there is very little information about borrelia infection in Saudi Arabia. The prevalence or incidence in Saudi Arabia is unknown. Its apparent rarity may be due to under diagnosis and under reporting. A high index of suspicion in appropriate clinical situations will lead to its early recognition and treatment

Relationship of hyperlipidemia and hypoproteinemia with severity of nephrotic syndrome

Back Ground: there is a large body of literature implicating hyperlipidemia as a major risk factor in the pathogenesis of cardiolvascular disease [CVD] in the general population and it is well known that patients with chronic kidney disease [CKD] exhibit significant alterations in lipoprotein metabolism. Present cross sectional study was designed to find out the relation of hyperlipidemia and hypoproteinemia with severity of nephritic syndrome

Material and Methods: twenty four adults with severe nephritic syndrome [group 1] and twenty adults patients with less severe nephrotic syndrome [group II] between 30 to 65 years of age were included in the study. Twenty healthy subjects with age and sex matched were enrolled as control subjects in the study. Lipid profile including total cholesterol, free cholesterol, cholesterol ester, triacylglycerol, phospholipids, serum proteins, albumin and urinary protein [albumin] were estimated by using standard techniques

Results: a significant increased level of total cholesterol, free cholesterol, cholesterol ester, triacylglycerol, phospholipids was observed in less severe nephrotic syndrome. On the other hand a highly significant increased level of all the components of lipids was observed in severe nephrotic syndrome. A highly significant decreased level of serum proteins and serum albumin with proteinuria was observed in both groups of patients as compared to normal subjects

Conclusion: in both less severe and severe nephrotic syndrome, a complex metabolic process occurs which may cause marked changes in protein and lipid profile which further deteriorates the condition by enhancing the rate of progressive glomerular injury, perhaps by promoting an intraglomerular equivalent of atherosclerosis. This constitutes an additional rationale for reducing lipid levels in nephritic patients