Frequency of hyperuricemia in thyroid dysfunction

Objective: To determine the frequency of hyperuricemia in patients with thyroid dysfunction. Study Design: Cross-sectional descriptive study. Place and Duration of Study: Department of Chemical Pathology, Army Medical College Rawalpindi, National University of Sciences and Technology [NUST] Islamabad and Military Hospital [MH] Rawalpindi, from Apr 2013 to Jun 2014

Results: Among the fifty five participants, 16 [29.1%] were male while 39 [70.9%] were females. Mean age of the subjects was 45.49 +/- 16.7 years in this study. Hyperuricemia was observed in seventeen [30.9%] individuals with thyroid dysfunction. Mean serum uric acid level was found to be 418.3 +/- 147 micromol/l in participants

Material and Methods: Fifty five individuals with thyroid dysfunction were included in this study. Detailed history was recorded on a questionnaire, blood samples were collected and serum total tri-iodothyronine [T3], free thyroxine [T4], thyroid stimulating hormone [TSH] and uric acid levels were measured

Conclusion: High frequency of hyperuricemia occurs in patients with thyroid dysfunction. Therefore in patients presenting with thyroid dysfunction, evaluation of underlying hyperuricemia should be considered by the clinicians

Frequency of hepatitis B and C virus among the healthyblood donors, a single centre study

Objective: To determine the frequency of hepatitis B and C virus among the healthy blood donors

Study Design: Cross sectional study

Place and Duration of study: This was carried out at Pakistan Air Force [PAF] Hospital Islamabad from January 2015 to April 2017

Patients and Methods: The blood donors were both male and female came from Islamabad and surroundings. A detailed medical history and examination was carried out by medical officer. All donors were provided questionnaire and consent Performa. The blood donors negative for previous history of viral hepatitis and other contraindications for blood donation were included in study. All donations were screened for HBV surface antigen [HBsAg] and anti-HCV antibodies by ELISA

Results: A total of 2185 healthy blood donors were enrolled. Out of them, 2137 [97.8%] were male and 48[2.2%] were female. In female donors, HBsAg was negative in all donors and anti-HCV antibodies was positive in 2[4.16%]. Whereas, in males HBsAg was positive in 34[1.59%] and anti-HCV antibodies was positive in 81[3.79%]

Conclusion: The prevalence of HCV among blood donors was high as compared to HBV. Hepatitis B and C are one of major sources of transfusion transmitted diseases. Prevention of transfusion transmitted diseases is possible with vigilant donor selection and strict screening process

Internet use: Disruptive or enhancing towards learning? Views and perceptions of undergraduate medical students

Objective: To describe the perceptions and behaviors of undergraduate medical students regarding the use of internet

Study design: Cross-sectional descriptive study

Place and Duration of Study: Army Medical College, National University of Medical Sciences [NUMS] Rawalpindi, from January 2014 to June 2014

Methodology: Data had been obtained from volunteer undergraduate medical students who were computer literate and were using the internet facility in their daily routine. Students, who did not have the computer and internet using skills and were not using the internet services, were excluded from this study. A structured questionnaire was used which included following items: duration and frequency of internet use, impact of internet use on academic grades, influence of internet usage on relationships with friends and family, effect of overuse on sleep cycle and having the self-knowledge of being internet addicted

Results: Two hundred and twelve students gave consent to participate in this study. Different perceptions of undergraduate medical students regarding the internet use were observed: 64 [30.2%] students spent about two hours daily in internet surfing and 79 [37.3%] participants in our study utilized internet facility for social networking while 67 [31.6%] used it for educational and learning purposes. A total of 147 [69.3%] participants reported that internet use enhanced their learning and had a positive effect on their academic grades

Conclusion: Our study concludes that internet-using skill is a very powerful tool in today's world with regards to academic learning. With appropriate guidance and support, students can get maximum benefit from this facility and can enhance their learning capabilities. Institutes should play their role by making every student computer literate and also by making on-campus advisory services available to figure out internet abuse related issues of the students

Role of skill laboratory training in medical education - students' perspective

Objective: To evaluate the perceptions of medical students regarding their training utilizing facilities provided in the skill laboratory of a public sector medical college. Study Design: Cross-sectional study. Place and Duration of Study: Army Medical College, Rawalpindi, from October to December 2014

Methodology: Students of final year MBBS who had underwent skill laboratory training were recruited through convenience purposive sampling. Students not exposed to skill laboratory training were excluded. Data collection tool was a questionnaire having 23 questions with responses on Likert Scale as strongly disagree, disagree, agree and strongly agree coded as 1, 2, 3 and 4, respectively. Data was analysed on SPSS version 22

Results: There were 78 [57%] male and 59 [43%] female students out of 137, with mean age of 22.59 +/- 0.74 years. The response rate was 68.5%. Cronbach's Alpha test was 0.84 showing high reliability. The mean of sum of all the 23 items was 63.85 +/- 8.71, whereas item means was 2.78 +/- 0.38, reflecting a high inclination of students towards skill laboratory training. Frequency of students responding in favour of skill laboratory training was significantly high [p < 0.05]

Conclusion: Medical students perceived skill laboratory training as a favoured learning strategy as compared to practising on real patients for acquisition of various aspects of clinical skills, knowledge and attitude

Evaluation of percutaneous kidney biopsy complications in ambulatory patients - a two year review from a tertiary care centre

Objective: To evaluate the complications of percutaneous kidney biopsy in ambulatory patients in a tertiary care centre over a two year period

Study Design: Cross sectional, descriptive

Place and Duration of Study: The study was carried out at the Department of Nephrology Military Hospital, Rawalpindi from Jan 2008 to Jan 2010

Material and Methods: Patients referred to the Nephrology Department for kidney biopsy were considered for inclusion in the study provided they did not have any contraindications to the procedure and had a normotensive state with BP <130/90 mm Hg and a normal coagulation profile including partial thromboplastin time, prothrombin time, bleeding time and platelet count. Patients with an evidence of malignancy, congenital anomalies of kidneys on ultrasound examination or a skin disorder affecting the likely site of biopsy were excluded

Results: A total of 100 patients who merited standard indications for kidney biopsy were included in the study. Average age was 45.53 years [+1 SD = 10.96] with age range of 25 years to 75 years. There were 83 males [83%] and 17 females [17%] with male to female ratio of 4.9:1. Microscopic hematuria occurred in 82 [82%] patients. Gross hematuria occurred in 12 [12%] patients. Decrease in hemoglobin level by 1 g/dL or more occurred in 35 [35%]

There was no episode of hypotension secondary to severe bleeding. No patient required transfusion. Surgery was not required in any patient for controlling bleeding. Death was not recorded among the reported complications

Conclusion: Percutaneous kidney biopsy can be safely conducted as an outpatient procedure with an observation time of 12 hours post-biopsy to watch for any complications

Establishment and comparison of nephrotoxicity associated with the use of various doses of colistin in rabbits

Objective: This study was designed to assess the nephrotoxicity associated with various doses of Colistin sulfate in rabbits

Study Design: Laboratory based randomized controlled trials, Place and Duration of Study: This study was held at Army Medical College, Rawalpindi. Study period was from 15[th] April till 30[th] April 2012

Material and Methods: Rabbits were divided into three groups of six rabbits each. Baseline serum urea, serum creatinine and serum electrolytes were estimated. A loading dose of colistin infusion was given followed by I.M injections for six days. Rabbits were sacrificed 24 hours after the last dose and both kidneys were sent for histopathology

Results: There was marked nephrotoxicity in high toxic group where as in low toxic group mild nephrotoxicity was evident

Conclusion: It was established that we may safely escalate dose of colistin up to four times the currently recommended schedule to combat the threat of resistance when using it for one to two weeks

Research design and statistical error of articles submitted in a public sector medical journal - a retrospective survey

Objective: The objective of this study was to identify the quality of statistical procedures used, the accuracy of study design, sampling and relevant statistical analysis

Study Design: Retrospective Survey study

Place and Duration of Study: Army Medical College from June 2014 to Jan 2015

Methodology: Three hundred and forty two original research articles published in Pakistan Armed Forces Medical Journal were reviewed. The selected research articles were all original articles. Case series and case reports were excluded

Results: Among 342 articles, the major error was that the objectives, results and conclusion were not in accordance with each other in 115 [33.6%] articles. In 48 [14%] articles study design was incorrect and does not matched with the objectives. In 26 [7.6%] articles sample size was not appropriate as per the guidelines of journal. In 12 [3.5%] articles sampling technique used for sample selection was not mentioned. In 62 [18.1%] articles type of variables was incorrectly defined. In 6 [1.8%] articles descriptive statistics were not given at all. In 13 [3.8%] articles inferential statistics were not given articles. In 60 [17.5%] articles figures and tables were either not given or if given were incorrect. The pattern of statistical errors was almost similar in different years with a little bit difference but that difference could not attained any statistical significance [p = 0.460]

Conclusion: In order to maintain the standards of the medical writing in research with authentication the teaching of statistical methods should be enhanced

Relationship between thyroid stimulating hormone and various components of metabolic syndrome

To determine the relation between thyroid stimulating hormone and various components of metabolic syndrome. Descriptive cross-sectional study. Pathology department, Army Medical College of National University of Sciences and Technology [NUST] Islamabad and Military Hospital [MH], Rawalapindi, Pakistan; from January to March 2013. Handred adult inhabitants [30-60 years] of Rawalapindi participated in this study. Subjects who fulfilled the WHO criteria for metapolic cyndrome [MetS] were included and those who had any thyroid illness, or were using any thyroid medications were excluded from this study. For thyroid function tests [TFT's], serum thyroid stimulating hormone [TSH], total tri/iodothyronine [T3], free throxine [FT4] were estimated. Insulin resistance [IR] was measured by Homeostasis Model Assessment for IR [HOMA-IR]. Data was analyzed by SPSS-18. Out of 50 subjects of control group, 26 [52%] were male and 24 [48%] were female. Basal metabolic rate [BMI], serum triglyceride [TG], HOMA-IR were higher and serum high density lipoprotein cholesterol [HDL-c] was lower in MetS patients. There was no significant difference in serum TT3 and FT4 between MetS patients and control group, however, mean serum TSH levels were higher in MetS [2.622 + 0.924 vs 5.002 + 1.074 mIU/1,p<0.001]. In correlation analysis, serum TSH was positively and significantly correlated with BMI [r=0.344, p=0.014] and HOMA-IR [r=0.419, p<0.002]. These results suggest that serum TSH correlates with various components of metabolic syndrome patients. Analysis of serum TSH levels in metabolic syndrome patients may prove beneficial in preventing the various cardiometabolications in such patients

Frequency of co-morbidities associated with spinal cord injury

To determine the frequencies of comorbidities [dyslipidemias, diabetes mellitus, and hypertension] in patients with spinal cord injury [SCI] of duration > 1 year. Spinal Cord Injury Department, Armed Forces Institute of Rehabilitation Medicine [AFIRM] Rawalpindi and Department of Chemical Pathology, Army Medical College, National University of Sciences and Technology [NUST], from October 2013 to March 2014. Thirty six patients with complete spinal cord injury [SCI], level C5 to T12 were included by non-probability, convenience sampling. Control group consisted of age and sex matched healthy individuals. A detailed medical history was obtained. Anthropometric measurements and blood pressure were recorded. Fasting blood samples were obtained and analyzed for plasma glucose and serum lipid profile. Out of thirty six patients, 31 [86.1%] were male and 5 [13.9%] were females; their mean age was 36.6 +/- 11 years. Mean duration of injury was 6.04 +/- 3.35 years. Among cases, dyslipidemias were detected in 25 [69.4%] patients while 7 [19.4%] patients had diabetes mellitus. Whereas in control group, frequency of dyslipidemias and diabetes mellitus were significantly lower than cases i.e 13.8% and 5.5% respectively. Also no significant difference was found between blood pressures of study group when compared with control group. Individuals with chronic SCI had more frequent associated co-morbid conditions like dyslipidemias and diabetes mellitus than normal individuals. Early screening is recommended in patients having SCI >6 months for better patient care and reduction in long term comorbidities in such patients

[Structured viva as an assessment tool: Perceptions of undergraduate medical students]

To document the undergraduate medical students' perceptions regarding the structured viva as an assessment tool. Cross sectional. Army Medical College, National University of Sciences and Technology [NUST], Islamabad from April 2013 to April 2014. Data was collected from fourth year students of a public sector medical college. A structured questionnaire was used to evaluate student's perception regarding relevancy of viva questions to syllabus, level of comfort while being assessed and provision of adequate time to answer, bias or harassment by the mentors, freedom to answer in their own learning styles. One hundred seventy one, fourth year students gave consent to participate in this study. Almost all of the students were satisfid after being assessed in oral structed viva room: the results obtaind were: relevancy of questions to course: 169 [98%]; comfortable environment of viva room: 165 [97%]; appropriate time to answer the questions: 162 [94.7%], structured viva: 132 [94.7%]; welcomed upon arrival for viva: 147 [86%]; encouraged by examiner: 144 [84%]; facilitated to answer in their own learning style: 137 [80%]; covered all the topics: 120 [70% 1; demotivated during viva: 11 [6.4%] and bias during viva: 14 [8.1%] There is substantial need of introducing innovations in the conventional exam strategies being practiced in our medical colleges. Introducing structured viva examination, making the exam environment comfortable and adapting an appreciative inquiry approach while assessing students can greatly help them to overcome exam stress

Searching the research or re-searching the search: where to start from? a post-graduate medical trainees perspective from rawalpindy lslamabad

To explore the post-graduate medical trainees perceptions and practices towards research and to investigate potential barriers to perform research. Cross sectional descriptive study. Military hospital, Combined Military hospital, Rawalpindi and Pakistan institute of medical sciences Islamabad, from Jan 2013-Dec 2013. A pretested, structured and validated questionnaire was used to collect data from 114 final year post-graduate medical trainees [PGMTs]. SPSS version 17 was used for descriptive data analysis. One hundred and fourteen [n=114] final year post-graduate medical trainees [PGMTs] of fellowship program of College of Physician and Surgeons of Pakistan gave their written consent to participate in this study. Among them 68 [59.6%] were males while 46 [40.3%] were female. One hundred and twelve [98.2%] trainees agreed that research is an important and healthy activity and have a great impact on their future carriers. 63 [55.2%] PGMTs had worked as data collector in various studies conducted at their institutions while only 21[18.4%] PGMTs had published their manuscript. Obstacles that prevented the PGMTs from conducting research included: lack of professional supervisors: 103 [90.3%], poor research training: 98 [86.0%], and lack of resources: 84 [73.6%]. Although the majority of the PG trainees believe that research is important in medical field, only about 55.2% of them have participated in the research activities other than mandatory dissertation during their training. Measures should be taken at postgraduate level to involve and support the PGMTs in health research with formal training programs and good mentorship

Post graduate students' perception of educational environment at army medical college, rawalpindi: assessment by pheem [post graduate education environment measure]

To assess the post graduate students perception of various aspects of the learning and educational environment at Army Medical College, Rawalpindi. A descriptive study. Army Medical College, Rawalpindi from May 2014-July 2014. The modified Postgraduate Hospital Educational Environment Measure [PHEEM] a scored 34 item questionnaire was administered to evaluate various aspects of the learning environment. Three domains of the learning environment were covered with the help of PHEEM scores: perceptions of autonomy; perceptions of teaching; and perceptions of social support. Total and subscale scores were calculated according to Likert scale. Descriptive statistics were used to calculate mean SD. Analysis of variance [ANOVA] was used to compare scores between different departments. Total 39 postgraduate trainees were included in the study. Average of total score came out to be 107, whereas for perception of teaching it was 45.57 [SD = 5.22, range: 43 - 48], for social support it was 24.76 [SD =3.76, range: 21 - 27] and for perception of autonomy it was 36.84 [SD = 4.09, range: 33 - 39]. The overall and subscale scores were also compared between post graduates of the different departments of the public sector medical colleges. The education climate was rated as more positive than negative determined by overall PHEEM scores. Army Medical College as an institution has a positive education environment

Premenstrual syndrome: messes with my academic performance

This study aims to determine the ediucational impact of premenstrual syndrome [PMS] on various academic activities of undergraduate female medical students. Cross sectional study. Army Medical College, National University of Sciences and Technology [NUST], Islamabad, Pakistan from June 2013 to November 2013. This cross sectional study was conducted at Army Medical College, National University of Sciences and Technology [NUST] Islamabad. Data were collected from 224 undergraduate female medical students of all professional years. PMS was diagnosed according to WHO's ICD-10 criteria. Impact of premenstrual syndrome on academic activities of female medical students was assessed using a 22-itemed, structured questionnaire. Two hundred and twenty four female undergraduate medical students gave their written consent to participate in this study. PMS was present among 207 [92.4%] female students. Major PMS symptoms experienced by the female students were: backache [87.5%], fatigue [80.2%], depressed mood [78.2%], anxiety [76.8%], hypersomnia [71%] and poor emotional control [64.3%]. The frequency of various PMS symptoms interfered with their academic activities [76.3%], with large group discussion sessions [79.2%], with small group discussion sessions [72.9%], written assessment [66.6%] and oral assessment [70.0%].The study findings affirm the fact that premenstrual syndrome profoundly affects the academic activities of young female medical students. In the light of these pertinent findings we recommend that health education and counselling services are essential to be provided at medical college campuses for female undergraduates. This will not only help them alleviate the negative effects of PMS but also develop an understanding about their problems, enhancing their academic output and performance in early medical carrier

What went wrong: why did I fail?

To document the perceptions and views of undergraduate medical students on why did they fail in their annual examinations. Cross-sectional descriptive study. Army Medical College, National University of Sciences and Technology [NUST] Islamabad, Pakistan from March 2013 to March 2014. Data had been obtained from undergraduate students who failed at least once during their MBBS course and volunteered to participate in this study. Students who did not come across any academic failure during their MBBS course were excluded. A structured questionnaire was used which included following items: knowledge overload of failed or other subjects, poor time management for their studies, their own ineffective communication and expression skills [oral/ written], poor teaching skills of teachers/facilitators and boarding problems. One hundred and seventy nine students gave consent to participate in this study. Factors leading to their failure and identified by students were: poor time management with regards to their studies: 81.6%, lack of revision time due to co-curricular activities: 73.7%, poor output in written assignments/assessments: 62.6%, knowledge overload of the failed-in subject: 47.5%, poor motivation to make serious efforts to understand and learn the subject: 57%. The reflections of medical students signify a variety of causes. It would be pertinent to organize strategies to rectify and address the basis of these expressed specific causes, especially those that had the highest impact towards the failure of these students. Such measures will help to rescue majority of these medical students and prevent them from failing in their examinations. Remedial steps when in place, shall also equip them with required skills to work on their weaknesses and turn them into strengths for their academic successes

Early detection of doxorubicin-induced cardiotoxocity and its prevention by d-tocopherol

To detect doxorubicin-induced myocardial injury by quantitative estimation of cardiospecific protein, Cardiac Troponin I [cTnl] at early stage and to evaluate the cardioprotective effects of a-Tocopherol. Lab based randomized controlled in-vivo study in rabbits. Department of Pharmacology in collaboration with Pathology department, Army Medical College Rawalpindi, Pakistan from Jan 2012 to Dec 2012. Eighteen healthy male adult rabbits were used. Cardiotoxicity was induced by single intravenous injection of 12 mg/kg of doxorubicin in a group of rabbits, control group was treated with normal saline only and the rabbits of third group were pretreated with a- Tocopherol 200 mg/kg of body weight for ten days before injection of doxorubicin 12 mg/kg. Doxorubicin produced severe cardiotoxicity confirmed by markedly raised serum levels of cTnl, CK-MB, LDH and grade 3 necrosis of the heart tissue in rabbits. The pre-treatment with a-Tocopherol resulted in improved serum levels of cTnl and the histological picture of heart tissue. The quantitative cTnl estimation for detection of cardiotoxicity at subclinical level can lead to significant economic impact in management of cancer patients because the troponin-negative subjects can be excluded from long term cardiac monitoring programs, which require high cost imaging techniques. Furthermore, the outcome of most potent and widely used doxorubicin chemotherapy can be made successful with the concurrent use of alpha-Tocopherol

Association of vitamin d deficiency with tuberculosis in adult patients reporting to a tertiary care hospital of Rawalpindi

To compare the mean vitamin D levels in pulmonary tuberculosis patients and healthy controls and to find out the frequency and association of vitamin D deficiency in patients with tuberculosis. Study Design: Case control study. Pulmonology department, Military Hospital Rawalpindi from Jan 2013 to Dec 2013. Patients and Methods: Fifty two incident outdoor pulmonary tuberculosis patients were selected with 52 age and gender matched controls. Tuberculosis was diagnosed by the sputum examination through gene Xpert technique from National Institute of Health [NIH], Islamabad. Serum 25-hydroxvitamin D level <50 nmol/1 [electrochemiluminescene assay] was taken as vitamin D deficiency. Mean vitamin D was much lower [20.688 +/- 14.065 nmol/1] in cases as compared to the controls [57.917 +/- 18.197 nmol/1] which was statistically significant [p<0.001]. Forty nine [94%] cases and 18 [34.6%] controls were found to be vitamin D deficient. [Odd's Ratio = 3.8, 95% CI = 2.423-5.999, p>0.00l]. Sensitive tuberculosis patients had mean vit D levels of 18.55 +/- 9.99 nmol/1 while multi-drug resistant tuberculosis patients had the mean serum vitamin D levels of 22.38 +/- 16.60 nmol/1 but the difference was statistically insignificant [p > 0.05]. Significant vitamin D deficiency was seen in newly diagnosed TB patients. It was found that vitamin D deficiency is associated with tuberculosis, but its causal role has not been established

Low serum HDL-c levels: a hidden threat to patients with spinal cord injury

To determine the serum lipid profile in patients with traumatic spinal cord injury [SCI] of duration >1 year and to compare the serum HDL-c levels of SCI patients undergoing regular physiotherapy for >60 minutes daily with those who did not undergo physiotherapy. Cross-sectional, comparative study. Spinal Cord Injury Department, AFIRM Rawalpindi and Department of Chemical Pathology, Army Medical College, Rawalpindi, from January 2013 to June 2013. Forty six patients suffering from traumatic spinal cord injury [SCI] wore included. After recording the detailed medical history, fasting blood samples were obtained and analyzed for serum lipid profile. Dyslipidemias were assessed using guidelines from the National Cholesterol Education Project Adult Treatment Panel III [ATP III]. Serum high-density lipoprotein cholesterol [HDL-c] < 0.9 mmol/1 [40 mg/dl] was considered as low HDL-c level. Out of total 46 patients, 33 [71.7%] were male and 13 [28.3%] were females with mean age of 34.9 +/- 9.55 years. Low levels of serum HDL-c were found in 21 [45.7%] SCI patients [mean serum HDL-c levels: 0.97 +/- 0.23]. SCI patients were further categorized in two groups depending upon the status of regular physiotherapy. Statistically significant difference was found in mean serum HDL-c levels of 22]47.82%] SCI patients undergoing regular physiotherapy as compared to 24 [52.18%] SCI patients who did not underwent physiotherapy [p < 0.05]. Patients with SCI have decreased levels of serum HDL-c, imparting an increased risk of cardiovascular disease [CVD] in these disabled persons. SCI individuals following regular physiotherapy, have better serum HDL-c levels as compared to bed-ridden SCI patients, suggesting the physical activity as an important factor to elevate the serum HDL-c in such patients. Knowledge of relative risk of CVD in persons with SCI is important for appropriate interventional strategies, including planned physical activities or exercises and therapeutic intervention

Faculty perceptions and objective impact of faculty development workshops

To document the perception of participants and the impact of faculty development and related educational workshops arranged in a public sector medical education setting. The departments of medical education [DME]; army medical college and armed forces Post Graduate Medical Institute, Rawalpindin, Pakistan from 2013 to 2014. A descriptive study. During 2013 to 2014, nine faculty educational workshops were arranged by the faculty members of the departments of medical education [DME], Army Medical College and Armed Forces Post Graduate Medical Institute, Rawalpindin, Pakistan. Both clinical and pre-clinical teaching faculty members attended the workshops. Proper consent was taken from each participant to document their perceptions for this study. Two hundred and forty of the teaching faculty members of the army medical corps participated in different proportion for the workshop arranged during a period of one year. At the end of each workshop a questionnaire was completed by each participant. The study addressed the perceptions of the participants regarding impact of workshop,the facilitator's knowledge about the workshop topic and his/her communication skills.The responses of the participants were documented for each question and the percentages were calculated. The planning efforts of professional development workshops by the departments of medical education at Army Medical College and Armed Forces Postgraduate Medical Institute resulted in a satisfactory implementation of the set objectives for faculty development

Estimated reference interval of ionized [free] calcium

To determine the reference values of Ca++ in whole blood in our setup. The Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Rawalpindi from Jan 2008 to June 2008. Three hundred healthy individuals were included in the study after obtaining written consent. Out of these 76 individuals were excluded from the study after clinical assessment and collection of laboratory data. One hundred and fourteen were males with mean age 35 +/- 12 years and 110 were females, with mean age 28 +/- 9 years of age. Their Ca++ was estimated by ion selective electrode [ISE] method in heparinized whole blood [WB]. The mean and SD of whole blood Ca++ was calculated separately for the females and the males. The results showed that in our setup males have Ca++ levels of 1.12 +/- 0.05 [mean +/- SD] mmol/l and females have Ca++ levels of 1.12 +/- 0.04 [mean +/- SD] mmol/l. The study revealed that estimated reference range of Ca++ of the studied population was lower than the reference range published for the western population that is used by our physicians for the interpretation and comparison of results

frequency of preclinical nephropathy in patients of type II diabetes mellitus with diabetic retinopathy

Objective: To determine the frequency of preclinical nephropathy in patients with diabetic retinopathy and its correlation to the severity of retinopathy

Study Design: Prospective case study

Place and Duration of Study: Department of Ophthalmology, Military Hospital [MH], Rawalpindi for six months

Methods: Ninety [90] diabetic patients [thirty in each grade of retinopathy i.e. background, preproliferative and proliferative] with no known renal dysfunction were included in the study. They were investigated for albumin/creatinine ratio a sport urine sample. The outcome of renal function was described as either positive or negative. The cutoff value for albumin creatinine ratio was 200 mg/g. The various grades of retinopathy were compared to the values of urine albumin creatinine ratio, to find the correlation

Results: Five [17%] patients with background diabetic retinopathy had preclinical nephropathy. Seventeen [60%] patients with preproliferative diabetic retinopathy and 27 [90%] of patients with proliferative diabetic retinopathy had preclinical nephropathy. The frequency of nephropathy correlated to the severity of retinopathy [correlation co efficient, r value: 0.630] and p value of <0.001

Conclusion: it is important for ophthalmologists to carefully consider the renal status of any patient with retinopathy as this can influence the progression of retinopathy and its response to treatment