ABSTRACT
Objective: To determine median values of biochemical maternal serum markers during second trimester maternal screening to rule out chromosomal anomaly, Down syndrome. Study Design: Cross sectional study. Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology [AFIP], from Nov 2016 to May 2017
Patients and Methods: Non-probability consecutive sampling technique was used. All healthy pregnant women with single pregnancy were included. As non-parametric statistics was used, the sample size was collected to be 155. Blood sample for serum human chorionic gonadotropin [HCG] was analyzed on random access immulite 2000, alpha-fetoprotein [AFP] was analyzed on ADVIA Centaur, unconjugated estriol [uE3] and Inhibin A measured by Enzyme-Linked Immunosorbent Assay [ELISA] method by PR 4100 Micro plate Reader
Results: Total 155 women were enrolled in this study. Mean maternal age was 33.46 +/- 2.35 years and mean maternal body weight was 54.98 +/- 2.88 kg. Median value of quadruple markers, calculated from 15-18[th] week of gestation, was used for calculation of multiple of median [MoM] for screening of trisomy 21 in this gestational age. Median values at 15 week of gestation: hCG 36650 mIU/ml, AFP 23.3 IU/ml, uE3 3.5 nmol/l, Inh A 198 ng/l, at 16 week of gestation: hCG 29050 mIU/ml, AFP 35.4 IU/ml, uE3 4.1 nmol/l, Inhibin-A 179 ng/l; at 17 week of gestation: hCG 28450 mIU/ml, AFP 36.0 IU/ml, uE3 6.7 nmol/l, Inhibin-A 175 ng/l and at 18 week of gestation: HCG 25200 mIU/ml, AFP 38.2 IU/ml, uE3 8.2 nmol/l, Inhibin-A 190 ng/l
Conclusion: In this study we were able to get median values of quadruple markers for regional population, which will be used in future to calculate MoM for the screening purpose of Down syndrome. It will help to rule out Down syndrome by non-invasive test and at early stage of pregnancy
ABSTRACT
Objective: To determine the diagnostic accuracy of non-fasting lipid profile in the diagnosis of hyperlipidemia, taking fasting lipid profile as gold standard, in adult population
Study Design: Cross-sectional validation study
Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Rawalpindi, from July to December 2014
Methodology: One hundred seventy-five adult patients coming for fasting lipid profile were included; their non-fasting samples were taken on the next day. Patients on anti-cholesterol treatment and indoor patients were excluded. Total cholesterol [TC], high density lipoprotein-cholestrol [HDL-C], and triglycerides were measured by direct enzymatic colorimetric method by Modular p-800[registered]. Low density lipoprotein-cholesterol [LDL-C] was calculated by Friedewald's formula, but when triglyceride was greater than 4.5 mmol/l, then LDL-C was measured directly by homogenous enzymatic colorimetric method. Non-HDL-C was calculated by simple equation, i.e. TC-HDL-C
Results: Non-fasting lipid profile had 93% specificity, 51% sensitivity, 94% positive predictive value and 49% negative predictive value; and 65% accuracy with 7.28 positive likelihood ratio and 0.52 negative likelihood ratio. Non-fasting TC and non-HDL-C were significantly higher than fasting TC and non-HDL-C by mean difference of 0.2 mmol/l each with p=0.001 and p=0.004, respectively. Fasting and non fasting HDL-C are comparable to each other with mean difference of 0.01 mmol/l [p=0.745]. Receiver operating curve [ROC] of non-fasting non-HDL-C showed 0.804 [95%CI [0.738-0.870], [p=0.000] area under the curve [AUC] indicating that it was a significant test for ruling out hyperlipidemia. Bland-Altmann plot showed a significant difference between non-fasting, non-HDL-C and fasting LDL-C and non-fasting, non-HDL-C -0.087540 with bias -0.00109; therefore, these cannot be alternative to each other
Conclusion: Diagnostic accuracy of non-fasting lipid profile was found significantly higher than fasting lipid profile [p=0.004] for the assessment of lipoprotein coronary risk on the basis of non-HDL-C, which seemed to be significant test for ruling out hyperlipidemia
ABSTRACT
Objective: To find the frequency cll HBV and HCV infection among healthy adult males of Southern Punjab soeking recruitmcnL in Pakistan Armed Forces Material and methods: This cross sectional, obssrvaticnal study was carried out from Augusl 2009 to March 2010, at Combiried Vilitav Hospital Bahawalpur. Healthy young adult males recruited from Southern Punjab were screened tor Hepalilis B surface antigen [HBsAg] and Hepatitis C virus antibodies [Anti-HCV] by rapid method and positive cases were confirmed by ELISA [Enzyme Linked Immunosorbant Assay]. Results: A total of 1555 individuals were examined. Out cf those 62 [3.98%] were HBsAg positive and 65 [4.18%] were positive for anti HCV. Conclusion: There is a dire need for nationwide survey to identify the exact burden of hepatitis B virus and hcpatitis C virus in the socicly for fiading tangible solulions in the farm of proper planning and implementalion of ncpatitis prevention and control interventions
ABSTRACT
Hydatid disease [Hydatidosis / Echinococcosis] is a zoonosis in which humans are the intermediate host who become infected by accidentally ingesting tapeworm eggs passed in carnivore faeces. Echinococcus is a cosmopolitan parasite with six genetically distinct strains, two of which are related to human infection [Sylvan strain and Pastoral strain]. Progress and advancement in the field of medicine has led to accurate diagnosis, localization and successful treatment. Public awareness needs to be increased regarding hazards of the disease with special emphasis on personal and pet hygiene. Patients presenting with vague symptoms having pet dogs or any history of liver ailments in the past be dealt with high suspicion of Hydatidosis, because it is re-emerging as a major health issue entailing threatening complications