Plasma lipid abnormalities in Pakistani population: trends, associated factors, and clinical implications

Previous studies have reported increased prevalence of coronary heart disease (CHD) in Indians and South Asian settlers in North America. This increased burden of CHD among South Asians is mainly caused by dyslipidemia. To the best of our knowledge, none of the previous works has studied the patterns and prevalence of dyslipidemia in the Pakistani population. The present work aimed to study the plasma lipid trends and abnormalities in a population-based sample of urban and rural Pakistanis. The study included 238 participants (108 males,130 females). Plasma lipid profiles of the participants were determined using standard protocols. We observed that 63% of the study population displayed irregularities in at least one major lipid-fraction including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), or triglycerides (TG). The most common form of isolated-dyslipidemia was low HDL-C (17.3%) followed by high TG (11.2%). Several overlaps between high TC, LDL-C, TG and low HDL-C were also noted. Gender, urbanization, and occupational class were all observed to have an impact on lipid profiles. Briefly, male, urban, and blue-collar participants displayed higher prevalence of dyslipidemia compared to female, rural, and white-collar participants, respectively. In comparison to normal subjects, dyslipidemic subjects displayed significantly higher values for different anthropometric variables including body mass index (BMI), body fat percentage, and waist circumference. The present work provides a comprehensive estimation of the prevalence of dyslipidemia and CHD risk in the Pakistani population. This information will be helpful for better healthcare planning and resource allocation in Pakistan.

Diagnosis of acute appendicitis: a comparison of the efficacy of clinical signs and symptoms and laboratory investigations

the purpose of the study was to compare the validity of clinical presentations and laboratory tests in the diagnosis of acute appendicitis, the major cause of emergency surgical procedures. Patients and a total of 200 patients with suspected acute appendicitis who underwent surgery were included in the study. Clinical history, detailed physical examination, and laboratory investigations were reviewed. The postoperative findings were obtained directly from the operating surgeon. in this group, 69% had acute appendicitis, 9% had acute appendicitis with complications, and the remaining 22% had normal appendices. Right iliac fossa pain, nausea and vomiting were sensitive but not specific symptoms. Tachycardia, hypotension, and fever were of low sensitivity but high specificity. Tenderness in the right iliac fossa and rebound tenderness were highly sensitive but not specific. The WBC count was a sensitive test in the diagnosis of acute appendicitis in comparison with ultrasound examination, which showed a low sensitivity. General urine examination was not valuable in the diagnosis. acute appendicitis is a condition, which requires immediate treatment. The use of highly sensitive tests with high positive predictive value, though of low specificity, favors the appropriate diagnosis and treatment and minimizes the risk of missing cases

Insulin-mimetic effect of (-) epicatechin on osmotic fragility of human erythrocytes.

(-) Epicatechin, a benzopyran extracted from the bark of Pterocarpus marsupium, is reported to have insulin like activity. The present work is undertaken to study the effect of insulin on erythrocyte osmotic fragility (OF) and then to evaluate the insulin-like role of (-) epicatechin on human erythrocytes. Insulin exerts a protective effect on erythrocyte OF and shows a dose response which is similar to other typical insulin effects i.e. a maximum at 0.1 nM and a lower effect at higher and lower concentration. (-) Epicatechin (1 mM) also shows protective effect, similar to insulin, on the OF. Ouabain (1 mM) has completely abolished the insulin effect on OF, and failed to have any effect on the action of (-) epicatechin, showing that (-) epicatechin and insulin act by a different mechanism of action while eliciting their protective effects on red cell OF.