Serum levels of phosphorylated heat shock protein 27 (pHSP27) are associated with bone mineral density in pre- & postmenopausal women: A pilot study.

Background & objectives: Phosphorylated heat shock protein 27 (pHSP27) has been implicated in the pathogenesis of osteoporosis. Oxidative stress and proinflammatory cytokines, which are known to be involved in aetiology of osteoporosis, can trigger HSP27 phosphorylation. Since pHSP27 is present in circulation, it was hypothesized that serum pHSP27 would be elevated in low bone mineral density (BMD) condition and might serve as an indicator of osteoporosis/osteopenia. Hence, the aim of this study was to examine serum levels of pHSP27 in relation with BMD in pre- and postmenopausal women. Methods: Premenopausal (30 to 40 yr) and postmenopausal (50 to 60 yr) women having either low BMD (osteopenia/osteoporosis) or high BMD were selected (n=80) from a prospective cohort (n=200). Serum levels of pHSP27; along with levels of oestradiol, malondialdehyde, total antioxidant capacity, interleukin (IL)-1, IL-6, tumour necrosis factor - alpha, (TNF-α), c-telopeptide fragments of collagen type I (CTX-1) and osteocalcin were estimated. Results: The serum levels of pHSP27 were significantly elevated in low BMD groups in premenopausal and postmenopausal categories (P<0.05). It also exhibited a significant odds ratio (OR) to differentiate between low and high BMD in both premenopausal (OR=1.734, P=0.013) and postmenopausal (OR=1.463, P=0.042) categories. Additionally, area under the curve to predict low BMD was non-significantly higher for pHSP27 than CTX-1 in premenopausal and postmenopausal categories. Interpretation & conclusions: This study highlights a novel relation between serum pHSP27 and BMD in Indian women however, these findings need to be confirmed in larger studies.

Hysterectomy comparison of laparoscopic assisted vaginal versus total abdominal hysterctomy

Abdominal hysterectomy, the procedure by which almost 90% of hysterectomies are currently being done. Laparoscopic assisted vaginal hysterectomy has been introduced as an alternative to abdominal hysterectomy, and is thought to allow a more rapid return to normal activity. Laparoscopic assisted vaginal hysterectomy has less postoperative morbidity and quicker recovery than abdominal hysterectomy. To compare the laparoscopic assisted vaginal hysterectomy with total abdominal hysterectomy in term of operative time, per operative blood loss and post-operative wound infection. Randomized trial. This study was carried out in the department of obstetrics and gynaecology, Shaikh Zayed Hospital, Lahore. Six months [15th September, 2008 to 15th March 2009]. Eighty patients fulfilling the inclusion criteria were selected for this study. Patients were equally divided in two groups; group A [laparoscopic assisted vaginal hysterectomy] and group B [total abdominal hysterectomy]. Operative time [in minutes], blood loss [in ml] as estimated and post-operative wound infection was assessed by presence or absence of wound discharge, redness and edema around the incision on 3rd, 5th and 7th post-operative day. The mean ages of women in group A was 49.13+4.26 and 45.68+4.54 years in group B. The maximum number of parity between 3-4 was 19 in group Aand 20 in group B. Mean weights of cases in group A was 65.60+10.45 kilograms and 70.77+15.59 kilograms in groups B. The per-operative time in group Awas 105.13+6.55 minutes and 83.38+14.82 minutes in group B. The mean blood loss in group Awas 178.0+43.51 ml and 228.25+72.49 ml in group B. The wound discharge was not found in group A, while in group B, 4 cases [10%] on 3rd post-operative day, 6 cases [15%] on 5th post-operative day and 11 cases 27.5% on 7th post-operative. Laparoscopic assisted vaginal hysterectomy has a quicker post-operative recovery but at the expense of a bit long duration of surgery. Laparoscopic vaginal assisted hysterectomy is a feasible option in a selected group of patients who would otherwise require an abdominal hysterectomy. The drug requirement to control pain and level of pain experienced by patients were also significantly less

Gestational diabetes mellitus

Gestational diabetes mellitus is common disorder in pregnancy. It is associated with adverse pregnancy out come. There is no consensus regarding the optimal approach to screening of gestational diabetes mellitus. The present study has tried to observe the value of fasting blood glucose in screening of gestational diabetes. To determine the frequency of patients in whom fasting blood glucose and 100gm glucose tolerance show agreement for screening of gestational diabetes mellitus at 24-28 wks. Comparative cross sectional study. The study was conducted at Gynecology and Obstetrics department Shaikh Zayed Federal Post Graduate Institute Lahore. 6 months from 12 Nov 2010 to 11 May 2011. The study included 135 booked patients with positive family history of diabetes mellitus. All patients underwent fasting blood glucose at 24-28 weeks of gestation, regardless of results of fasting blood glucose on next visit they underwent 100g oral glucose tolerance test [OGTT]. The agreement between fasting blood glucose and 100g oral glucose tolerance test was calculated in frequency and percentages. The mean age of women in studied population was 27.15 +/- 3.70. Out of 135 patients 86.7% [117] showed agreement between results of fasting blood glucose and 100g OGTT while 13.31% [18] showed no agreement between both of the tests. Fasting blood glucose is a good screening option for gestational diabetes mellitus along with positive history. It provides a simple, cheap and more practical test for screening of gestational diabetes mellitus. However diagnostic confirmation with 100g OGTT should be done

Placenta previa; etiology and fetomaternal outcome

To analyze the causative factors and short term complications in cases of placenta previa. A retrospective study carried out in Obstetrics and Gynecology Department of Sheikh Zayed Post Graduate Institute Lahore. From June 2004 to June 2007. Fifty patients with placenta previa. Main outcome measures: Age, parity, previous cesarean section, previous history of evacuation/myomectomy, average hospital stay, need for blood transfusions, emergency/elective LSCS, associated maternal and fetal morbidity and mortality. There were 50 cases of placenta previa over the period of 3 years. Most frequently occurring intra operative complication was postpartum hemorrhage in 19 patients [38%]. Highest morbidity was due to anemia which was in 23 patients [46%]. Maternal mortality was 2%, while neonatal mortality was 14%. Placenta previa is a multifactorial disease. No doubt that the rising incidence of cesarean section is increasing the intraoperative complication associated with the condition but other risk factors are also important like age, parity, history of evacuation etc

Treatment compliance and associated demographic factors in newly diagnosed tuberculous patients on directly observed therapy - short course [DOTS]

To asses the treatment compliance and effectiveness of DOTS program at a secondary health facility level. A Hospital based Cross Sectional study. Patients attending TB clinic at Taluka Hospital SajawaL District Thatta Sindh. a secondary health facility during 2003-2004. A total of 240 Patients were enrolled for the study irrespective of gender, ethnicity and religion. Present study showed population compliance of 82.19%, success rate of 75% and disease specific death rate [case fatality rate] of 7.5% on DOTS therapy. DOTS [directly observed treatment short-course] strategy for tuberculosis [TB] control as recommended by the World Health Organization has proved to be a is a very effective program for decreasing morbidity and mortality in tuberculous patients provided it is practiced properly

Measurement of optical parameters: absorption scattering and Auto-florescence of skin in vitro

To measure various optical parameters in skin sample of chicken. We illuminated the chicken breast skin tissues with collimated radiation of 400-700 nm Nd-YAG pumped dye laser, and measured skin optical properties for dry and hydrated sample in vitro. Total reflectance and transmitted intensities were recorded by which scattering, absorption and anisotropic factors of the sample obtained using double integrating sphere setup. The in vitro optical parameters are higher then in vivo measurements. Hydration of skin is found to influence its scattering properties. Dry sample scatter less then hydrated sample. Our in vitro results are in agreements with other data available in literature