Vitamin B[12] deficiency- a major cause of megaloblastic anaemia in patients attending a tertiary care hospital

Folate and vitamin B[12] deficiencies have been known to cause megaloblastic anaemia. Since the deficiencies of these two vitamins are very common in Pakistani population, it would be imperative to investigate their role in causing megaloblastic anaemia. The objective of this study was to find out the contribution of folate and vitamin B[12] deficiencies in causing megalobalstic anaemia in our patient population. In this retrospective cohort study, clinical records of 220 patients [101 females and 119 males with an age range of 1-80 years] who presented themselves with macrocytic anaemia at the Aga Khan University Hospital were collected. Data pertaining to complete blood count and serum levels of folate and vitamin B[12] were analysed. The mean haemoglobin [Hb] level was 6.8 +/- 0.2 gm/dl. Sixty-nine percent of the patients had severe anaemia [Hb<8gm/ dl]. Mean +/- SEM values of haemoglobin, serum folate and serum B[12] were not significantly different between males and females [Hb 6.4 +/- 0.3 gm/dl vs 6.3 +/- 0.3 gm/dl; folate 6.9 +/- 0.8 eta g/ml vs 7.8 +/- 1 eta g/ml; B[12] 259 +/- 65 rho g/ml vs 225 +/- 45 rho g/ml, respectively]. Linear regression analysis showed that serum folate was inversely related with the mean corpuscular volume [MCV, p=0.04]. Spearman's correlation analysis indicated an inverse mild association between MCV and serum folate [correlation coefficient= -0.18]. Folate deficiency was 43.3%, while vitamin B[12] deficiency was 78.5% in these patients. Seventy-one percent of folate-deficient patients had vitamin B[12] deficiency was 78.5% in these patients. Seventy-one percent of folate-deficient patients had vitamin B[12] deficiency as well, while 26.1% of patients with B[12] deficiency had a co-occurrence of folate deficiency. Vitamin B[12] deficiency appears to be the major factor leading to megaloblastic anaemia in our study population. Inadequate dietary intake, over-cooking of our food and poor absorption might be contributing to high prevalence of vitamin B[12] deficiency in this population

Risk factors and behaviors for coronary artery disease [CAD] among ambulatory Pakistanis

To determine the frequency and distribution of various risk factors and behaviours for coronary artery disease [CAD] among ambulatory Pakistanis. It is a cross-sectional descriptive study carried out at the Aga Khan University Hospital, a teaching hospital in Karachi. All the subjects were adults [18-60 years] presenting at the general checkup clinic with no history or evidence of CAD by convenient sampling method. Demographic variables included risk factors and behaviors including diabetes, hypertension, dyslipidemia, family history of heart disease, obesity, smoking and sedentary lifestyle. Among 370 ambulatory Pakistanis, the proportions of major risk factors for CAD were: sedentary life style 72%, family history 42%, dyslipidemia 31%, obesity 24%, hypertension 19% and diabetes mellitus 15%. Diabetes, hypertension and dyslipidemia were poorly controlled in the study population. Proportions of the three major risk factors [smoking, hypertension and dyslipidemia] occurring singly, doubly and all three together in the study population were found to be 39%, 11% and 1%, respectively. Data were also analyzed for risk factors by comparing those with and without family history of CAD to eliminate any bias. The results were not statistically significant except for the sedentary life style [P=0.016]. There is a high prevalence of CAD risk factors in this study population. Modifiable risk factors like diabetes, hypertension and high cholesterol need better control. Preventive screening programs and healthy lifestyle behaviours need to be emphasized upon in the community