Gestational diabetes mellitus; still a great problem

Objectives: The present study was designed to find the importance of proper screening and early diagnosis of gestational diabetes mellitus. Study Design: A prospective/ descriptive study Place of Study: tertiary care hospital Hyderabad. Duration of Study: from September 2014 to November 2014

Materials and Methods: A total of 168 pregnant females between the ages of 20-40 years and in their 24[th] to 28[th] week of gestation were enrolled for the study. Oral Glucose Tolerance Test of all the participants was done after an overnight fasting of 10-12 hours. All the participants were given 75gm of glucose per 100 ml of distilled water. The blood samples were collected after two hours time for serum glucose levels

Results: Most of the participants were below 26 years of age 47[27.9%] with the mean age of 30.2 +/- 5.83 years. However the highest prevalence of GDM was observed in age group 31-35 years [36%]. Among the 25 cases of gestational diabetes mellitus the highest number of patients with GDM were multipara [40%] followed by parity of 3-4 gravida [32%]. Twenty seven women [16%] women had family history of diabetes mellitus. Among these 12/27 [44.4%] women were found with GDM, compared to 15/141 [10.6%] who have no family history of diabetes mellitus. Total 14 [8.33%] women were found obese, out of these 8 [57%] women had GDM while only 6 [42.8%] women had no GDM

Conclusion: The prevalence of GDM in the present study is found to be 14.8%. A prevalence of GDM was higher in the elderly multiparous females who were overweight and had family history of diabetes mellitus

Celiac disease; histopathological evaluation of endoscopic duodenal [D2] biopsies in patients

To find out the Modified Marsh type of celiac disease [CD] patients on histopathological examination of duodenal [D2] biopsies and to correlate it with tissue transglutaminase IgA levels. Cross sectional study. Place of Histopathology laboratory [Department of Pathology], Isra University Hospital and Asian Institute of Medical Sciences [AIMS], Hyderabad. July 2013 to December 2013. 96 patients with a history of malabsorption or atypical symptoms with clinical suspicion of CD were subjected to endoscopy. Endoscopic duodenal [D2] biopsies were taken regardless of age and gender. D2 biopsies were processed for histopathological examination under light microscopy. Out of 96 patients, 45 [46.9%] patients had moderate type of lamina propria inflammation along with highly significant p-value [0.0001].CD type 3a was observed in 34 patients [35.4%]. In this study the comparison of serological level of tissue Transglutaminase IgA [tTGA] and histological severity revealed significant correlation. All Modified Marsh types of CD with tTGA level seen in our study were highly significant [p-value 0.001]. In this study strong correlation was observed between the serological tTGA level and histological findings by Modified Marsh classification along with lamina propria inflammation of duodenal mucosa in CD patients

Relationship of chromium toxicity with diabetes mellitus and chronic renal failure

To assess the association between diabetes mellitus and chronic renal failure with toxic effects of chromium on the onset of the Chronic Kidney disease. A prospective cross sectional study. This study was carried out at the Jinnah Post graduate Medical Centre and Kidney Centre Karachi during December 20 12 to December 20 13. The present study was conducted on a total of 150 patients [age > 40 years] divided into three groups. Patients in Group I included 50 patients with diabetes mellitus type 2 whereas Group II included 50 patients with diabetes mellitus associated with chronic renal failure [CRF] and Group III consisted of 50 healthy controls. Results showed that levels of fasting blood sugar and HbAlc in both group I and group II were significantly high where as it was lower in controls. Serum urea [125.2 +/- 32.49] and creatinine [7.3 +/- 1.41] levels in patients with DM with CRF were significantly high as compared to patients with DM only and control group. The Creatinine clearance [55.1 +/- 9.61] in patients with DM with CRF was decreased in comparison with DM patients and control group. Serum chromium levels were significantly high in patients with DM with CRF and in patients with DM. Serum chromium level showed significant correlation with glycemic index when the two groups including DM patients and patients with DM accompanied with CRF were compared with the controls, while correlation with renal failure was significant only in group II patients

Histopathological evaluation of uterine curettings in patients with abnormal uterine bleeding

The main objective of the present study is to determine the histopathological patterns and diagnostic value of endometrial curettings in patients presenting with abnormal uterine bleeding. A prospective study. This study was conducted at Department of Pathology Liaquat University of Medical and Health Sciences Jamshoro during March 2010 to February 2011. A total of 100 cases of endometrial curettage were processed for routine staining with Haematoxylin and Eosin and slides were evaluated for histopathological diagnosis. The results showed that patient's age ranged between 40-52 years and most of the patients about 77%presented with menorrahgia. The histological findings showed normal phase [Proliferative and Secretory phase] of menstrual cycle in 52% of cases followed by simple hyperplasia without atypia 23%, chronic endometritis 13%,polyp 2%, tuberculous endometritis 2%, anovulatory cycle 1%, anovulatory cycle with chronic endometrits 1%,atrophic changes 1%, atypical complex hyperplasia 2% and malignancy in 3% of cases. The Simple hyperplasia23% and chronic endometritis 13% were the commonest pathological alteration. The accidental findings of organic lesions including polyps and malignancy in 5% cases focused the diagnostic importance of curettage in patients presenting with abnormal uterine bleeding. It is concluded that simple hyperplasia without atypia and chronic endometritis are most important causes of abnormal uterine bleeding in the perimenopausal age groups

Effects of lactobacillus [acidophilus] on cutaneous wound repair with respect to neutrophil count in comparison with steroid

Objective: To evaluate the effects of lactobacillus [acidophilus] in repairing of wound with respect to neutrophil count in comparison with steroid therapy

Study Design: Experimental study

Place and Duration of Study: This study was conducted in the Department of Anatomy of Al-Tibri Medical College Isra University Karachi Campus from June 2014 to October 2014

Materials and Methods: Randomly selected Wistar albino rats were taken and their weight was between 100 -150 gms. The rats were divided in three groups on the basis of topical application. Group I was treated with topical normal saline, Group II with topical lactobacillus[acidophilus], and Group III topical Steroid were applied once daily].Each group is further divided into four sub groups according to the day of sampling like group Ia[day 03], group Ib[day 07], group Ic[day 14] and group Id [day 21]. Samples were taken on day 3,7,14 and 21 from each group and tissues were processed and stained to observe the neutrophil count that showed rapid healing processes. Data was analyzed on SPSS version 21 by applying ANOVA and post hoc tukey'stest

Results: Results compared the neutrophil count of Lactobacillus group with steroid group and control group.Mean +/- SD of numbers of Neutrophils / x400 in group IIa was20.500 +/- 0.577, in group IIb11.250 +/- 1.258, in group IIc5.7500 +/- .0.5000, group IId3.7500 +/- 0.9574and in groupIawas54.25 +/- 2.872, group Ib41.250 +/- 2.629, group Ic23.500 +/- 3.000 and group Id18.750 +/- 0.957. The significant value was in group IIa and group Ia[P<0.000], group IIb and group Ib[P<0.000], group IIc and group Ic[P<0.000] and group IId and group Id [P<0.000]. Mean +/- SD of numbers of Neutrophils / x400 in groups IIa was 20.500 +/- 0.577, in group IIb 11.250 +/- 1.258, in group IIc 5.7500 +/- .0.5000, group IId 3.7500 +/- 0.9574 and group IIIa was54.500 +/- 1.290, group IIIb 42.000 +/- 1.414,group IIIc32.000 +/- 0.8165 and group IIId28.750 +/- 1.258. The significant value was in group IIa and group IIIa[P<1.000], group IIb and group IIIb[P<0.002], group IIc and group IIIc[P<0.000] and group IId and group IIId[P<0.000]

Conclusion: Lactobacillus showed potent anti-inflammatory effect against both therapeutic groups

Estimation of monocytes in patients with coronary artery disease

To evaluate the role of monocyte count in patients presenting for coronary artery heart disease and to assess its significance as a risk factor. Cross sectional study. This study was carried on the patients taken from Coronary Care Unit [CCU] Department of Isra University Hospital, Dewan-e-Mushtaque CCU and from Red Crescent Hospital CCU from May 2011 to October 2011. In this study 140 individuals were enrolled to observe the monocyte count in patients with coronary artery disease. In control group 42, Stable Coronary Artery Disease [CAD] 34 and Acute Myocardial Infarction [AMI] 64 individuals were taken. Three ml of blood was collected in EDTA bottles for differential leukocyte count [DLC] from each patient presenting with chest pain in coronary care unit. The total leukocyte count [TLC] and other parameters were determined by different automatic analyzers in the clinical laboratory. In all three groups male predominance with 70/o, 64% and 64% in Stable CAD, control, and AMI group was seen respectively. In stable CAD group highest percentage [53%] of patients were seen in 56 to 65 years age followed by 50% of patients of 35-45 years and 42% of patients of 46-55 years in control and AMI group respectively. Both in stable CAD and AMI groups; monocyte count was highly significant in diabetic patients however in individuals with higher BMI; monocyte count was significantly increased in AMI group than stable CAD and control groups. It is concluded from the present study that monocyte count has significant relationship between clinical stages of CAD and diabetic patients. However individuals with higher BMI showed significant high levels of monocyte count in AMI group only

Anti diabetic effects of cinnamon extract in albino rats with effects on the serum insulin levels

To determine the changes in the serum insulin levels in alloxan induced diabetic albino rats in comparison with oral hypoglycemic drugs. An experimental study. This study was conducted at Al Tibri Medical College Karachi during December 2012 to December 2013. The present study was conducted on 60 Albino rats which were group from A to F consisting of 10 rats in each group. These groups were further divided into two sub groups which were treated with low dose and high dose of the cinnamon and oral hypoglycemic drugs. The results showed that there is significant reduction in serum insulin level in the alloxan treated group animals which was improved in group C animals treated with low dose of cinnamon extract in alloxan induced diabetic rats. Also animals in group D and group E treated with tolbutamide and acarbose respectively showed higher increase in serum insulin level as compared with cinnamon extract treated groups, however when cinnamon extract was used in combination with tolbutamide or acarbose it showed synergetic effects. Tolbutamide and Acarbose treated groups showed better anti diabetic effect by increasing the serum insulin level in comparison with cinnamon extract treated groups when used individually. This effect was enhanced when cinnamon extract was used in combination with either tolbutamide or acarbose

Significance of cd markers in the classification, patterns and sub typing of non hodgkin's lymphoma

Aim of this study is Immunohistochemical analysis of H and E diagnosed cases of NHL for confirmation, classification and differentiation on the basis of phenotypic expression of CD3, CD30, CD45 and CD20 markers. Prospective study. This study was conducted in the Pathology department of Liaquat University of Medical and Health Sciences Jamshoro [LUMHS] during October 2010 to March 2012. The sample consisted of all the specimens received in the Pathology department of Liaquat University of Medical and Health Sciences Jamshoro [LUMHS] during the above period. Immunohistochemical stains including CD3, CD30, CD20 and CD45 were used for classification and differentiation of cases of NHL. Out of one hundred and eighty [180] H and E diagnosed cases of Non Hodgkins Lymphoma, only 142 [78.8%] were positive for CD20 and were confirmed as B cell NHL; however 6 [3.3%] cases showed positivity with CD30 and were confirmed as large T-cell NHL. 38[21.2%] cases showed positivity for CD3 and all 180 [100%] cases were positive for CD45 and were confirmed as NHL. It is concluded that Immunohistochemistry is helpful in differentiation of NHL. Cases of B cell NHL occur more frequently than T cell NHL. Furthermore NHL is more common in males and mostly presents with nodal involvement

Pregnancy induced hypertension; assessment of prognostic value of platelet count in women with varying degree

Objective: To assess the early detection of thrombocytopenia in women presenting with varying degree of pregnancy induced hypertension [PIH]. Study Design: A case control study. Place of Study: Hematology laboratory Isra University Hospital Hyderabad. Duration of Study: From July 2009 to December 2010

Materials and Methods: Total 130 pregnant women were included in this study. The subjects were divided into three groups as Group 1 with pre-eclampsia, Group 2 with eclampsia and Group 3 with normotensive pregnant women as control group. The Group 1 was further divided into two sub groups such as Subgroup 1a with mild preeclampsia and Sub-group 2b with severe pre-eclampsia

Results: Anticoagulated whole blood samples [5cc] from all subjects were analyzed for the detection of thrombocytopenia for the possible involvement of pregnancy induced hypertension. It was noted that out of total subjects, 33[25.39%] had mild pre-eclampsia, 17[13.07%] had severe preeclampsia, 15[11.54%] had eclampsia and 65 [50.0%] were normotensive pregnant women. Based on the comparative findings, the results showed significant differences between group 3 and group 1a [p-value 0.001], group 3 and group 1b [p-value 0.001], group 2 and group 3 also showed same results [p-value 0.001] but the subjects of group 1a and 1b when compared, showed non-significant findings [p value 0.955]

Conclusion: The results suggested that early detection of platelet count provide significant role for the assessment of severity of disease in women with pregnancy induced hypertension when compared with normotensive pregnant women

Clinical presentation and evaluation of histopathological patterns of hospital-based frequency of thyroidectomic biopsies

The aim of this study is to evaluate the clinical presentation of different histophathological pattern of hospital-based surgical thyroidectomic specimens. Multicentre, Prospective Study. This study was conducted at the department of Pathology, Isra University Hyderabad; Liaquat University of Medical and Health Sciences, Jamshoro; Memon Hospital, Hyderabad and Al-Tibri Medical College and Hospital, Isra University Karachi Campus from July 2009 to December 2011. In the present 358 thyroidectomic specimens were collected from four different hospitals of Sindh. Specimen of thyroid tissue was taken after the end of thyroidectomy. The tissues were fixed in buffered neutral formalin and after processing embedded in paraffin to form tissue blocks. A 5 micro m thick sections were cut by microtome and the sections were then stained with Hematoxylin and Eosin [H and E] strain. Special stain like PAS were also used for confiring specific diagnosis. The histopathalogical examination was then carried out for any morphological changes. The results showed that hospital-based frequency of throidectomy specimens was found to be 4.1%, indicating that the thyroid diseases are common in plain areas of Sindh. Multinodular goiter was the most common histopathological pattern in 202 cases and usually presents as asymptomatic lump in the neck. Thyroid neoplasms were found to be the second most common disease in 94 cases specially in the follicular adenoma and papillary carcinoma. The mean +/- SD age of the patients in 358 thyroidectomy specimen was 32.65 +/- 10.66 years. The persons having age ranges between 10 to 70 years were considered. The youngest patient included in our study was 10 years old female with colloid adenoma. The female to male ratio was 2.5:1. Thyroid diseases are common in plain areas. Multinodular goiter is the most prevalent thyroid disease. Follicular adenoma and papillary carcinoma are the most frequent thyroid neoplasms. It is therefore concluded that multinodular goiter and thyroid neoplasm are the most common pattern in thyroid diseases in these ares

Frequency of hepatitis B and C in patients reported at Al-Tibri medical college and hospital

The aim of this study is to determine the frequency of hepatitis B and C in the residents of Malir district who reported to Al Tibri Medical College and Hospital. A Cross Section Prospective study. The study was conducted in the Department of Medicine and Pathology of Al Tibri Medical College and Hospital from May 2010 to April 2011. This study was based on the data of patients who reported to the hospital in a year. Pakistan is a developing country. On one side we have a population burden and on the other side communicable diseases. Viral Hepatitis is one of them. In general population the frequency of hepatitis B and C viral infection ranges from 8-15%. Rapid Chromatography immunoassay and ELISA were the methods for the tests. The data was collected in a preset Performa and analyzed on SPSS version 16. Total of 2093 specimen were reported. Both hepatitis B surface antigen and anti HCV antibody were checked. Total number of persons screened were 2093. Out of them male were 963 and female were 1130. HBV were 124 positive cases while 426 were anti HCV positive. This showed that HBs antigen were 5.9% while Anti HCV antibody were 20.35%. Among HBs Antigen positive cases 61% were males while 39% were females and in Anti HCV antibody positive cases the females were 67% while 33% were males. Hence combined infection were 2.7%. Cases were divided into five groups according to their ages. The group of ages between 25 to 45 had maximum positivity. The frequency of HBV and HCV in this particular area of our great province is quite high. This is the time to educate the general population of area so as to prevent the disease

effect of Cedrus deodara root oil on the histopathology of rat stomach

The aim of this study was to observe the anti-ulcer effects of Cedrus deodara root oil on the rat's stomach and compare it with standard anti-ulcer drugs, femotidine and protonix. The study was conducted on 50 albino Wistar rats in three different doses i.e. 30, 40, and 50 mg/kg. The animals were divided into five groups, each group comprised of 10 rats [5 male and 5 female]. The oil was extracted from the plant root by dry destructive distillation method and the dose was calculated by dissolving 1.25 gms of Cedrus deodara in 25ml of 10% ethanol. The drugs were administered to the treated animals orally through feeding tube for two weeks. Animals received the dose of 50 mg cedar oil only, showed the healing effects on the mucosal epithelium of stomach, decreased inflammatory cells and granulation tissues on the submucosal layer upon histopathological examination. Therefore it may be concluded that Cedrus deodara root oil has anti-ulcerative effects and may be used in the management of gastrointestinal disorders particularly in peptic ulcer

effect of abietic acid [cedrus deodara compound] on the histopathology of rat stomach in comparison with ulcer healing drugs

The aim of this study is to observe the anti-ulcer effects of Abietic acid [a compound of Cedrus deodara] on the histopathology of rat's stomach in comparison with standard anti-ulcer drugs such as Femotidine [H2 receptor blocker] and Protonix [a proton pump inhibitor]. Experimental study. This study was conducted in the department of Pharmacology, Institute of Pharmaceutical Sciences, Baqai Medical University, Karachi. This study was carried out on 50 albino rats of Wistar Strain for experimental purpose. The animals were divided into five groups and each group comprised of 10 rats [i.e. 5 male and 5 female]. The experimental procedure was repeated for three times. The compound of abietic acid was provided by the chemistry department of Karachi University. The ulcer was induced in the animals by giving 1ml of 100% ethanol after 48 hrs of fasting. The induction of ulcer in animal was then treated with abietic acid [25 mg/kg for 2 weeks] orally through feeding tube. The ulcer healing effects of this compound were then compared with the effect of known anti-ulcer drugs. Abietic acid used in this study showed the healing effects on the mucosal epithelium of stomach, decreased inflammatory cells and formation of granulation tissues on the sub mucosal layer during histopathological examination. It is thus concluded that abietic acid has an anti-ulcerative effects when given in the required dose and may be adapted in the management of gastrointestinal disorders particularly in peptic ulcer