Amino acid racemization in human detine as an estimator of chronological age - a study in Karachi Pakistan

Background: Amino acid racemisation is a reliable method to estimate age in developed countries. This pilot study was designed to determine the coefficient of amino acid racemisation [AAR] with reference to age in our population. Also as no such study has been conducted in our setting, the study also aims to discuss reproducibility of this study on a larger scale

Objectives: To determine the coefficient of amino acid racemisation [AAR] with reference to age; To measure the mean error in calculating age using this method; To identify any differences from earlier observation and discuss the reproducibility in our setting

Methods: Teeth were obtained from subjects between the age of 15 and 60 years who had come for routine extraction procedure or for orthodontic procedures. Incisors, canines, premolars and, first and second molars were included. Carious tooth and third molar were excluded. Samples were stored, dried, de-mineralised, hydrolysed, and derivatised. High-Pressure Liquid Chromatography [HPLC] was performed to quantify the L- and D- forms of aspartic acid in dentin. Correlation and regression was then tabulated based on the quantification, and was compared with data from other studies

Results: Based on the analysis of selected samples, a strong positive correlation of 0.93 was observed between co-efficient of racemisation and chronological age. The regression line derived was Age = 200 [KR] + 17.306 [where KR= coefficient of racemisation].The computed regression line was tested by using coefficient of racemisation for 8 samples selected during the study and the mean error [difference between actual and calibrated age] determined came out to be 3.99 +/- 5.77

Conclusion: The correlation coefficient was strongly positive. The results strongly suggests that aspartic acid racemisation of human dentine is a precise method for estimation of chronological age in living and in dead. The methodology should be standardized to make the results more accurate and prevent fallacies. However it remains an expensive procedure, especially the laboratory equipment that would not be available in most cities of Pakistan

Variation in serum vitamin D levels in healthy population of Islamabad

Objective: To determine the levels of Vitamin D in apparently healthy population of Islamabad

Study design: A Descriptive Study

Place and duration: From March 2012 to April 2013 at Rawal Institute of Health Sciences, Islamabad

Methodology: Two hundred and ninety nine healthy subjects were selected between the age of 10-85 yrs. Convenient sampling was done. Subjects with complain of bone pain, musculoskeletal or rheumatologic problems, pregnant and lactating mothers, smokers or alcoholics were excluded from the study. History was taken and Blood samples were collected and stored at -80[degree]C for estimation of Vitamin D levels in batches. Vitamin D level was determined by ELISA technique [Enzyme linked immunosorbant assay] after standardizing it and controls were run simultaneously. The data was collected and analyzed on SPSS version 17.Percentage was determined and Chi square test applied on data

Result: Vitamin D levels of 299 subjects were categorized according to deficiency and insufficiency criteria specified [Roche]. The study shows that 65.2% [n =195] subjects were deficient in Vitamin D, 26.09% [n = 78] were insufficient and only 8.7% [n=26] had normal 25 OH Vitamin D levels

Conclusion: The subjects in the population are suffering from hypovitaminosis D. The cause of vitamin D deficiency remains an area of concern, when availability of sunlight is adequate especially in asian population

Visfatin and its relationship with the severity of coronary artery disease in Pakistani population

To determine plasma visfatin in patients with and without coronary artery disease and to correlate it with the coronary vessels blockage by using anagiography. Comparative Cross Sectional Study. This study was conducted at the Department of Biochemistry, Ziauddin University and Jinnah Medical and Dental College, Karachi from June 2009 to November 2010. The study includes 80 subjects [mean age 48.8 +/- 6.15; 40-55 years age range] who underwent coronary angiography for suspected coronary artery disease. Plasma visfatin levels were determined by using ELISA. Out of these 80 study subjects, 30 [37.5%] had single vessel CAD, 12 [15%] had two vessels CAD, 24 [30%] had three vessels CAD and 14 [17.5%] had non significant disease. Serum Visfatin levels were higher in three vessel disease [5.82 +/- 0.58] when compared with non significant [4.55 +/- 1.10] single vessel disease [4.86 +/- 0.93] and two vessels disease [5.53 +/- 0.79] respectively but these values were statistically nonsignificant in all four study groups. Serum Visfatin levels were high in all three study groups when compared with non significant disease group and positive correlation of serum visfatin with the extent of the coronary artery disease was observed

Comparison of serum adiponectin and interleukin 6 concentrations in nondiabetic hypertensive and diabetic hypertensive patients who developed cerebral infarct

Stroke is the second leading cause of death and a major cause of morbidity and mortality in western as well as developing countries. Adiponectin is a fat-derived plasma protein that has beneficial actions on cerebrovascular disorders. A low level of plasma adiponectin is associated with increased mortality after ischemic stroke. Interleukin 6 is a cytokine, which is elevated in inflammatory, traumatic and ischemic injuries. The objective of this study was to compare serum adiponectin and interleukin-6 levels in diabetic hypertensive and nondiabetic hypertensive patients and to measure the size of cerebral infarct. 89 patients [30 controls, 30 nondiabetic hypertensive and 29 diabetic hypertensive] were recruited in the study according to inclusion criteria of Ziauddin University Hospital. Serum adiponectin and interleukin 6 concentrations were measured by ELISA. Blood glucose and lipid profile was done by standard kit methods. Serum adiponectin concentration was significantly lower [P<0.05] in both study groups and interleukin 6 was significantly higher [P<0.05] in diabetic hypertensive group as compared with controls. The mean serum interleukin 6 in diabetic hypertensive patients with cerebral infarct was significantly higher than that of nondiabetic hypertensive patients with cerebral infarct [P< 0.001]. Serum adiponectin concentration was decreased while the infarct size was larger in diabetic hypertensive group as compared to nondiabetic. Hypertensive group but the difference in these parameters was statistically non significant. Hence the study supports to the evidence of involvement of adiponectin and interleukin 6 in patients of stroke

Circulating leptin levels in elderly subjects with and without cerebrovasular disease

Serum concentrations of leptin was investigated in 40 patients with ischemic stroke, in context of the size of the lesion and also in 40 non-diseased control, matched according to age, gender and waist hip ratio. Serum leptin concentrations were determined in ng/ml with ELISA and computer tomography [CT] scan was performed in patients to estimate lesion size in cms. Serum leptin concentrations were found to be significantly higher [p < 0.001] in stroke patients [51.61 +/- 1.39], compared with controls [37.76 +/- 1.207]. Moreover, positive correlation [r=0.93] existed between serum leptin level and infarction size in patients with stroke

Perception of medical students on structured viva examination in an integrated undergraduate curriculum at Ziauddin University

Exponential growth of knowledge in the biomedical field has forced the medical educators for a change from traditional to integrated curriculum and conventional assessment techniques to newer structured techniques. Survey of medical students' views about the Structured Viva Examination [SVE] in an integrated curriculum. Feedback forms of Structured Viva Examination [SVE] were given to 144 students of first and second year MBBS [2008], after they completed their professional examination. SVE feedback form was categorized in the domains of agree, disagree and neutral with five different statements. Out of 144 students 140 responded. One hundred and thirteen out of hundred and forty [80.71%] students agreed that the language of the cases was simple and easy to understand. One hundred and ten [78.57%] stated that the reading time of cases was adequate. One hundred and seven [76.42%] agreed that the time was adequately spaced between SVE stations. Hundred and one [72.14%] agreed that the examination was relevant with course content, while one hundred and two [72.85%] agreed that PEL in modules helped in interpreting such cases in their annual examinations. Educators need to explore newer assessment methods for better understanding of the health sciences with relevance to common disease

Adiponectin and infarction size in subject with and without cerebrovascular disease

To investigate whether hypo-adiponectinemia is present in ischemic stroke patients. This comparative study was carried out in the Biochemistry Department, Ziauddin University, Karachi, Pakistan in 2008. In this study, plasma adiponectin concentration was measured by an enzyme-linked immunosorbent assay in subjects with and without ischemic cerebrovascular disease [CVD]. A total of 80 subjects were studied [40 patients with CVD, and 40 without CVD as controls]. The mean plasma level of adiponectin of the 40 patients with ischemic CVD was significantly lower than that of the 40 subjects without CVD [4.36 +/- 0.21 ug/mL versus 6.97 +/- 0.241 ug/mL; p=0.000]. Decreasing concentrations of adiponectin were negatively correlated with infarction size in ischemic CVD patients. These data show that there are significantly lower levels of plasma adiponectin in patients with ischemic CVD. Moreover, adiponectin is negatively correlated with infarction size in these patients suggesting the possible role of adiponectin in cerebrovascular disease

Pattern of prostatic carcinoma metastases in bones detected by bone scans using technitium[99m] methyl diphosphate [TC[99M] MDP] imaging technique

To determine the pattern of bone secondaries in prostatic carcinoma patients using Technitium 99m Methyl Diphosphate [TC99m MDP] imaging technique. Retrospective study. Ziauddin Hospital, Karachi from 1998 to 2004. The study included 135 subjects, which were divided into four groups according to age. Patients with biopsy proven prostate carcinoma under went total body bone scan in different positions, five anterior and five posterior views, skull, chest, pelvis, knee and foot for the evaluation of metastases at the time of diagnosis. Bone scans were interpreted by the nuclear medicine consultant as negative or positive for skeletal metastases, or as intermediate. 135 subjects were analyzed. They were divided into four groups according to age. Group A comprised of 25 subjects of age 30 to 39 years. Out of them 18 were positive for bone secondaries. Group B comprised of 30 subjects from 40 to 49 years. Out of them 21 were positive for bone secondaries. Third group i.e. C comprised of 50 to 59 years of age. Out of 49 subjects 36 were positive for bone secondaries. Group D was from 60 years and above in which 31 subjects were analyzed. Out of them 23 were positive for bone secondaries. The most common site involved was dorsal vertebrae in which 44 [32%] secondaries were isolated. Shoulder joint 38 [28%] and sacroiliac joint 29 [21%] were the second and third most commonly affected areas respectively. Other sites involved were skull, sacrum, lumber vertebrae, ileum, mandible, femur, sternum, cervical vertebrae, iliac crest, scapula, hip joint, tibia and pelvis. This study focuses on pattern of prostate carcinoma metastases to various bony sites. Metastases are common in age group 50 to 59 years and above 60 years while the most common site involved is dorsal vertebrae followed by shoulder joint and sacroiliac joint

Adiponectin! obesity and coronary artery disease

Plasma adiponectin rapidly accumulates in the subendothelial space of the injured human artery. Plasma concentrations of adiponectin are reduced in the setting of obesity in patient with non-insulin dependent diabetes mellitus, and in patients with coronary artery diseas [CAD] Several studies have been carried out on animals and recently in humans also to it vestigate the role of adiponectin in obesity and insulin resistance leading to coronary artery disease

Comparison of troponin T and enzyme levels in acute myocardial infarction and skeletal muscle injury

The objective of this study was to compare the levels of troponin T and enzymes levels in myocardial infarction and skeletal muscle injury. This study was carried out at Basic Medical Sciences Institute, JPMC Karachi, Pakistan. Ninety subjects were selected. Thirty controls, thirty patients suffering from myocardial infarction and thirty suffering from skeletal muscle injury were selected from National Institute of Cardiovascular Diseases. Creatine kinase, aspartate amino-transferase, lactate dehydrogenase and Troponin T were determined by kit methods. Troponin T level rises significantly [p<0.01] in patients suffering from myocardial infarction. Creatine kinase [CK], CKMB, aspartate aminotransferase and lactate dehydrogenase levels rises significantly [p<0.01] in both groups compared with controls. Troponin T is an early indicator of myocardial infarction and is superior to CKMB in diagnosis of myocardial injury. There is no increase in troponin T levels in skeletal muscle injury

Biochemical parameters for detection of haemmolysis in pregnancy induced hypertensive

A study on biochemical parameters for detection of haemolysis in pregnancy induced hypertensive [PIH] women was carried out in gynaecology units of Civil Hospital and Jinnah Postgraduate Medical Centre, Karachi. One hundred and fourteen cases were studied. Among them thirty were normal non pregnant women, thirty normal pregnant women, twenty seven pre-eclamptic and twenty seven eclamptic women. Serum bilirubin, lactate dehydrogenase, aspartate aminotransferase levels were determined for detection of haemolysis in PIH women and then compared with controls. Highly significant rise was observed in serum levels of bilirubin, lactate dehydrogenase and aspartate aminotransferase in PIH women as compared to non pregnant and pregnant women. Early detection of haemolysis by these parameters can prevent the patients from going into HELLP syndrome ie syndrome of haemolysis, elevated liver enzymes and low platelet count

Serum uric acid: a predictor of hellp syndrome

The study was conducted to determine the changes in uric acid level in pre-eclamptic and eclamptic women. One hundred and fourteen females of reproductive age group 15-45 years were included in the study. The study group comprised of 27 pre-eclamptic and eclamptic women each and the control group consisted of 30 pregnant and 30 non pregnant women. All pregnant women included in the study were in third trimester of pregnancy. Serum uric acid was determined by kit method. Uric acid level increases highly significantly in pre-eclamptic and eclamptic women as compared to control groups. The study concluded that uric acid can be an economical biochemical parameter in pre-eclamptic patients and is the predictor of HELLP syndrome in eclamptic women

Gamma Glutamyl transferase [GGT] activity in pregnancy induced hypertensive women

To find out the activity of gamma glutamyl transferase [GGT] in pregnant as well as pregnancy induced hypertensive women. Design: Case control study of one hundred and fourteen cases over a period of one year. Setting: Study was carried out in biochemistry department Basic Medical Sciences Institute [BMSI] J.P.M.C., Karachi. Samples were collected from Gynae Units of Civil and Jinnah Hospital, Karachi. Subjects: The study included thirty non pregnant, thirty normal pregnant, twenty seven preeclamptic and twenty seven eclamptic women. Main outcome measures: GGT activity in non pregnant, pregnant and pregnancy induced hypertensive women. GGT activity decreases highly significantly in normal pregnant women as comapred to non pregnant women. [control group]. GGT activity in preeclamptic and eclamptic women increases highly significantly as comapred to control group and increases significantly and markedly significantly in preeclamptic and eclamptic women respectively as compared to control group. GGT is better and earlier indicator of detection of patients going into pregnancy induced hypertension and HELLP syndrome