Reference range of zinc in adult population [20-29 years] of Lahore, Pakistan

To determine the reference range of zinc in adult population [age range 20 to 29 years] of Lahore. It was a descriptive cross sectional study which was carried out from Jan- August 2012 in Chemical Pathology Department of University of Health Sciences, Lahore. Serum zinc concentration was measured by name atomic absorption spectrometry in randomly selected 450 healthy adults aged 20 to 29 years. After application of exclusion criteria reference values were determined in apparently healthy subjects according to guidelines of International Federation of Clinical Chemistry. The data was entered and analyzed using SPSS version 20.0. Serum Zn levels was expressed as Mean +/- SD. A total of 450 healthy subjects were included in this study. Out of these, 234 were females. Mean age was 25 +/- 0.13years. The mean concentration of zinc in serum of healthy individual was 24.02 +/- 7.03 pol/L [rangel 1.47-36.72]. The mean +/- SD for males subjects were 22.33 +/- 6.42 pmol/L[range11.93-32.4]. Similarly the mean +/- SD for females were 21.72 +/- 7.34 pmol/L [range9.94-36.87]. This study presents reference range for serum zinc concentration in adult population of Lahore. The results showed that there is significant difference in serum level of zinc among different countries. This study will help us in establishing reference ranges of trace elements on larger population in future

Growth hormone estimation; insulin-like growth factor-1 a possible alternative

Introduction: Despite the use of growth hormone replacement therapy for decades, our ability to make a definitive diagnosis of growth hormone deficiency in children is limited. Growth hormone stimulation tests have been used to discriminate between Growth hormone deficiency and idiopathic short stature. However all these tests lack reproducibility, accuracy, cost affectivity and safety. Insulin like growth factor-1 is an effector hormone and its serum level may be used as simple, easy to perform diagnostic test for growth hormone deficiency

Objective: To determine the efficacy of IGF-1 as a diagnostic tool in children with growth hormone deficiency

Study Design: Prospective cross sectional survey

Place of Study: Departments of Pediatrics and Pathology, Shalamar Medical and Dental College, Lahore

Duration of study: 1st July to 31st December, 2011

Material and Methods: We included 40 children of 3.5 - 17 year age and detailed clinical data was collected. All these children were subjected to stimulation by standardized exercise on treadmill, after taking basal blood samples for GH and IGF-1. Post stimulation growth hormone was recorded to identify growth hormone deficient children

Results: 17 [42.5%] children had post stimulation growth hormone level <10ng/ml while 23 [57.5%] had values >10ng/ml. Post exercise stimulation GH level showed weak correlation with IGF-1 in either of the two study groups. P value was found >0.05 in deficient as well as sufficient groups, depicting non significance of IGF-1 in relation to post stimulation GH level

Conclusions: IGF-1 is not a suitable surrogate diagnostic marker for growth hormone deficiency. Diagnosis should always be based on combination of auxological biochemical, radiological and genetic considerations

Parathyroid hormone and magnesium levels in vitamin D deficient females

Vitamin D deficiency is a major health problem worldwide. In healthy subjects, vitamin D deficiency causes an increase in serum parathyroid hormone [PDH] level in response to hypocalcemia that in turn effectively restores serum calcium and phosphorus levels. However, the response in adult female in vitamin D deficient population in particular has not been studied especially in our set up. The objectives of this study were to determine the levels of iPTH and magnesium in vitamin D deficient adult females, among a sector of population living in a suburban area of Lahore. A total of 125 asymptomatic apparently healthy women [aged 20 - 60 years] were included in this study. Subjects were randomly selected from the Shalamar / Mughalpura area in Lahore. The research was started after taking permission from ethical committee of UHS. In a total of 125 subjects, 59 [47%] had deficient, 41 [33%] had insufficient and 25 [20%] had sufficient levels of vitamin D. The serum iPTH level in vitamin D deficient women was significantly higher and an inverse correlation existed between vitamin D and iPTH. Magnesium levels, on the other hand deteriorated only with severe deficiency of vitamin D. This study indicates that serum iPTH is a better marker of detection of low vitamin D states, as compared to serum calcium and phosphorus levels which remain normal. Furthermore, magnesium levels must be monitored in vitamin D deficiency because of its implications in bone metabolism, muscular and cardiac activity

Correlation of HbA[1c] with zinc and magnesium levels in patients with type 2 diabetes mellitus

To determine the plasma levels of Zn and Mg in Type 2 Diabetic patients with HbA[1c] >8% and <8% and to determine the correlation of Zn and Mg with HbA[1c]. A total population of 60 patients of Type 2 DM and 30 normal healthy control subjects were included in this study. Three ml of blood was collected in EDTA vacutainer tube [BD vacutainer] for determination of HbA[1c] and 6 ml blood was collected in EDTA vacutainer tube [BD vacutainer] for determination of Zn and Mg, HbA[1c] was performed on Bio Rad D10 hemoglobin testing system. Zn and Mg were measured on ContrAA 700 atomic absorption spectrophotometer. The age range of the patients and controls was 40 to 60 years. The mean age of the patients was 51.7 +/- 7.1 year and mean age of the control subjects was 46.7 +/- 7.2 years. Statistically significant differences were observed between levels of HbA[1c], Zn and Mg in patients and control groups [p < 0.05]. Mean Plasma Zn and Mg levels were low in Diabetic patients than in control group. We also found that diabetic patients with HbA[1c] >8% have lower levels of Zn and Mg as compared to diabetic patients with HbA[1c] <8%. A significant negative correlation of HbA[1c] with Zn and Mg was also observed. Type 2 Diabetes mellitus is associated with the deficiency of Zn and Mg. Patients with poor giycemic control have more severe deficiency of Zn and Mg than patients with good giycemic control. HbA[1c] levels correlate negatively with Zn and Mg in patients with type 2 diabetes mellitus

Serum trace elements [aluminium, copper, zinc] in hemodialysis patients

Trace element is defined as one that makes up less than 0.01% of body's mass. Those present at micro g/dl in body fluids and at mg/kg in tissues are referred to as trace elements and those found at micro g/dl in body fluids or micro g/kg in tissues are referred to as ultra-trace elements. Although these elements constitute a relatively small amount of total body tissues these are essential for many vital processes. To determine the serum level of trace elements i.e Aluminum [Al], Zinc [Zn] and Copper [Cu] in haemodialysis [HD] patients. Methods: Fifty patients of End Stage Renal disease [ESRD] on [HD] for more than three months from dialysis center of Shalamar Hospital Lahore were included in the study. Patients of acute renal failure, duration less than three months were excluded from the study. Fifteen subjects age and gender matched having normal kidney functions were included as controls. Demographic data was collected in a separate form having age, gender, cause of ESRD, duration of dialysis and viral markers. The major causes of ESRD were diabetic and hypertensive nephropathy. The mean age was 46.10 +/- 16.29 years and predominantly patients were from middle class. Mean duration of dialysis was 24.87 +/- 22.1 months and majority of the patients 40 [74.1%] were on twice weekly dialysis. Mean serum Al level was 65.44 +/- 33.41 micro g/L as compared to controls [13.20 +/- 6.155] which was statistically significant [p<0.001]. Mean serum Zn level was 59.17 +/- 32.51 micro g/L and Cu level was 35.35 +/- 31.52 micro g/L which were significantly [p<0.001] lower than controls [107.53 +/- 13.32, 107.00+11.85 micro g/L]. Duration of the dialysis had negative correlation with serum Zn level. It was significantly [p<0.02] low [44.78 +/- 33.061 micro g/L] when duration of dialysis was more than 30 months as compared to duration less than 30 months [66.36 +/- 30.174 micro g/L]. Serum levels of trace elements were significantly different in ESRD patients. Majority of patients had high Al levels and decreased Cu and Zn level. High serum Al levels in patients were due to intake of Al based phosphate binders. Decreased Zn and Cu levels were due to poor intake and dietary restriction. Duration of the dialysis had negative correlation with serum Zn level

Assessment of thyroid dysfunction in children with celiac disease

Celiac Disease [CD] is an immune response to ingested wheat gluten and related proteins of rye and barley that leads to inflammation, villous atrophy and intestinal crypt hyperplasia. 1,2 CD was considered as a rare malabsorption syndrome in the previously that can only occur in children, now it is a common condition that may be diagnosed at any age.3 The aim of this study was to assess the thyroid functions in Celiac Disease patients by measuring serum levels of free thyroxine [fT4] and thyroid stimulating hormone [TSH]. Anti thyroid peroxidase antibodies [Anti TPO] were also measured to assess the autoimmune nature of thyroid disease. Patients and Methods: It was an analytical cross sectional study, on 50 patients of celiac disease and 25 apparently healthy non celiac children were included in the study. CD patients were already diagnosed by elevated levels of serum anti tissue transglutaminase [IgA class] antibodies [>15X ULN]. CD was ruled out in control group by normal levels of serum anti tissue transglutaminase [IgA class] antibodies. TSH and fT4 were performed on Vitros ECIQ immunodiagnostic system and anti-TPO Antibodies were performed by manual ELISA technique. Mean age of the patients included in the study was 5.3 +/- 3.3 [range, 1.5-13] years. Mean age of individuals in control group was 5.8 +/- 2.5 [range, 2.0-12] years. Statistically significant increase levels of TSH and Anti TPO Antibodies were observed in the patient group. No statistically significant difference was observed between means of fT4 in patients and control group. Subclinical hypothyroidism was noticed in 10% patients of celiac disease while anti TPO Antibodies were positive in 16% patients. The present study showed an increased occurrence of thyroid dysfunction and serological evidence of thyroid autoimmunity in patients with CD. Assessment of thyroid function in patients of celiac disease is recommended at regular intervals

Comparison of action exchange HPLC and immunoturbidimetric method for determination of HbA1c

The objective of this study was to compare and correlate the analytical performance of D10 Hemoglobin Testing System based on Cation Exchange HPLC and Roche Hitachi 902 Immunoturbidimetric method. Subjects and Methods: A total of 110 patients of Type 2 Diabetes Mellitus were included in the study. HbA1c was determined using D-10 Hemoglobin Testing system and Roche Hitachi 902 Analyzer. Both methods showed good correlation with the correlation coefficient [r] of 0.95. Between run Coefficient of variance was found to be lower for HPLC system compared to immunoturbidimtric method. HPLC method also produces a chromatogram that shows the different hemoglobin fractions, allowing identification of different hemoglobin variants. In the present study both methods showed good correlation but the D10 HPLC system provided adequate throughput and improved precision as compared to immunoturbidimetric method

Child labor; determinants in Shadman market Lahore

Child Labor is any kind of work that harms or exploits the children in some way [physically, mentally, morally or blocking access to education]. Child labor is quite common in Pakistan, and is still ignored; which depicts the society's attitudes towards child care. Child labor is an ethical dilemma and special attention must be given to this issue. To determine the factors responsible for child labor in Shadman Market Lahore. Descriptive, Cross sectional. Place and duration: Shadman Colony Lahore, July-August 2010. Structured Pretested questionnaire was used to asses the factors responsible for child labor. Large family size, low income per capita and parental illiteracy were shown to be responsible for child labor. Family size, income per capita and patrental education has a large scale effect on child labor.Key words:-Child labor, Family size, income per capita, parental education

Dialysis-related factors affecting quality of life in patients on hemodialysis

Treatment modalities for end-stage renal disease affect quality of life [QOL] of the patients. This study was conducted to assess the QOL of patients on hemodialysis and compare it with caregivers of these patients. Cause of ESRD and dialysis-related factors affecting QOL were also examined. This cross-sectional study was conducted on patient on maintenance hemodialysis for more than 3 months at 3 dialysis centers of Lahore. Fifty healthy individuals were included as controls from among the patients' caregivers. The QOL index was measured using the World Health Organization QOL questionnaire, with higher scores corresponding to better QOL of patients. Eighty-nine patients [71.2%] were men, 99 [79.2%] were married, 75 [60.0%] were older than 45 years, and 77 [61.6%] were on dialysis for more than 8 months. Patients on hemodialysis had a poorer QOL as compared to their caregivers in all domains except for domain 4 [environment]. There was no difference in the QOL between the three dialysis centers of the study, except for domain 3 [social relationship] of the patients at Mayo Hospital [a public hospital], which was significantly better. Nondiabetic patients had a better QOL in domain 1 [physical health] as compared to diabetic patients. Duration of dialysis had a reverse correlation with the overall QOL. We found that QOL of hemodialysis patients was poor as compared to caregivers of the patients, especially that of diabetics. Also, duration of dialysis had a reverse correlation with QOL

Serum zinc and copper levels in nephrotic syndrome patients

To determine the serum zinc and copper levels in patients of nephrotic syndrome and healthy subjects. Forty patients of nephrotic syndrome, fulfilling the pentad criteria [proteinuria, hypoalbuminemia, hyperlipidemia, hyperlipiduria and edema] were included in this study. Proteinuria was more than 3.5g per 24 hour in adults and more than 1000 mg/m2 in children. Ten healthy subjects were included as control. Patients on dialysis, pregnancy and with proteinuria of less than 3.5g per 24 hour were excluded from the study. Patients were selected from Nephrology outpatient department of Shalamar Hospital Lahore and Children hospital and Institute of child Health Lahore. The trace metals were measured on continuous source Atomic Absorption Spectrophotometer [ContrAA700] using flame mode for Zn and Cu. The levels of serum Zn and Cu were significantly lower [28.61 +/- 24.07, 47.62 +/- 34.1 microg/dl] as compared to controls [100.8 +/- 14.8, 112.3 +/- 10.6 microg/dl] respectively. Serum Zn level and 24 hour urinary protein had negative correlation with each other which was statistically significant [r= -0.442, p= 0.021]. There was positive and significant correlation / [[r= 0.712, p= 0.001], [r=0.612, p=0.002]/ ] between serum albumin and serum Zn and serum Cu levels. The results of the present study showed that there was high prevalence of Zn and Cu deficiency in patients suffering from nephrotic syndrome. Causes of hypozincemia and hypocuperemia were hypoalbuminemia and increased twenty four hour urinary protein losses. Other probable factors were decreased dietary intake and increased loss of trace metals in urine

Importance of polymerase chain reaction in diagnosis of pulmonary and extra-pulmonary tuberculosis

Pakistan ranks 8[th] on the list of 22 high-burden tuberculosis [TB] countries in the world according to the World Health Organization's [WHO] Global Tuberculosis Control 2009. Including other reasons the main cause is improper and late diagnosis of the disease. PCR may play an important role to control the disease with its rapid, sensitive and specific diagnosis. But in Pakistan due to lake of knowledge about this latest technique we are not using this technique appropriately. Clinicians still trust on conventional methods of TB diagnosis, which are time consuming or insensitive. The present study was arranged to highlight the importance of PCR in TB diagnosis in pulmonary and extra-pulmonary cases and its comparison with conventional methods. Samples obtained from 290 patients of suspected TB [pulmonary or extra-pulmonary] were subjected to ZN smear examination, LJ medium culture and PCR test by amplifying 541bp fragment of Mycobacterium tuberculosis complex genome. The present prospective study is performed at Shalamar Hospital Lahore from November 2008 to November 2010. A distinctly difference was observed in the test results done by PCR and other conventional techniques in pulmonary or extra-pulmonary tuberculosis samples [p<0.001]. The sensitivity of different tests was 68.62% for PCR, 26.90% for LJ medium culture, and 14.14% for ZN smear examination [p<0.05]. However, there was no significant difference between different tests as for as specificity was concerned. PCR test sensitivity in pulmonary and extra-pulmonary clinical samples was 78.34 and 61.76% respectively, being significantly higher [p<0.05] when compared with sensitivity of other tests. The mean detection time for M. tuberculosis was 25 days by LJ medium culture and less than 1 day by smear examination and PCR test. PCR test is more sensitive than ZN smear examination and LJ medium culture for the diagnosis of TB in pulmonary and extrapulmonary clinical samples

Percentage of CD4[+] and CD8[+] T-lymphocytes in blood of tuberculosis patients

Tuberculosis is a fatal infectious disease, mainly caused by Mycobacterium tuberculosis. Spread of TB is controlled by cell-mediated immunity. Purpose of this study was to determine CD4[+] and CD8[+] T cell percentages in TB patients. 77 subjects consisted of 39 patients of active tuberculosis and 37 normal healthy individuals were recruited for the study. Among patients, 27 were at different stages of anti-tuberculous therapy while rests of the patients were not taking treatment. Sixteen patients were sputum positive for AFB while other patients were sputum negative for AFB. T cells percentages were determined by flow cytometer. In TB patients CD4[+] and CD8[+] T cells percentages were 34.4 +/- 9.8 and 32.0 +/- 9.8 while in controls these were 37.1 +/- 6.9 and 30.2 +/- 7.2 respectively but the difference was statistically insignificant. CD4[+] T cell percentage in newly diagnosed TB patients was 28.8 +/- 8.7 while it was 37.9 +/- 8.9 in TB patients who were on therapy and difference was statistically significant whereas difference in CD8[+] T-cell percentages was statistically insignificant. A negative correlation between CD8[+] Tcells percentage and the duration of ATT was found. CD4[+] and CD8[+] T-cells percentages may help to find out the immune status of TB patients before and after the completion of ATT

Effect of anemia and hyperhomocysteinemia on mortality of patients on hemodialysis

Anemia and hyperhomocysteinemia are risk factor of mortality of patients on dialysis. This study was conducted to assess the relationship of hemoglobin and homocysteine levels and mortality of patients on hemodialysis. Fifty patients on hemodialysis and 20 healthy individuals were enrolled in the study. Blood samples were drawn for measurement of hematological parameters, serum iron, serum ferritin, transferrin saturation, and homocysteine levels. The patients were followed up for 1 year to determine the mortality rate and evaluate its association with anemia and hyperhomocysteinemia. The majority the patients [54%] were not on erythropoietin therapy. Forty-three patients [86%] were anemic [hemoglobin < 11 g/dL]. Serum ferritin was high [> 500 ng/mL] in 33 patients [66%]. Mortality was 28% in 1 year [33% in anemic patients versus no death among patients with a hemoglobin level greater than 11 g/dL]. The relative risk of mortality was increased by 1.58 with every 1 g/dL decrease in hemoglobin level. All of the patients had a high homocysteine level, and a significant difference was observed between the homocysteine levels of the patients on hemodialysis and the control group [P < .001]. Hyperhomocysteinemia did not affect mortality. In multivariate Cox regression analysis, only hemoglobin level was associated with mortality. Almost all of our patients on hemodialysis were anemic and this condition was a risk factor of mortality. Iron stores, however, were adequate in more than half of the patients. The reason of anemia could be untreated erythropoietin deficiency. Hyperhomocysteinemia was present in the majority of the patients, but it did not independently affect mortality

Significance of appropriate sampling in the diagnosis of tuberculosis [TB] - a comparison of different techniques

After years of decline, tuberculosis [TB] has re-emerged as a serious public health problem worldwide causing significant mortality and morbidity in developing countries like Pakistan, where the estimated incidence of TB is 181 per 10000. The present prospective study was conducted in Shalamar Hospital Lahore from January 2007 to October 2009. The objective was to compare the PCR results of specific site samples and blood of the same TB patient to see the validity of PCR results based on blood samples. Clinical samples obtained from 205 patients of suspected TB [pulmonary or extra-pulmonary] were subjected to ZN smear examination, LJ medium culture, and PCR test by amplifying 541 fragment of Mycobacterium tuberculosis complex genome. A highly significant difference was seen in the test results clone on samples obtained from specific site according to disease and blood samples of the same patient infected with pulmonary or extra-pulmonary tuberculosis. The sensitivity of different tests was found to be significantly different, which was 67.32 percent for PCR test, 27.81 percent for LJ medium culture and 12.20 percent for ZN smear examination. However, there was no significant difference between different tests as far as specificity was concerned. PCR test sensitivity in pulmonary and extra-pulmonary clinical samples was 77.15 and 61.6 percent respectively, being significantly higher, when compared with sensitivity of other tests. The mean detection time for M. tuberculosis was 24 days by LJ medium culture and less than 1 day by .smear examination and PCR test. We concluded that the PCR test is more sensitive than ZN smear examination and LJ medium culture for the diagnosis of TB in pulmonary and extra-pulmonary clinical samples. To get more accurate results PCR for TB diagnosis should be done on specific site samples. Blood samples are not appropriate for the diagnosis of TB by PCR when the PCR is clone on TB genomic DNA

Evaluation of four ELISA based immunoassays for the detection of IgM antibodies against dengue virus

Dengue fever is a problem of serious concern which is mainly transmitted by mosquito, Aedes aegypti. These days' different ELISA kits are used for the diagnosis of dengue fever. It was a validation study. Study was conducted in the Department of Immunology at University of Health Sciences, Lahore during the period of August 2009 to October 2009. In this study four ELISA kits [Human, Nova Tech, Vircell and DRG] were used to determine IgM antibodies against dengue fever in forty four patients who were labelled positive for dengue fever by different commercially available ELISA kits. Human ELISA kit gave most accurate results with respect to the agreement, sensitivity, specificity and K value. Human ELISA kit was found most reliable for the diagnosis of dengue fever

Sex hormones and erectile dysfunction in hemodialysis patients

To determine the prevalence of Erectile Dysfunction [ED] in hemodialysis patients [HD] and to study the associated changes in sex hormones in these patients. This is a hospital based cross sectional study conducted at hemodialysis units of Shalamar and Mayo Hospitals, Lahore from January to March 2008. All male patients with ESRD on maintenance [HD], whose spouses were alive and able to perform intercourse, were included in the study. Patients with cognitive and communication deficits were excluded from study. International index of erectile function-5[IIEF-5], adopted in Urdu was used for determination of prevalence of ED. Demographic data was collected and sex hormones [total testosterone, Dihydroepiandrosteronediones [DHEA], Follicle Stimulating Hormone [FSH], Leutinizing Hormone [LH] and serum Prolactin] were measured. A total number of fifty patients were included in the study. The major cause of ESRD was diabetes mellitus 28 [56%]. The prevalence of ED was 86% with a mean IIEF-5 score 10.36 +/- 7.13. The majority of patients, 33 [66%], were suffering from a severe degree of ED. The total testosterone level was low in 30 [60%] patients and DHEA were low normal in most of patients, 46 [92%]. Compared to patients with non-ED, those with ED had a significantly lower DHEA [1.93 +/- 0.73 vs 0.81 +/- 0.11, p value = 0.007]. Total testosterone and DHEA had a negative correlation with age and diabetes mellitus. FSH showed a variable response in these patients, it was low [< 1.55 mIU/ml] in three, normal [1.55 +/- 9.74 mIU/ml] in 39 and high [> 9.74 mIU/ml] in eight patients. LH was low [< 1.2 mIU/ml] in two, normal [1.2 +/- 7.8 mIU/ml] in thirty three and high [> 7.8 mIU/ml] in fifteen patients. FSH and LH showed a positive correlation with duration of dialysis. Prolactin level was low in 21[42%] patients. Total testosterone, FSH, LH and Prolactin had no association with ED. The majority of the patients suffering from ESRD, on maintenance HD had ED. DHEA was significantly lower in patients with ED, compared to those with no-ED. Total testosterone and DHEA had an inverse relationship with diabetes and age of the patients. Total testosterone, FSH, LH and prolactin did not affect erectile function

Lead exposure in children living around the automobile and battery repair workshops

The aim of this study was to screen children 1-12 years of age for lead exposure living around automobile and battery repair workshops. A total of 190 children living in one kilometer areas around the automobile and battery repair workshops were selected from houses and schools. These were divided into two groups: group A comprised of the children living around the automobile repair workshops and group B comprised of the children living around the battery repair workshops. Among the 190 children, 115 [60.5%] were males and 75 [39.5%] were females. The mean age of the children was 8.7 years. Majority of the children was less than 4 years of age [55.8%]. The blood lead levels were between the range of 1.3 - 34.2 mg/dl [mean 11.4 mg/dl]. Children living around the battery repair workshops [mean +/- SD 12.85 +/- 6.02] had high blood lead levels [p 0.020] as compared to the children living around the automobile repair workshops [mean +/- SD 10.19 +/- 6.13]. There was a significant negative correlation of blood lead levels and haemoglobin [r = - 0.400 and p 0.001]. Children living around automobile and battery repair workshops had significantly high blood lead levels according to WHO and CDC criteria. Blood lead level [BLL] is a good screening and diagnostic test for the assessment of lead exposure in children living in lead contaminated high risk areas

Depression in hemodialysis patients

To measure the frequency of depression and its risk factors in patients under going hemodialysis. It is a cross-sectional prospective study conducted at Hemodialysis unit of Shalamar Hospital and Shaikh Zayed Hospital, Lahore from 1[st] January 2006 to 30[th] April 2006. All patients getting regular hemodialysis for more than three months were included. Beck's Depression Inventory- II [BDI-II; adapted in Urdu] was administered on all the patients who were able to read or understand it. Blood sample were drawn at the same time for routine hematological, biochemical parameters and viral markers [Anti HCV and HbsAg]. Diagnosis was made as per Diagnostic and Statistical Manual of Mental Disorders, fourth edition [DSM IV] for correlation of psychological variables with clinical, hematological and biochemical parameters. Eighty nine patients were enrolled which included fifty two [58.4%] were male and seventy seven [86.5%] were married. Major causes of renal failure were diabetes, hypertension and chronic glomerulonephrotis. Duration of dialysis was from 03 to 49 months with mean of 19.64 +/- 11.7 months. Severity of depression was categorized in to mild, moderate and severe on the basis of BDI score. Majority of the patients fifty [56.1%] were moderately to severely depressed and there was no gender difference in the prevalence of depression. Majority of patients undergoing hemodialysis were depressed. Major risk factors for depression were marital status, illiteracy, number of children, socioeconomic factors, gender, hypertension and hypoalbuminemia. Patients with anemia, hyponatremia and hyperkalemia had suicidal tendency. Patients with hepatitis C and disturbed liver function have strong correlation with psychological parameters

Prevalence of hepatitis b surface antigen and anti hepatitis C virus; among general population in Lahore

Objective: To assess and compare the prevalence of hepatitis B and C in normal population. Design: This is a descriptive, non-interventional study. Setting: Data was collected from a free screening camp for hepatitis B and C at Shalamar Hospital, Lahore

Subjects and Methods: Normal people of any age and either sex were included in the study. Screening was performed for HBs Ag and Anti HCV by Acu-Check one step test [Chromatographic immunoassay] in serum

Results: A total 757 subjects were screened. Prevalence of HBs Ag was 2.6% and Anti HCV 13.5%. The mean age was 24.96+ 14.67 years. Females were 55.2% and males were 44.8%. Seroprevalence in females and males of Hbs Ag was 2.2% and 3.2% and of Anti HCV 15.6% and 10.9% respectively. HBs Ag was more prevalent in younger population [up to 10 years]. The majority of Anti HCV positive subjects were in 31-50 years age group

Conclusion: Seroprevalence of HBs Ag and HCV is high in general population. Prevalence of HCV is very high in this region and HBV is very high in children up to 10 years of age. Larger population based studies are needed to confirm the results