Nephrotoxic effects of Valeriana wallichii

Aminoglycosides are the commonly used antibiotics against Gram negative bacteria. Their clinical applications are limited due to nephrotoxic side effects. Therefore, the current study was undertaken in an attempt to increase the use of these drugs without causing nephrotoxicity by exploring the nephroprotective effects of a medicinal plant with high flavonoid contents and strong antioxidant properties, namely Valeriana wallichii. A daily dose of 200mg/kg of the extract derived from V. wallichii was employed for a period of three weeks. The results obtained revealed that co-therapy of extract with gentamicin protected some changes in renal functions; however, failed to provide a complete protection as assessed by biochemical, physiological and histological parameters. It can be concluded from the current findings that V. wallichii failed to deliver protective effects against gentamicin induced renal damage in spite of strong flavonoid contents and antioxidant properties

Phenotypic and metabolic dichotomy in obesity: clinical, biochemical and immunological correlates of metabolically divergent obese phenotypes in healthy South Asian adults

<p><b>INTRODUCTION</b>Metabolic heterogeneity among obese individuals is thought to translate into variations in cardiovascular risk. Identifying obese people with an unfavourable metabolic profile may allow preventive strategies to be targeted at high-risk groups. This study aimed to identify clinical, biochemical and immunological differences between insulin-sensitive and insulin-resistant obese subgroups, to understand the population-specific pathophysiological basis of the adverse cardiovascular risk profile in the latter group.</p><p><b>METHODS</b>Cardiovascular risk indicators, including anthropometric parameters, blood pressure, acanthosis nigricans area, and related biochemical, endocrine and inflammatory markers, were determined in 255 healthy South Asian volunteers aged 18-45 years, with a 2:1 ratio of obese/overweight to normal-weight individuals. Lifetime atherosclerotic cardiovascular disease (ASCVD) risk was also calculated.</p><p><b>RESULTS</b>Body mass index (BMI) and insulin sensitivity-based tertiles independently showed incremental trends in waist-hip ratio, skinfold thickness, acanthosis nigricans area, blood pressure, serum lipids, hepatic enzymes, adipokines, inflammatory markers and ten-year ASCVD risk. The anthropometric, biochemical and inflammatory parameters of obese insulin-sensitive and obese insulin-resistant groups differed significantly. Extreme group analysis after excluding the middle tertiles of both insulin resistance and BMI also showed significant difference in anthropometric indicators of cardiovascular risk and estimated lifetime ASCVD risk between the two obese subgroups.</p><p><b>CONCLUSION</b>Obese insulin-sensitive individuals had a favourable metabolic profile compared to the obese insulin-resistant group. The most consistent discriminative factor between these phenotypic classes was anthropometric parameters, which underscores the importance of clinical parameters as cardiovascular risk indicators in obesity.</p>

Incidence and risk factors of pulmonary complications after cardiopulmonary bypass

Objective: To determine the frequency of post-operative pulmonary complications [PPCs] after cardio-pulmonary bypass and association of pre-operative and intraoperative risk factors with incidence of PPCs

Methods: This study was an observational analysis of five hundred and seventeen [517] patients who underwent cardiac surgery using cardiopulmonary bypass. Incidence of PPCs and risk factors of PPCs were noted. Logistic regression was applied to determine the association of pre-operative and intraoperative risk factors with incidence of PPCs

Results: Post-operative pulmonary complications occurred in 32 [6.2%] patients. Most common postoperative pulmonary complication was atelectasis that occurred in 20 [3.86%] patients, respiratory failure in 8 [1.54%] patients, pneumonia in 3 [0.58%] patients and acute respiratory distress syndrome in 1 [0.19%] patients. The main risk factor of PPCs were advance age > 60 years [odds ratio 4.16 [1.99-8.67], p-value <0.001], prolonged CPB time > 120 minutes [odds ratio 3.62 [1.46-8.97] p-value 0.003], pre-op pulmonary hypertension [odds ratio 2.60 [1.18-5.73] p-value 0.016] and intraoperative phrenic nerve injury [odds ratio 7.06 [1.73-28.74], p-value 0.002]. Operative mortality was 9.4% in patients with PPCs and 1.0% in patients without PPCs [p-value 0.01]

Conclusion: The incidence of post-operative pulmonary complications was 6.2% in this study. Advanced age [age > 60 years], prolonged CPB time [CPB time > 120 minutes], pre-op pulmonary hypertension and intraoperative phrenic nerve injury are independent risk factors of PPCs after surgery

Conservation of indigenous knowledge of medicinal plants of Western Himalayan region Rawalakot, Azad Kashmir, Pakistan

The aim of present was to document indigenous knowledge of medicinal plants traditionally used by inhabitants of Rawalakot Azad Kashmir and to screen selected medicinal plants for their antibacterial potential. Several field surveys were conducted to document indigenous knowledge of medicinal plants through interviews from local inhabitants during 2010-2013. During the study, 58 plant species, belonging to 37 families, were identified and their medicinal uses were recorded. Ethnobotanical data indicates that inhabitants of Rawalakot use medicinal plant mainly for the treatment of stomach, liver and sexual disorders. Usually fresh plant materials were used for medicinal preparations and administrated orally. Among all the species studied, three most frequently used medicinal plants Achillea millefolium, Berberis lycium and Zanthoxylum armatum were screened for their antibacterial potential by using disc diffusion method. The crude aqueous, petroleum ether and ethanolic extracts were found to be very active against selected bacterial strains. The present study contributes significantly to the medicinal plant knowledge and shows that medicinal plant knowledge is deteriorating among younger generations. Therefore, further research is needed to document indigenous knowledge, to find conservation status of medicinal plant species and to find antimicrobial compounds for more sophisticated usage of medicinal plants in future

Effects of deltamethrin treated uniform on malaria prophylaxis in troops of Bahawalpur garrison

Objective: To determine the efficacy of deltamethrin treated uniforms on repellant action against mosquitos in serving soldiers

Study Design: Randomized control trial

Place and Duration of Study: Bahawalpur Garrison, from 18 Aug to 24 Aug 2014

Patient and Methods: Two groups were selected for the study, one group comprising of 100 x soldiers wearing deltamethrin treated uniforms and other group comprising 100 x soldiers wearing non-treated [normal working] uniforms-control group. All soldiers were males, their age ranged from 20 years to 41 year. Uniforms were issued centrally with no group knowing which group has been issued treated uniforms, [double blind study was carried out to eliminate subject bias]. Coding system was evolved while issuing the uniforms which were only known to the main researchers, president of the study board. Both the groups were made to sit for one hour in a large training ground of the formation in two separate groups at a distance of 50-60 feet between the groups and 10-15 feet between the individuals. All the individuals were asked to count the number of mosquitos attracted towards them, whether sitting/biting on their uniforms or on their bodies. Mosquito counting was also facilitated by the organizing/conducting staff. The study continued for a week from 18-24 Aug 2014. All soldiers were given 2 x tabs Chloroquine stat as prophylaxis for malaria prior to the study. Mean and SD of no of bites of both groups were compared and analyzed. Student t-test was applied to note the statistical significance among the study groups

Results: Out of the two groups the individuals wearing deltamethrin treated uniforms showed about overall 90% protection from mosquitos as compared to the control group. The average number of bites by mosquitoes in the control group was 7/person in one hour, whereas it was less than one bite/person in the case group

Conclusion: This study confirmed that the deltamethrin treated uniform is highly effective in having mosquito repellant action in the field and may be used during operational/training duties in the field so as to better protect the troops against this health hazard

Preventive Gabapentin versus Pregabalin to Decrease Postoperative Pain after Lumbar Microdiscectomy: A Randomized Controlled Trial

STUDY DESIGN: Randomized controlled trial. PURPOSE: The purpose of this study was to compare pregabalin and gabapentin for mean postoperative visual analog score (VAS) for pain in patients undergoing single-level lumbar microdiscectomy for intervertebral disc prolapse at a tertiary care hospital. OVERVIEW OF LITERATURE: Pregabalin has a superior pharmacokinetic profile and analgesic effect at lower doses than gabapentin; however, analgesic efficacy must be established during the perioperative period after lumbar spine surgery. METHODS: This randomized controlled trial was carried out at our institute from February to October 2011 on 78 patients, with 39 participants in each study group. Patients undergoing lumbar microdiscectomy were randomized to group A (gabapentin) or group B (pregabalin) and started on trial medicines one week before surgery. The VAS for pain was recorded at 24 hours and one week postoperatively. RESULTS: Both groups had similar baseline variables, with mean ages of 42 and 39 years in groups A and B, respectively, and a majority of male patients in each group. The mean VAS values for pain at 24 hours for gabapentin vs. pregabalin were comparable (1.97±0.84 vs. 1.6±0.87, respectively; p=0.087) as were the results at one week after surgery (0.27±0.45 vs. 0.3±0.46, respectively; p=0.79). None of the patients required additional analgesia postoperatively. After adjusting for age and sex, the VAS value for group B patients was 0.028 points lower than for group A patients, but this difference was not statistically significant (p=0.817, R²=0.018). CONCLUSIONS: Pregabalin is equivalent to gabapentin for the relief of postoperative pain at a lower dose in patients undergoing lumbar microdiscectomy. Therefore, other factors, such as dose, frequency, cost, pharmacokinetics, and side effects of these medicines, should be taken into account whenever it is prescribed.

Biosynthesis, characterization and antimicrobial action of silver nanoparticles from root bark extract of Berberis lycium Royle

Various biological methods are being recognized for the fabrication of silver nanoparticles, which are used in several fields. The phytosynthesis of nanoparticles came out as a cost effective and enviro-friendly approach. When root bark extract of Berberis lycium was treated with silver ions, they reduced to silver nanoparticles, which were spherical, crystalline, size ranged from 10-100nm and capped by biomolecules. Synthesized silver nanoparticles were characterized by UV-visible spectroscopy, Scanning Electron Microscopy [SEM], Energy Dispersive X-ray Spectroscopy [EDX], Transmission Electron Microscopy [TEM], X-Ray Diffraction [XRD] and Fourier Transform Infra Red Spectroscopy [FTIR]. The plant mediated synthesized silver nanoparticles showed pronounced antimicrobial activities against both Gram negative bacteria [Escherichia coli, Klebseilla pneumoniae, Pseudomonas aeruginosa] and Gram positive bacteria [Staphylococcus aureus and Bacillus subtilis]. The plant mediated process proved to be non-toxic and low cost contender as reducing agent for synthesizing stable silver nanoparticles

Frequency of nutritional vitamin D deficiency in children 6 months to 5 years of age presenting with rickets at civil hospital, Karachi

Objective: to determine the frequency of Vitamin D deficiency in children presenting with rickets

Methods: descriptive case series was conducted at the department of Paediatrics Unit III, Dow University of Health Sciences and Civil Hospital Karachi in children 6 months to 5 years of age presenting with clinical rickets. Children taking vitamin D were excluded. The subjects fulfilling inclusion criteria were enrolled after informed consent. Blood samples were taken from each patient and were sent to the laboratory for vitamin D [25[OH] D] level. Serum level of vitamin D less than 20ng/ml was labeled as vitamin D [25[OH] D] deficiency rickets. The data was collected on pre-designed performa by the principal researcher. The data was analyzed using SPSS version 10

Results: the age of enrolled participants was 1.5 +/- 1 year. Of 159 enrolled participants, 91 [57.2%] were male and 68 [42.8%] were female. Frequency of sun exposure of 2-3 days a week was 97 [61.01%] and using vitamin D fortified foods were 34 [21.38%]. The frequency of vitamin D deficiency was 120 [75.47%] cases

Conclusion: in this study the frequency of vitamin D deficiency in children 6 months to five years with rickets was 75%

Blood glucose, cholesterol, body mass index and systemic blood pressure in psychiatric patients attending a tertiary care hospital of sindh

Objective: The present observational study was conducted to determine the blood glucose, body mass index, blood pressure and serum cholesterol in psychiatric patients

Study Design: Observational study

Place and Duration of Study: This study was carried out at Psychiatric Clinic, Department of Medicine, Indus Medical College, Tando Muhammad Khan, Sindh from June 2014 to January 2016

Materials and Methods: A sample of 275 new cases suffering from different Psychiatric disorders was selected

Diagnosis of Psychiatric disorders was made by a consultant Psychiatrist. Body weight, height and systemic blood pressure were measured by standard methods. Willing participants were asked to sign a proforma of consent for ethical issues. Data was entered on excel sheet and copied to the SPSS 22.0 for statistical analysis. Analysis was performed at P value of < 0.05

Results: Mean +/- SD age was noted as 47 +/- 11.97 years [p = 0.02]. Male to female ratio was 1.83 vs. 1.0 [p=0.0001]. BMI > 30 was noted in 26.5% of subjects. Of 275 study subjects, normal blood glucose was noted in 79.6% while 20.3% of psychiatric patients showed raised blood glucose levels. Normal and raised blood cholesterol was noted in 65.09% and 34.9% respectively. Psychiatric disorders were correlated with blood glucose and blood cholesterol levels

Conclusion: Psychiatric disorders are a risk factor for raised blood glucose, blood cholesterol, BMI and Systemic hypertension; this predisposes patients for diabetes mellitus and associated morbidities

Frequency of Congenital Hypothyroidism [CH] in Neonates of a Tertiary Care Hospital of Karachi, Pakistan

Objective: To determine the frequency of congenital hypothyroidism among healthy newborns presenting to a public health facility in Karachi, Pakistan

Methods: This cross sectional study was carried out for six months duration at the Well Baby Clinic, Paediatric unit III, Civil hospital Karachi. Neonates of both sex delivered after 37 weeks of gestation, at Civil Hospital Karachi and visited the well baby clinic, after 48 hours of birth to <4 weeks of age for follow up were included in the study. A 3 cc venous blood sample taken for serum Thyroid Stimulating Harmone [TSH] level. Data analysis was done using SPSS statistics version 16

Results: A total of 215 healthy newborns were included, 112 were male and 103 female patients

Congenital hypothyroidism was considered according to the TSH value. The results showed that 35 patients had TSH >40 [microU/ml]

Conclusion: This study shows that in the screening for the congenital hypothyroidism, 16.3% had a TSH level of >40 [microU/ml]

This suggests that screening of hypothyroidism should be mandatory in all newborns especially in our region for early diagnosis and treatment of congenital hypothyroidism

Mean platelet volume as an indicator of glycemic control in type 2 diabetes mellitus

Objective: To study platelet counts [PC], mean platelet volume [MPV] and glycated HbA1 in type 2 Diabetes mellitus [T2DM]

Study Design: Case control study

Place and Duration of Study: This study was conducted at the Department of Medicine, Indus Medical College Hospital, Tando Muhammad Khan, Sindh from March to November 2015

Materials and Methods: A sample of 150 subjects; comprising of Group A- controls [n=50], Group B- controlled diabetics [n=50] and Group C- [n=50] uncontrolled diabetics. DM was diagnosed according to American Diabetes Association. Permission was taken from ethics review committee of institute. Only willing subjects were included after they signed consent proforma voluntarily. Blood pressure, BMI, Blood glucose, Platelet counts, MPV and HbA1c were determined Data was typed on Microsoft excel, and then pasted SPSS 22.0 sheet for statistical analysis. Chi square test, one way ANOV, post-Hoc Tukey Cramer and Pearson's association was used for analysis of data variables. All data was analyzed at Confidence interval of 95% [

Results: MPV was raised in Diabetics in particular with uncontrolled glycemic index as shown in table II. MPV showed negative correlation with platelets was found with MPV [r = -0.27, p=0.03]. MPV was positively correlated with glycated HbA1 [r = 0.78, p= 0.0001]. HbA1c as high as 14.3% was noted in uncontrolled diabetics

Conclusion: The present study reports raised Mean platelet volume in Diabetics in particular uncontrolled diabetics. MPV showed positive correlation with HbA1c and negative correlation with platelet count

Biodistribution and kinetic studies of technetium-99m labeled Naja naja karachiensis venom via gamma scintigraphic and SPECT images

Naja naja karachiensis have been responsible for plentiful deaths in Pakistan. To investigate bio distribution and blood kinetics, venom was labeled with the radiotracer [technetium-99m] by following the method of direct labeling technique. Its maximum labeling percentage was 97.7% [pH 6, 100microg stannous chloride clihydrate] which was higher than some other reported venom. Radio labeled venom was stable for more than 4 hours both in vivo [96%] and in vitro [serum 94.1%, saline 94.3%] experimentations. Intravenous doses of venom [250microg, 0.5mCi] were found to be evenly distributed [having R/L ratio=1.0] in all parts of sacrificed rabbits. Kidneys [53.75% activity/g] and urinary bladder [23.70% activity/g] were found with the copious quantity of injected dose of venom. Rest of all other organs was found with subsequent remaining dose of venom. Among them, lungs [14.2% activity/g], liver [4.32% activity/g], bones [1.38% activity/g], heart [0.8% activity/g], blood]0.56% activity/g], skin[0.45% activity/g] intestines [0.35% activity/g], skeleton muscles [0.3% activity/g], brain [0.14% activity/g] and stomach [0.05% activity/g] are included. After 24 hours of injection, poisoned blood of rabbits was almost cleared from venom. Gamma scintigraphic images [up to 2 hours] along with bio distribution suggest that kidneys are main organs of excretion in rabbits. Elimination started immediately after administration of venom however, possible sites for metabolism of venom are liver and lungs. More accumulation of venom in heart compared to brain suggests its higher affinity [thus possible higher toxicity] to cardiac muscles as compared to brain tissues

Effects of thirty minutes regular brisk walk on blood pressure in hypertensive subjects

Objective: The present prospective study was conducted to observe the physiological effects of brisk walk on the systemic blood pressure in hypertensive subjects

Study Design: Observational study

Place and Duration of Study: This study was conducted at Outpatient Department, NICVD-Jinnah Postgraduate Medical Center [JPMC] / Physiology department, BMSI, Karachi from December 2001 to May 2002

Materials and Methods: A sample of 30 diagnosed cases of mild uncomplicated systemic hypertension and 30 healthy controls were selected as per study criteria. Aerobic exercise was explained as of doing regular briskwalking of 30 minutes on alternate days for 60 days. Systolic blood pressure [SBP], diastolic BP [DBP], heart rate [HR] and respiratory rate [RR] were checked at baseline and after 60 days of aerobic exercise. Consent of subjects and approval of ethics committee of institute was observed. Data was analyzed on the SPSS 10.0. Continuous and categoricaldata wasanalyzedbystudent`st-testand Chisquaretestrespectivelyas95%confidenceinterval

Results: Baseline systolic BP, diastolic BP, HR and RR were raised in hypertensive subjects compared to controls [p=0.001]. After 60 days aerobic exercise, the systolic BP, diastolic BP, HR and RR were reduced in hypertensive subjects compared to controls [p >0.05]

Conclusion: The present study concludes that the aerobic exercise improves Systolic blood pressure [SBP], diastolic BP [DBP], heart rate [HR] and respiratory rate [RR] in hypertensive subjects

Effects of aerobic exercise on lipid profile in patients with type 2 diabetes[NIDDM]

Objectives: This study was undertaken to observe the effects of aerobic exercise on lipid profile in newly diagnosed type 2 diabetic patients

Study Design: Observational study

Place and Duration of Study: This study was conducted at Physiology Department, JPMC Karachi from December 2001 to May 2002

Materials and Methods: 30 adult male subjects with uncomplicated type 2 diabetes were selected from diabetic clinic of JPMC, Karachi. 30 apparently healthy adult male subjects were selected from friends, students and staff members of BMSI, as control. The subjects belonging to diabetic groups were then briefed about exercise protocol, which consisted of a regular brisk walk of 30 minutes on alternate days per week for 60 days

Results: Base line Values of mean HDL-cholesterol serum cholesterol, serum total triglycerides, LDL-cholesterol, and mean fasting blood glucose were significantly different in diabetic group as compared to control group [P<0.001] After aerobic exercise, all the parameters except HDL-C were significantly decreased while HDL-C was significantly increased as compared to the pre-exercise values

Conclusion: Regular aerobic exercises improve blood glucose, TAG, LDLc and cholesterol and increases the HDLc in type 2 diabetic subjects has been concluded by the present study

New cases and types of leprosy in Interior Sindh: an analysis of 3 years [2012-2014]

Objective: To evaluate the new cases and clinical types of leprosy in interior Sindh

Methods: Data analysis and evaluation of 3-year record of leprosy centers/clinics in Interior Sindh

Results: Of total 238 new registered cases, 98 [41%] were diagnosed after a delay of 1 year. The types of disease found were tuberculoid 59 [25%], borderline tuberculoid 100 [42%], borderline 13 [5%], borderline lepromatous 53 [22%] and lepromatous lepromatous 13 [5%] cases. Multibacillary cases were 179 [75%] and paucibacillary 59 [25%]

Conclusion: The 3-year analysis of Interior Sindh shows endemic regions of leprosy in Pakistan which will help in devising strategy for an effective leprosy control program

Comparative evaluation of various solubility enhancement strategies for furosemide

Drugs with good solubility exhibit good oral absorption, and subsequently good bioavailability. Thus, most exigent phase of drug development practice particularly for oral dosage forms is the enhancement of drug solubility. This review describes various traditional and novel methodologies proposed for the solubility enhancement of furosemide. For furosemide, solubility and permeability are crucial rate limiting factors to achieve its desired level in systemic circulation for pharmacological response. Thus, problematic solubility of furosemide is one of the main challenges for dosage form developing researchers. Various procedures, illustrated in this review, have been successfully employed to improve the furosemide solubility; however successful improvement essentially depends on the assortment of technique. It is concluded from the results that dissolution rate of drug increases by increasing the quantity of solubility enhancer. Dissolution rate also depends upon the type of enhancer and dissolution medium. In order to achieve relatively enhanced percentage drug release after 30 min [DP[30]], complexation by solvent evaporation using beta-cyclodextrin is the best method. Solid dispersion is found the best if polyethylene glycol is used as enhancer along with microcrystalline cellulose as hydrophilic adsorbent. All the approaches narrated in this article possess good perceptions for additional research i.e. in-vivo studies should be carried out focusing on delivery system development

Salt toxicity [sodium intake]: a serious threat to infants and children of Pakistan

Excess sodium intake can lead to hypertension, the primary risk factor for cardiovascular disease. The aim of this study was to investigate the sodium and potassium contents of foodstuff used by infants and children of Pakistan. We analyzed the sodium and potassium contents of infant milk formula [<6 months], follow up milk formula [>6 months], baby food [cereals], biscuits, fruit juices, potato chips [crisps], cheese puffs, roasted cereals [salty], ice cream cones [kulfi] all of which are the processed food extensively used by the children. The amount of sodium and potassium contents in drinking water of few cities of Pakistan were also considered to assess the additional sodium/potassium in the preparation of milk using infant milk formula. Na to K ratio [Na:K] was determined 0.3-1.23, 0.3-1.16, 0.33-0.82, 0.54-2.68, 0.51-0.85, 2.86 and 1.02 for infant milk formula [<6 months], follow up milk formula [>6 months], baby food [cereals], biscuits, fruit juices, potato chips [crisps, cheese puffs, roasted cereals], ice cream cones [kulfi], respectively. The higher sodium content is present than most of the quoted values; whereas lower potassium is present than the recommended values. The higher Na:K ratio indicates the severity of the situation where it is commonly stated that "higher an individual's salt intake, the higher an individual's blood pressure". Present study indicates that nearly all Pakistani children consume substantially more salt than they need which will affect health status in later life

Ultrasonography of lower limb vascular angiopathy and plaque formation in type 2 diabetes patients and finding its relevance to the carotid atherosclerotic formation

One of the major complications of diabetes is blood vessel disease, termed angiopathy, which is characterized by abnormal angiogenesis. The objective of this study was to discuss the characteristics of lower limb vascular angiopathy and plaque formation in type 2 diabetes patients and finding its relevance to the carotid atherosclerotic plaque formation, thus directing the clinical diagnosis and treatment. The ultrasonography was used to monitor the patients with carotid artery and lower limb artery. Compared with the control group, decreased blood flow to lower limb and lower limb angiopathy occurred more obviously in dorsal artery of foot than in popliteal artery. The study revealed that the detection rate of the prevalence of carotid atherosclerosis plaque and lower limb arterial plaque and the combination of plaque both carotid and lower limb arteries in diabetic patients was 369:342:296 [about 1.25:1.15:1] and that the prevalence of carotid plaque and lower limb arterial plaque in all subjects with plaque was 71.3%. The risk of plaque formation also had positive correlation with patient's age. Color Doppler ultrasound had a clinical significance in the early diagnosis and curative effect observation in type 2 diabetes with lower limb angiopathy. The risk of simultaneous plaque formation in both carotid artery and lower extremity artery was greater in type 2 diabetes than that of control subjects, but they were not necessarily to occur simultaneously. The symptoms were inconspicuous in the early course of diabetes. The application of ultrasound monitoring in patients with carotid artery and lower limb artery might play a role in early warning, delaying the occurrence of macrovascular diseases, and slowing down the development of macroangiopathy such as cerebral infarction and diabetic foot and so on, thus providing a significant basis for clinical diagnosis and treatment

Validation of modified estimated glomerular filtration rate in chronic kidney disease patients

To derive the ethnic factor and validate the modified estimated Glomerular Filtration Rate [eGFR] by Modification of Diet in Renal Disease [MDRD] equation for Chronic Kidney Disease [CKD] patients of Rawalpindi. Cross- sectional study. Armed Forces Institute of Pathology [AFIP], Rawalpindi, from July 2011 to July 2012. A total of 140 patients with CKD reporting to AFIP for GFR measurement by [99m] Technetium diethylenethiaminepenta-acetic acid [[99m]Tc-DTPA] renal scan were consecutively inducted. Serum creatinine was measured by the Jaffe's assay on Beckman DxC 600 Analyzer prior to the renal scan. Ethnic factor for population of Rawalpindi with CKD was derived for the MDRD eGFR equation using [99m]Tc-DTPA renal scan by Gates method as the reference method. MDRD equation was modified by inclusion of the ethnic factor in it. Agreement between the reference GFR [rGFR] and the modified MDRD eGFR [mGFR] was assessed by applying paired samples t-test. Out of 140 patients of CKD, 99 [71%] were males and 41 [29%] females, with mean age of 55 +/- 13.42 years. The mean values were 32.91 +/- 14.96, 34.89 +/- 16.45, 0.971 +/- 0.20 and 33.87 +/- 15.97 for rGFR, original eGFR, ethnic factor and mGFR respectively. The mGFR with new ethnic factor of 0.971 showed improved performance as compared to original eGFR and showed a significant level of correlation with rGFR [r[2] = 0.817], at a p-value of 0.000. This study validates the mGFR equation by inclusion of newly derived ethnic factor of 0.971 in the population of Rawalpindi with CKD and it was found to be not significantly different from the rGFR.

Pre-auricular sinus and its microsurgical excision

Objectives: to determine the role of operating microscopic magnification in reducing its recurrence after surgical excision of pre-auricular sinus

Methods: all patients who underwent microscopic magnification guided surgical excision of pre-auricular sinus were studied. Follow up was carried out for one year for recurrence and other complications

Results: one year follow up revealed satisfactory results regarding recurrence [ 10,%] and post-operative complications

Conclusions: magnification under operating microscope gives good results regarding recurrence, tissue trauma, wound infection, ugly scar and complete excision