Vitamin D status among vegetarians and nonvegetarians

Vitamin D helps in maintaining bone and muscle health. Vitamin D deficiency is a global problem, with the prevalence of deficiency being widespread in Pakistan. The present study was planned to associate serum vitamin D, Parathyroid Hormone [PTH], calcium and phosphate concentrations with dietary habits of individuals living in urban/rural areas of Sindh, Pakistan. This was a crosssectional study at two locations, urban [Karachi] and rural [Haji Goth of Shadadpur city]. The study period was May-October 2012 on 176 healthy subjects, aged 20-80 years. Venous blood was collected for analysis of vitamin D, PTH, calcium and phosphorus. Statistical analysis was done using SPSS-18. Statistical differences between variables were determined by student's t-test and p<0.05 was considered significant. The 176 subjects were divided into non-vegetarians [93, 52.84%] and vegetarians [83, 47.16%] with each group subdivided into urban and rural. The BMI of non-vegetarians vs vegetarians was high [p<0.001]. Vitamin D in non-vegetarians vs vegetarians was low [p<0.001]. The vegetarians of urban compared to rural had low vitamin D [p<0.05]. The PTH of non-vegetarians vs vegetarians was significantly high [p<0.001]. Serum calcium was significantly low [p<0.05] in urban and rural subjects on either diet. Non-vegetarians had severe vitamin D deficiency, while vegetarians had vitamin D insufficiency irrespective of belonging to urban or rural area

Assessment of sub-clinical hypothyroidism and hyperthyroidism status in adult patients

Generally sub-clinical hypothyroidism and hyperthyroidism are diagnosed on the basis of laboratory evaluation and mostly such patients' manifest with mild or devoid of any clinical signs or symptoms. It is known to be a common disorder, also refer to as sub-clinical thyroid disease particularly in middle-aged and elderly individuals. Moreover, it is reported that most patients who were found to have sub-clinical hyperthyroidism depicts TSH values between 0.1 to 0.45 micro IU/L and those with sub clinical hypothyroidism between 4.5 to 10 micro IU/L. In this respect, studies were carried out during January 2006-Dec 2007 in 230 adult patients [98 males, 132 females] for evaluation of sub-clinical thyroid disease. TSH and thyroid hormones [T3 T4, FT3 and FT4] levels of all patients were determined by standard methods to assess the extent of the sub-clinical status. In female group which comprised of 132 patients, a total of n =28 [21.20%] exhibited sub-clinical thyroid disorders [n = 18; 13.63% Sub-clinical hypothyroidism, n=10; 7.57% sub-clinical hyperthyroidism], whereas 59 [44.69%] exhibited true-thyroid disorder. Subsequent assessment in males shows that out of 98 patients; n = 15 patients [15.30%] showed sub-clinical thyroid disorders [n = 9; 9.18% sub-clinical hypothyroidism; n = 6; 6.12% sub-clinical hyperthyroidism], whereas 20 [20.40%] without any sub-clinical or true thyroid disease, respectively and thus presented as normal. It is concluded that sub-clinical thyroid dysfunction prevails in females with 12.17% occurrence whereas 6.52% in males. Furthermore, the evaluation and subsequent review of existing literature and reports, it is also advisable that routine screening for thyroid disease through clinical investigations aided with lab findings be promoted, especially in pregnant women

Evaluation of urinary protein to creatinine ratio as a predictor of end-stage renal disease

To evaluate the role of urinary protein to creatinine [P:C] ratio as a predictor of end-stage renal disease [ESRD] in renal failure patients. This study was conducted at Liaquat National Medical College and Hospital, Karachi from Jan-Dec 2006 on 121 patients [77 males, 44 females] with acute renal failure [ARF] and chronic renal failure [CRF]. Clinical history, relevant investigations, renal status, dialysis routine and frequency were recorded. Random Urine samples [single void] were collected and the P:C ratio were calculated. Out of 121 patients, 21 patients developed ESRD including 16 males [12 CRF, 4 ARF] and 5 females [all CRF]. Statistical analyses shows no significant difference between sum of P:C ratio of CRF and ARF patients. However moderate significance [P < 0.05] was noted among P:C ratio of ESRD patients when compared with males CRF and ARF groups. Similarly, female groups also showed non-significant difference, whereas ESRD patients [FCES], depicts moderate [P < 0.05] significance when compared with female CRF and ARF groups. P:C ratio of males and females ESRD groups showed no significance difference. Mean P:C ratio in male CRF end stage category was 4.12 +/- 0.82 [range 2.5 - 9.1] where as in male ARF end stage 3.78 +/- 1.67 [range 1.80- 7.12]. Mean P:C ratio in female CRF end stage category was 3.94 +/- 0.79 [range 1.76 - 5.98]. Patients with > 1.0 of P:C ratio has developed ESRD. Higher the ratio of P:C, the more was risk of deterioration of clinical condition

Polymorphism of HLa-DR and HLA-DQ in rheumatoid arthritis patients and clinical response to methotrexate - a hospital-based study

To investigate the frequency and distribution of DRB1 and DQB1 alleles in Patients with rheumatoid arthritis [RA] and analyze the relationship between clinical response to methotrexate [MTX] and the HLA-DR and HLA-DQ genotypes in these patients. In this case-control study, the HLA-DRB1 and HLA-DQB1 polymorphism in 91 RA patients and 91 healthy controls was done using polymerase chain reaction and sequence specific primers. There was no statistical difference in frequencies of HLA-DRB1*03, DRB1*04, DRB1*07, DRB1*10, DRB1*11, DRB1*12, DRB1*13, DRB1*14, DRB1*15 and DRB1*16 genotypes between patients and controls. However, DRB1*01 was found to be significantly more common [p=0.015] in RA patients compared to controls. HLA-DRB1*15 was more common in patients [43.5%] compared to controls [30.8%] but results were not significant. HLA-DRB1*08 and DRB1*09 were present in negligible number in patients as well as controls while HLA-DRB1*12 was conspicuously absent in controls. Similarly, DQB1*06 was also significantly more common [p = 0.01] among the patients compared to healthy control subjects, while there was no statistical difference in the frequencies of DQB1*02, DQB1*03, DQB1*04 and DQB1*05 among the cases and the controls. RA susceptibility in most patients appeared to be associated with the HLA-DRB1*01/DQB1*06 genotype. Regarding association between HLA-DR or HLA-DQ genotype and clinical response to methotrexate [MTX], the data showed that with the exception of HLA-DRB1*03, there appears to be no association between the particular subtypes of HLA-DR and HLA-DQ. HLA-DRB1*03 was significantly more common among non-responders to MTX alluding to the possibility that another genes responsible for MTX metabolism, might be in linkage disequilibrium with HLA-DRB1*03 in the Pakistani population, thereby making such individuals non-responsive to MTX-therapy. RA susceptibility in most Pakistani patients is associated with the HLA-DRB1*01/DQB1*06 genotype. HLA-DRB1*03 was found to be significantly more common among non-responders to MTX treatment suggesting that Pakistani patients with this genotype are less likely to benefit from MTX