Understanding the fat gene. Obesity common variant FTO RS9939609

Obesity, attributable to the interaction of genetic makeup, lifestyle and environment Factors are a multifactorial disease. However, not all people with similar genetics or same environmental setup become obese. Currently, extensive research is being conducted regarding increases in the prevalence of obesity, apparent in many societies, studying their eating habits and physical activity. Although, people with obesity have the equal distribution of body fat, yet they do not suffer from the same medical ailments. The recent identification of obesity-risk FTO variants rs9939609 associated with body mass index [BMI] and risk of obesity in multiple populations has led to the major success in the field of obesity genetics, making FTO the first locus unequivocally associated with adiposity. The role of FTO gene as a risk factor of obesity has also been identified by the Genome wide association which is entirely a new approach. The function of FTO gene was unknown, but recent investigation showed that the FTO gene regulates ghrelin a key mediator of ingestive behavior, which might explain a predisposition to increased food intake leading to obesity. People with rs9939609 variant of the FTO gene are at increased risk of obesity they have higher circulating levels of the hunger hormone ghrelin, and feel hungry soon after eating a meal. This review focuses on the genetics of FTO gene and the association of each additionally minor allele of [FTO] rs9939609 single nucleotide polymorphism [SNPs] with the risk of obesity

Frequency of osteoarthritis among patients of knee joint pain

Background: Osteoarthritis knee causes disablity among middle aged people

Objective: To find out the frequency of osteoarthritis among patients of knee and its association with gender and obesity

Methodology: This cross sectional study was conducted at Department of Orthopedics, Bahawal Victoria Hospital, Bahawalpur from 1[st] January to 31[st] May 2014. Patients of both sexes with knee pain, age from 40 to 70 years were included in this study. Physical examination of all the patients was done and x-ray of knee joint were also taken from every patients to assess the knee osteoarthritis. The data was entered and analysed by using SPSS version 15

Results: Total 100 patients were included in this study. Mean age of the patients was 52.64 +/- 8.8 years. Osteoarthritis was found in 72 [72%] patients. 20 [55.6%] among male and 52 [81.25%] among female were having osteoarthritis. Out of 60 [60%] obese patients osteoarthritis was found in 56 [93.33%] patients

Conclusion: Obesity is found to be significant important risk factor for Osteoarthritis Knee [KOA]. KOA is also found more in females and obese

profile of plasma concentration of adiponectin in primary school children in Dera Ismail Khan

The objective of the present study was to determine the plasma Adiponectin concentration in primary school children 6-11 years and to evaluate negative association of Adiponectin in obese children. This cross sectional study was carried out in the Department of Chemistry, Gomal University, Dera Ismail Khan from June 2007 to August 2010. A total number of 1336 primary school children were examined in the Municipality area of Dera Ismail Khan and excluding those suffering from chronic health problems. Height [m], weight [kg] of each child was taken and BMI was calculated according to Quatelet's Index. Body mass Status was also calculated through CDCs' Growth Charts 2002, 2-20years for children to have percentile for each school child. School children with >/= 5[th] percentile were declared normal weight and the ones having >/= 95[th] percentile as obese. 83 school children were randomly selected among 1336 children with 23 [27.71%] normal weight and 60 [72.28%] as obese ones. Gender wise distribution of the sample was 48 [57.83%] boys and 35 [42.16%] as girls. Fasting plasma adiponectin concentration was determined by ELIZA method. Mean plasma adiponectin concentration in normal weight children was noted as 21.38micro g/ml [P = 0.013] and 20.89micro g/ml [P = 0.011] in boys and girls respectively. The observed, mean plasma adiponectin level in obese children was 20.38micro g/ml [P =0.0130] and 25.56micro g/ml [P = 0.0016] in boys and girls respectively. Significant difference in plasma adiponectin concentration was observed between normal weight and obese girls

[VDR] gene polymorphisms - rapid and noninvasive oral detection method

Background: In recent years, the importance of vitamin D receptor [VDR] gene restriction fragment length polymorphisms for various types of disease and cancers has been investigated by a great number of studies. A non invasive method could be employed for extracting DNA. Oral rinse has been found to be one of the sources for collecting genomic DNA

Objective: To develop a rapid and non-invasive method for the detection of Vitamin D Receptor [VDRFok1] Gene from oral rinse

Methods: Oral rinse samples were collected normal individuals with informed consent. Individuals included were healthy adults between 20-40 years of age. Oral rinse [40ml] was taken after gentle brushing over the lesions. DNA extraction was done according to Lucky MH et al and PCR was performed using beta globin primers GH02/PC04 and VDR-Fok1 primers. A 256bp amplified products was visualized by Gel Doc Hero Lab software [Germany]. The PCR-RFLP results showed the 20 or 40% FF genotype [homozygote of common allele] with one band of 265bp

Results: The mean concentration of 60 DNA samples was 14.484 +/- 10.63ug/ml. The results of VDR-Fok1 gene polymorphism shows that out of 60 subjects 48 were normal [FF 80%], 12 were Heterozygous [Ff 20%] and 0 were mutated [ff 0%]

Conclusion: Oral rinse is a perfect medium for rapid and non invasive diagnostic applications of VDR gene may be optimized for other salivary biomarkers

BCG vaccination is associated with decreased severity of tuberculosis in Pakistan

Vaccination with Bacille Calmette-Guerin [BCG] is given at birth to protect against tuberculosis [TB] in Pakistan. The country ranks 6th amongst high-burden countries worldwide and has an incidence of 231/100,000 population. This was a cross-sectional multi-center hospital-based study. TB patients [n = 218] with pulmonary [PTB, n = 120] or extrapulmonary [ETB, 98] were recruited, and the presence of a BCG vaccination scar was documented. Cases were further classified into minimal, moderate and advanced PTB or less severe [LETB] or severe disseminated [D-ETB] disease. The association of age, gender and severity of TB infections with BCG vaccination of the individual TB cases was investigated. No difference was found of the BCG vaccination status of PTB and ETB cases, or in relation to age or gender. Patients under 29 years of age comprised the largest group. There were more females with ETB than PTB. The largest group within ETB comprised those with tuberculous lymphadenitis [LNTB, 39%]. A significantly greater number of LNTB cases had received BCG vaccinations than had those with pleural [unilateral] TB [p = 0.004], and tuberculous meningitis [p = 0.027] groups. Also, there were more immunized patients with pulmonary as compared with pleural disease [p = 0.001]. LNTB represents localized granulomatous disease and the observation of higher vaccination rates in this group suggests that BCG has protected against more severe forms of TB in this high-burden region.

Prevalence of sub clinical hypothyroidism in school children [6-11 years] of Dera Ismail Khan

To determine the prevalence of sub clinical hypothyroidism [hyperthyrotropinemia] in obese school children. This cross-sectional study was carried out in Department of Chemistry, Gomal university, Dera Ismail Khan, from June 2007 to August 2010 including eight primary schools of Dera Ismail Khan having mixed population with some of the wards belonging to high socioeconomic group. Thorough clinical examination excluded those suffering from chronic health problems. Height and weight of each child was taken according to standard anthropometric procedures. Body mass index and body mass status of each study subject was calculated according to Quetelet's Index and WHO criteria respectively. a total of 83 school children [6-11 years] were randomly selected among 1336 children. The sample included 23 [27.71%] normal weight children and 60 [72.28%] obese. Gender wise distribution of the sample was 48 [57.83%] boys and 35 [42.16%] girls. Free Thyroxin [FT] and Thyroid Stimulating Hormone [TSH] were measured using radioimmunoassay. Hyperthyrotropinemia was the most commonly observed thyroid hormone dysfunction [8.43%] in the whole sample [n=83] and 8.33% in obese children compared with 3-8% in general population of the United States. Sub clinical hypothyroidism is the most common finding in the childhood obesity. The prevalence of sub clinical hypothyroidism in the present study is 8.43% in the whole sample [n=83] compared with 3-8% in general population of the United States. It is suggested that all the obese children expressing minimum organ abnormalities be investigated to prevent the irreversible problems over the course of many years

Waist circumference and lipid profile among primary school children

To explore the association of lipids and lipoprotein levels with large waist circumference in obese primary school children of Dera Ismaii Khan. This study explores the frequency of adverse level of waist circumference in primary school children and associated high serum concentration of lipids and lipoproteins to identify children at risk for cardiovascular disease. The study involved 86 primary school children, [Obese: 61 [70.93%], Normal weight: 25 [29.06%]]. Adverse level of waist circumference [WC] was observed in 32% normal weight and 78.69% in obese children. Gender difference for higher level of WC, was observed in obese children [boys = 42%, girls = 36 .68%]. Higher level of lipids [Triglyceride and Total Cholesterol] and lipoproteins [High Density Lipoprotein Cholesterol and Low Density Lipoprotein Cholesterol] was noted in children with higher WC [Normal weight 6 [24%], Obese 48 [80%]] compared with children having low level of WC [normal weight <61cms and obese <71cm]. The adverse level of waist circumference was observed in most of the obese children and a higher level of lipids and lipoproteins was also noted in children with adverse level of waist circumference

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

frequency of urinary symptoms in women attending gynaecology clinics at the Aga Khan University Hospital Karachi, Pakistan

To determine the frequency of urinary symptoms in women attending Gynecology clinics at Aga Khan University Hospital, Karachi. A total of 186 women attending the gynaecology clinics for symptoms of menstrual disorders, vaginal discharge or uterovaginal prolapse were asked to fill the survey questionnaire which included all the details about lower urinary tract symptoms [LUTS]. Of the 180 women, 82.8% were aged between 15-44 years with BMI >25. Culture confirmed recurrent urinary tract infection [at least 3 episodes of urinary tract infections evidenced by positive urine culture or treated by repeated use of antibiotics] was reported by 32 [17.2%] women. The frequency of urinary incontinence was 44.4% with 17.2% cases having stress urinary incontinence [SUI]. Symptoms of urinary tract infection were not significantly affected by age, parity and mode of delivery. Parity was strongly associated with prevalence of SUI [F=10.48, P<0.001]. Both urge and mixed incontinence were significantly related to age [F=20.57, P, 0.001 and F=13.88, P<0.001] but were not affected by parity and mode of delivery. The high frequency of urinary symptoms in our community demands a need for more extensive epidemiological study and a specialized unit to provide awareness, treatment and training in this area