Association of thrombomodulin gene polymorphism [C1418T] with coronary artery disease in Pakistani population

Objectives: To find out the association between Thrombomodulin gene polymorphism [C1418T] with coronary artery disease in population of Karachi, Pakistan

Methods: This case-control study was conducted in Tabba Heart Institute in collaboration with the National Institute of Blood Diseases, Karachi. We compared C/T dimorphism in 92 cases with 90 control subjects by allele-specific amplification. The results of PCR were confirmed by Gene sequencing. All the laboratory methods were strictly in compliance with the international standards. All variables that were either statistically significant in the univariate analyses or potentially important with respect to prevention or biologically relevant variables were included in logistic-regression analyses. Potential confounding was assessed with the use of multivariate models adjusted for participant's characteristics and other major risk factors for coronary artery disease. All reported p values are two-tailed, with statistical significance at p value <0.05

Results: The frequency of CC, C/T and TT genotype was 81 [90%], 6 [6.7%] 3 [3.3%] in controls and 67 [72.8%], 20 [21.7%] and 5 [5.4%] in cases respectively. In cases group the CT/TT genotypes were found to be significantly highly represented among the patients with coronary artery diseases when compared with control group [p-value 0.009]

Conclusion: TM C1418T polymorphism emerges as a risk marker in Coronary Artery Disease patients in the population of Karachi, Pakistan

Drug resistance pattern in multidrug resistance pulmonary tuberculosis patients

To evaluate the frequency of drug resistance profiles of multidrug resistant tuberculosis [MDR-TB] isolates of pulmonary tuberculosis patients, against both the first and the second line drugs. An observational study. The multidrug resistant tuberculosis [MDR-TB] ward of Ojha Institute of Chest Diseases, Karachi, from 1996 to 2006. Culture proven MDR-TB cases [resistant to both isoniazid and Rifampicin] were retrospectively reviewed. Susceptibility testing was performed at the clinical laboratory of the Aga Khan University. Sensitivity against both first and second line anti-tuberculosis drugs was done. Susceptibility testing was performed using Agar proportion method on enriched middle brook 7H10 medium [BBL] for Rifampicin, Isoniazid, Streptomycin, Ethambutol, Ethionamide, Capreomycin and Ciprofloxacin. Pyrazinamide sensitivity was carried out using the BACTEC 7H12 medium. During the study period MTB H37Rv was used as control. Out of total 577 patients, all were resistant to both Rifampicin and Isoniazid [INH]. 56.5% isolates were resistant to all five first line drugs. Resistances against other first line drugs was 76.60% for Pyrazinamide, 73% for Ethambutol and 68.11% for Streptomycin. Five hundred and ten [88%] cases were MDR plus resistant to one more first line drug. Forty [07%] isolates were MDR plus Quinolone-resistant. They were sensitive to Capreomycin but sensitivity against Amikacin and Kanamycin were not tested. There were high resistance rates in MDR-TB to remaining first line and second line drugs. Continuous monitoring of drug resistance pattern especially of MDR isolates and treatment in specialized centers is a crucial need for future TB control in Pakistan

Analysis of kidney stones by FTIR spectroscopy

This study was carried out to investigate the composition and type of kidney stones in our population. Analytical study. Kidney stones recovered from patients of different hospitals of Hyderabad and adjoining areas [Liaquat University Hospital Jamshoro, Memon Charitable Hospital Hyderabad, Wali Bhai Rajputana Hospital Hyderabad, Naseem Medical Center Hyderabad and Isra University Hospital, Hyderabad, Sindh] during 2005 - 2006. A total of 58 kidney stone samples were collected randomly and analyzed for composition by Fourier Transform Infrared Spectroscopy [FTIR]. Of 58 kidney stone samples, 37.9% were pure calcium oxalate stones, 3.4% were uric acid, 44% calcium oxalate + uric acid, 3.4% calcium oxalate + aspartate and 10.3% were magnesium ammonium phosphate. The IR bands were compared with standards. Gender wise comparison revealed that majority of the stones [68.9%] analyzed were recovered from male patients. Whereas, stones recovered from females were only 31.1%. Age wise comparison data disclosed that age range for the presentation of kidney stone disease was 15-29 years. Calcium oxalate + uric acid stones are commonly found in patients of Hyderabad and adjoining areas

Normal limits of knee angle in pakistani children ; a photographic study of genu varum and genu valgum

Total 636 lower limbs of 318 normal Pakistani children from newborn to 12.5 years were marked for anterior superior iliac spine [ASIS], centre of the patella [PC] and centre of the intermalleolar line [IMC]. Limbs were photographed in straight standing position and knee angle was geometrically measured. Male and female difference of knee angle was insignificant [P>0.05]. We observed a general trend from extreme bowlegs in infancy to maximum knock-knees at 4 years. Then there was a gradual progression towards neutral knee angle. Greatest mean Varus of 10.01 degrees was noted in children less than 6 months. Maximum valgus of 5.96 degrees was measured at 4 years. After 11 years of age a mean valgus of 3.08 degrees was maintained. Compared to Chinese children, Pakistanis are 5 degrees less valgus at 2 years, values level at 4 years and become 4 degrees more valgus beyond 6 years of age. Compared to American white children, Pakistanis initially show less Varus, progress slow, attain less valgus and finally remain closer to the neutral knee angle. Racial difference in knee angle should be considered for Pakistanis to achieve the optimum results with regards to knee angle correction or knee replacement arthroplasty