Serum leptin level in adolescent girls with polycystic ovary syndrome: correlation with anthropometric and endocrine parameters

Background: Polycystic Ovary Syndrome [PCOS] is linked with hyperinsulinemia and insulin resistance, characteristics that are linked to the level of leptin and leptin receptors. This study was planned to estimate serum leptin levels in adolescent girls with PCOS and its relation with endocrine and anthropometric parameters

Methods: Fifty [50] girls with PCOS, aged 16-20 years, and 60 age- matched normal subjects were included in the study. Study duration was from Jun 2014 to Dec 2016. Patients were taken from Sir Ganga Ram Hospital, Lahore. Normal subjects [controls] were students of Fatima Jinnah Medical University, Lahore. Serum levels of Fasting blood sugar, leptin, testosterone, and serum insulin were estimated. Homeostasis Model Assessment of Insulin Resistance [HOMA-IR] was used to calculate insulin resistance. Body mass index [BMI] was calculated using the standard formula

Results: Mean age of adolescent girls with PCOS was 19+/-2.8 years. BMJ of PCOS patients was increased non-significantly compared to normal subjects. Fasting blood sugar and serum testosterone level was non-significantly decreased in PCOS patients compared to normal subjects. Level of serum insulin was significantly increased in patients compared to normal subjects. On the other hand, serum leptin level was increased in patients as compared to normal subjects. A weak correlation between leptin hormone, serum insulin and insulin resistance was observed. Significant positive correlation was observed between BMT of PCOS women and their leptin hormone

Conclusion: In adolescent girls, increased leptin level showed a significant correlation with BMI, whereas its correlation with endocrine parameter was weak

Screening of pneumococcal pneumonia by amplification of pneumolysin gene in children visiting hospitals in Lahore, Pakistan

Streptococcus pneumoniae is a common worldwide potential pathogen causing pneumonia among children and the detection of pneumococcal infections by conventional culturing techniques is cumbersome. The present study describes a comparative analysis of sensitive nested-PCR and bacterial culture in pediatric patients with clinical and radiological indication of S. pneumoniae infection. PCR was performed using outer primers to amplify a 348-bp region and inner primers a 208-bp region of the pneumolysin gene. For pneumolysin PCR assay, DNA from peripheral blood and middle ear fluid [MEF] samples was extracted by salting out method. The sensitivity of the assay was evaluated with about 0.06 pg of purified S. pneumoniae genomic DNA. Among 90 MEF culture negative samples from acute otitis media pediatric patients, 8.8% pneumolysin-PCR positivity was detected, demonstrating the sensitivity and reliability of PCR for rapid pneumonia evaluation. Binomial test of proportionality performed on [SPSS 17] gives P<0.05 indicating that PCR technique is statistically significant and sensitive in the diagnosis of S. pneumoniae infection. The research work evaluated the effectiveness and efficacy of nested-PCR for detecting S. pneumoniae in pediatric patients with clinical and radiological confirmation of bacterial infection. This simplified method permitted quick selection of the patients and played a significant role in preliminary management of pneumococcal infections

Serum trace elements in diagnosis of breast malignancy

Breast cancer is a highly heterogeneous disease globally. The absolute risk of breast cancer increases with age and is higher in postmenopausal women. This study tried to find out role of serum trace elements [cadmium, cobalt, copper and zinc] and biomarkers in diagnosis of breast malignancy. Levels of serum trace elements were estimated by atomic absorption spectrophotometry in serum samples of 23 breast cancer patients of stage III. Analysis of protein pattern was observed by sodium dodecyl polyacrylamide gel electrophoresis [SDS-PAGE]. In menstruating women, the mean serum level of cadmium, copper and cobalt were significantly lowered as compared to control, however, zinc showed no significant difference. In premenopausal and postmenopausal women, the mean serum level of cadmium, copper, cobalt and zinc was decreased significantly in patients as compared to controls [p<0.001]. The ratio of Cu/Zn was also decreased in patients when compared to controls. Three major peptide bands with molecular weights of 33 kDa, 52 kDa and 185 kDa appeared in these samples when subjected to SDS PAGE. Serum trace elements are significantly lower in breast cancer patients compared to controls. The exact mechanism responsible for the alterations in trace element levels in patients with breast cancer is unclear and requires further evaluation. Gel electrophoresis may be important to find out breast cancer markers that may help in diagnosing the disease and response to treatment.

To study the role of serum bilirubin and lipoproteins in prediction of ischemic heart disease

Objective: to determine if serum bilirubin, when combined with various risk factors like lipid and lipoprotein predicts ischemic heart disease [IHD]

Material and Methods: hundred patients with IHD were included in the study from in and out patient departments of Medicine. 25 normal subjects were studied as controls. The traditional risk factors like cholesterol, high-density lipoprotein cholesterol [HDL-C], cholesterol/HDL-C ratios, triglycerides as well as serum bilirubin, albumin and creatinine were determined by standard methods. Besides, age, cigarette smoking, and systolic blood pressure were also recorded

Results: it was observed that the bilirubin is negatively correlated with hemoglobin, albumin, HDL and LDL-cholesterol. On the other hand a direct correlation with total lipid, cholesterol and ratio of cholesterol/HDL-cholesterol is also observed. High level of serum creatinine level was also found in the patients as compared to normal subjects

Conclusion: no definite relationship between serum bilirubin and I HD was observed

To study the effects of simvastatin on lipid profile in obese patients with changing lifestyle

Simvastatin is a competitive inhibitor of HMG-CoA [3-hydroxy 3-Methyl glutaryl Coenzyme A] reductase. Present study proposed that the lipid lowering effect of simvastatin may be enhanced, if it was taken with fat free diet and morning walk. Cross Sectional Study. This study was conducted at Fatima Jinnah Medical College, Lahore for a period of six months from December 2009 to May 2010. 20 male and 20 female obese patients were selected. The obese patients were re-examined three times i.e. before giving the simvastatin, then after 6 and 12 weeks. The patients were advised to take fat free diet and a morning walk. Serum Cholesterol, serum Triglycerides and serum Lipoprotiens [HDL, LDL] were determined. This study shows that with use of simvastatin, serum cholesterol, serum triglycerides, and serum LDL-Cholesterol was reduced significantly and serum HDL-Cholesterol increased significantly in both sexes. It was also observed that the fat free diet and some exercise causes weight reduction. It is therefore concluded that simvastatin shows significant lipid lowering effects augment process of body weight reduction, if patients used calorie restricted diet with some morning walk

To study the role of serum biliurbin and lipoproteins in prediction of ischemic heart disease

An inverse relationship between the bilirubin level and ischaemic heart disease was accounted. Cross Sectional Study. This study was conducted at Dept. of Biochemistry, Fatima Jinnah Medical College, Lahore from Feb. 2007 to July 2007. Study was performed to determine if serum bilirubin, when combined with various risk factors like lipid and lipoprotein predict ischemic heart disease [IHD]. It is observed that the bilirubin is negatively correlated with hemoglobin, albumin, HDL and LDL-cholesterol. On the other hand a direct correlation with total lipid, cholesterol and ratio of cholesterol/HDL-cholesterol is also observed. High level of serum creatinine level was also found in the patients as compared to normal subject. Our study observed not a definite relationship between serum bilirubin and IHD. Hence the relationships between bilirubin and lipoproteins [risk factors of IHD] require further clarification, although abnormal intermediary metabolism and antioxidant deficiency may be possible linking factors

Pleural fluid estimation and tubercular infection in the people admitted with pleural effusion

We prospectively conducted this study to evaluate the diagnostic value of Pleural fluid estimation and find the rate of tubercular infection in the people with pleural effusion in city of Lahore. Pleural TB is a common form of extrapulmonary disease and may occur in the presence or absence of pulmonary parenchymal disease on the chest radiograph. Prospective Study. This study was conducted in the Biochemistry Department, FJMC, Lahore from May 2010 to Nov. 2010. This study to evaluate the diagnostic value of Pleural fluid estimation and tubercular infection in the people with pleural effusion. All patients aged 22 years and older with clinical and radiographic findings consistent with pleural effusion due to TB admitted to the hospital were evaluated consecutively. The studies were performed on pleural fluid samples: glucose and protein were estimated. Specific gravity was calculated. Cell count, differential cell count, bacterial culture, acid-fast bacilli smear were performed using standard procedures. Specimen was cultured, if effusion contains more than 150 WBC/cumm. It was observed that the level of fluid glucose was increased in both sexes as compared to the normal reported values. Level of fluid protein was more in both sexes as compared to the normal reported values. However level of pH was neutral in both sexes. Present study found that pleural TB is still a major cause of pleural effusion in the city of Lahore, and microbiological and biochemical investigation may be helpful in diagnosing the disease

To study the relationship of caffeine elimination and Child's Pugh classification in groups of patients with liver cirrhosis

Serum Caffeine clearance determination is a useful method to evaluate the severity of liver disease and predict short-term survival of cirrhotic patients. Caffeine concentrations correlated well with the score indicating the sufficiency of the organ according to Child- Turcotte classification score. It offers another choice for the quantitative measurement of liver functional reservoir. Study is designed to find out the relationship of Caffeine elimination and child's classification in groups of patients with liver cirrhosis. Cross sectional Study. The study was conducted at the Medical Ward of Services Hospital Lahore from July 2004 to December 2004. Forty patients with liver cirrhosis with age range 40-55 years and 20 aged matched normal healthy volunteers were enrolled in this study. Patients were taken from the medical ward of Services Hospital Lahore. After an overnight fast, the first blood sample was collected at 8 a.m., immediately followed by an oral administration of 200 mg Caffeine. Subsequent samples of venous blood were obtained at 8.30 a.m., 9 a.m., 11 a.m., 2 p.m. and 5 p.m. The Caffeine clearance was determined by reversed-phase high pressure liquid chromatography using a Phenomenex Gemini C18 column using a wavelength of 273 nm. [Jaundice presented with highest frequency distribution and percentages. This was followed with ascities, edema. Family history of hepatitis/jaundice and anemia. Ultrasonographic findings showed that in 50% of the patients. Other 50% of patients have normal and shrunken liver]. Caffeine concentration in child class A was significantly decreased at base line [P<0.001], 3 hours [P<0.05], 6 hour [P<0.001] and 9 hour [P<0.001] as compared to the controls. In child class B the Caffeine concentration was significantly to the controls. On the other hand in child class C the Caffeine concentration was remaining same as in their controls. Caffeine clearance could provide a practical assessment of hepatic function in cirrhotic patients. Our data emphasize the value of the child-Turcotte or child-Pugh classification in assessing the severity of liver cirrhosis in a simple and less time-consuming way than using quantitative liver function tests

BMI and lipid profile: a serious health threat for middle aged women

Study tried to find out factors that associated with the weight gain or increased BMI in middle aged women and lipid profile that may become a cause of different disease in women in middle/later ages. Study tried to find out factors that associated with the weight gain in middle aged women and lipid profile that may become a cause of different disease in women in middle and also in later ages. Cross sectional Study. This study was conducted at the department of Biochemistry, Fatima Jinnah Medical College, Lahore from August 2010 to October 2010. 50 females with age range 40-50 years were included in the study. The proforma of questionnaire recorded the age, socioeconomic status, BMI, blood pressure, dietary pattern, Physical activity and family history of female subjects. Lipid profile included total lipid, serum cholesterol, triglyceride, HDL-chil and LDL-chol were also estimated. It was observed that mean age at which females gained the weight is 45.23 years. Most females belong to class B and Class C. Females were over weight when compared with the standard criteria of weight to height ratio. No change in blood pressure was seen. A positive family history of obesity was also seen in many females. It was observed that the level of total lipids, cholesterol, triglyceride and LDL-cholesterol was significantly increased in female subjects as compared to normal subjects. In view of this study, it is suggested that a diet is not simply a list of permitted food but it may include the total count of calorie a person consume in the form of food in addition to cut down some percent of sugar, salt and oil. A regular exercise may help to maintain the circulation of blood and maintain the level of lipid profile

Alpha1-microglobulin: a marker for early detection of tubular disorders in diabetic nephropathy

Tubular damage as suggested by tubular proteinuria is a recognised feature of glomerulonephritis. The objectives of the study were to compare the level of alpha-microglobulin in normal and diabetic patients, and also to find out whether the level of alpha-1 microglobulin could become a laboratory marker for tubulo-interstitial damage in diabetic nephropathy. Twenty-nine registered Type II diabetic patients of either sex were studied. The patients' age ranged from 41-50 years who were admitted in the medical ward, and those who visited the outdoor department of Sir Ganga Ram Hospital, Lahore were included in the study. The duration of study was one year from June 2006 to June 2007. Ten normal subjects with no history of diabetes were taken as controls. Blood samples and 24 hour urine samples of patients of all groups were collected. The levels of urinary protein and blood sugar were estimated by auto analyser. Proteinuria positive urinary samples were analysed by SDS-PAGE electrophoresis. The level of alpha-1 urinary protein was significantly increased in the group of diabetic patients as compared to the urinary protein level of normal subjects. Blood sugar level was also significantly increased in patients as compared to controls. Level of low molecular weight protein alpha-1 microglobulin showed an electrophoresis band of 28 Kda with an average volume of 6741.88 in the urine sample of patients. On the other hand, a very light, hardly recognizable band was observed in normal subjects. Urinary alpha-1 microglobulin provides a noninvasive and inexpensive diagnostic alternative for the diagnosis and monitoring of urinary tract disorders, i.e., early detection of tubular disorders of diabetic nephropathy. We propose that SDSPAGE electrophoresis is a comparatively inexpensive diagnostic approach to detect this marker in the urine sample

Breast cancer; role of tamoxifen as selective estrogen receptor modulator in preventing bone loss, reducing serum cholesterol and activity of liver enzymes in patients with different hormonal states

To assess the alterations of serum cholesterol, liver and bone enzyme with breast cancer patient taking tamoxifen with different hormaonal status. Experimental study. Period: April to September, 2006 [24 weeks]. The study was carried out on serum samples that were obtained from out department of Oncology, Sir Ganga Ram Hospital of Lahore. The study included 68 [serum specimen] of breast cancer patients. These patients were different stages of menstruation [postmenarche, perimenopausal and post menopausal]. Clinical history and provisional diagnosis were also noted. These patients [68 women] with breast cancer were divided into three major groups; [1] Postmenarche patient, [2] perimenopausal [3] post menopausal status. It is observed that the level of serum cholesterol, ALT and serum alkaline phosphatase in post menarche women were within the normal limits. While women in perimenopausal and post menopausal age groups, had increased level of serum cholesterol [P<0.01] and alkaline phosphatase. Level of ALT however was observed on border line. It is therefore concluded that tamoxifen either prevents or shows no effect on the bone and liver function as well as on cholesterol in postmenarche patients. While in case of perimenopausal and postmenopausal breast cancer patients who received tamoxifen, it may induce increase in cholesterol level and bone resorption, which may be due to decreased level of estrogen. However, further research is needed to reach better conclusions

MUC1 based breast cancer vaccines: role of post translational modifications

Vaccine development is one of the most promising fields in cancer research. After autologous transplantation, due to low tumour burden, patients are more likely to respond immunologically to a cancer vaccine[7]. MUC1 with its adhesive and antiadhesive functions, immunostimulatory and immunosuppressive activities, is therefore a good candidate for breast cancer vaccine. A structure-based insight into the immunogenicity of natural MUC1 glycoforms, of its sub-domains, motifs and post translational modification like glycosylation and myriostoylation may aid the design of tumour vaccines. Primary sequences of human MUC1 were retrieved from the SWISSPROT data bank. Protein pattern search: The primary sequence of Human MUC1 was searched at PROSITE [a dictionary of protein sites and patterns] database. Our study observes that post-translational modifications play an important role in presenting MUC1 as a candidate for breast cancer vaccine. It is found that the phosphrylation and glycosylation of important functional motifs of MUC1 may take part in the production of cytokines that may provide immunization

Bone mass measurement and factors associated with risk of fracture in a group of peri-and postmenopausal women

This study tried to find out the physiological risk factors as well as biochemical factors in a group of Pakistani peri- and postmenopausal women. One hundred female subjects with age range of 40-52 years were included in the study. Female subjects were divided into two groups, i.e., 65 women with perimenopausal status age range 40- 52 years old and 35 women with post menopausal status age range of 50-60 years. Detailed histories of subjects including factors that may contribute in bone fracture were recorded. Bone density was scanned. Blood parameters like serum calcium, alkaline phosphatase, total protein and uric acid were estimated. It was found that 70% of perimenopausal women belonging to class B were physically active. Hormonal replacement therapy [HRT] was observed in 25-30% of both groups. On the other, only 15% of both groups used oral contraceptives. Family history was found to be only in 10% of both groups. Level of serum calcium of perimenopausal/postmenopausal was less than normal control subject. Although the level of alkaline phosphatase was increased in perimenopausal women as compared to postmenopausal women and normal control subjects. Bone density of both peri- and postmenopausal women significantly decreased as compared to T score of normal control. It was concluded that a number of factors are predictive of future risk for the development of osteoporosis in women of reproductive age. Given the severity of the medical consequences of osteoporosis, the medical community needs to assess all women for these risk factors during their perimenopausal years

To study the significance of apoptotic enzyme granzyme H in breast cancer patients

Breast cancer is the most common type of cancer and the most common cause of cancer-related mortality among women worldwide. The rising global incidence, morbidity and mortality from breast cancer have led to intensified efforts in search for etiological factors of the disease. Present study tried to find out the significance of apoptotic enzyme granzyme H in breast cancer patients. It was a cross sectional study. Fifty women with pre/post menopausal status were included in the study. Their physiological characteristics including age at menarche, menopause, life style and receptor status including oestrogen, progesterone and HER 2-neu were recorded. Level of serum granzyme H was estimated. It was observed that there is a variation in physiological characteristics. Level of serum granzyme was increased in patients before chemotherapy that may be decreased after treatment but not as much decreased as in normal control subjects. Increased level of granzyme H after chemotherapy may indicate the response of treatment. A direct relationship of oestrogen with granzyme H was also observed. However further study is suggested to reach a better conclusion

Detection of mycobacterium tuberculosis in clinical samples by smear and culture

To compare the smear stained by Ziehl-Neilsen [ZN] and Lowenstein-Jensen [LJ] medium for the detection of Mycobacterium tuberculosis in clinical samples from different categories. This laboratory based retrospective study was carried out at Sir Ganga Ram Hospital /Fatima Jinnah Medical College, Lahore over a 5 year period between January 2001and June 2006. A total of 798 clinical samples were collected from patients with a provisional diagnosis of tuberculosis. A ZN stain of smear and culture on LJ medium were performed for the detection of Mycobacterium. The specimen categories were sputum, pus, lymph node aspirate, urine and endometrial curetting. Out of 798 specimens received over the study period, only 46.3% [n=369] were respiratory whereas 53.7% [n=429] were non respiratory tract category samples. Among these, 3.578% were positive in ZN stain while 11.65% were positive on culture. Out of a total of 369 respiratory tract category samples, 38[10.3%] sputum samples were positive for AFB on both ZN and culture. Among the non respiratory tract category, 47[28.2%] pus, 26[31%] lymph node aspirates, 05[15.6%] urine, 05[3.42%] endometrial curetting were positive. Fifteen percent of clinical samples belonging to 05 different categories of specimens with a provisional diagnosis of tuberculosis, tested positive for Mycobacterium by both Zn stain smear and culture on LJ medium. Among these, 3.57% were positive for AFB on ZN smear and 11.65% were positive on culture on LJ medium. These conventional techniques have proved to be reliable testing tools for detection of Mycobacterium tuberculosis in our setting

Diagnostic significance of adenosine deaminase in pleural tuberculosis

Tuberculosis [TB] is a major cause of pleural effusion, which in TB usually has lymphocytic and exudative characteristics. The analysis adenosine deaminase [ADA] activity is a very useful diagnostic approach to achieve a more rapid and precise diagnosis in the cases of pulmonary TB. Fifty male and fifty female patients presenting with tuberculous pleural effusion were included in the study. The patients were taken from the medical ward of Sir Ganga Ram Hospital. Activity of adenosine deaminase [ADA] was estimated by the technique of Sodium dodecyl sulphate electrophoresis [SDS-EF] using 10% polyacrylamide gel. There is an increased level of enzyme ADA in pleural fluid of tuberculous patients as compared to normal subjects. Estimation of ADA activity may provide the basis for the rapid and efficient diagnosis of pleural TB in different clinical settings. However study should be carried out on large number of patients to reach a better conclusion

Identification of sensitive and specific markers for typhoid fever: the rapid detection

Typhoid fever is common in Pakistan and several developing countries, especially among children. There has been a continuous search for a simple and reliable test that can be carried out in a small laboratory, for an early and rapid diagnosis. For this purpose, Typhidot test and TUBEX test have been evaluated in the present study. Blood samples from 131 patients with age range of 2-10 years presented with 4 days of fever. The patients were recommended for the detection of 1gM and IgG antibodies to Salmonella typi. Typoidot test was positive for both IgG and 1gM antibodies to S. typhi in our samples. Typhidot test gave a sensitivity of 100 percent and specificity of 80 percent when bacteraemic patients were analyzed. It has been concluded that the Typohidot is a quick and easy-to-perform test that requires no special equipment and training of staff for interpretation of results. The ELISA results for 1gM and IgG were more sensitive and specific than any combination of the Widal test, and hence it could be a useful tool for the serologic diagnosis of typhoidal fever with a single blood sample

Role of ions, lipids, serum and urinary protein profile in developing hypertension

Study was conducted to observe the relationship of ions with lipid profile and protein content of hypertensive patients. Lipid profile, ions and serum and urinary proteins were studied in patients with hypertension and compared with normal subjects. Serum cholesterol, triglyceride and LDL-chol were significantly increased, whereas the level of HDL-cholesterol was significantly decreased in patients as compared to their controls. Serum calcium was increased, whereas the level of serum magnesium was decreased as compared to control subjects. Serum protein level is non significantly decreased whereas serum albumin and urinary protein decreased significantly. Beside lipid profile, there may be a role of ions like calcium and magnesium as will as of protein in hypertension

Study the combined effects of amlodipine and simvastatin on lipid profile in Hypertensive obese patients

A study was conducted to evaluate the combined effect of Amlodipine and Simvastatin on the lipid levels of hypertensive obese patients. Amlodipine belongs to the dihydropyridine subclass of calcium antagonist whereas Simvastatin is a competitive inhibitor of HMG-CoA [3Hydroxy 3Methyl Glutaryl Coenzyme A] reductase. Three group of patients of both gender comprises 40 in each were included. Group A [hypertensive obese patients] was given amlodipine, group B [obese patients] was given simvastatin and group C [hypertensive obese patients] was given combination of amlodipine and simvastatin. Blood pressure was checked and tests for serum Cholesterol, serum Triglycerides and serum Lipoprotiens [HDL, LDL] was carried out by Standard kit methods [Merck]. The patients were evaluated three times i.e. before giving the medicines 0 week, at 6[th] and 12[th] week. The patients were advised to take fat free diet and a morning walk. Mean blood pressure of both male and female patients was significantly reduced. It was observed that combined therapy of Amlodipine and Simvastatin, significantly decreased the level of serum cholesterol, triglycerides and LDL-Cholesterol and significantly increased the level of HDL-Cholesterol in both sexes, but they did not show any significant synergistic effect as compared to the levels of these parameters in group A [amlodipine] as well as in group B [simvastatin]. A significant weight reduction is observed in male patients which may be due to low calorie diet and physical exercise. It is therefore concluded that synergism with Amlodipine and Simvastatin is not significant as the major action of Amlodipine is on blood pressure and the major effects of Simvastatin is on lipid profile and also reduced the body weight, if patients used calorie restricted diet with some morning walk

Effect of lithium carbonate on serotonin [5'HT] and creatine phosphokinase [CPK] in depressed patients

Depression is an illness that involves feelings of sadness lasting for two weeks or longer, often accompanied by a loss of interest in life, hopelessness, and decreased energy. It is a medical illness linked to changes in the biochemistry of the brain. Lithium is used for acute mania or prevention of recurrences of bipolar manic-depressive illness in adults. Lithium is a toxic drug and not metabolized in the body. Twenty patients with manic depression, 5 with hypomania and 5 hysteria were taken in the study. Effect of lithium on biochemical parameters like serotonin [5'hydroxy tryptamine], CPK and lithium were determined. Lithium treatment when applied to patients suffering from depression increases level of 5'HT, which is beneficial. However, increase in levels of serum CPK and lithium also occurs which may be toxic. Hence care needs to be taken in treatment to avoid brain damage to patients. It is therefore concluded that during lithium treatment careful monitoring of lithium blood level must be done to ensure adequate therapeutic efficacy without toxicity