To Study the Characteristic of Occlusion of Primary Dentition in Pre School Children-An Epidemiological Study

Background: Childhood is the mirror that reflects our future and habits that form part of our childhood are inculcated in our adulthood. Similarly the primary dentition lays down foundation stone for our permanent dentition and determines all the basic characteristics of permanent dentition. The objective of the study is to assess the occlusal characteristics of primary dentition in the age group of 3-5 years in school of Sriganganagar. All the basic parameters, terminal molar relationship, primary canine relationship, the degree of overbite and overjet (in millimeters) were considered in this study. Methods: The study was based on examination of the primary dentition of 600 preschool children aged 3-5 years old from Sriganganagar, India. The sample was selected from nursery school and the age of each child were obtained from school records. Healthy preschool children irrespective of socioeconomic status whose age was between 3-5 years were included in the study. Results: A total of 600 children who met the selection criteria were examined. In this sample size, 136 were of 3 year of age, 152 children were 4 year of age and 321 children were of 5 year of age respectively. Age wise distribution of primary molar relationship for Right side was 83.8% for flush terminal plan, 12.5 % was mesial step, 3.7 % distal step and on left side it was 84.6% for flush terminal plan, 11.8% was mesial step, 3.7% distal step and it was found to be significant however the age wise distribution of canine relationship, overbite and overjet was found to be insignificant. Conclusion: There is an increase in mesial step molar relationship with age, which is statistically highly significant. Distal step molar relationship was less prevalent and was not significant with age. However, the Class I canine relationship was the most prevalent type of deciduous canine relationship than the Class II canine relationship, though the changes in canine relationship with age were not statistically significant. In addition, the changes in overjet and overbite with age were not statistically significant. Also No case of anterior open bite (negative overlap) was observed. Probably larger scale of sample size may be required to assess the incidence of cases of negative overlap.

Sexual dimorphism using mandibular canine in establishing sex identity among Kashmiri population – A clinical study

Gender determination in forensic investigation is of immense medico legal importance especially in mass disaster. Teeth are excellent tools for identification as they are resistant to physical and chemical agents. The aim of the present study was to investigate gender dimorphism by measuring the linear dimensions of mandibular canine width and inter canine width among Kashmiri population. The study consists of 125 subjects selected from outpatient clinic of oral medicine and radiology, 64 were males and 61 were females. The age groups selected were in range from 18-24 years. There was statistically significant difference in canine width on right and left sides and inter canine distance between males and females (p value less than 0.05). These parameters can be helpful in determining the gender of the unknown deceased person in forensic investigations among Kashmiri population

Left atrium volume as a surrogate marker of left ventricular diastolic dysfunction

Objective: To determine correlation between left atrial volume and left ventricular diastolic dysfunction

Methodology: This was a single center observational study conducted at Lady Reading Hospital, Peshawar. Patients above 18 years of both genders, who were in sinus rhythm and having no significant systolic dysfunction or significant mitral insufficiency on echocardiography, were included in the study, using purposive non-probability sampling technique. A total 339 patients underwent transthoracic echocardiography from July 2013 to June 2014. Detailed cardiac echocardiography was performed to determine left atrial volume, ejection fraction, E and A velocities, deceleration time and e've-locity, E/e

Results: A total of 339 patients were studied. Male were 61.9%. Mean age of study population was 58.42 +/- 10.48 years. Baseline characteristics of patients having some degree of diastolic dysfunction were; mean age 65.5 +/- 12.3, mean body mass index 25.2 +/- 2.5 kg/m2, mean ejection fraction 55.1 +/- 7.5%, hypertension 48.6%, diabetes mellitus 10.1% and left ventricular hypertrophy 38.6%. Echocardiographic findings in diastolic dysfunction patients were as follow: mean left atrial volume was 65.3 +/-10.1 ml, E/A 1.4 +/- 0.6, TDI e' was 6.7 +/-1.3 m/sec and TDI E/e' was 12.7 +/- 2.1. Increasing left atrial volume was well correlated with increasing severity of left ventricular diastolic dysfunction [y = +0.8, Spearman rank correlation]

Conclusion: Increase in left atrial volume is directly correlated with severity of diastolic dysfunction. Severity of diastolic dysfunction increases with increased left atrial volume

Assessment of status of thyroid functions in patients of beta thalassemia major, reporting to OPD of military hospital, Rawalpindi

Objective: To determine the status of thyroid functions in patients of beta Thalassemia Major, reporting to OPD of Military Hospital, Rawalpindi

Study Design: Descriptive cross sectional study

Place and Duration of Study: Paediatric Outpatients Department of Military Hospital, Rawalpindi from 1st Jan to 30th Jun 2012

Material and Methods: After taking informed consent from the parents of all the children fulfilling the inclusion criteria, detailed history was taken and blood samples were drawn by strict aseptic means. Samples taken from these patients included complete blood and thyroid profile [serum thyroxine T4, triiodothyronine T3 and thyroid stimulating hormone TSH]. These blood samples were labeled and sent to Armed Forces Institute of Pathology [AFIP], Rawalpindi for analysis by enzyme-linked immunosorbent assay [ELISA]. Primary hypothyroidism was defined by TSH levels >4IU/ml. Statistical analysis was done at the end of study using SPSS version 10. Significance for association was calculated using student t-test

Results: Sixty patients fulfilled the inclusion criteria out of these sixty four patients lost the follow up while 56 patients completed the study. Out of 56 patients, 21 [37.5%] had biochemical evidence of hypothyroidism. Mean Ferritin level was 3924 +/- 1247ng/ml in hypothyroid and 3136 +/- 1387ng/ml in euthyroid patients indicating a significant difference in mean serum ferritin levels between hypothyroid patients and others

Conclusion: The study demonstrates hypothyroidism in a significant number of hyper transfused beta- thalassemic patients, emphasizing the importance of monitoring thyroid functions in thalassemic patients, particularly in those receiving suboptimal chelation

Intragenic deletion mutation in the gene desmoglein 4 underlies autosomal recessive hypotrichosis in six consanguineous families

Objectives: Localized autosomal recessive hypotrichosis is a non-syndromic human hair loss disorder, affecting scalp, eyebrows and eyelashes, and other parts of the body. Six consanguineous families with this form of hair loss disorder were investigated at both the clinical and molecular levels

Methods: Linkage in six families with twenty-one affected members was tested by genotyping microsatellite markers linked to autosomal recessive hypotrichosis loci including localized autosomal recessive hypotrichosis [LAH] 1, 2 and 3. Sequence analysis of the entire coding and splice sites of the gene DSG4 was performed to search for the disease-causing mutation

Results: Genotyping established linkage in families to the DSG4 gene at LAH1 locus on chromosome 18q21.1. Sequence analysis detected an intragenic deletion mutation [Ex5_8 del] in affected members of all six families

Conclusion: Identification of recurrent mutation in six additional Pakistani families strengthens the body of evidence that this is an ancestral mutation that is widespread among different Pakistani ethnic groups

Decreased serum 25-hydroxycalciferol levels in pre-diabetic adults

Objective: To determine the serum 25-hydroxycalciferol levels [25[OH]D] in adults with pre-diabetes and normoglycaemia to examine a possible association of vitamin D deficiency with pre-diabetes

Study Design: Case control study

Place and Duration of Study: Armed Forces Institute of Pathology, Rawalpindi, from November 2012 to July 2013

Methodology: A total of 272 adults including 136 pre-diabetics and 136 normoglycaemics of either gender aged 20 years and above were consecutively inducted. Patients with diabetes mellitus, pregnancy, rickets and osteomalacia, ischemic heart disease, chronic kidney disease and chronic liver disease were excluded. Fasting Plasma Glucose [FPG] was estimated with hexokinase method on Modular p800 Roche chemistry analyzer while serum 25[OH]D was measured on Diasorin Liaison immunoassay analyzer using the chemiluminescent technique. Mean 25[OH]D levels in pre-diabetic and normoglycaemic groups were compared using Mann-Whitney U test. Spearman's correlation coefficient 'r[s]' was determined between serum 25[OH]D and FPG. Odds ratio for vitamin D deficiency was also calculated

Results: Mean serum 25[OH]D level was low in pre-diabetics [23.2 nmol/L] as compared to normoglycaemics [29 nmol/L; p=0.001]. Serum 25[OH]D level had inverse correlation with FPG [r[s] = -0.448, p=0.000]. There was also significant association of vitamin D deficiency with pre-diabetes compared with normoglycaemia [OR: 2.21, p= 0.016; 95% CI: 1.15-4.27]

Conclusion: Vitamin D deficiency with pre-diabetes suggested that vitamin D may have an important role in pathogenesis of pre-diabetes

Does preoperative predictive lung functions correlates with post surgical lung functions in lobectomy.

Background: Patients with normal pulmonary function tolerate removal of an entire lung without respiratory problems. In patients witth impaired pulmonary function, post resectional function is of importance for the assessment of surgical risk. This necessitates the ability to measure the relative contribution of the parenchyma to be resected to the total lung function and the predicted postoperative lung functions. Objective: To determine preoperative lung functions as assessed with split lung functions and correlates with postsurgical lung functions and to determine the effect of lung resections on spirometric lung function. Material and methods: All those patients planned for lung resection surgery were included in the study. Predicted postoperative FEV1 and FVC were calculated. Preoperative spirometry was performed within a week before surgery. Predicted postoperative values were calculated. Postoperative spirometry was performed at the end of first month, third month, and sixth month for each patient. The relationship between potential predictors and postoperative complications were assessed. The predicted values were correlated with measured values (actual values) during the postoperative follow up. Results: Lobectomy was done in 64 persons. The predicted postoperative FEV1 and FVC correlated well with observed FEV1 and FVC in lobectomy (p<.05). The mean preoperative FEV1/L were 1.8 and the mean predicted postoperative (L) FEV1 were 1.4. The mean FEV1 at 1 month follow up were 1.6 and the mean FEV1 at 3 month follow up were 179.8.

Sonographic measurement of renal size in normal North Indian children.

Objective: To determine the renal size in normal North Indian children by renal sonography. Design: Hospital based (outpatient based) cross sectional observational study. Material and methods: Total 1198 normal children aged 1 month to 12 years were included in the study. Sonographic assessment of renal size (length, width and thickness) was performed using Philips, multi frequency (3.5, 5 and 7.5 Mhz) linear and convex probes in B-mode. The mean renal dimensions and volume were calculated for each age group with ± 2SD. The renal length and calculated renal volume were correlated with somatic parameters like age, weight, height, and body surface area (BSA). Linear Regression equations were derived for each variable. Results: A strong correlation was seen between renal size and renal volume with various somatic parameters (age, weight, height, BSA), (coefficient of correlation = 0.9). Conclusion: This study provides values of renal size (mean± 2SD) in normal North Indian children and its correlation with age, weight,height, and BSA. Renal size can be easily calculated by derived linear regression equation.

Heart failure clinical outcomes in hyponatremic versus normonatremic patients

To compare the outcome in heart failure patients between normonatremic and hyponatremic cases in the short term. A cross-sectional study focusing on descriptive statistics at the Department of Cardiology, Lady Reading Hospital Peshawar was performed from 9th August 2011, till 29th April, 2012. Both male and female patients aged 14 years and above admitted diagnosed with heart failure were enrolled and data observed. Those having serum sodium of ?135mmol/L were defined as hyponatremic. All the patients were managed according to guidelines. All patients were followed during their hospital stay. Patients who survived were discharged on standard HF medications and followed till the end of third month for 3 month mortality and re-admissions for heart failure. Total study population was 241. Mean age was 59.2 +/- 14.9 [18- 100] years. Female patients were 51% [123]. Mean serum sodium was 136 +/- 5.1mmol/L [116-151]. Hyponatremia was present in 35.3% [85] patients. Overall three month follow up mortality was 14.7%, while it was significantly higher in hyponatremic group 22.7% compared to normonatremic patients 10.7% [P=0.02]. Being followed for a period of 3 months 25% patients were readmitted to hospital with heart failure decompensation. Hyponatremic group had readmission rate of 26.7% compared with 24% in normonatremic patients [p=0.74]. Hyponatremia in patients diagnosed with heart failure possess a significant over all risk to a higher mortality as compared to those that are normonatremic. Re-admissions for heart failure are equally common in hyponatremic and normonatremic patients

Characteristics of pseudoaneurysms in Northern India; risk analysis, clinical profile, surgical management and outcome

Objective: To determine the risk factors, clinical characteristics, surgical management and outcome of pseudoaneurysm secondary to iatrogenic or traumatic vascular injury

Methods: This was a cross-sectional study being performed in department of cardiovascular and thoracic surgery skims soura during a 4-year period. We included all the patients referring to our center with primary diagnosis of pseudoaneurysm. The pseudoaneurysm was diagnosed with angiography and color Doppler sonography. The clinical and demographic characteristics were recorded and the risk factors were identified accordingly. Patients with small swelling [less than 5-cm] and without any complication were managed conservatively. They were followed for progression and development of complications in relation to swelling. Others underwent surgical repair and excision. The outcome of the patients was also recorded

Results: Overall we included 20 patients with pseudoaneurysm. The mean age of the patients was 42.1 +/- 0.6 years. Among them there were 11 [55%] men and 9 [45%] women. Nine [45%] patients with end stage renal disease developed pseudoaneurysm after inadvertent femoral artery puncture for hemodialysis; two patients after interventional cardiology procedure; one after femoral embolectomy; one developed after fire arm splinter injury and one formed femoral artery related pseudoaneurysm after drainage of right inguinal abscess. The most common site of pseudoaneurysm was femoral artery followed by brachial artery. Overall surgical intervention was performed in 17 [85%] patients and 3 [15%] were managed conservatively

Conclusion: End stage renal disease is a major risk factor for pseudoaneurysm formation. Coagulopathy, either therapeutic or pathological is also an important risk factor. Patients with these risk factors need cannulation of venous structures for hemodialysis under ultrasound guide to prevent inadvertent arterial injury. Patients with end stage renal disease who sustain inadvertent arterial puncture during cannulation for hemodialysis should receive compression dressings for 5 to 7 days

Extensively and pre-extensively drug resistant tuberculosis in clinical isolates of multi-drug resistant tuberculosis using classical second line drugs [levofloxacin and amikacin]

To find out the frequency of Extensively Drug Resistant [XDR] and pre-XDR tuberculosis in clinical isolates of Multi-Drug Resistant [MDR] Tuberculosis [TB] by determining the susceptibilities against Levofloxacin and Amikacin [classical second line antituberculosis drugs]. A descriptive cross-sectional study. Microbiology Department, Armed Forces Institute of Pathology [AFIP], Rawalpindi, from September 2011 to August 2013. Amikacin [AK] and Levofloxacin [LEVO] were obtained in chemically pure form from Sigma [Taufkirchen, Germany]. The breakpoint concentration used for AK was 1.0 microg/ml and for LEVO 2.0 microg/ml. Mycobacterial Growth Indicator Tube [MGIT] 960 system was used to carry out drug susceptibility testing as per recommended protocol. A total of 3 MDR-TB isolates [3%] turned out to be XDR-TB based upon simultaneous resistance to injectable second line antituberculosis drug AK and one of the fluoro-quinolones [LEVO]. A total of 24 MDR-TB isolates [24%] were found to be pre-XDR based upon resistance to LEVO alone. Treatment status record of patients with XDR and pre-XDRTB isolates revealed that majority of patients had received fluoroquinolones [FQs] during the course of treatment. XDR-TB has started to emerge in MDR-TB isolates in our set up. The worrying sign is the high frequency of pre-XDR tuberculosis. Urgent steps need to be taken to stem the tide of pre-XDR-TB in our population. It is thus recommended to develop facilities to carry out drug susceptibility testing to monitor the status of pre-XDR and XDR-TB in our population

Rapid mycobacterium tuberculosis dna detection on fine needle aspirates from extra pulmonary lymph nodes

To evaluate the diagnostic efficacy of two rapid methods i.e. Mycobacterium tuberculosis [MTB] Polymerase Chain Reaction [PCR] on Fine Needle Aspiration [FNA] samples by comparing with cytology of respective site sample. Cross-sectional comparative study. Department of Microbiology, Armed Forces Institute of Pathology [AFIP], Rawalpindi, Pakistan, from July 2010 through November 2013. A total of 105 extra pulmonary lymph nodes aspirates obtained through fine needle aspiration were processed. Cytology and PCR were done on each specimen. Cytology was taken as gold standard. Out of the total 105 samples, 71 [67.6%] were positive for the MTB PCR while 34 [32.4%] showed negative status. According to FNA cytology [FNAC] results, 72 [68.6%] cases were positive for the disease while 33 [31.4%] were negative. Sensitivity of PCR was 90.3%, specificity 81.8%, positive predictive value [PPV] 91.5%, negative predictive value [NPV] 79.4%, with diagnostic accuracy of 87.6%. Area under the curve was 0.860 [p < 0.001]. PCR is a sensitive tool for detection of MTB on FNA samples from EPTB cases. The results are available within few hours which is helpful for the clinicians to initiate therapy

In vitro evaluation of linezolid and meropenem against clinical isolates of multi drug resistant tuberculosis by mycobacterial growth indicator tube [MGIT] 960

To evaluate the in vitro effectiveness of multiple breakpoint concentrations of newer antituberculosis agents [Linezolid and Meropenem] against Multi Drug-Resistant Tuberculosis [MDR-TB] isolates. A descriptive cross-sectional study. Microbiology Department, Armed Forces Institute of Pathology [AFIP], Rawalpindi, from September 2011 to August 2013. A total of 100 MDR-TB isolates recovered during the study period were subjected to susceptibility testing against multiple breakpoint concentrations of Linezolid [LZD] and Meropenem [MER]. The breakpoint concentration used for LZD were 0.5, 1.0 and 2.0 microg/ml, while for MER were 4.0, 8.0 and 16 microg/ml. Mycobacterial Growth Indicator Tube [MGIT] 960 system was used to carry out drug susceptibility testing as per recommended protocol. At break point concentration of 0.5 microg/ml, 80 out of 100 [80%] MDR-TB isolates were susceptible to LZD while at breakpoint concentration of 1.0 microg/ml and 2.0 microg/ml, 96/100, [96%] of MDR-TB isolates were susceptible. For MER, at breakpoint concentrations of 4.0 microg/ml no MDR-TB isolate was susceptible, while at 8.0 microg/ml 3/100, [3%] and at 16.0 microg/ml 11/100, [11%] of MDR-TB isolates were susceptible. LZD was found to have excellent in vitro efficacy as 96% of MDR-TB isolates were susceptible at breakpoint concentration of 1.0 microg/ml or more. In case of MER it was found that in vitro susceptibility improved as the break point concentrations were increased

Assessment of the immunization status of children between 1-3 years of age, coming to opd of military hospital, Rawalpindi

To determine the immunization status of children between 1-3 years of age, reported at children OPD; Military Hospital, Rawalpindi. Descriptive cross sectional study. Paediatric outpatients department of Military Hospital, Rawalpindi from January to June 2010. Vaccination data of 2200 children of 1-3 years of age coming to outpatients department, regarding seven EPI target diseases was collected using a standard proforma. Statistical analysis was done at the end of study using SPSS version 14.0. Out of 2200 children, 1256 [57.1%] were completely immunized, 740 [33.6%] were partially immunized and 204 [9.3%] were unimmunized.: This study concludes that immunization indicators have not met the expected benchmarks and achievements are inadequate as compared to the regional and global immunization level

Clinical profile of patients with normal coronary angiogram

To observe the clinical and bio-chemical profile of patients having normal coronary angiogram following an abnormal stress test. This was a single center retrospective, descriptive study. Coronary angiograms done from July 2009 to December 2011 were retrieved and reviewed for normal coronary arteries. Clinical and bio-chemical profile of the patients having normal coronary angiogram was retrieved from hospital record. Patients, whose computerized data could not be retrieved from department database, were excluded from the study. Out of 8425 angiograms reviewed, 816[9.7%] were having normal coronary arteries. Mean age was 4 +/- 27.4 years. Females were 66.7%. Clinical and biochemical profile for normal coronary angiograms was as follows: smokers 59%, family history of premature coronary artery disease 41%, hyperlipidemia18.5% and hypertension 14%. Diabetes was present only in 2.1%. Among females: 11% were current users of oral contraceptives pills, 3.4% were post menopausal and 0.87% pregnant. Mean BMI was 25.4 +/- 5.2 and total cholesterol and triglyceride were 278 +/- 31mg/dl and 180 +/- 28mg/dl respectively. Normal coronary angiogram is infrequently observed in catheterization laboratories and mostly found in younger to middle aged females. Smoking is very common in such patients. Hyperlipidemia, hypertension, diabetes mellitus are not frequently present in these patients.

Frequancy of hyponatremia and in hospital clinical outcomes in these patients hospitalized for heart failure

To determine the frequency of hyponatremia and in-hospital clinical outcomes in hyponatremic patients hospitalized for heart failure.This was a descriptive study conducted in department of cardiology, Lady Reading Hospital, Peshawar. Both male and female patients aged 14 years and above admitted with heart failure fulfilling the inclusion criteria, were included in the study. Patients were subjected to detailed history and clinical examination. Admission Serum sodium was measured in all patients. All the patients were managed according to guidelines. All patients were followed for in hospital mortality and length of hospital stay [LOHS].The total number of patients was 241. Mean age was 59.2 +/- 14.9 [range 18-100] years. Females were 123 [51%] patients. Mean serum sodium was 136 +/- 5.1mmol/L. Hyponatremia [serum sodium

efficacy of rigid bronchoscopy for foreign body aspiration

The aim of the current study was to determine the pattern, presentation and management of foreign body aspiration in our population. This prospective study comprised 55 patients with foreign body aspiration admitted to our department from January 2009 to December 2011. All patients underwent rigid bronchoscopy under local or general anesthesia. The patients' demographic information along with clinical characteristics and their outcome were recorded and reported. The mean age of the children was 13.3 +/- 3.6 years. There were 32 [58.2%] females and 23 [41.8%] males. The frequent symptom was an attack of chocking followed by cough. The predominant sign was wheezing. Rigid bronchoscopy was successful in removing foreign body from 52[94.5%] patients. Three [5.5%] patients who had undergone thoracotomy with bronchotomy needed exploration, after failure of bronchoscopy to remove the foreign body. There was no mortality in our series. Average hospital stay was 12 hours. It could be concluded that rigid bronchoscopy is modality of choice in management of foreign body aspiration especially in pediatric population

Hirschsprung's disease; diagnosis and management: experience at Ibn E Siena and Nishtar hospital, Multan

To determine the frequency of Hirschsprung's Disease as a cause of neonatal intestinal obstruction, to compare the results of treatment with others and to suggest means and ways to improve the deficiencies in our circumstances. Nishtar hospital and Ibn-e-Siena Hospital, Multan from January, 2008 to June, 2012. A total number of 115 patients from neonatal age to more than 5 years were diagnosed and treated for Hirschsprung's Disease. Hirschsprung's Disease was a cause of neonatal obstruction in 26 [22.6%] patients. Hirschsprung's Disease was a cause of recurrent diarrhea in 37 [32.17%] patients. 76 [66.08%] patients presented with chronic constipation. 27 patients underwent for pull-through operation. The overall complications rate and stooling pattern after Soave's procedure are not significantly different from others

Comparison of friedewald formula and modified friedewald formula with direct homogeneous assay for low density lipoprotein cholesterol estimation

To compare the Friedewald and modified Friedewald formulae with direct homogeneous assay for serum lowdensity lipoprotein cholesterol [LDL-C] levels estimation. Cross-sectional study. Armed Forces Institute of Pathology, Rawalpindi, from June to December 2011. Healthy subjects of either gender, from Rawalpindi, aged 18-75 years were included by consecutive sampling. Patients with diabetes mellitus, chronic liver disease, chronic kidney disease, those taking lipid lowering drugs and samples with triglyceride [TG] > 4.52 mmol/l were excluded from the study. Total cholesterol, high-density lipoprotein cholesterol, TG and LDL-C were measured on Hitachi 912 chemistry analyzer [Roche]. LDL-C levels were also calculated by Friedewald formula [FF] and Vujovic modified formula [VMF]. Paired sample t-test and scatter plots were used for statistical analysis. Although both calculated methods showed good correlation with direct assay [r > 0.93] in 300 subjects, but the difference was statistically significant. The ffLDL-C were 0.12 A +/- 31 mmol/l [p < 0.001] lower and vmfLDL-C were 0.11 A +/- 26 mmol/l [p < 0.001] higher than dLDL-C. The difference was not significant between ffLDL-C and dLDL-C at TG levels < 1.70 mmol/l [p = 0.58] and between vmfLDL-C and dLDL-C at TG levels 2.26 - 4.52 mmol/l [p = 0.38]. At all other TG levels, the difference between LDL-C calculated by both formulas and dLDL-C was statistically significant [p < 0.001]. As compared to direct assay, 11% and 14% subjects were classified in wrong National Cholesterol Education Programm's cardiac risk categories by FF and VMF respectively. LDL-C should be measured by direct homogeneous assay in routine clinical laboratories, as the calculated methods did not have a uniform performance for LDL-C estimation at different TG levels