Assessment of genetic diversity in chinese hulless barley accessions for qualitative traits

Cultivated barley (Hordeum vulgare L.) has been proven to be an economically important model plant and having large genetic diversity among the species. The effective exploitation of qualitative characters in barley can be measured by its genetic diversity and interrelationship. This study aims to determine the assessment of genetic diversity in Chinese hulless barley accessions for qualitative traits. Presently, in this study, the genetic diversity of 208 Chinese hulless barley from different Provinces of China, 111 genotypes were from the Tibet plateau, 30 Sichuan, 2 USA, 1 Canada, 12 Gansu, 51 Qinghai, 1 Yunnan was investigated; collected. Almost all the qualitative traits including crude protein, fiber, starch, neutral detergent fiber, and acid detergent fiber exhibited significantly high variability (p≤0.0001) among the cultivars. The data were analyzed using Statistics 8.1. In this study, significantly high variation was observed between starch content and neutral detergent fiber (23.64% and 11.54%). However, the highest diversity is based on the magnitude of the coefficient of variation exhibited in crude protein (13.82%), starch (12.87%), and fiber (12.17%). There was a significantly positive correlation between fiber, acid detergent fiber, and neutral detergent fiber except for starch content with crude protein and fiber that exhibited a significant negative correlation (r= -0.38*** and r= -0.92***). A large genetic diversity was observed through cluster analysis among all the 208 barley accessions, distance coefficient ranging between 0.28 and 75.86. The histogram revealed that frequency distributions of 208 different genotypes of hulless barley crop with all five different characters, crude protein, fiber, starch, neutral detergent fiber, and acid detergent fiber, showed normal distribution. It is concluded that this hulless barley study showed genetic diversity among the accessions and confirmed genetic diversity in various traits used.

Toxoplasma gondii virulence prediction using hierarchical cluster analysis based on coding sequences (CDS) of sag1, gra7 and rop18

Toxoplasma gondii consists of three genotypes, namely genotype I, II and III. Based on its virulence, T. gondii can be divided into virulent and avirulent strains. This study intends to evaluate an alternative method for predicting T. gondii virulence using hierarchical cluster analysis based on complete coding sequences (CDS) of sag1, gra7 and rop18 genes. Dendrogram was constructed using UPGMA with a Kimura 80 nucleotide distance measurement. The results showed that the prediction errors of T. gondii virulence using sag1, gra7 and rop18 were 7.41%, 6.89% and 9.1%, respectively. Analysis based on CDS of gra7 and rop18 was able to differentiate avirulent strains into genotypes II and III, whereas sag1 failed to differentiate.

Identification of Cryptosporidium parvum Oocysts among Hospitalized Children under-5years in Northeastern Nigeria

Cryptosporidium parvumis among the major pathogens causing diarrheal diseases in children. It is of major public health significance due to its low infectious dose and its oocysts are highly resistant to chlorination, common household disinfectants and survive long periods in the environment. This study was designed to evaluate the occurrence of Cryptosporidium parvum oocysts in stool of hospitalized children under-5years. One hundred and fifty (150) stool samples were collected from one hundred and fifty children (Male:Female= 1:1.08, Mean Age±S.D=22.08 months ± 21.02) and were processed using the modified Ziehl-Nelson method for identification of protozoan oocysts. Out of the one hundred and fifty (150) stool samples analyzed, 16 tested positive to oocysts of C. parvum, which gives a parasite prevalence rate of 10.7%. This was observed to be higher among male patients (52.0%) and children between the age 32-41months (31.3%). Parasite prevalence in relation to age of patients was statistically not significant (X2=0.105, DF=1, P-value= 0.74591, p<0.05). Other intestinal protozoan parasites identified include Entamoeba histolytica(1.33%) and Giardia lamblia (2.60%

Association between Parental Smoking and Pneumonia among Children Less Than 5 Years of Age

Introduction: Pneumonia continues to be the biggest killerworldwide of children under five years of age. Although theimplementation of safe, effective and affordable interventionshas reduced pneumonia.Objective: The objective of this study was to find associationbetween parental smoking and pneumonia in children under 5years of age presenting to tertiary care hospitals in Peshawarcity, Pakistan.Methodology: It was Unmatched Case Control Study with aratio of 1:1. Cases were children less than five years of agepresenting to four major tertiary care hospitals with Pneumoniainfection. Controls were selected from same hospital withmedical condition other than respiratory infection.Results: Among the total sample of 248 children, 67 (27%) ofthe children’s parents were smokers while 181 (83%) were notsmoking. Pneumonia infections were twice likely to developamong those children who were exposed to parental smokingat home with an odd ratio of 2.02 (95% C: 1.14-3.60)Conclusion: Children exposed to second hand smoking are athigh risk of developing respiratory problems like asthma later inlife. More effective policies and strategies are required to limitthe second hand smoking exposure at homes.

Early outcome of cardiac surgery in dialysis-dependent end-stage renal failure patients

@#Introduction: Preoperative dialysis-dependent renal failure is a strong independent risk factor for in-hospital mortality and morbidity after open heart surgery. This retrospective study analyses the early outcome in dialysis-dependent renal failure patients who underwent elective open-heart surgery in the Institut Jantung Negara (IJN). Methods: We retrospectively analyse a series of 228 consecutive postoperative patients with dialysis-dependent (end stage renal failure (ESRF)) admitted to the adult cardiothoracic ICU in IJN between January 2012 and December 2016. Results: The overall early mortality rate included 34 patients (15.8%). Patients with ESRF underwent combined procedure recorded a very high mortality rate at 56.3%. Twenty-four patients (11.2%) needed resternotomy for postoperative bleeding or cardiac temponade. Postoperative mediastinitis rate was high, involving 13 patients (6%). The neurological and gastrointestinal complications rate were recorded at 2.3% (5 patients) and 6% (13 patients) respectively. In the group of patients (n=199) with sinus rhythm during the preoperative period, 100 patients (50.3%) developed postoperative AF. 77 patients (35.8%) stayed in hospital for more than 14 days. Conclusions: dialysis-dependent patients undergoing cardiac surgery poses higher perioperative risk of mortality and morbidity of 3-4 times higher compared to those patients with normal renal function. IJN shows acceptable perioperative risk of mortality and morbidity which is comparable to other centres

Maternal diet and its association with human milk energy and macronutrient composition among exclusively breastfeeding Malaysian Malay mothers

@# Introduction: This study aimed to determine the relationship of maternal dietary intake with human milk nutritional composition, among Malay mothers during the postpartum period of exclusive breastfeeding. Methods: Human milk samples (20- 30ml) were collected from mothers (n=32) at least once monthly for six months postpartum. Macronutrients and fatty acids contents were determined using proximate analysis and gas chromatography methods, respectively. Maternal dietary intakes were recorded using the multiple-pass diet recall method prior to each milk sampling and were analysed using the Nutritionist ProTM software. Associations between the milk composition and maternal diet were tested using Spearman correlation. Results: The energy content ranged between 49.6-59.2 kcal/100ml, protein 1.3-1.4 g/100ml, carbohydrate 6.5-9.7 g/100ml and total fat 6.5-9.7 g/100ml. The polyunsaturated, monounsaturated, and saturated fatty acids concentrations were 10.5-19.1 %, 40.6-43.5 %, and 38.0-49.7 %, respectively. During confinement (first month postpartum), total energy and total fat content of human milk were the highest whereas total carbohydrate was the lowest, compared to the rest of the exclusive breastfeeding period. In contrast, intakes of total calorie and total fat were the lowest, whereas protein was the highest during this period. However, no associations were detected between human milk nutritional contents and maternal dietary intake. Conclusion: In our study population, the composition of maternal diet and nutritional content of human milk differed between confinement and post-confinement periods. However, the association between maternal diet and human milk composition itself warrants further investigation.

Bioethanol Production by Enzymatic Hydrolysis and Fermentation of Cocoyam

Bioethanol, produced by anaerobic fermentation of carbohydrates with microorganism is a liquid fuel used either as energy source or as an additive/enhancer for fossil petrol. This research was carried out to explore the potential of cocoyam starch as an alternative feedstock for bioethanol production. Cocoyam corms and cormels were peeled, dried and milled to flour, the slurries were then mashed with different enzyme cocktails comprising of amylase, glucoamylase and protease enzymes. The saccharified wort obtained was fermented with yeast; Saccharomyces cerevisiae without exogenous nutrient supplementation. Two fermentation processes were employed. Simultaneous Saccharification and Fermentation (SSF) and Separate Hydrolysis and Fermentation (SHF). Glucose liberated during mashing was determined by glucose oxidase method and it was found that enzymatic hydrolysis of cocoyam flour was effective in yielding favourable levels of fermentable glucose up to 86g glucose/100g substrate with batch 1 of enzymes. Ethanol production was measured from the cocoyam mash and it was found that S. cerevisiae produced ethanol levels equating to 398 L/ton which compares favourably with yields from cassava 280 L/ton and corn 420 L/ton. These observations indicated that cocoyam can serve as a very cheap alternative biomass for bioconversion to bioethanol with minimal inputs.

Socio-economic factors affecting quality of life of Hemodialysis patients and its effects on mortality

Objective: Many factors affect quality of life [QOL] of dialysis patients. This study was conducted to determine the effect of socio-economic factors effecting QOL of hemodialysis patients

Methods: This descriptive multi-centric, follow up study was conducted at Department of Nephrology, Mayo Hospital, Lahore, from February 2015 to August 2017. All patients who were on regular maintenance hemodialysis [MHD] for more than three months and able to read and understand Urdu version of Kidney Disease Quality Of Life [KDQOL] tool were included in the study. Patients were included from hemodialysis units of Mayo Hospital [MH], Shalamar Hospital [SH], and Shaikh Zayed Hospital [SZH], Lahore. Patients with less than three-month duration on dialysis, with cognitive impairment, dementia, active psychosis, non-Urdu readers/speakers were excluded. Demographic data and lab data was collected on predesigned pro forma. Patients were divided into different groups on the basis of education, monthly income, source of funding for treatment and employment. Patients were followed up for two years to determine the effect of QOL on mortality

Results: One hundred and thirty-five patients were included in the study. Socio-economic factors like education, employment, income, funding was compared with KDQOL sub scales and were found statistically significant [p-value [<0.05]. We found that patients with higher income had better work status [p=0.039] but social [0.04] and sexual function [p=0.029] were relatively better in patients with low income. Employed patients had better work status [p=0.01], ability to do social function [p=0.027] but they had more pain [0.049], symptoms/problems of disease [p=0.05] and effect of kidney disease [p=0.015]. Those patients whose dialysis were funded by their family could socially interact [p=0.012] better and deal more efficiently with effect of kidney disease [p=0.007]. Higher education was associated with better emotional well being [p=0.045], patient satisfaction [p=0.046] and staff encouragement [p=0.045] then patient with lower level of education. QOL had no effect on mortality

Conclusion: The socio-economic factors consisting of education, employment, income and funding are important parameters affecting QOL of kidney patients. QOL does not affect mortality of the dialysis patients

Factors affecting dermatological manifestations in patients with end stage renal disease

Objective: To determine skin changes in patients of End Stage Renal Disease [ESRD] on maintenance hemodialysis [MHD] and factors affecting these changes

Study design: Cross-sectional observational study

Place and duration of study: Nephrology Department, Mayo Hospital, Lahore in collaboration with Dermatology Department, King Edward Medical University, Lahore, from October 2015 to January 2016

Methodology: Two hundred patients who were undergoing MHD for more than three months were included in the study. Patients' demographic data, laboratory reports and dialysis records were noted in a predesigned questionnaire. Skin examination was carried out by consultant dermatologist after patient's permission

Results: Among 200 patients included in study, 105 were malesand rest of them were females. Major causes of ESRD were Diabetes Mellitus [n=83, 41.5%, followed by Hypertension [n=80, 40%], Nephrolithiasis [n=15, 7.5%] and Chronic glomerulonephritis [n=5, 2.5%]. At least one cutaneous finding was present in every patient. Common skin findings observed were pigmentation [86%], xerosis [83%], pallor [79%], pruritus [69%], acquired ichthyosis [50.5%], and bacterial skin infections [18.5%]. Among them, nail manifestations were half-and-half nails [52%], onychomycosis [30.5%], onycholysis [20.5%], subungual hyperkeratosis [23.5%], and Mee's lines [7.5]. Among hair changes were sparse scalp hair [38.5%], brittle and lustreless hair [28%]. The factors contributing to skin changes were patient's age, cause of ESRD, anti HCV positivity, high urea and creatinine levels, duration and frequency of hemodialysis, hemoglobin levels, calcium phosphate product and socioeconomic status. Some skin manifestations were interrelated with each other like xerosis with pruritus [p<0.001], pruritus with bacterial infection [p<0.022], acquired Ichthyosis [p=0.008] and hair changes [p=0.035]

Conclusion: ESRD patients on hemodialysis develop various skin changes during the course of disease process, which contribute to increased morbidity. Different factors affecting skin changes were the cause of ESRD, adequacy and duration of dialysis, employment, financial status, anti HCV positivity, and metabolic factors

Congenital synechia and syngnathia: two case reports

This case report presents two cases of rare congenital malformation, i.e syngnathia. First case is of 2-day infant with bilateral fusion of maxilla and mandible, leaving a small anterior portion. After consultation with other concerned specialties, early intervention was planned and fusion was released to facilitate feeding. The infant suffered from frequent respiratory tract infections and subsequently died at the age of ten months. The second case is of 8-month baby girl with unilateral congenital maxillomandibular bony fusion without any other anomaly. She underwent general anesthesia for thorough examination and release of soft tissue union. Second surgery was performed after few months for removal of bony fusion. Good mouth opening was seen on 1 month follow-up

Outcome of chronic kidney disease patients on the basis of referral to nephrologist: a one-year follow-up study

Objective: To determine the outcome of chronic kidney disease [CKD] patients presenting for dialysis on the basis of referral to nephrologist. Study Design: Observational study. Place and Duration of Study: Nephrology Department of King Edward Medical University/Mayo Hospital, Lahore, from January 2014 to January 2016

Methodology: All patients who were presented in nephrology outpatients department and with the indication of dialysis were included in study. Patients who refused dialysis, and with acute kidney failure were excluded from the study. Proforma was designed for demographics, vital signs, volume status, and laboratory data [hemoglobin, urea, creatinine, albumin, bicarbonate etc.] of all the patients. On the basis of referral, patients were divided into two groups, i.e. early referral and late referral. Early referrals were those patients who were referred to a nephrologist more than three months before dialysis initiation. Late referrals were those patients who were referred to a nephrologist less than three months before dialysis initiation. Patients were followed up at one, three, six, and 12 months for outcome, i.e. still on dialysis or died

Results: One hundred and seventy-six patients were enrolled in the study, and 141 were followed up to one year. Seventy two [51.1%] patients were male, 69 [48.9%] were female and most [n=69, 48.9%] were in the middle age group. Major causes of end-stage renal disease [ESRD] were hypertension 70 [49.6%] and diabetes mellitus 66 [46.8%]. Seventy-six [53.9%] patients were in fluid overload and acidotic [n=123, 87.2%]. Twenty-seven [19.1%] patients were referred early and 114 [80.9%] were referred late. Overall mortality was 78 [55.3%] at one year. Factors affecting mortality were financial status and metabolic acidosis, but not referral. Temporary access for hemodialysis has 1.38 times more risk for mortality than the patients with permanent access

Conclusion: There is no difference on the outcome of dialysis patients on the basis referral to nephrologist. Factors affecting overall mortality in both groups were financial status, metabolic acidosis, and temporary access for dialysis. Most of the patients were referred late to the nephrologists

Immunomodulatory activity and chemical characterization of fixed oils obtained from different parts of Oxytropis glabra DC

Oxytropis glabra DC. is a plant with enormous therapeutic vitality. In the present study a comparison of lipophilic profiling of different parts of O. glabra has been carried out by using gas chromatography-mass spectrometry. A total of 32 compounds have been identified from this plant, amongst which 31 have been identified for the first time. These compounds have been further confirmed from their Van den Dool and Kratz [I] Indices. Out of these 32 compounds, 18 have been identified from flower [80.94%], 15 from fruit [85.36%], 11 from leaves [66.35%] and 11 from root [45.96%]. The major class of metabolite identified from different parts is fatty acid. Hydrocarbons have also been detected in flower and fruit but not in root and leaves. The extracts were screened for their immunomodulatory activity on whole blood cells. The root oil was found to be moderately active [IC50 32.3 micro g/ml]. At present only limited data is available on the phytochemical composition of O. glabra

Translation, validation and reliability of the kidney diseases quality of life-short form [KDQOL-SF form] tool in Urdu

Objective: to translate, validate and assess the reliability of kidney disease quality of life - short form [KDQOL-SF-36] in Urdu, national language of Pakistan

Study Design: a multicentric descriptive cross-sectional study

Place and Duration of Study: department of Nephrology, Mayo Hospital, Lahore, from February to July 2015

Methodology: patients of end-stage renal disease [ESRD] on maintenance hemodialysis [MHD] for more than three months were included in the study. Patients of ESRD not on dialysis and those with acute renal failure were excluded. The English version of KDQOL-SF-36 was translated in Urdu and then translated back in English; further validation was done by a senior professor of Punjab University, Lahore

Results: one hundred and thirty patients were included in the study. Fifty patients were from Mayo Hospital, 35 from Shalamar Hospital and 50 from Shaikh Zayed Hospital, Lahore. The internal consistency reliability coefficient for overall scale was 0.84. Twelve sub-scales [symptoms, effect of kidney disease, and burden of kidney disease, cognitive function, and quality of social interaction, sexual function, social support, physical functioning, role physical, pain, emotional wellbeing and role emotional] had more than 0.70 internal consistency reliability coefficients. Overall mean score of the domains i.e kidney disease component score [KDCS], physical component score [PCS], and mental component score [MCS] was 60.62 +/-17.61, 43.12 +/-19.54, and 49.27 +/-14.52, respectively. A significant positive relationship was observed between KDCS and MCS domains, KDCS and PCS domains, PCS, and MCS domains

Conclusion: the Urdu version of KDQOL-SF-36 is a reliable and valid version to measure QOL in kidney disease patients on dialysis in Pakistan

Relationship of oxidative stress with elevated level of DNA damage and homocysteine in cardiovascular disease patients

Amounts of DNA damage and homocysteine [Hcy] in heart patients blood may have strong function in the causation of cardiovascular disease [CVD]. The main objective of this work was to know experimentally the role of total oxidants [produced by Reactive Oxygen species [ROS], clinical biochemical indices, their oxidized products and total antioxidant status [TAS] among such patients to find the association of homocysteine, total oxidation status [TOS] and oxidative DNA damage with other clinical parameters in sixty positive CVD patients compared with those of 60 normal subjects. As compared to healthy individuals, CVD patients had significantly higher concentrations of homocysteine [p<0.0001], total oxidants stress [TOS] [p<0.0001], serum total lipids [p<0.04], malondialdehyde [MDA] [p<0.001], high density lipoprotein-cholesterol [HDL-C] [p<0.0001], and low density lipoprotein cholesterol [LDL-C] [p<0.01], than those of healthy individuals. Plasma Hcy content, TOS and amount of DNA were positively and significantly associated with cholesterol, triglycerides, systolic blood pressure, urea, and albumin [p values<0.01]. TOS, Hcy and oxidative DNA damage were negatively correlated with HDL-c, TAS and proteins. It is suggested that these parameters have pivotal role in diagnostic process of determining severity in CAD patients. Oxidized products of macromolecules in blood of CVD patients impart major functions in causing CVD disease

Frequency and outcome of hypoglycemia in children having severe protein energy malnutrition presenting with diarrhea

Background: Hypoglycemia in malnourished child with diarrhea is a complicated situation faced by pediatrician in emergency department

Objective: To determine the frequency and outcome of hypoglycemia in severely malnourished children suffering from diarrhea at time of admission

Methodology: Study Design: Cross sectional study. Sampling Technique: Non probability, consecutive sampling. Setting and Duration of Study: This study was conducted in Pediatric Medicine Unit-1, Bahawal Victoria Hospital, Bahawalpur from 16th May to 15th November 2012. Total 184 patients were selected. All were suffering from severe malnutrition and had acute diarrhea at admission. Serum sugar levels of all patients were checked and results were noted on the performa. SPSS version 10 was used for data analysis

Results: Among the 184 children 56 [30.4%] were hypoglycemic and 128 [69.6%] were normoglycemic. 41 [67.21%] out of 56 children from hypoglycemic group while 20 [15.6%] out 128 children from normoglycemic group expired. The mortality was significantly more in hypoglycemic children. [P Value = 0.000]

Conclusion: The frequency of hypoglycemia and mortality in severely malnourished children suffering from diarrhea at the time of admission was significantly higher than normoglycemic children in this study

Patient's influx at outpatient medical laboratory [OPML]; Forecasting of patient's influx at Mayo hospital, Lahore using arima model

Uni-variate time series data analysis has been reported in medical literature for prediction the patients volume, emergency overcrowding, stay length in hospital on surgical procedure and bed occupancy in hospital wards, patients influx or patients arrival, moreover to estimate the cost of hospital stay or any medical or surgical procedure. The present study was designed to fit an appropriate uni-variate ARIMA model [Box-Jenkin methodology] to forecast the patient's incoming at OPML, Mayo Hospital, Lahore. Mayo Hospital Lahore, September 2009 to December 2013 were used for fitting the best model. Time series data of male, female and peads patients coming/reporting in OPML, OPD. The appropriate model for male and female data was found as ARIMA [1, 0, 1] and for peads as ARIMA [1, 1, 1] after residuals diagnostic checks. The estimated number of male patients for Month of January2014 is 632 whereas the actual incoming of male patients in the month of January, 2014 was 649, which shows that the estimated model has ability to forecast the number of incoming patients accurately. It is now concluded that the fitted ARIMA model can be used to forecast the patients incoming to OPD Medical Laboratory for future planning and management

VAAFT: video assisted anal fistula treatment; bringing revolution in fistula treatment

To share our findings that the new treatment modality Video Assisted Anal Fistula Treatment [VAAFT] is a better alternate to the conventional treatments of Fistula in Ano in our setup with minor changes in the initial method described by Meinero. Karl Storz Video equipment including Meinero Fistuloscope was used. Key steps are visualization of the fistula tract, correct localization of the internal fistula opening under direct vision and endoscopic treatment of the fistula. This is followed by an operative phase of fulguration of the fistula tract using glycine solution mixed with manitol, curetting the tract with curette and fistula brush. Internal opening is closed with a Vicryl 1 suture. Total of 40 patients were operated using VAAFT from October 2013 to March 2014. Three were re-operated. The other 37 cases were followed up at 6 weeks, 3 months and 6 months. Primary healing took place in 20 [50%] cases at 6 weeks. In the remaining 17 [42.5%] cases, minor discharge occurred with itching which resolved till the next visit at 8 weeks and 12 weeks. As the main aim in treating fistula is proper identification of the internal opening, excision of the tract and sparing the sphincter function, VAAFT achieves all aims with additional benefits of patients' satisfaction and negligible scaring

Comparison of awareness about nephrology and kidney diseases amongst doctors in institutes with and without nephrology departments

To compare the awareness about nephrology and kidney diseases in medical officers and postgraduate trainee doctors working in institutes with and without nephrology departments. This cross sectional study was conducted at Nephrology Department, Shalamar Hospital Lahore from 1[st] Jan to 31[st] Mar 2013. Doctors working on medical floor with more than one year experience after house job were included in the study. Each doctor was given questionnaire comprising of 28 questions. Two hundred and eleven doctors fulfilling the criteria were included in the study. Most of the doctors were male 150[71.1%]. Knowledge had strong correlation with practice [p= 0.001]. Knowledge regarding nephrology and chronic kidney disease [CKD] was found significantly different among doctors of different hospitals [[F=36.09, p=0.000]. Practice regarding nephrology and chronic kidney disease [CKD] was found significantly different [F= 7.222, p=0.000]] among doctors of different hospitals of Lahore. Doctors working in the Shaikh Zayed Hospital [SZH], Lahore were having maximum score in the components of the knowledge and practice than other hospitals. Awareness of the Medical Officers and postgraduate doctors is poor regarding nephrology and kidney diseases. Doctors working in institutes with established nephrology services have better knowledge than other units. Working experience of doctors improve the practice significantly

Dialysis-related factors affecting quality of life in patients on hemodialysis

Treatment modalities for end-stage renal disease affect quality of life [QOL] of the patients. This study was conducted to assess the QOL of patients on hemodialysis and compare it with caregivers of these patients. Cause of ESRD and dialysis-related factors affecting QOL were also examined. This cross-sectional study was conducted on patient on maintenance hemodialysis for more than 3 months at 3 dialysis centers of Lahore. Fifty healthy individuals were included as controls from among the patients' caregivers. The QOL index was measured using the World Health Organization QOL questionnaire, with higher scores corresponding to better QOL of patients. Eighty-nine patients [71.2%] were men, 99 [79.2%] were married, 75 [60.0%] were older than 45 years, and 77 [61.6%] were on dialysis for more than 8 months. Patients on hemodialysis had a poorer QOL as compared to their caregivers in all domains except for domain 4 [environment]. There was no difference in the QOL between the three dialysis centers of the study, except for domain 3 [social relationship] of the patients at Mayo Hospital [a public hospital], which was significantly better. Nondiabetic patients had a better QOL in domain 1 [physical health] as compared to diabetic patients. Duration of dialysis had a reverse correlation with the overall QOL. We found that QOL of hemodialysis patients was poor as compared to caregivers of the patients, especially that of diabetics. Also, duration of dialysis had a reverse correlation with QOL

Serum zinc and copper levels in nephrotic syndrome patients

To determine the serum zinc and copper levels in patients of nephrotic syndrome and healthy subjects. Forty patients of nephrotic syndrome, fulfilling the pentad criteria [proteinuria, hypoalbuminemia, hyperlipidemia, hyperlipiduria and edema] were included in this study. Proteinuria was more than 3.5g per 24 hour in adults and more than 1000 mg/m2 in children. Ten healthy subjects were included as control. Patients on dialysis, pregnancy and with proteinuria of less than 3.5g per 24 hour were excluded from the study. Patients were selected from Nephrology outpatient department of Shalamar Hospital Lahore and Children hospital and Institute of child Health Lahore. The trace metals were measured on continuous source Atomic Absorption Spectrophotometer [ContrAA700] using flame mode for Zn and Cu. The levels of serum Zn and Cu were significantly lower [28.61 +/- 24.07, 47.62 +/- 34.1 microg/dl] as compared to controls [100.8 +/- 14.8, 112.3 +/- 10.6 microg/dl] respectively. Serum Zn level and 24 hour urinary protein had negative correlation with each other which was statistically significant [r= -0.442, p= 0.021]. There was positive and significant correlation / [[r= 0.712, p= 0.001], [r=0.612, p=0.002]/ ] between serum albumin and serum Zn and serum Cu levels. The results of the present study showed that there was high prevalence of Zn and Cu deficiency in patients suffering from nephrotic syndrome. Causes of hypozincemia and hypocuperemia were hypoalbuminemia and increased twenty four hour urinary protein losses. Other probable factors were decreased dietary intake and increased loss of trace metals in urine