Iron-Deficiency Anemia in Women of Reproductive Age in Urban Areas of Quetta District, Pakistan.

Anemia is associated with poor health outcomes, and the prevalence of anemia is a significant public health indicator for both developed and developing countries. Iron-deficiency anemia (IDA) is the most common type of anemia, which often develops during pregnancy. A cross-sectional study was conducted in the urban areas of Quetta city among the women of reproductive age (15-49 years) to update the status of IDA in the region. The study participants (n = 216) were selected on a random basis, and the samples were further distributed by age. Overall, 75% of females were nonanemic, and among those that were anemic, 2% were severe, 13% were moderately, and 10% were mildly anemic. Among the IDA-affected women, 83% were non-pregnant. Age-wise distribution of IDA revealed no significant difference among different age groups, but numerically higher observations were recorded in the age groups of less than 30 years. The highest number of moderately IDA-affected women (15%) were in the age group 15-19 with the following IDA indicating parameters: hemoglobin 9.64 g/dl, mean corpuscular volume 63.11 fl, mean corpuscular hemoglobin 20.40%, red cell distribution 19.28%. This study will be beneficial for illustrating the requirement and the development of a program to raise extended awareness in the Quetta communities to overcome the negative health effects of IDA on the female population.

In Vitro Anti-Inflammatory, Anticancer (MCF-7, 3T3, and HeLa Cell Lines), and Brine Shrimp Lethality Assay and FTIR Analysis of the Extract and Fractions of the Whole Plant of Heliotropium europaeum.

In this study, anti-inflammatory, anticancer, brine shrimp lethality, and FTIR studies were evaluated. The oxidative burst assay using the chemiluminescence technique, MTT assay, brine shrimp lethality assay, and FTIR analysis were the methods used for the evaluation of anti-inflammatory, anticancer, brine shrimp lethality, and FTIR studies, respectively. The whole-plant butanol fraction of Heliotropium europaeum (WBFHE) showed anti-inflammatory activity on ROS having IC5014.7 ± 2.5 while the extract and other fractions of the whole plant of Heliotropium europaeum exhibited no anti-inflammatory activity. None of the extract and fractions of the whole plant of Heliotropium europaeum exhibited anticancer (MCF-7, 3T3, and HeLa cell lines) activities. The whole-plant aqueous fraction of Heliotropium europaeum (WAFHE) and whole-plant butanol fraction of Heliotropium europaeum (WBFHE) showed lethality at high concentration while at low concentration, no toxicity was shown. The whole-plant methanolic extract of Heliotropium europaeum (WMEHE) and whole-plant n-hexane fraction of Heliotropium europaeum (WHFHE) exhibited no toxicity. FTIR interpretation showed the functional groups for the aromatic compounds, phenols, carboxylic acids, esters, alkanes, alkenes, alcohols, alkyl halides, sulfate esters, phosphines, silanes, nitriles, thiols, amines, phosphoric acids, and nitro compounds.

Evaluation of kidney injury molecule-1 as a disease progression biomarker in diabetic nephropathy.

BACKGROUND & OBJECTIVE: Kidney Injury Molecule-1 (KIM-1) is a peptide whose release into circulation is specific to tubular injury. This study aimed to estimate levels of kidney injury molecule-1 in diabetic patients with and without kidney disease. And evaluate the role of KIM-1 as an early screening marker of progressive kidney injury. METHODS: This follow-up study included n=85 subjects from the diabetic clinic of Jinnah Post Graduate Medical Center (JPMC) in collaboration with Aga Khan University from November 2016 till September 2017. They were divided as: i) Group A1 (n=30) participants with diabetes for <5 years without microalbuminuria ii) Group A2 (n= 30) subjects with diabetes for 6-10 years with microalbuminuria; iii) Group B (n=25) subjects as healthy control group. All study participants were followed for 6 months and their blood glucose, urea, creatinine, electrolytes, albuminuria and serum KIM-1 were assayed. RESULTS: High KIM-1 at baseline was present in group A2 patients as compared to controls and group A1 (p<0.001). Higher levels were seen after six months in group A1 along with the presence of micro albuminuria (p<0.001) suggesting kidney damage. Moderate positive association were seen for KIM1 with creatinine levels (r=0.530; p<0.001), and HbA1c (r=0.576; p<0.001) in all patients. While a strong positive association was seen for blood urea nitrogen as a marker for kidney function both at baseline (r= 0.728; p=0.000) and follow up (r=0.747; p=0.001). Multiple logistic regression controlling for age showed that KIM1 was independently associated with BUN (r=0.727; p<0.001), creatinine (r=0.510; p<0.001) and HbA1c (r=0.401; p=0.008) in all groups. CONCLUSION: Rising KIM-1 levels with progressive kidney damage with or without derangement of kidney function is reported in this study. This finding may pave a way towards identifying KIM1 as a prognostic marker for kidney injury.

Evaluation of soluble TNF-like weak inducer of apoptosis (sTWEAK) levels to predict preeclampsia in early weeks of pregnancy.

INTRODUCTION: Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) is linked to endothelial dysfunction; a key factor in pre-eclamptic pathogenesis. This study aimed to compare sTWEAK levels during pregnancy to assess for its prognostic ability. MATERIALS AND METHODS: Sixty three high risk pregnant women were followed up from 12 weeks of gestation till term. Serum levels of sTWEAK and platelet derived growth factor (PlGF), blood pressure, serum glucose, uric acid, urea/creatinine and liver function tests were measured. Subjects were stratified according to the ACOG criteria as women who developed PE, or PIH or remained normotensive at term. A negative control group of normotensive healthy pregnant women (n = 17) was also recruited for comparison. RESULTS: Baseline sTWEAK levels were lower (4.03 ± 0.37 ng/dl) in HR cohort that developed PE and further reduced at term (1.93 ± 0.23 ng/dl) as compared to HR subjects who remained normotensive and negative control group (30.53 ± 0.79 ng/dl; p < 0.01). Likewise PlGF levels were significantly lower (74.22 ± 10.11 pg/ml) in HR cohort that developed PE (p = 0.013). At term 39.68% (n = 22) HR subjects with low sTWEAK developed PIH and 34.92% (n = 24) developed PE. In terms of high risk characteristics observed in the HR group; 73% of the subjects were multiparous, whereas 26.98% reported to have developed PE in previous pregnancies. CONCLUSION: sTWEAK levels at early pregnancy weeks were found to be low in high risk females who developed PE at follow up versus normotensive pregnant women. Baseline TWEAK might serve as an independent variable for prediction of pre-eclampsia; however longitudinal studies with larger sample size are required to ascertain the causal relation.

Association of tissue inhibitor of metalloproteinase 2 with non-alcoholic fatty liver disease in metabolic syndrome.

The aim of this case-control study was to assess TIMP2 level in subjects with or without metabolic syndrome (MetS) and to associate levels with non-alcoholic fatty liver changes (NAFLD). Thirty-three MetS subjects and 55 controls were recruited. Anthropometric data, lipid and glucose profile, TIMP2 and liver ultrasound was performed. High TIMP2 was seen in MetS group (145.28 ± 23.11 pg/ml) versus controls (19.06 ± 1.19 pg/ml; p < .001). Serum cholesterol, triglyceride, LDL-c and glucose levels were significantly higher in MetS subjects (p < .05). MetS individuals (72.72%) showed positive fatty liver changes versus 14.5% controls. Elevated TIMP2 positively correlated with waist circumference, body fat, blood glucose and NAFLD. Furthermore, every unit rise in waist circumference and TIMP2 and a unit decrease in HDL were associated with higher odds of developing NAFLD (p < .05). There may be concurrent relationship between TIMP2 and NAFLD in MetS that requires further evaluation to improve risk assessment and early diagnosis of MetS.

Electrochemical investigation on the corrosion inhibition of mild steel by Quinazoline Schiff base compounds in hydrochloric acid solution.

The inhibitory effect of two Schiff bases 3-(5-methoxy-2-hydroxybenzylideneamino)-2-(-5-methoxy-2-hydroxyphenyl)-2,3-dihydroquinazoline-4(1H)-one (MMDQ), and 3-(5-nitro-2-hydroxybenzylideneamino)-2(5-nitro-2-hydroxyphenyl)-2,3-dihydroquinazoline-4(1H)-one (NNDQ) on the corrosion of mild steel in 1M hydrochloric acid were studied using mass loss, potentiodynamic polarization technique and electrochemical impedance spectroscopy measurements at ambient temperature. The investigation results indicate that the Schiff Bases compounds with an average efficiency of 92% at 1.0mM of additive concentration have fairly effective inhibiting properties for mild steel in hydrochloric acid, and acts as mixed type inhibitor character. The inhibition efficiencies measured by all measurements show that the inhibition efficiencies increase with increase in inhibitor concentration. This reveals that the inhibitive mechanism of inhibitors were primarily due to adsorption on mild steel surface, and follow Langmuir adsorption isotherm. The temperature effect on the inhibition process in 1MHCl with the addition of investigated Schiff bases was studied at a temperature range of 30-60°C, and the activation parameters (Ea, ΔH and ΔS) were calculated to elaborate the corrosion mechanism. The differences in efficiency for two investigated inhibitors are associated with their chemical structures.

Typhoid vaccine introduction: An evidence-based pilot implementation project in Nepal and Pakistan.

The World Health Organization (WHO) in 2008 recommended the use of currently licensed typhoid vaccines using a high risk or targeted approach. The epidemiology of disease and the vaccine characteristics make school-based vaccination most feasible in reducing typhoid disease burden in many settings. To assess feasibility of school-based typhoid vaccination, two districts in Kathmandu, Nepal and two towns in Karachi, Pakistan were selected for pilot program. Vaccination campaigns were conducted through the departments of health and in partnerships with not-for-profit organizations. In total 257,015 doses of Vi polysaccharide vaccine were given to students in grades 1-10 of participating schools. The vaccination coverage ranged from 39 percent (38,389/99,503) in Gulshan town in Karachi, to 81 percent (62,615/77,341) in Bhaktapur in Kathmandu valley. No serious adverse event was reported post vaccination. The coverage increased for vaccination of the second district in Pakistan as well as in Nepal. There was an initial concern of vaccine safety. However, as the campaign progressed, parents were more comfortable with vaccinating their children in schools. Supported and conducted by departments of health in Pakistan and Nepal, a school-based typhoid vaccination was found to be safe and feasible.