Serum homocysteine as a risk factor for coronary heart disease.

BACKGROUND: Homocysteine (Hcy) is an intermediate formed during the catabolism of sulphur containing essential amino acid, methionine and Less than one percent of tHcy is found as the free form. Development of atherosclerotic changes and thrombo-embolism are common features in patients with homocysteinuria. This study was conducted to assess the relationship of Hcy and coronary heart disease (CHD) in our population. METHODS: The cross-sectional analytical study was carried out at the Department of Biochemistry, Hazara University Mansehra and Ayub Medical College, Abbottabad. A total of 80 subjects were included in this study and were divided into 2 groups. Cases Group consisted of 40 patients who had confirmed Myocardial Infarction (MI) coming for routine follow-up (first re-visit) after the acute attack. Control Group consisted of 40 matching healthy individuals. Demographic data including age, gender, dietary habits, height and weight as documented in preformed proforma. Blood pressure was taken in sitting posture. Serum total Hcy were measured. Data was entered into computer using SPSS 16.0 for analysis. RESULTS: The mean age of the cases was 59.68 +/- 8.06 (30-70) years and that of the controls was 58.93 +/- 6.93 (48-76) years. The average BMI of cases was 27.70 +/- 3.61 Kg/m2 and of the controls was 25.66 +/- 2.98 Kg/m2. This increase of BMI from controls to cases was statistically significant (p < 0.050). The mean systolic BP of the cases was 153.88 +/- 11.90 mmHg in comparison with 142.62 +/- 11.65 mmHg for the controls. This difference was statistically significant (p < 0.001). Mean tHcy level of the cases was 17.15 +/- 4.45 micromol/l while that of controls was 12.20 +/- 2.53 micromol/l. There is a statistically significant difference between cases and controls with respect to Hcy levels (p < 0.001). CONCLUSION: Plasma tHcy level has a powerful predictor value of CHD and routine screening for elevated Hcy concentrations is advisable especially for individuals who manifest atherothrombotic disease without their traditional risk factors.

Liver function tests in preeclampsia.

BACKGROUND: Preeclampsia is a multisystem disorder that can induce damage to cardiovascular system, kidneys, brain and liver. Pregnancy-induced hypertension (PIH) is responsible for significant maternal and perinatal morbidity. This study was conducted to compare the liver function tests in preeclampsia with normal pregnancy. METHODS: This study was carried out on 100 pregnant women after 20 weeks of gestation admitted in Obs/Gyn units of Ayub Teaching Hospital, Abbottabad. The subjects were divided into two groups. Group A consisted of 50 cases of preeclampsia having blood pressure > or = 140/90 mmHg, proteinuria in 24 hours > or = 300 mg and oedema; Group B had 50 normal pregnant women after 20 weeks of gestation. The data including BMI, parity, period of gestation, blood pressure and presenting complaints of all subjects were recorded. Serum bilirubin and plasma levels of liver enzymes ALT, AST and ALK were measured. RESULTS: The mean BMI of the cases was 29.04 +/- 3.97 and that of controls was 26.54 +/- 3.11. The mean value of serum bilirubin in cases was 10.78 +/- 3.74 micromol/L and in controls it was 7.92 +/- 2.42 micromol/L (p < 0.001). The mean values of enzyme ALT in cases was 55.81 +/- 31.93 U/L while in the controls it was 15.22 +/- 3.30 U/L (p < 0.001). Mean serum AST in the cases was 41.34 +/- 10.76 U/L and in the controls it was 24 +/- 2.54 U/L (p < 0.001). Mean ALK level of cases before delivery was 454.16 +/- 243.69 U/L, and in controls it was 181.34 +/- 66.76 U/L (p < 0.001). CONCLUSION: Raised levels of serum bilirubin and liver enzymes ALT, AST and ALK were found in preeclampsia cases.

Assessment of iron deficiency in pregnant women by determining iron status.

BACKGROUND: Pregnant women constitute a high risk group for iron deficiency. Maternal iron deficiency and particularly iron deficiency anaemia may be associated with detrimental effects on maternal and infant function and particularly with a higher risk of preterm delivery and delivery of low birth weight neonates. Objective of this study was to assess and compare the iron status of normal healthy non-pregnant women with that of pregnant women of Hazara Division. METHODS: This study was conducted at Faculty of Health Sciences, Hazara University, and Ayub Medical College, Abbottabad from 1st March to 31st August 2006. Altogether 120 women, 90 pregnant at various stages of pregnancy and 30 non-pregnant women as control group were included in this study by convenience sampling. Their iron status was assessed by determination of haemoglobin (Hb), Serum ferritin, Serum-iron, Total Iron Binding Capacity (TIBC), Unsaturated Iron Binding Capacity (UIBC), and Percentage saturation of transferrin. Data generated on these variables were subjected to ANOVA and correlation analysis. RESULTS: The salient finding of this study is a significant decrease in Hb, Serum ferritin, Serum iron, percentage saturation of transferrin and a significant increase in values of TIBC and a pronounced increase in UIBC in 2nd and 3rd trimester compared to 1st trimester in iron deficient pregnant women. The mean values of Hb, SF, and Fe/TIBC% were significantly lower in the cases than in the control and significantly higher values of TIBC and UIBC were observed in the cases compared to controls. Significant correlations were observed for TIBC, UIBC and Fe/TIBC% against serum iron in different trimesters of pregnancy. CONCLUSION: A high percentage of the pregnant women are iron deficient due to factors such as high parity, poor dietary habits and socioeconomic status.