Prevalence of Vitamin D Deficiency and Its Association with Insulin Resistance in Obese Women with Normal Fasting Glucose.

RESULTS: A total of 264 obese and 133 normal BMI women (controls) of age range 20-50 years were selected. Obese women had significantly lower vitamin D compared to control women (P < 0.05). Among euglycemic (fasting glucose < 100 mg/dl) obese women (n = 221), 90 (40.7%) were vitamin D deficient. Serum PTH and calcium levels were negatively correlated, though nonsignificantly with vitamin D (r = -0.172, P = 0.090, and r = -0.051, P = 0.557, respectively). The mean age, BMI, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), fasting glucose, fasting insulin, PTH, and calcium were not significantly different in vitamin D-deficient as compared to nondeficient obese women. IR was detected in 109 (49.3%) obese women. Mean HOMA-IR in vitamin D-deficient women was significantly higher than that in the nondeficient obese women (3.03 ± 1.64 vs. 2.40 ± 1.02; P = 0.041), but the percentage of women with IR was comparable in both groups (51.1% vs. 45.8%; P = 0.745). Univariate analysis revealed that HOMA-IR was negatively correlated with vitamin D and positively with BMI and PTH. A multivariate regression analysis, stepwise method revealed that BMI and PTH were independent determinants of HOMA-IR instead of vitamin D. CONCLUSION: More than 40% of obese women were vitamin D deficient. Among euglycemic obese women, 49% were insulin resistant. Prevalence of insulin resistance, though negatively correlated with vitamin D, could be better explained by BMI and PTH levels.

Linear and crosslinked Polyurethanes based catalysts for reduction of methylene blue.

The large amount of synthetic dyes in effluents is a serious concern to be addressed. The chemical reduction is one of the potential way to resolve this problem. In this study, linear and crosslinked polyurethanes i.e. LPUR & CLPUR were synthesized from toluene diisocyanate (TDI), polyethylene glycol (PEG;1000g/mole) and tetraethylenepentamine (TEPA). The structure and morphology of synthesized materials were examined by FTIR, SEM and BET. The CLPUR was found stable in aqueous system with 0.80g/cm3 density and 16.4998m2g-1 surface area. These materials were applied for the reduction of methylene blue in presence of NaBH4. Both, polymers catalyzed the process and showed 100% reduction in 16 and 28mins., respectively, while, the reduction rate was significantly low in absence of these materials, even after 120mins. Furthermore, negligible adsorption was observed with only 7% removal of dye. The best reduction rates were observed at low concentration of dye, increasing concentration of NaBH4 and with more dosage of polymeric catalyst. The kinetic study of process followed zero order kinetics. It was hence concluded that both synthesized polymers played a catalytic role in reduction process. However, stability in aqueous system and better efficiency in reduction process endorsed CLPUR as an optimal choice for further studies.

Thyroid Dysfunction in Non-Interferon Treated Hepatitis C Patients Residing in Hepatitis Endemic Area.

BACKGROUND: Association of thyroid dysfunction (TD) with interferon treatment of HCV is well known to clinicians. However, a few studies have highlighted the role of hepatitis C virus per se in the development of TD. The aim of this study was to know the prevalence of TD in non-interferon treated HCV infected patients referred for thyroid function testing. PATIENTS AND METHODS: Among 557 ELISA-positive HCV patients 446 (341 females, 105 males) were selected for this study. Serums FT4, FT3, and TSH were determined by radioimmunoassay method. RESULTS: TD was detected in 15.2% of patients: 9.0% hypothyroidism and 6.3% hyperthyroidism. In increasing order subclinical hypothyroidism, overt hypothyroidism, overt hyperthyroidism, and subclinical hyperthyroidism were found in 4.7%, 4.3%, 3.6%, and 2.7% patients, respectively. Overall TD was more common in female than in male HCV patients but the difference was not significant (16.1% versus 12.4%; p = 0.648). Hyperthyroidism and subclinical hypothyroidism were slightly more common in female and overall hypothyroidism and overt hypothyroidism in male patients but the difference was not statistically significant (p > 0.05). The incidence of TD was relatively high in patients above 36 years (median age) but the difference was not statistically significant either collectively or in gender base groups (p > 0.05). CONCLUSION: Prior to interferon treatment, HCV infection itself causes biochemical thyroid dysfunction in 15.2% of local HCV patients.

Comparing twice- versus four-times daily insulin in mothers with gestational diabetes in Pakistan and its implications.

BACKGROUND: Gestational diabetes mellitus is a common medical problem associated with maternal and fetal complications. Good glycemic control is the cornerstone of treatment. OBJECTIVE: Compare outcomes between four times (q.i.d) and twice daily (b.i.d) regimens. The morning dose of the b.i.d regimen contained two-thirds of the total insulin, comprising a third human regular insulin and two-thirds human intermediate insulin; equal amounts in the evening. METHODS: 480 women at >30 weeks with gestational diabetes mellitus with failure to control blood glucose were randomly assigned to either regimen. RESULTS: Mean time to the control of blood glucose was significantly less and glycemic control significantly increased with the q.i.d regimen. Operative deliveries, extent of neonatal hypoglycemia, babies with low Agpar scores and those with hyperbilirubinemia were significantly higher with the b.i.d daily regimen. CONCLUSION: The q.i.d daily regime was associated with improved fetal and maternal outcomes. Consequently should increasingly be used in Pakistan, assisted by lower acquisition costs.

Steroid sensitive nephrotic syndrome in paediatrics.

Nephrotic syndrome is basically a set of signs or symptoms that may point to kidney problems, a condition when large amounts of protein leak out into the urine. In children protein excretion greater than 40 mg/m2.hr(-1) indicate presence of nephrotic syndrome. Edema is the prominent feature of nephrotic syndrome and initially develops around the eyes and legs. The 1st line treatment given is steroid therapy. The prospective study was conducted to determine the rational use of steroidal therapy, steroid sensitive nephrotic syndrome and causes of remission. 10 children were selected randomly presenting with the complaint of steroid sensitive nephrotic syndrome. The result of this study provide some evidence that steroidal therapy is effective in treating childhood nephrotic syndrome and they recover more rapidly if the steroidal regimen is carefully followed. It is concluded that rational use of steroid (prednisolone) has a very effective role in the prevention and control of nephrotic syndrome either at initial stage or in complicated cases. Corticosteroids have decreased the mortality rate upto 3%. Some very interesting findings have been observed and thus recorded and reported in this paper.