C-Reactive Protein Level In Coronary Artery Disease And Its Correlation With Serum D-Dimer.

BACKGROUND: C-reactive protein concentration has continuous associations with risk of coronary artery disease, ischemic stroke and death from several cancers. In addition, several studies have shown that CRP could be used to predict first ever myocardial infarction and stroke in healthy subjects, as well as outcome in acute setting. High levels of another biomarker, D-dimer, have been found to be independently associated with occurrence of coronary events. METHODS: This correlational study was carried out at the Department of Cardiology, Ayub Teaching Hospital Abbottabad, in collaboration with the department of Biochemistry Postgraduate Medical Institute Lahore from 15th July 2013 to 15th May 2014. Patients aged 30 years or more of either gender having coronary artery disease was included in the study. Their serum D-dimer levels and Creactive protein levels were measured for correlation with coronary artery disease. RESULTS: A total of 50 patients of CAD were included in this study. Out of these 30 (60%) were males and 20 (40%) were females. Elevated CRP levels and D-dimer levels were noted in all of these patients. Pearson correlation coefficient test was performed on both CRP and D-dimer levels. Pearson correlation coefficient was calculated to be r= -0.1522 and when a p value was calculated, it was found to be 0.292 which implied that the results were not significant. CONCLUSIONS: This study showed that there is no correlation between CRP levels and D-dimer levels in patients with Coronary Artery Disease.

Association Of Serum Total Bilirubin Level With Diabetic Retinopathy In Type 2 Diabetes Mellitus.

BACKGROUND: Serum bilirubin has anti-inflammatory, antioxidant and immunological properties. It is considered a protective substance against atherosclerotic and microvascular complications of diabetes mellitus (DM). This study was designed to find the association between total serum bilirubin concentration and diabetic retinopathy (DR). METHODS: This case control study was conducted in the Department of Endocrinology, Diabetes and Metabolic Diseases, Hayatabad Medical Complex, Peshawar. Type-2 DM patients more than 18 years of age of either gender with duration of T2DM more than 6 months were included and sub categorized in two groups. Cases (DM with DR) and Controls (DM without DR) while patients with acute and chronic liver diseases, haemolytic anaemia, history of chronic alcohol consumption, use of hepatotoxic drugs (anti-tuberculous, anti-epileptic), women on oral contraceptive pills were excluded. All participants underwent ophthalmic examination at diabetic retinopathy screening clinic followed by pre designed set of investigations. RESULTS: A total of 152 patients, 76 cases and 76 controls were included. Serum bilirubin concentration was found inversely and independently (p 0.000) associated and inversely co related (r -0.345and p 0.000) with prevalence of DR. Cases were concentrated in the lower quartiles of serum bilirubin concentration and vice versa. Low haemoglobin (p 0.00) and longer duration of DM (0.003) were independently and directly associated with prevalence of DR. CONCLUSIONS: Serum bilirubin concentration is inversely and independently associated and inversely correlated with the prevalence of DR and may predict progression of DR over time.

FREQUENCY OF DIFFERENT VALVULAR LESIONS OF RHEUMATIC HEART DISEASE PRESENTING TO A TERTIARY CARE HOSPITAL.

BACKGROUND: Rheumatic Hearth Disease (RHD) is still prevalent in our country and a great source of morbidity. This study was done with an objective to determine relative frequency of different valvular lesions of RHD presenting in a tertiary care hospital. METHODS: This cross sectional study was conducted at the Cardiology Department of Hayatabad Medical Complex, Peshawar. A total of 171 cases of RHD were included through consecutive sampling technique. RESULTS: There were 64.33% females. Mean age was 25.6 +/- 6.95 years ranging from 15 to 40 years. The different percentage of valvular lesions in RHD were MR (59.06%), MS (46.78%), AR (43.85%) and mixed lesions (38.59%). CONCLUSION: Rheumatic heart disease is a very common disease in our community and mitral regurgitation is a predominant lesion at presentation Females are usually affected more than males.

Frequency and characterisation of pancytopenia in megaloblastic anaemia.

BACKGROUND: A wide variety of clinical conditions, that primarily or secondarily affect the bone-marrow may present with pancytopenia, one of such conditions is megaloblastic anaemia. The purpose of this study was to determine the frequency and nature of pancytopenia in megaloblastic anaemia. METHODS: This was a prospective, cross-sectional descriptive study conducted in Medical Units, Ayub Teaching Hospital, Abbottabad, Pakistan during July 2010-January 2011. Total 90 patients were included in this study. Data were collected including history, clinical examination, haemoglobin level, mean cell volume, bone marrow examination and peripheral smear examination. RESULTS: Of total 90 patients, 54 were male and 36 were female. Mean age was 28 +/- 15.84 years. Common presenting features were weakness, fever and bleeding manifestations. Pancytopenia was present in 63 (70%) patients. Most common presenting feature related to anaemia was weakness (80%). Bleeding manifestations, related to low platelet count were found in 35 (39%) patients. Physical Examination findings were: pallor (100%), splenomegaly (33%), bleeding manifestations (25%), hepatomegaly (17%), and hepatosplenomegaly (19%). Mean peripheral blood findings of the study population included haemoglobin level (6.25 g/dL), total leukocyte count (2818.7/microL), platelet count (44040/uL), and reticulocyte count (1.7%). Mean values for red cells indices included red blood cells count (2.6 million/uL), mean corpuscular volume (114.3 fL), mean corpuscular haemoglobin (27.3 pg) and mean corpuscular haemoglobin concentration (31.8 g/dL). CONCLUSIONS: In megaloblastic anaemia, pancytopenia is a common and important clinical and haematological problem. Patients should be properly investigated for pancytopenia and its causes because many of them are completely curable while others are manageable. This will help to reduce patients' suffering, improve quality of life and prolong survival.

Inflammatory markers and lipid profile in patients of coronary artery disease.

BACKGROUND: Coronary artery diseases encompass a spectrum of disorders ranging from angina to fatal myocardial infarctions with the main underlying pathology being identified as atherosclerosis. METHODS: The level of inflammatory markers, C-reactive protein and fibrinogen was determined in hundred patients with established coronary artery disease and correlated with lipid profile which included serum cholesterol, high density lipoprotein (HDL), low density lipoprotein and triglycerides. RESULTS: The results showed a positive correlation between Inflammatory Marker CRP with LDL and serum cholesterol in patients with coronary artery disease. While no significant correlation of CRP was seen with high density lipoprotein (HDL) and triglyceride. Fibrinogen did not show any significant correlation with lipid profile parameters. CONCLUSION: Although the inflammatory markers were found to have weak positive correlation with the levels of serum lipids, determining both of these parameters together may help in the early detection and treatment of individuals who are at a high risk for cardiac events.