Search

Objectives: To compare the levels of cortisol in patients of vasovagal syncope (VVS) and postural tachycardia syndrome (POTS). Methods: A cross-sectional analytical study was conducted at Islamic International Medical College, Rawalpindi and Electrophysiology Department at (AFIC). This study included 80 subjects, comprising of 35 patients in each group of vasovagal syncope and postural tachycardia syndrome and 10 healthy subjects. Patients with complaint of syncope was evaluated for vasovagal syncope and postural tachycardia syndrome using Head Up Tilt Test (HUTT). Blood samples of all the participants were taken and serum cortisol was analyzed using ELISA method. Results were analyzed on SPSS Statistics 21 using ANOVA with a p-value of ≤0.05 regarded as significant. Results: Hormonal analysis shows that cortisol levels in the vasovagal, postural tachycardia syndrome and in control group was 153±16.7pg/ml, 160.17±pg/ml, and 69.65±5.8pg/ml respectively. Cortisol levels were significantly higher in both vasovagal and POTS groups as compared to controls with a p-value of 0.04 and 0.023 respectively. However, there was no significant difference between vasovagal and POTS patients with p value 0.570. Conclusion: It is concluded from the study that cortisol responses of VVS and POTS were positive. doi: https://doi.org/10.12669/pjms.38.1.4122 How to cite this:Khan HF, Ambreen S, Raziq H, Hayat A. Comparison of cortisol levels in patients with vasovagal syncope and postural tachycardia syndrome. Pak J Med Sci. 2022;38(1):185-189. doi: https://doi.org/10.12669/pjms.38.1.4122 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: To determine the level of serotonin in patients of vasovagal syncope and postural tachycardia syndrome after head-up tilt test. Method: The cross-sectional analytical study was conducted at the Islamic International Medical College and the Department of Electrophysiology, Armed Forces Institute of Cardiology, Rawalpindi, from April 2017 to March 2018. Group A comprised cases of vasovagal syncope, group B had patients of postural tachycardia syndrome, and group C had healthy controls. Cases were chosen on the basis of history, episodes of syncope and findings of head-up tilt test. After the test, blood samples were taken for hormonal analysis of serotonin using enzyme-linked immunosorbent assay. Data was analysed using SPSS 21. Results: Of the 80 subjects, 35(43.8%) were in group A, 35(43.8%) in group B and 10(12.4%) in group C. Mean serotonin value in group A was 918.39±380.16nM, in group B it was 1188.70±449.55nM., while in control group C the mean value was 771.40±376.14nM (p

Syncope occurs as a result of cerebral hypoperfusion. Various neuroendocrine hormones have some role in the pathogenesis of Syncope. Current study was conducted to determine the role of Angiotensin II in pathophysiology of vasovagal syncope (VVS) and Postural tachycardia syndrome (POTS). Study Design: Cross sectional analytical study. Setting: Islamic International Medical College, Rawalpindi and in Electrophysiology department (AFIC). Period: April 2017 to April 2018. Material and Methods: Sample size of this study was comprises of 80 subjects, having 35 cases of VVS and POTS each and 10 controls were also taken. Cases were collected on the basis of Head up tilt test (HUT) result and on their previous history of syncope, then their blood samples were collected and stored. Hormonal analysis of Angiotensin II was performed by ELISA technique. SPSS statistics 21 was used to evaluate result by applying ANOVA test. p value of < 0.05 was considered significant. Result: Analysis of Angiotensin II concentration in Postural tachycardia syndrome, Vasovagal and control group was found 170.93 ± 118.59 pg/ml, 152.16 ± 91.40 pg/ml and 136.93 ± 43.18 pg/ml respectively. In statistical analysis p value was 0.570 which is insignificant. Conclusion: It is concluded that Angiotensin II exerts role in the pathophysiology of VVS and POTS as shown by the difference in the value of Angiotensin II in VVS, POTS and in control group.

Arid regions are highly vulnerable and sensitive to drought. The crops cultivated in arid zones are at high risk due to the high evapotranspiration and water demands. This study analyzed the changes in seasonal and annual evapotranspiration (ET) during 1951–2016 at 50 meteorological stations located in the extremely arid, arid, and semi-arid zones of Pakistan using the Penman Monteith (PM) method. The results show that ET is highly sensitive and positively correlated to temperature, solar radiation, and wind speed whereas vapor pressure is negatively correlated to ET. The study also identifies the relationship of ET with the meteorological parameters in different climatic zones of Pakistan. The significant trend analysis of precipitation and temperature (maximum and minimum) are conducted at 95% confidence level to determine the behaviors of these parameters in the extremely arid, arid, and semi-arid zones. The mean annual precipitation and annual mean maximum temperature significantly increased by 0.828 mm/a and 0.014°C/a in the arid and extremely arid zones, respectively. The annual mean minimum temperature increased by 0.017°C/a in the extremely arid zone and 0.019°C/a in the arid zone, whereas a significant decrease of 0.007°C/a was observed in the semi-arid zone. This study provides probabilistic future scenarios that would be helpful for policy-makers, agriculturists to plan effective irrigation measures towards the sustainable development in Pakistan.

Summary Precipitation variability has direct and serious impacts on society. In this study, the latitudinal precipitation characteristics and trends in Pakistan have been examined to identify vulnerable areas. Nonparametric statistical method was used to detect trends in observational data collected over a 60-year period from 48 rain gauges. The results reveal increasing precipitation trends over high latitudes, and no significant trends over lower latitudes. The spatial display of the observed trends is also shown to understand the significant variation and shift of monsoon rainfall in the specific areas. This study not only provides important information on precipitation variability in Pakistan, but is also helpful for policy makers seeking to adopt measures to mitigate the effects of rapidly changing climate in the vulnerable areas.

This paper reports the analysis of a multiblock environmental dataset consisting of 176 samples collected in Islamabad Pakistan between February 2006 and August 2007. The concentrations of 32 elements in each sample were measured using Proton Induced X-ray Emission plus black carbon for both coarse and fine particulate matter. Six meteorological parameters were also recorded, namely maximum and minimum daily temperatures, humidity, rainfall, windspeed and pressure. The data were explored using Principal Components Analysis (PCA), Partial Least Squares (PLS), Consensus PCA, Multiblock PLS, Mantel test, Procrustes analysis and the R V coefficient. Seasonal trends can be identified and interpreted. Using the elemental composition of the particulates it is possible to predict meteorological parameters. Based on the models from PLS, it is possible to use elemental composition in the airborne particulates matter (APM) to predict meteorological parameters. The results from block similarity measures show that fine APM resembles meteorological parameters better than coarse APM. Multiblock PLS models however are not better than classical PLSR. This paper also demonstrates the potential of multiblock approach in environmental monitoring.