Search

Background and Objectives: The acute-phase reactant C-reactive protein (CRP) has been shown to reflect systemic and vascular inflammation and to predict future cardiovascular events. The objective of this study was to evaluate the prognostic value of CRP in predicting cardiovascular outcome in patients presenting with acute coronary syndromes. Patients and Methods: This prospective, single-centered study was carried out by the Department of Pathology in collaboration with the Department of Cardiology, Bolan Medical College Complex Quetta, Balochistan, Pakistan from January 2009 to December 2009. We studied 963 consecutive patients presenting with chest pain to Accident and Emergency Department. Patients were divided into four groups. Group-1 comprised patients with unstable angina; group-2 included patients with acute ST elevation myocardial infarction (STEMI); group-3 comprised patients with Non-ST elevation myocardial infarction (Non-STEMI) and group-4 was the control group. All four groups were followed-up for 90 days for occurrence of cardiovascular events. Results: The CRP was elevated (>3 mg/L) among 27.6% patients in Group-1; 70.9% in group- 2; 77.9% in group-3 and 5.3% in the control group. Among cases with elevated CRP, 92.1% had a cardiac event compared to 34.3% among patients with CRP £3 mg/L (P < 0.0001). The mortality was significantly higher (P < 0.0001) in group-2 (8.9%) and group-3 (11.9%) as compared to group-1 (2.1%). There was no cardiac event or mortality in Group-4. Conclusions: Elevated CRP is a predictor of adverse outcome in patients with acute coronary syndromes and helps in identifying patients who may be at risk of cardiovascular complications.

Background/Aim: The objective was to evaluate the sero-prevalence of hepatitis B surface antigen (HBsAg) and IgM antibodies to hepatitis core antigen in Balochistan Province of Pakistan. Design of the study: A cross-sectional, population-based study. Place and time of the study: The study was conducted in Balochistan from 1 st January 2004 to 31 st December, 2008. The screening areas included Barkhan, Eashani, Khuzdar, Kodi Zikriani, Kohlu, Rakhni and Turbat. Materials and Methods: A total of 15,260 subjects were enrolled; 11,900 (78%) agreed to undergo screening. Fresh serum samples were tested for the presence of hepatitis B surface antigen and IgM antibodies to hepatitis B core antigen. Results: HBsAg was detected in 1166 (9.8%) while anti-HBc IgM was found in 117 (10.0%). HBsAg positivity was seen in 875 (12.7%) males and 291 (5.8%) females. The prevalence of hepatitis B in Balochistan varies from 3.3% in Khuzdar to 17.0% in Kodi Zikriani. Conclusions: It is utmost important to educate the public, to take proper measures to control the spread of infection and vaccination in order to interrupt transmission of this threatening public health problem in Balochistan province of Pakistan.

Summary Objective: To determine the peak time of outbreak of Crimean-Congo haemorrhagic fever (CCHF) and to highlight the disease-specific areas in the Balochistan province of Pakistan. Design: A hospital-based case-series study. Place and Duration: A five-year study was conducted by the Department of Pathology in collaboration with the Department of Medicine, Sandeman Provincial Teaching Hospital, Quetta, Balochistan, Pakistan, from 1 March 1997 to 28 February 2002. Patients and methods: A total of 135 cases were included in the study based on a high index of suspicion of CCHF. The mean age was 33.5 ± 18.7 years. Two sets of blood samples were drawn on admission; one set was sent for urgent routine investigations while the other was sent to CDC, Atlanta, USA, for confirmation. Results: The study showed that CCHF was more common between March and May and again, between August and October, depicting a bi-annual surge. Out of 135 suspected cases, 83 (61.4%) were confirmed to have CCHF and were given platelet concentrate and ribavirin. It was observed that CCHF was more common in specific areas of the province. Conclusions: It is essential to raise the level of knowledge regarding CCHF, especially in disease-specific areas, focussing on the peak outbreak periods.