Search

OBJECTIVE: This study aimed to compare the serum levels of Glutathione and Oxidized Low-Density Lipoprotein in early hypertensive and normotensive subjects and to evaluate the diagnostic accuracy of these biomarkers for detecting oxidative stress in essential hypertension. METHODOLOGY: An analytical cross-sectional study was conducted at Civil (Dr. Ruth K.M. Pfau) Hospital Karachi from July 2020 to March 2021 after approval from the ethical committee. After informed consent, the serum oxidized low-density lipoprotein and glutathione levels were measured with ELISA's help in 40 normotensive and 40 early hypertensive participants. The results were analyzed by SPSS 21, keeping a significant p-value at <0.05. RESULTS: The median levels of Oxidized Low-Density Lipoprotein were higher in hypertensive than in normotensive (i.e. 31.47 ng/ml vs. 15.27 ng/ml). The median levels of glutathione were also raised in hypertensive compared with normotensive(i.e. 15.69 ng/ml vs. 4.46 ng/ml). The differences were significant (p-value <0.001). Both markers showed adequate diagnostic accuracy, sensitivity and specificity to detect oxidative stress in early hypertension. CONCLUSION: Oxidized Low-Density Lipoproteins are raised in early hypertension, endorsing the detrimental role of oxidative stress, while the levels of glutathione are increased to compensate for and combat increased oxidative stress in early hypertension. These biomarkers can be utilized clinically to discern the burden of oxidative stress in early hypertension. [ABSTRACT FROM AUTHOR]

Present work investigates the effects of hydro-methanolic roots extract (HyMREt) of Rauwolfia serpentina in type 1 diabetic mice. Mice were divided into normal, diabetic, negative and positive controls (I-IV) and three test (HyMREt doses) groups (V-VII - 50, 100, &150mg/kg). Allocated treatment of each group was given orally for 14 days in overnight fasted state. Percent change in fasting blood glucose (FBG), body weights, body tissue weights, hepatic glycogen, total lipids, glycosylated hemoglobin (HbA1c), complete blood profile and antioxidant enzymes including catalase (CAT) and superoxide dismutase (SOD) were estimated. HyMREt doses produced meaningful (p<0.0001) reduction (-39 to -53%) in FBG. Hemoglobin (Hb) levels were raised, HbA1c were considerably decreased (4.5-3.77%) and glycosylation (HbA1c to Hb) ratio was expressively (p<0.0001) improved in test groups. Dose-wise improvement (p< 0.05) in total glycogen and decrement (p<0.05) in lipids were observed in livers of test groups. HyMREt significantly decreased (p<0.05) percent inhibition of SOD and CAT. HyMREt doses progressively (p<0.05) improved RBC and other hematological parameters while decrement was only noticed in leucocyte counts. Administration of test doses of HyMREt were significantly reduced the glycosylation, oxidative stress and anemia caused by alloxan intoxication in mice. [ABSTRACT FROM AUTHOR]

Background: Awareness and proper practice of sterilization and disinfection protocols can significantly reduce the risk of infection transmission associated with the use of invasive and noninvasive medical and surgical devices. Lack of knowledge and failure to comply with scientifically based guidelines has led to numerous outbreaks of lethal diseases like HIV, Hepatitis B and C as well as transmission of various bacterial infections. Material and Methods: A descriptive cross sectional study conducted among medical students and healthcare workers using a self administered questioner which was designed to assess the awareness of sterilization and disinfection among medical students, paramedical staff and doctors in a public sector hospital in Karachi. Results: Th e sample size and response rate were 356 and 100% respectively. Th e respondents included 66 doctors, 122 paramedics and 168 medical students. About 58.3% medical students and 62.1% doctors knew the difference between sterilization and disinfection but only 37.7% paramedics were aware of the difference. 79.8% medical students, 69.7% doctors and 60.7% paramedics had received the complete regimen of any vaccine. Overall, the awareness proportion of paramedical staff was significantly lower than doctors and medical students. Conclusion: Our results show that awareness of healthcare workers regarding sterilization and disinfection is not up to the mark. Many of them have not received the complete regimen of HBV vaccine. Th ere is therefore substantial need for the education and training programs to equip the healthcare workers with awareness and knowledge regarding sterilization and disinfection protocols. [ABSTRACT FROM AUTHOR]

To assess the risk of anthropometric measures and serum markers of insulin resistance in non-diabetic heart failure (NDHF) patients and the difference among male and female subjects. 53 males, 27 females NDHF patients were enrolled and 80 healthy subjects were matched as control. Anthropometric measures, fasting blood glucose level (FBGL) and serum insulin (SI) were measured. Insulin's function (β-cells quantification) was computed through Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Significant (p<0.05) difference in height was observed in NDHF male and female patients, whereas, weight was only significant in females. Higher mean values of FBGL, SI, and HOMA-IR in NDHF patients were observed. Highly significant (p<0.0001 & p<0.05) difference was also found in similar gender based case-control markers like FBGL, SI, and HOMA-IR. Phi coefficient for risk associations showed weak-positive correlation in both genders in FBGL, SI, and HOMA-IR. Anthropometric measures indicated lesser risk in both gender, especially in females' decreased risk in body height and waist circumference was observed. Risk measurement through odds ratios (OR) of FBGL and HOMA-IR in female subjects indicated significantly (p<0.001) double risk, whereas, in SI, three fold risks were measured in females as compared to male. Odds of exposure in cases were significantly (p<0.001) greater than in controls verified with significant Pearson and Fisher Exact Probability Test (FEPT) values with two-tailed estimates of probability in Χ2 (Chi--Square) estimation test. Findings suggest increased risk of IR in female NDHF patients. Increased in FBGL IR and HOMA-IR and BMI were also found as distinguishing findings in NDHF cases. [ABSTRACT FROM AUTHOR]

Present work seeks to investigate the biochemical parameters in terms of hypoglycemic and hypolipidemic effects of hydro-methanolic roots extract (HyMREt) of Rauwolfia serpentina in type 1 (alloxan induced) diabetic mice. Animals were divided into seven groups, four control groups, and three were test groups (HyMREt at 50, 100, & 150mg/kg). Each treatment was repeated for 14 days regularly in all seven respective groups and afterwards the body weights, fasting blood glucose (FBG), insulin, and serum lipid levels were determined. Total body weights of diabetic mice treated with HyMREt extract were dose dependently (p≥0.05) improved. FBG of test groups were significantly (p ≥ 0.0001) reduced in comparison with diabetic controls which displayed elevated fasting blood glucose level. The insulin levels of HyMREt treated groups were significantly (p≥0.0001) higher than those of diabetic controls. Lower triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-c) and very low density lipoprotein cholesterol (VLDL-c) whereas elevated level of high density lipoprotein cholesterol (HDL-c) were observed in test dose treated groups. In comparison with diabetic controls, the converse levels of serum lipid were observed. Significant improvement in cardio-protective indices and coronary risk index was also observed. Findings of present study support the hypoglycemic and hypolipidemic potential of HyMREt of R. serpentina. [ABSTRACT FROM AUTHOR]

Heart failure is a progressive, chronic disorder. Insulin resistance (IR) has been more and more involved as a preliminary metabolic perturbance predisposing to hyperglycemia, hyperlipidemia and atherosclerosis with others heart diseases. To investigate the relation of insulin resistance (IR) in non-diabetic heart failure patients this case-control study was carried out to ascertain the presence of IR with the aid of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) in non-diabetic heart failure patients (NDHF patients) compared with healthy controls. The sample size was calculated for both, cases (NDHF patients) and control (healthy subjects), which was initially consisted of 113 respondents each. The study consisted of two phase duration. In Phase I, NDHF patients were approached initially; only 80 patients with NDHF completed the study procedure. In Phase II, 80 healthy subjects were targeted and matched. Fasting blood glucose level (FBGL) and serum insulin was estimated. Mathematical model to quantify β-cell function and insulin resistance was also computed through Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) in both groups. Data was analyzed on SPSS version 16. Mean values with ± standard deviation (SD) of insulin (10.2±4.36) and HOMA-IR (2.52±1.15) were significantly (p<0.05) higher in NDHF patients as compared to control subject (6.4±3.39, 1.45±0.80). Average insulin to glucose ratio was 0.10±0.044 in NDHF patients which was significantly (p<0.0001) lowered in controls i.e., 0.073±0.039. Marginal and matrix plot analysis revealed that a higher patients count have had the HOMA-IR values <1.5 units while opposite scenario was observed in control group. Regression analyses of HOMA-IR with FBGL (as independent indicator) also authenticate the similar pattern. The present study concludes that insulin resistance (decreased insulin sensitivity) is a characteristic finding in Pakistani population of heart failure as compared to matched healthy controls. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the difference between the health management system of public and private sectors hospitals. STUDY DESIGN: A cross sectional study. PLACE AND DURATION: A survey based study from private and public sector hospitals of Karachi during the period of 3 months from 1st June 2015 to 31st August 2015. METHODOLOGY: This study includes 72 hospitals in total including both public and private sectors. A questionnaire was designed which comprises of questions about different aspects of management related to hospital's working, like existence of different department (human resource, finance, procurement, training and development, engineering) their working status either the departments active fully or just the name is there. How the communication takes place within the hospital. The data analyzed at the end of study. RESULTS: It was observed that Finance and Human Resource (HR) are the departments 100% present in both sectors while private sector also includes Marketing and Procurement Departments (50%). Emergency disaster program runs only in 30% of hospitals. The employees and management communicates 64.7% by complex way through 94.4 % face to face rest includes e.mail and software generated system. The training and development department was found to be non -significantly working in either hospital sectors. CONCLUSION: There was significant difference observed in the working of finance, engineering and procurement department of public and private sector hospitals. [ABSTRACT FROM AUTHOR]

Background: There is some evidence which suggests that areca nut chewing has a relationship with metabolic syndrome. Areca nut chewing is continue to increase and so is the metabolic syndrome which is a major cause of cardiovascular mortality in developing countries. The aim of this study was to determine the relationship of raw areca nut and areca nut chewing with tobacco additives and metabolic syndrome. Methods: This cross sectional study was conducted on population of Karachi, Pakistan. Simple random sampling was implied using the voter list as a sampling frame. A detailed questionnaire about the demographic details of all subjects was filled and an informed consent obtained for blood sampling. Logistic regression analyses were carried out to investigate the relationship between areca nut chewing and metabolic syndrome. Results: Of the 1070 individuals, 192(17.9%) had metabolic syndrome with significantly higher (p-value <0.001) prevalence among females (26.3%) compared with males (11.4%). Eight individuals (11.1%) among non users had metabolic syndrome while significantly higher (p-value <0.001) proportion of both, raw areca nut users (n = 67, 29%) and areca users with tobacco additives (n = 45, 38.5%) had metabolic syndrome. The crude odds ratio for central obesity among raw areca nut users was 1.46 (95% CI 1.07-1.98) and among areca nut users with tobacco additives was 2.02 (95% CI 1.36-3.00), hypertension among raw areca nut users group was 1.31(0.96-1.78) and among areca nut users with tobacco additives group was 2.05 (95% CI 1.38-3.04). A significant positive association of raw areca nut chewing and metabolic syndrome was found among males (crude OR 2.74, 95% CI 1.52-4.95) and females (crude OR 3.80, 95% CI 2.32-6.20). Similarly, a significant positive association was found with regard to raw areca nut with tobacco additives chewing among males (crude OR 5.46, 95% CI 2.73- 10.91) and females (crude OR 4.32, 95% CI 2.41-7.72). These associations remained significant adjustment for age, social class. Conclusions: This study suggests a harmful relationship between areca nut chewing and metabolic syndrome. The deleterious effects were even stronger among areca nut chewer with tobacco additives. Further research with longitudinal data might help to understand the temporal relationship between areca nut chewing and metabolic syndrome. [ABSTRACT FROM AUTHOR]

Objective: To estimate the levels of anti-sperm antibodies in infertile males attending a tertiary care hospital in Karachi. Methodology: Out of 160 males studied, 132 met the criteria and were included in the study. Semen analysis was done by proper standardized procedures as mentioned in WHO manual for examination of human semen and sperm cervical mucus interaction. A blood sample was drawn to detect the presence of anti-sperm antibodies. Results: Antisperm antibodies were found positive in 8 males suggesting that antisperm antibodies are the etiologic factor causing infertility in 6% infertile male subjects. A positive correlation was found between the ages of patients and antisperm antibodies greater than 70 IU/ml. Conclusion: Direct correlation of circulating antisperm antibodies with male infertility suggests the role of immunologic infertility as an etiologic cause of infertility in idiopathic infertile males of Pakistan. [ABSTRACT FROM AUTHOR]