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Objective: This laboratory study evaluated the effect of Salvadora persica (S. persica) root extracts and Chlorhexidine Digluconate (CHX) on the antibacterial and surface hardness properties of glass ionomer cement (GIC). Methods: The in vitro experimental study was conducted at the Baqai Institute of Pharmaceutical Sciences of Baqai Medical University, Karachi, Pakistan, from October 2022 to March 2023. There were a total four experimental groups. The first group consisted of ethanol extract (GIC-SPEE) and second group consisted of hexane extract as (GIC-SPHE) both prepared from Salvadora persica root respectively, and mixed with liquid of GIC separately. The third group comprised chlorhexidine (GIC-CHX) that was also mixing into liquid portion of GIC and the last group was Control i.e. (cGIC). The GIC samples were prepared by using stainless steel metallic moulds with dimension (5mm x 2mm), following the manufacturer guidelines. Antibacterial activity against Streptococcus mutans was done by disc diffusion test (DDT), and surface hardness test was done by Vickers hardness tester. Statistical analysis was performed using One-Way ANOVA and Tukey’s post hoc tests (p<0.05). Results: The antibacterial activity against S. mutans reported that the maximum zone of inhibition was obtained at 3 wt% by the GIC-SPEE, when compared with other experimental groups. For surface hardness, the highest mean and standard deviation and significant findings was reported by the group GIC-SPEE. Conclusions: Considering the outcome of this in vitro study, it can be concluded that the addition of 3 wt% GIC-SPEE increased the surface hardness and antibacterial activity against Streptococcus mutans. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of a single-dose, oral vitamin D supplementation (soft gel capsule of 200,000 IU) in subjects with painful diabetic neuropathy (PDN) in Pakistan. Design: Randomized control trial. Materials and Methods: This randomized control trial was conducted at the Baqai Institute of Diabetology and Endocrinology (BIDE), Pakistan from November 2021 to August 2022. Subjects with diabetes without any signs of vitamin D deficiency were included. Baseline details were obtained by a predesigned questionnaire. Douleur neuropathy 4 (DN4) score was used for diagnosing PDN. Biochemical tests include serum 25-hydroxyvitamin D (OH)D and HbA1c for screening at baseline and at 3 months follow-up were analyzed. Subjects were categorized into two: a control group and an intervention group. The intervention group was given a single soft gel vitamin D capsule (200,000 IU) after screening by expert paramedical staff. Based on baseline serum vitamin D levels, the intervention group was further categorized into insufficient vs. deficient groups, and the control group was categorized into insufficient vs. sufficient. Results: Of 159 participants, 19.5% vs. 44.7% subjects were with insufficient vs. deficient vitamin D levels in the intervention group, and 10.7% vs. 25.1% were with insufficient vs. sufficient vitamin D levels in the control group, respectively. Though the findings are insignificant, DN4 score at follow-up in intervention groups and control groups was reduced compared to the baseline DN4 score. Furthermore, we observed a reduction in post-HbA1c levels in both the intervention groups (insufficient vs. deficient) and the control-sufficient group. Conclusion: Treatment with vitamin D supplementation in people with PDN helps to improve vitamin D levels, DN4 score, and HbA1c levels, though doseresponse is yet to be compared. [ABSTRACT FROM AUTHOR]

Objective: To correlate the serum levels of ceruloplasmin (Cp), copper (Cu), and superoxide dismutase (SOD) with pulmonary function tests (PFTs) in non-diabetics (controls) and patients suffering from Type-1 and Type-2 diabetes. Methods: The comparative cross-sectional study of 348 participants was performed at the Baqai Institute of Diabetes and Endocrinology (BIDE) - Karachi, Pakistan, from February 2019 to September 2020. Individuals having diabetesrelated complications, asthma, chronic obstructive pulmonary disease, chest infection, pregnant women and smokers were excluded. A total of 348 participants were included into three groups after signing informed consent. The control group had 107 non-diabetic participants, with an age range of 6 to 60 years. The diagnosed T1D group (n=107) had an age range of 6 to 25 years. While diagnosed T2D group (n=134) had an age range of 26 to 60 years. During the fasting state, anthropometric parameters, blood pressure, spirometry, and a venous blood sample (5ml) were collected to measure serum Cp, serum Cu, serum SOD, and HbA1c levels by using commercially available kits. The SPSS, version 21, was used for data analysis. Results: The reduced FVC (p-value <0.001), FEV1 (p-value <0.001), and PEFR (p-value <0.001) were found in both groups of diabetes. However, the lower levels of serum Cu (p-value <0.001), SOD (p-value <0.001), and significantly increased values of FEV1/FVC (p-value <0.001) and Cp levels (p-value 0.030) were found only in T2D group as compared to T1D and controls. The study found no significant correlation of PFTs and serum Cp, Cu, and SOD levels in patients suffering from T1D and T2D. Conclusion: Hyperglycemia leads to more non-enzymatic glycosylation of tissue proteins that reflects reduced PFTs and increased Cp; particularly in T2D, which may alter lung tissue's physiology. Moreover, the study showed no correlation of PFTs with the Cp, Cu, and SOD in patients suffering from T1D and T2D. [ABSTRACT FROM AUTHOR]

The purpose of this study is to evaluate quality of life, the gonadotropins and estrogen levels in type 1 diabetic adolescent females. This cross-sectional study was conducted at Baqai Institute of Diabetology and Endocrinology (BIDE). The Diabetes quality of life for youth questionnaire (DQOLY) was used to evaluate quality of life. FSH was found to be significantly lower in Type 1 Diabetes. HbA1c had a significant inverse moderate correlation with FSH(- 0.300*). In Type 1 Diabetes, FSH had a positive moderate correlation with LH(0.415*), (P-value<0.05). LH and estradiol levels were almost similar in both groups. Overall mean percentage score of DQOLY questionnaire for Type 1 Diabetes was 26.94±1.36. Low QOL score was observed on the basis of impact on activities. Adolescent females with Type 1 Diabetes were found to be shorter and underweight than non-diabetic adolescent females. Lower height and weight of the diabetes as compared to controls cannot be attributed to only metabolic control, suggesting other mechanisms for short stature. Control on metabolism has always been the target for diabetes treatment for ensuring the improved prognosis of disease but also for the quality of life in Type 1 diabetes. [ABSTRACT FROM AUTHOR]

As the state of hyperfibrinogenemia in diabetes patients occurs due to hyperglycemia which also activates the coagulative cascade ultimately stimulating hepatic fibrinogen synthesis and thus increases clotting factors and PAI-1 levels in the blood. Therefore, in present study our aim is to correlate between type of diabetes and plasma fibrinogen level and plasminogen activator inhibitor-1. This cross sectional study was conducted at Baqai Medical University (BMU) with the collaboration of Baqai Institute of Diabetology and Endocrinology, Karachi. Data was collected from 161 subjects, out of which 51 were control and 55 were subjects in each type 1 diabetes, type 2 diabetes simultaneously. Anthropometric measurements included measurement of weight, height, BMI and blood pressure which were done for each participant. Blood sugar levels and glycated hemoglobin, lipid profile, PAI-1 and fibrinogen were measured in cases and controls. Out of 161 subjects, 80 (49.7%) were male and 81 (50.3%) were female with mean age of 37.75±1.25 years. Fibrinogen level was significantly decreased in healthy subjects as compared to type 1 and type 2 diabetes subjects P-value<0.0001, however no significant difference was observed in fibrinogen level of type 1 diabetes subjects and type 2 diabetes subjects. Plasminogen activator inhibitor-1 of type 2 diabetes subjects was significantly increased as compared to type 1 diabetes subjects (P-value<0.05) but not significantly different to healthy subjects (P-value>0.05). Since, fibrinogen and plasminogen activator inhibitor type 1 was increased in diabetes patients this predisposed them to increased risk of coronary artery disease, our study further supports the clinical observation that diabetes is a thrombophillic condition. [ABSTRACT FROM AUTHOR]

Objective: To investigate the polymorphism superoxide dismutase (SOD1) gene and its relationship with the development of cataracts in patients of Karachi. Methods: This was a case-control study carried out at different centers in Karachi, Pakistan between September 2019 and 2020. A single nucleotide polymorphism (SNP) at rs2070424(SOD1) locus was examined with polymerase chain reaction (PCR) using high resolution melting curve (HRM) technique in 250 cataract patients and 250 healthy control groups of similar age and gender. Results: Of 500 subjects, there were 250 cases and 250 controls. The mean age of the cataract patients (cases) was 43.97±13.36 years. Among cases, 150 (60.0%) were males and 100 (40.0%) were females whereas in controls, 127 were males (50.8%) and 123 (49.2%) were females. A significant association of cataract was found with age (p value = 0.005), and smoking (p-value = 0.001). AG genotype has a smaller risk (OR=1.77, 95% CI 1.11 - 2.66, p-value=0.006) associated with cataract while GG has a higher risk (OR = 2.83, 95% CI 1.71 - 4.68, p-value < 0.001). Further, calculation of allelic distribution revealed that the G allele was more prevalent in the cataract group 200 (61.7%) as compared to controls 124 (38.3%) (p-value=0.001). Conclusion: The significantly higher G allele frequency in the SOD1 gene at the rs2070424(SOD1) locus in the cataract group indicates that potential risk factors contribute to cataracts' development. This study contributes to the genetic profiling of cataract patients in the Pakistani population. [ABSTRACT FROM AUTHOR]

Objective: To determine the association between homocysteine serum levels and metabolic risk factors in adults of Karachi - Pakistan. Study type, settings & duration: This prospective study was carried out in peripheral out-patient department, primary care unit, affiliated with Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi from November 2007 to June 2008. Methodology: Non-diabetic subjects were selected after taking informed consent. Subjects were advised to visit with at least 8 to 12 hours of fasting for oral glucose test. The anthropometry parameters were measured and blood tests for glucose levels, lipid profile, serum insulin, and homocysteine levels were done. Results: Of the 75 recruited subjects, 52% (n=39) were males and 48% (n=36) were females. Age (mean years) of the subjects was 44.26±10.98 and mean BMI kg/m2 was found 27.33±4.17. Fasting homocysteine, serum insulin levels, and HOMA found 15.6±6.52, 16.96±8.26, and 5.02±3.06, respectively. A significant association of elevated homocysteine level was found with BMI value p <0.04, male gender p <0.026, and smoking p <0.006. Insignificant correlation was seen between elevated homocysteine levels and age, fasting plasma glucose, hypertension, serum lipid parameters and waist circumference. Conclusion: Serum homocysteine level was significantly correlated with BMI, male gender, and smoking. Furthermore, an elevated homocysteine serum level was found in our study but not significantly associated with metabolic risk factors among population of Pakistan. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of iron deficiency anemia (IDA) on HbA1c levels in non-diabetic Pakistani individuals. Study Design: Observational Study. Setting: Baqai Institute of Diabetology and Endocrinology, Baqai Medical University Karachi. Period: March 2019 to May 2019. Material & Methods: After approval by the ethics committee of BMU. A world Health Organization (WHO) criterion was used for screening normal glucose tolerance. Subject with type 1 and 2 diabetes, and gestational diabetes were excluded. Selected subjects were categorized into 2 groups (anemic and non-anemic). Data was collected on a structured questionnaire. Result: Out of 139 subjects, 72 were males and 67, were females. Anemia was more common in males as compared to females (34.7% vs 19.4%). Among males, HbA1c level was found higher in anemic subjects with MCV<76fl than anemic subjects with MCV>76fl and subjects without anemia. While in females, HbA1c level was similar in both anemic and nonanemic subjects. Conclusion: HbA1c as a diagnostic marker should be assessed carefully as the presence of IDA can lead to falsely elevated HbA1c levels in non-diabetic subjects. [ABSTRACT FROM AUTHOR]

Dipeptidyl peptidase IV (DPP-4) and Glucagon like peptide 1 (GLP-1) has profound effect on insulin and glucagon secretion; ultimately decreasing glucose levels. We find out the association of GLP-1 levels and DPP-4 in normal, impaired and newly diagnose type 2 diabetic glucose tolerance. Prospective case control study was conducted at Department of Physiology, Baqai Medical University by the collaboration of Baqai Institute of Diabetology and Endocrinology; Karachi-Pakistan. Study groups were categorized into three groups Control, Impaired glucose tolerant (IGT) and newly diagnose type 2 diabetes mellitus (NDD). Biochemical parameters were estimated by international standard protocols. Logistic regression analysis and Chi square test with statistical significance at p value <0.05 were applied. DPP-4 concentrations were significantly lower in NDD participants compared to control and IGT participants (p=0.01), whereas GLP-1 levels were significantly higher in Control than Impaired glucose tolerant and NDD (p = 0.013). GLP1 levels and SBP were also found to be positively correlated with serum DPP4 levels in NDD group (p<0.05). GLP1 and DPP4 levels in NDD group (p<0.05) and in controls (p<0.001) respectively showed strong significant positive correlation. Effective correlation between GLP1 and DPP4 was found as both contribute to control hyperglycemia in NDD and impaired glucose tolerant people. [ABSTRACT FROM AUTHOR]

Objective: To determine the association of estimated Glomerular Filtration Rate (eGFR) with HbA1c and microvascular complications in patients with type 2 diabetes. Study design, settings & duration: This retrospective study was based on a hospital data record of patients visiting the outpatient department of Baqai Institute of Diabetology and Endocrinology, Baqai Medical University from January 2018 to October 2018. Methodology: Data was obtained from hospital management system (HMS). Records of Patients with type 2 diabetes having data on eGFR were included. Calculation of eGFR was done by MDRD formula. Following clinical practice guideline (KIDGO) eGFR was grouped into five GFR Categories of CKD Stage 1, 2, 3, 4 and 5. Results: Total of 3165 patients, 1773 (56%) males and 1392 (44%) females with type 2 diabetes were recruited. Mean age of patients was 50.4±10.84 years. Frequency of patients were higher 57.7% in eGFR category 2 (60-89 ml/min/1.73 m2) and 32.1% eGFR category 3 (30-59 ml/min/1.73 m2). Very low eGFR (<15 ml/min/1.73 m2) was significantly associated with reduction of glycated HbA1c (%) and HDL-Cholesterol. While, decreased eGFR was significantly (p <0.0001) associated with increased risk of diabetic nephropathy, neuropathy, retinopathy and hypertension. Conclusion: Overall, eGFR reduction especially in combination with longer disease duration is significantly associated with decreased HbA1c but increased risks of microvascular complications in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship of type 2 diabetes (T2DM) with different blood groups (A, B, AB and O) and Rhesus factor (positive or negative). Settings and duration: The study was conducted at the Biochemistry Department of Baqai Medical University from January 2015 to December 2015. Subjects and Methods: A total of 400 individuals were enrolled with 200 known type 2 diabetic patients and 200 healthy controls. Written informed consent was obtained from each study participant. Convenient sampling technique was adopted. Blood grouping procedure was based on Agglutination principle. The quantitative determination of hemoglobin A1C was done in hemosylate derived from whole blood on Roche automated clinical chemistry analyzer. Results: It was observed that blood group B was significantly more common among diabetic subjects (p-value <0.05), whereas blood group A was significantly less common in diabetic subjects as compared to non-diabetic subjects (p-value <0.05). No significant difference was found in terms of Rhesus factor among diabetic and nondiabetic subjects. Conclusion: The outcomes suggest that frequency of blood group B is significantly higher in type 2 diabetes while frequency of blood group A is significantly lower in type 2 diabetes as compared to non-diabetes. Further larger scale community based studies are needed to ascertain the findings of this study. [ABSTRACT FROM AUTHOR]

Dysphonia is frequently an expression of laryngitis, especially when it comes in the evolution of an immunosuppressed patient, as happens in chronic lymphoproliferation. But other causes of dysphonia should also not be forgotten, including the possibility of new malignancies, especially due to the fact that these patients have genomic instability that predisposes to appearance of a second or even a third cancer. We present the case of a patient who developed dysphonia during chronic lymphocytic leukemia evolution. Its etiology was a mediastinal compression through lymph nodes, not linked to leukemia, but produced by metastases of a bronchopulmonary cancer, appeared recently. Dysphonia condition due to vocal cord dysfunction must include diseases of the mediastinum, the neck and the brain stem. The rapid and correct diagnosis and the prompt start of an appropriate treatment are of paramount importance for clinician who manage their care and for patient survival. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of hepcidin and ferritin in pathogenesis and prognosis of type 2 diabetes mellitus subjects taking only metformin or combined anti-glycaemic agents., Methods: The observational case-control study was conducted at the Department of Physiology, Baqai Medical University, Karachi, from August 2019 to October 2020, and comprised subjects from both genders who categorised into equal groups as non-diabetic controls, newly-diagnosed type 2 diabetes mellitus patients without any treatment, type 2 diabetes mellitus patients with exposure to metformin only, type 2 diabetes mellitus patients taking oral hypoglycaemic agents along with metformin, type 2 diabetes mellitus patients taking only insulin, and type 2 diabetes mellitus patients taking insulin and oral hypoglycaemic agents. Fasting plasma glucose was determined using glucose oxidase-peroxidase method, glycated haemoglobin by high performance liquid chromatography, high-density lipoprotein and low-density lipoprotein by direct methods, cholesterol by cholesterol oxidase phenol 4-amino antipyrine peroxidase and triglycerides by glycerol phosphate oxidase-phenol 4-amino antipyrine peroxidase method. Serum levels of ferritin, insulin and hepcidin were evaluated using Enzyme-linked immunosorbent assay. Insulin resistance was assessed using homeostasis model assessment for insulin resistance. Data was analysed using SPSS 21., Results: Of the 300 subjects, there were 50(16.66%) in each of the 6 groups. Overall, there were 144(48%) males and 155(51.66%) females. The mean age was significantly lower in the control group 34.72±7.87 compared to all the diabetic groups (p<0.05), and the same was the case with respect to all the parameters (p<0.05) except high-density lipoprotein (p>0.05). Besides, hepcidin level was significantly higher in the control group (p<0.05). Ferritin levels were significantly increased in newly-diagnosed T2DM subjects compared to the controls (p<0.05) while all other groups showed decreased ferritin levels (p<0.05). Hepcidin gave inverse correlation with glycated haemoglobin only in diabetics taking only metformin (r = -0.27, p=0.05)., Conclusions: Anti-diabetes drugs not only addressed type 2 diabetes mellitus, but also reduced levels of ferritin and hepcidin that are found to play a role in diabetes development.