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Objective: The aim of this study was to determine and correlate the serum chromium in Carotid intima - media thickness (CIMT) in type 2 Diabetes Mellitus (T2DM) subjects. Materials and Methods: The present case - control study included 40 healthy controls and 45 T2DM subjects that were selected through non-probability (purposive) sampling by prior inclusion and exclusion criteria. Serum chromium (Cr) was detected and measured on inductively coupled "Plasma Optical Emission Spectrophotometer" (ICP-OES)- Carotid artery was examined with a 7.5-MHz linear-array transducer (Siemens Acuson x300) sonography. Data was analyzed by Student's t test and Chi square test in the SPSS 22.0 (USA). Linear regression model was used for predicting carotid intima media thickness. Level of confidence interval of statistical significance was 95% (P= 0.05). Results: Serum Cr in controls and cases was noted 0.873 (± 0.162) and 0.281 (± 0.240) µg/ml (P= 0.001). Serum Cr proved negative correlation with random blood sugar (r= -0.145, P= 0.185), HbA1c (r= -0.145, P= 0.0001) and CIMT (r= -0.730, P= 0.0001). Multiple regression analysis model showed significant association of serum Cr (r= -0.730, P< 0.0001) and HbA1c (r= 0.754, P< 0.0001) with the CIMT. Conclusion: The present study reported serum Cr was inversely correlated with the carotid intima - media thickness that is a marker of atherosclerosis. Cr supplements may be advised to diabetics in clinical management. [ABSTRACT FROM AUTHOR]

Objective: To determine association of Serum Uric Acid levels (SUA) in subjects suffering Systemic Blood Pressure and to determine its association with systolic and diastolic blood pressure. Study Design: Cross Sectional Study. Setting: Department of Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Sindh, Pakistan. Period: January 2018 to September 2019. Material & Methods: 150 diagnosed cases of systemic hypertension and 150 controls were selected though non-probability purposive sampling according to inclusion and exclusion criteria. 2 ml venous blood was taken, centrifuged and sera were used for uric acid. Data was saved in a pre-structured Performa. Statistical software (SPSS v 21.0, IBM, Incorporation, USA) of data variables was analyzed at 95% CI (P = 0.05). Results: Serum uric acid in controls was 2.93±0.72 compared to cases 4.25±1.44 mg/dl (P=0.0001). Hyperuricemia was observed in 58 (38.6%) cases compared to 23 (15.3%) controls. Uric acid shows strong positive association with Systolic BP (r= 0.52*, p=0.0001) and Diastolic BP (r= 0.46**, p=0.0001). Conclusion: We found hyperuricemia in 58 (38.6%) of systemic hypertension cases. Systolic and Diastolic Blood pressure show positive association with uric acid. [ABSTRACT FROM AUTHOR]

Objective: Determine the frequency of vitamin cobalamin deficiency in macrocytic anemia cases reporting at tertiary care hospital. Study Design: Cross Sectional study. Setting: Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Sindh Pakistan. Period: January 2017 to October 2018. Material & Methods: 450 cases of both genders, diagnosed as macrocytic- megaloblastic anemia were studied for the vitamin Cobalamin levels. Cases were collected through non- probability convenient sampling by inclusion and exclusion criteria. Consenting volunteers were asked for blood sampling. 5 mL blood was taken from ante - cubital fossa. Samples were centrifuged and sera were collected for the estimation of vitamin cobalamin by ELISA - assay kit. Continuous and categorical variables were entered in SPSS (version 21.0) and analyzed by Student t-test and Chi-square test respectively at 95% CI (P ≤ 0.05). Results: Male and female comprised 225 (43.3%) and 294 (56.6%) of 519 subjects. Male to female ratio was noted 1.30:1. MCV, MCH and MCHC show statistically significant difference between male and female (P<0.05). MCV in male was 96.8±9.92 fl vs. 105.5±12.04 fl in female (P=0.0001). Normal cobalamin was noted in 15.2% (n= 79) and any type of cobalamin deficiency was noted in 84.7% (n= 440) (P=0.0001). Conclusion: The present study reports frequency of 84.7% Cobalamin deficiency in macrocytic anemia reporting at Indus Medical College Hospital. Further studies are recommended by the treating physicians. [ABSTRACT FROM AUTHOR]

Objectives: To determine the serum uric acid (SUA) in systemic hypertension and its correlation with systolic (SBP) and diastolic blood pressure (DBP). Study Design: Cross sectional study design. Setting: Department of Medicine, Isra University Hospital. Period: From April 2016 - February 2017. Material and Methods: A sample of 100 cases of systemic hypertension and 100 age, gender, body weight and BMI controls were selected through nonprobability purposive sampling. Volunteers were asked for history, physical examination, and blood sampling. Systemic BP was measured with a mercury sphygmomanometer. 2 ml venous blood was taken, centrifuged and sera were used for detection of SUA. Data was saved in a prestructured Performa. Computed based statistical software (SPSS v 22.0, IBM, Incorporation, USA) was used for data analysis. Data variables were analyzed at 95% CI (P = 0.05). Results: Serum uric acid in controls was 2.91±0.75 mg/dl compared to 5.70±1.76 mg/dl (P=0.0001). 57% of cases revealed hyperuricemia compared to 11% in control (X2=17.5, P=0.0001). Serum Uric acid showed significantly positive correlation with Systolic BP (r= 0.518*, p=0.0001) and Diastolic BP (r= 0.397**, p=0.0001). Conclusion: The present study reports hyperuricemia in 57% cases of systemic hypertension and uric acid shows positive correlation with systolic and diastolic blood pressure. [ABSTRACT FROM AUTHOR]

Objective(s): Causality of occurrence of metformin-associated lactic acidosis (MALA) is a clinical problem. Currently, there is no drug available to prevent MALA. The present study was conducted to evaluate the protective effect of Berberine (BBR) against MALA in induced diabetic rat model. Materials and Methods: A sample of 75 healthy male Wistar rats was randomly selected according to inclusion and exclusion criteria. 75 male Wistar rats were randomly divided into a control and 4 experimental groups. Streptozotocin (STZ) in citrate buffer (pH 4.5) at a dose of 45 mg/kg was injected for induction of diabetes mellitus and rats achieving fasting blood glucose >250 mg/dl were included. Blood samples were collected 18 hr after the last dose of metformin and berberine. Ethical approval was taken before the study was conducted. Staistix 10.0 (USA) software was used for data analysis. Results: Berberine decreased MALA. Metformin, metformin + BBR 50 mg/kg bwt, and metformin + BBR 100 mg/kg bwt showed serum lactate as 1.87±0.4 mmol/lL, 1.62 ± 0.44 mmol/l and 1.47± 0.45 mmol/l, respectively (P=0.0001). Insulin resistance and liver enzymes were improved in BBR treated rats. Conclusion: The present study reports berberine protects against MALA in streptozocin-induced diabetes mellitus. [ABSTRACT FROM AUTHOR]

Objectives: To determine superoxide dismutase (SOD), glutathione peroxidase (GPX), and malondialdehyde (MDA), uric acid and serum bilirubin in healthy adult smokers. Study Design: Case control study. Place and Duration: Liaquat University of Medical and Health Sciences Hospital. Hyderabad, Sindh from December 2013 - July 2014. Subjects and Methods: 77 smokers and 50 healthy controls were selected through non-probability purposive sampling. Blood glucose, lipids, MDA, antioxidant enzymes (SOD & GPX), serum bilirubin and uric acid (UA) were measured. Data was analyzed on Statistic software 8.1 by student's t test and Chi square test. The significant p-value was taken at ≤ 0.05. Results: Anti-oxidant enzymes (SOD & GPX), blood lipids, lipid per oxidant marker; the MDA, bilirubin and UA showed statistically significant differences between smokers and controls (p<0.001). Total blood lipids and lipid sub fractions were elevated in smokers. MDA in smokers was 3.17±0.91 μmol/ml compared to 1.15±0.61 μmol/ml (p=0.001) in controls. Smokers showed reduced SOD, GPX, serum bilirubin and UA, was significant (p=0.0001) in comparison to controls. Conclusion: Cigarette smoke is a significant source of oxidative stress. Smoking increases malondialdehyde and reduces superoxide dismutase, glutathione peroxidase, uric acid and bilirubin. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate serum cobalamin with special reference to dyslipidemia in type 2 Diabetic subjects. Study Design: Observational study Place and Duration: Department of Medicine, Isra University Hyderabad, Sindh from January 2014 to July 2014. Methodology: A sample of 107 type 2 diabetic subjects was selected according to inclusion and exclusion criteria. Cobalamin was measured on Roche Cobas e411 chemistry analyzer and blood lipoproteins by standard laboratory methods. Data was analyzed by SPSS 21.0 (IBM, Incorporation, USA) using student t and Chi square tests for continuous and categorical variables respectively. P-value of ≤ 0.05 was taken significant. Results: Cobalamin deficiency was noted in 51 (47.6%) of diabetics and cobalamin deficiency was associated with dyslipidemia. Mean ± SD of cobalamin in normal and reduced cobalamin groups were noted as 355±29.5 and 183±17.5 pg/ml respectively (p=0.0001). Triglycerides, total cholesterol, HDLc, LDLc and VLDLc differed significantly in the normal and reduced cobalamin subjects (p<0.001). Lipoprotein sub fractions showed a negative correlation with serum cobalamin (p≤0.02). Conclusion: Cobalamin deficiency is common in type 2 diabetics and is associated with dyslipidemia. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate Vitamin D in Pulmonary tuberculosis and normal healthy adults. STUDY DESIGN: Case control study. PLACE AND DURATION: Department of Medicine, Isra University Hospital Hyderabad, from January 2013-June 2014. SUBJECTS & METHODS: A sample of 209 diagnosed pulmonary tuberculosis patients was selected through non-probability purposive sampling according to inclusion and exclusion criteria. After taking informed written consent from the participants, Vitamin D was measured by ARCHITECT I 1000 system for estimation of 25-OH-D3. . The data was recorded on a pre-structured proforma, and analyzed on SPSS version 21.0. The significant p-value was taken at ≤ 0.05. RESULTS: The mean ±S.D serum level of 25-hydroxyvitamin D3 in cases and controls were 27.1±9.7 and 36.8±8.1 (ngdl-1) respectively (p=0.0001). The 25-hydroxyvitamin D3 levels as low as 6 ng/dl were observed in pulmonary tuberculosis subjects. The normal, insufficiency and deficiency of 25-hydroxyvitamin D were observed in 37(33%), 16 (14.2%) and 59 (52.6%) in cases respectively compared to controls as 57 (58.7%), 21(21.6%) and 19 (19.5%) respectively. CONCLUSION: Patients with pulmonary tuberculosis are significantly Vitamin D deficient. Vitamin D supplements may be prescribed, however further studies are warranted. [ABSTRACT FROM AUTHOR]

Objectives: The present study aims to evaluate the serum cobalamin in Helicobacter pylori (H. pylori) infected patients. Study Design: Case control study. Place and Duration: Department of Medicine, Isra University Hospital Hyderabad from March 2013-April 2014. Methodology: A sample of 109 subjects including Helicobacter pylori positive subjects and controls were selected according to study criteria. Centrifugation of blood was performed at 4000 rpm for 10 minutes and sera were stored at -20°C. Blood sera were used for H. pylori serological testing. Blood counting was performed on hematoanalyzer. Cobas e411 analyzer was used for detection of cobalamin. 64 kD H. pylori antigens was detected by ELISA. The data was entered into SPSS version 21.0. (IBM, Incorporation, USA) A 2-tailed p-value of ≤0.05 was considered significant for statistical analysis. Results: Of total 109, 54.1% (n=59) were H. pylori seropositive cases and others were controls i.e. 45.9% (n=50). Cases and controls showed cobalamin levels of 290±49.3 vs. 351±32.9 pg/ml respectively (p=0.0001). Red blood cell indices were found to show statistically significant difference between cases and controls (p=0.001). Conclusion: Serum cobalamin deficiency was noted in both Helicobacter pylori positive and controls, however deficiency was more pronounced in Helicobacter pylori positive subjects. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to determine the frequency of skin lesions in type 2 diabetes patients. PATIENTS AND METHODS: A cross-sectional study was conducted at Muhammad Medical College Hospital Mirpukhas, Sindh from July 2008 to December 2009. The sample size comprised of 1270 type 2 diabetes patients. The patients were examined by a physician to determine the presence of diabetes mellitus-related skin lesions, skin infections and skin lesions caused by treatment. The data were collected on preformed proforma. Age, sex, duration of diabetes, mode of treatment, whether on oral hypoglycemic agents or insulin were noted. A multivariate logistic regression model was used to estimate the adjusted odds ratio (OR) for having diabetes related skin lesions. All data was analyzed by SPSS-10.0 for Windows (Chicago, IL. USA). The chi-square and student t-test were used as test of significance for qualitative and quantitative variables respectively. A p-value of <0.05 was considered statistically significant. RESULTS: The mean age of patients was 52±11 years, 768 (60.47%) were female and 502 (39.62%) were male. The mean duration of the diabetes was 19±7 years and mean HbAlc was 11.8±3g/dl. Oral hypoglycemic agents were used by 913 (81.88%) patients, insulin by 164 (12.91%) and both were used by 193 (15.19%). The skin lesions were observed 851 (67%). The most common lesion was diabetic dermopathy (28.34%), but different types of skin infections were seen in 42.6% of patients and thus forming the most common lesion. The third most common manifestation was pruritis (28.05%) and the least common was the perforating dermatoses (0.78%). The HbA1c was higher in patients suffering from diabetic foot ulcer and fungal infection than those without having these infections (10.34±1.67 and 11.5±1.4 vs.9.7±1.6 and 8.9±1.6, respectively) (p<0.05). CONCLUSION: This study shows that skin lesions are common in patients with type 2 diabetes mellitus. Therefore, frequent skin evaluation of the diabetic patients is warranted. [ABSTRACT FROM AUTHOR]

Seventy-six blood culture positive typhoid cases and forty-eight controls were studied. The typhidot test was positive in 74 (97.36%) cases, with a sensitivity, specificity and positive predictive value of 96%, 89.5%, and 95%, respectively, compared to the Widal test which was positive in 56 (73.68%) cases with a sensitivity, specificity, and positive predictive value of 72%, 87%, and 87%, respectively (P = 0.001). In the control group, seven (14.5%) cases tested positive for the Widal test and two (4.16%) for the typhidot (P = 0.001), yielding the sensitivity and specificity for the Widal test and the typhidot test of 63% and 83%, and 85% and 97%, respectively. We conclude that the Dot-EIA (enzyme immunoassay; typhidot) is a more sensitive and specific test which is easy to perform and more reliable compared to the Widal test and that it is useful in early therapy. [ABSTRACT FROM AUTHOR]