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Objective: This study aimed to investigate the impact of the Apo E polymorphisms on plasma lipid profile and identify the apo-E gene's polymorphism as a genetic predictor of calcific AS in the Pakistani population. Methodology: This was a case-control study conducted at Dow University of Health Sciences and the National Institute of Cardiovascular Disease, Karachi. It included a total of 100 individuals, 50 echocardiographically identified calcific AS cases and 50 age and gender matched controls. Apo E allele frequencies were computed, lipid profiles were estimated and Apo E gene polymorphism was identified by the techniques of polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Result: Apo E 2, 3, and 4 allele frequencies were 16%, 52%, and 32% in calcific AS cases, and 10%, 52%, and 28% in controls respectively (p=0.622). Out of 50 cases, 18% presented with mild AS, 22% with moderate AS and 60% lied in severe calcific AS. It was observed that levels of total cholesterol (TC), triglyceride (TG) and low-density lipoprotein (LDL) were higher in the Apo E4 allele as compared to other genes in both cases and control. Conclusion: The findings of this study suggested that the Apo E4 allele of the Apo E gene is an important risk factor for dyslipidemia while the Apo E4 allele is not associated with calcific AS and contemplates distinctive genetic backgrounds of CAD and AS. [ABSTRACT FROM AUTHOR]

Background: Loss to follow up from anti tuberculosis treatment (ATT) can result into, increase in cure time, drug resistance development, reduced probability of treatment compliance and increased chances of death. Therefore, interventions focused at improvement of treatment adherence can play a pivotal role in containment and control of TB. Objective: To reduce the loss to follow up rate from existing 9% at our settings i.e. National Institute of Child Health (NICH) Karachi, Pakistan. Study design, settings and duration: This prospective observational study of 18 months was conducted among children at TB clinic NICH, Karachi, Pakistan. Subjects and Methods: After taking informed written consent from parent/guardian, a Performa containing demographic and clinical information was filled and a pamphlet about adherence to treatment was given to them. After one week, every patient was contacted on mobile phone; in case of no response, home visit was made and a monthly follow up was also done. Those found to have stopped taking ATT were given awareness about complications of discontinuing ATT. Results: Out of 167 patients, 83 (49.7%) were males, mean age was 7.82 years and mean weight was 8.95 kg. Pulmonary TB was most prevalent (52.0%) followed by TB of lymph nodes (22.9%).More than 91% patients were cured, 8 (4.8%) were expired; one had MDR TB and loss to follow up rate reduced to 3.6% from previous 9% as per our hospital records. Conclusion: A visible decrease in loss to follow up rate has been achieved through multi step facilitation via mobile phone calls, messages and house hold visits of enrolled patients. [ABSTRACT FROM AUTHOR]