Basic Medical Sciences Institute Research Articles

Frequency of Tuberculosis and its Outcomes After Anti-Tuberculosis Treatment According to Age and Gender

Objective: To determine the frequency of pulmonary tuberculosis and its outcomes after anti-tuberculosis treatment according to age and gender. Methods: This cross-sectional study was conducted at the department of Microbiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre Karachi, with the collaboration of different DOTs centers and chest ward JPMC, Karachi Medical and Dental College, Karachi. All newly diagnosed pulmonary tuberculosis patients who registered for treatment, of either gender, were included. All the patients were followed until the end of the treatment, and they were assessed regarding treatment outcomes in terms of the success and failure of the treatment according to the age and gender of the patients. A self-made proforma was structured to collect the information, and SPSS version 26 was used for the purpose of data analysis. Results: A total of 237 cases were observed, their mean age was 41.80+16.44 years and their mean weight was 51.09+7.90 kg. Males were in majority 84.0% and females were 16.0%. The majority of cases (96.2%) had completed treatment, while 3.8% of cases had not yet completed treatment.91.0% of the patients were cured, while the remaining 8.40% were still not cured during the study period. Treatment outcome was statistically significant according to age (p = 0.001), while statistically insignificant according to gender (p = 895). Conclusion: As per the study conclusion, the frequency of pulmonary tuberculosis was frequently higher among males compared to females. Treatment outcome was influenced by age greater than 60 years, while no gender effects were observed. Keywords: Tuberculosis, age, gender, treatment

Highly Emissive Luminogens in Both Solution and Aggregate States

Highly Emissive Luminogens in Both Solution and Aggregate States

Animal model testing for efficacy and adverse effects of bacteriophages against Acinetobacter baumannii.

This study aimed to conduct a detailed study on murine model testing of bacteriophage against Acinetobacter baumannii. These bacteriophages were tested not only for their efficacy in healing wound of murine models infected with multidrug resistant A. baumannii but were also studied for any derangement in hematological parameters as well as liver and kidney function. The study also included any histological changes observed in hepatic and renal tissues of the bacteriophage treated murine animals. This experimental study was conducted at Institute of Basic Medical Sciences, Khyber Medical University, Peshawar and Institute of Pure and Applied Biology, Department of Microbiology and Molecular Genetics, Bahauddin Zakariya University, Multan. A. baumannii isolates were obtained from the Microbiology Department, Armed Forces Institute of Pathology, Rawalpindi. Antimicrobial susceptibility was done by using standard procedures and as per Clinical Laboratory Standards Institute guidelines. Bacteriophages were isolated from sewage water samples collected from different hospitals in Multan. These bacteriophages were characterized and finally used for treating the murine model and efficacy of phage as a therapeutic option was determined by using superficial rat wound model. In this study, the isolated lytic bacteriophage was effective in relatively faster wound healing of the infected animals. Moreover, there were no significant hematological or renal and hepatic profile changes in treated animals. Histology of renal and hepatic tissues was also normal as compared to control animals. Our study concluded that the isolated phage could serve as an attractive therapeutic candidate to combat the deadly multidrug resistant A. baumannii.

Effect of Diamond and Carbide Burs on Dentinal Tubules and Predentin Diameter

OBJECTIVES: To find out the effect of Diamond and Carbide burs on the diameter of dentinal tubules and predentin of premolar teeth. METHODOLOGY: A Laboratory-based experimental study was conducted at the anatomy department, Institute of Basic Medical Sciences, Khyber Medical University, from January 2018 to March 2018. Sixty premolars were obtained from patients considering the inclusion and exclusion criteria. Six teeth were extracted for control group A. Fifty-four maxillary and mandibular premolar teeth in patients underwent cavity preparation carried out by diamond bur (group B) for twenty-seven teeth and other twenty-seven teeth by carbide bur (group C) and were removed from patients at a dental hospital in Peshawar (RCD). They underwent processing and were then stained with Eosin, Hematoxylin and Masson's trichrome to observe the diameter of dentinal tubules and predentin. RESULTS: The dentinal tubules and predentin diameters were observed and measured in all samples in both control group A and experimental groups B and C. No effect was seen in dentinal tubules diameter. In the Control group, the diameter of predentin was less as compared to Experimental groups B and C, i.e., 10-17.5µm in group A whereas the range for Diamond bur (Group B) and Carbide bur (Group C) was 12.5-25µm and 20-37.5µm whereas. CONCLUSION: It was concluded that in comparison with Carbide bur, Diamond bur is more beneficial than Carbide bur as the Diamond bur has no effect on dentinal tubules diameter whereas little effects on predentin diameter.

EFFECTS OF METFORMIN AND INSULIN ON MORPHOLOGY, STEREOLOGY AND MEAN MORPHOMETRIC DIFFUSION CAPACITY IN DIABETIC PLACENTA

Background: Insulin given for the treatment of GDM is associated with hypoxic changes whereas Metformin has beneficial micro-vascular effects on the placenta. This comparative drug study was conducted with objectives to compare the effects of Metformin and Insulin on the morphology and stereology in gestational diabetes. And to calculate and compare the mean morphometric diffusion capacity for oxygen in Metformin and Insulin treated gestational diabetics. Methods: This clinical trial was conducted from Jan 2018 to Feb 2019 in the Department of Pharmacology, Basic Medical Sciences Institute, in collaboration with the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Karachi. Out of 136 high-risk females, 83 confirmed gestational diabetics were enrolled in second trimester and were further randomised into Group A (oral Metformin therapy) and Group B (subcutaneous Insulin therapy). They were followed till term and after delivery. Collected placentae (35 in each group) were subjected to gross, microscopic and detailed stereological study. Results: Placental weight on gross, hypoxic changes such as immature villi, chorangiosis and syncytial knots on light microscopic morphology, placental volume, the total volume of placental villi and total volume of foetal connective tissue on stereology were significantly more in Insulin-treated diabetic placentae whereas the mean villi diameter and mean morphometric diffusion capacity was significantly more in Metformin-treated placentae. Conclusion: Metformin-treated placentae were significantly different as compared to the insulin-treated placenta. Metformin treated placentae showed better morphometric diffusion capacity for oxygen than insulin treated placentae. Pak J Physiol 2022;18(2):22?7

“Effects of Medroxy Progesterone Acetate (Inject-Able Contraceptive) on Diameter of Graffian Follicle (Ovary) of Adult Albino Rats”

Objective: An injectable birth control called Medroxy Progesterone Acetate (MPA) was used in the study to see how it affects adult female albino rats' ovaries. Study design An experimental study Place of study : To conduct the research, scientists worked with animals at the Dow University of Health Sciences' Animal House, the Institute of Basic Medical Sciences, and the Dow Diagnostic Research and Reference Laboratory (DDRRL). In the months of April and July of 2012, researchers conducted their investigation. Materials and Method:For the purpose of the research, a total of 72 female albino rats were chosen and divided into three distinct categories. Each group was further subdivided into three smaller groups based on the length of time that the therapy session lasted. The experiment utilized a group size of n = 24, which served as the control. The dose of MPA that was given to Group B (which consisted of 24 people) was 3 mg/kg of body weight. Participants in Group C (n = 24) were given an MPA dose that was two times higher than those in Group A (3 mg/kg). A single injection of MPA was given to group B as well as group C at the beginning of the experiment. During the course of the research, it was noticed that the ovaries of the animals had changed both in terms of their shape and their structure. Hematoxylin, eosin, and masson's trichrome were the stains that were used to color the tissues of the ovary. With the assistance of an ocular and stage micrometer, even minute differences could be detected and measured. The Kruskal-Wallis test and Tukey's test are two examples of nonparametric statistical analysis that were used to investigate the differences in each group's variables. Result: In comparison to control groups, experimental animals fed MPA had significantly smaller diameters of graafian follicles (DOF) than animals in the control groups. There was a significant difference in depth-of-field (DOF) between groups A1, B1, and C1 after one month of treatment. Groups A2, B2, and C2 each had a DOF of 571.25 98.26 meters, 288.25 100.80 meters, and 179.0 37.23 meters. In groups A3, B3, and C3, the DOF ranged from 699.75 m to 128.7 m, 230.37 m to 20.83 m, and 159.37 m to 47.65 m. Conclusion: Research shows that MPA can lower the amount of follicular atresia as well as chronic anovulation, according to the findings of this study. With this study's findings, we can better understand the risks that hormonal contraceptives like injections have to women's health. Keywords: MPA: Medroxy progesterone acetate FSH:Follicular Stimulating Hormone ,LH: Luteinizing Hormone. DOF : Diameter of graafian follicles

Evaluation Of Triglycerides Levels In Serum And Tears Of Obese And Non-Obese Normal Adult Humans And Its Effects On Pupillary Response.

Triglycerides are a type of storage fat present in serum of both normal and obese individuals. Triglycerides are normally present in human tears. The presence of qualitative fats in the tears affect the pupillary response to the external light stimulus which is measured through portable field dark adaptometer (PFDA) device. The current study was conducted to evaluate the levels of triglycerides in serum and tears of obese and non-obese humans and its relationship with pupillary response. This descriptive cross-sectional study was conducted at Institute of Basic Medical Sciences, Khyber Medical University, Peshawar. A total of 500 participants were recruited out of which only 50 qualified for the study as per inclusion criteria. Out of these 50, 25 (50%) were obese and 25 (50%) were non-obese. Serum triglycerides were measured by using Micro lab 300 biochemistry analyzer, while thin layer chromatography was used to detect triglycerides in tear samples.. Triglycerides were detected only in tears of obese individuals. No statistically significant difference was observed in the serum levels of triglycerides between the two groups (p=0.849). The presence of triglycerides in tears of obese adults caused a low pupillary response as compared to normal individuals.

Lipid Profiles and Its Association with Pre-Eclampsia and Eclampsia in Nulliparous Pregnant Women

Objectives: To access the lipid profiles and its association with pre-eclampsia and eclampsia in nulliparous pregnant women.
 Material and Methods: This cross-sectional study was performed on 234 nulliparous pregnant women with gestation period of > 20 weeks and aged 15-45 years, from March to October 2014, in Institute of Basic Medical Sciences (IBMS), Khyber Medical University (KMU), Peshawar, Pakistan with cooperation from gynecology and obstetrics departments of three tertiary-care hospitals of Peshawar & Khyber Medical College, Peshawar, Khyber Pakhtunkhwa (KP), Pakistan. Subjects were assigned to three groups i.e., group A, group B and group C. For performing biochemical assays and lipid profiling, through ELISA, blood samples were collected from already subjects both with the disease and the controls.
 Results: Both subjects having pre-eclampsia and eclampsia showed significant elevated levels (p < 0.001) for low density lipoproteins cholesterols (LDL-c), high density lipoprotein cholesterol (HDL-c), total cholesterol (TC)/HDL-c and LDL-c/HDL-c ratio. But TC of pre-eclampsia subjects were found significantly elevated (p < 0.001) in relation to controls. LDL-c/HDL-c and TC/HDL-c also revealed an elevated significant change (p < 0.001) both for pre-eclamptic and eclamptic subjects. On the other hand, only TG/HDL-c in pre-eclamptic patients was found significantly higher (p<0.004) when compared to control group. 
 Conclusion: Serum lipid levels were observed higher in pre-eclampsia and eclampsia patients hence an early assessment is necessary to prevent complications in such patients.

Correlation between Serum Malondialdehyde levels and prevalence of cardiovascular disease in Haemodialysis treated patients.

To investigate the role of serum malondialdehyde as a diagnostic biomarker of free radical production and cardiovascular disease in patients treated with maintenance haemodialysis. The case-control study was conducted in the Department of Biochemistry, Basic Medical Sciences Institute (BMSI) of the Jinnah Postgraduate Medical Centre (JPMC), Karachi, and the JPMC Nephrology ward from January 12, 2018, to January 15, 2019, and comprised patients receiving haemodialysis as the cases and healthy controls. Blood samples were obtained from all the subjects for checking the level of serum malondialdehyde. Doppler ultrasonography was employed to detect the intima media thickness ratio of the common carotid artery of all the subjects. Data ws analysed using SPSS 23. Of the 90 subjects, 45(50%) each were cases and controls. There were significant differences in mean values related to age, body mass index and blood pressure between the groups. A statistically significant rise was seen in serum malondialdehyde and carotid artery intima media thickness ratio in the cases compared to the controls (p<0.05). Serum malondialdehyde was found to be significantly raised in haemodialysis patients compared to the healthy controls.

Histopathological effects with marwar teak (tecomella undulata) bark extract and N-acetylcysteine on acetaminophen induced hepatotoxicity in albino rats.

Objective: The study aims to determine histopathological effects associated with Marwar Teak Tecomella Undulata bark extract and N-Acetylcysteine on Acetaminophen induced liver damage in rats. Study Design: Experimental Comparative Study. Setting: Bahria University Medical and Dental College Karachi in Collaboration with Basic Medical Sciences Institute (BMSI) Karachi. Period: March 2020 till August 2020. Material &amp; Methods: Study included 56 healthy albino rats which were randomly divided into four groups. Each group comprised of 14 experimental animals which included (Group-1) Control Group, (Group-2) hepatotoxicity induced rats, which were given Acetaminophen 500 mg as a single dose orally, (Group 3) which was induced hepatotoxicity by Acetaminophen 500mg orally as a single dose, then they were given N-Acetylcysteine standard drug at dosage of 140mg/ kg intraperitonealy for 6 days and (Group 4), which was induced hepatotoxicity by Acetaminophen 500 mg orally as a single dose, then they were given Tecomella bark extract at the dose of 200 mg/kg orally for 15 days. Experimental animals were dissected. Liver samples were sectioned (3-5µ) thickness and were stained with H&amp;E. Histopathological findings were noted. SPSS version 23 was used for statistical analysis. P-value &lt;0.05 was considered significant. Result: Deranged liver architecture with presence of moderate inflammatory cells were observed in Acetaminophen induced hepatotoxic rats (Group-2). However, there was presence of moderate inflammatory cells with normal liver architecture in rats treated with standard drug (Group–3). There was improvement in liver histology in Tecomella bark extract treated group (p-&lt;0.05) Group-4. Conclusion: The Tecomella Bark extract improved histoarchitecture on acetaminophen induced hepatotoxicity in albino rats in comparison with N-Acetylcysteine.

Diagnostic Accuracy of Serologic (IGG) in Diagnosis of Helicobacter Pylori among Patients of Dyspepsia by Taking Stool Antigen (HPSA) as Gold Standard

Objective: To determine the diagnostic accuracy of serologic (IgG) in the diagnosis of Helicobacter Pylori among patients of dyspepsia by taking Helicobacter pylori Stool Antigen (HpSA) as the gold standard. Material and methods: The study was conducted in Microbiology Department, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi with the collaboration of gastroenterology OPD. All the patients with a history of dyspepsia, above 25 years of age and of either gender were included. After taking informed consent the clinical samples of blood and stool from patients were taken. A 6 ml venous blood was taken from the antecubital vein for detecting IgG antibody to H. pylori. Stool samples were collected for detecting H. pylori antigen in a wide mouth, sterile, leak proof container properly labeled by serial number and stool samples were stored in a refrigerator at 4°C up to 72h. On the specimens containing H. pylori antibodies, a colored line appeared in the test line region consider a positive result. H. pylori antigen was detected in stool (HpSA) by rapid chromatographic immunoassay. During analysis, the specimen responds with an anti-H. pylori antibody-coated particle. By capillary action, the mixture migrates upward on the membrane, reacting with anti-H. pylori antibodies on the membrane to produce a colorful line. A positive result is indicated by the presence of this colored line in the test zone, whereas a negative result is indicated by its absence. All the data were obtained using a study proforma, and the data was analyzed using SPSS version 26. Results: A total of 210 patients presented with dyspepsia were studied, their mean age was 49.07±10.97 and females were in majority (71.9%). H. Pylori was positive among 137 cases, those who underwent serological test (IgG) and 127 were positive for stool antigen (HpSA). The diagnostic accuracy of serological test (IgG) was found 95.23% by taking Stool Antigen (HpSA) test gold standard followed by sensitivity 92.7%, specificity 100%, PPV 100% and NPV 87.95%. Conclusion: The diagnostic accuracy of serological test (IgG) was found 95.23% by taking Stool Antigen (HpSA) test gold standard followed by sensitivity 92.7%, specificity 100%, PPV 100% and NPV 87.95%. Key words: H. pylori, diagnosis, IgG, Stool antigen

COMPARISON OF CELL BLOCKS AND SMEAR EXAMINATION WITH FINE NEEDLE ASPIRATES IN THE DIAGNOSIS OF SUPERFICIAL PALPABLE HEAD AND NECK LESIONS

OBJECTIVE: To compare the findings of cell blocks and smear examination with fine needle aspirates (FNA) in the diagnosis of superficial palpable head and neck lesions taking histopathology as the gold standard. METHODS: This cross-sectional comparative study was conducted at Pakistan Institute of Medical Sciences, Islamabad and Institute of Basic Medical Sciences, Khyber Medical University, Peshawar. Eighty patients of all age groups, having superficial clinically palpable lesions of head and neck region were recruited in the study from August 2014 to August 2015. FNA cytology, cell block and open biopsy were performed in all cases and compared with the histopathological examination. The data was recorded in a proforma and analyzed through SPSS Version-23. RESULTS: Out of 80 patients, 44 (55%) were males and 36 (45%) females. The age of patients ranged from 01-81 years with a mean age of 45.68±20.43 years. Lesions involving lymph nodes (n=31; 38.8%) and salivary gland (n=24; 30%) were common in head and neck region. Tuberculosis (n=15: 48.38%) and pleomorphic adenoma (n=13; 54.16%) were the common lesions involving lymph nodes and salivary glands respectively. Overall, 49 (61.2%) cases were benign/reactive and 31 (38.8%) cases were malignant on histopathology. Sensitivity, specificity, positive predictive value and negative predictive value was 74.2%, 95.9%, 92% &amp; 85.5% for FNA smears and 83.9%, 98%, 96.3% and 90.6% for Cell Block respectively in diagnosing head and neck lesions. CONCLUSION: Cell block with better diagnostic accuracy can be used as adjunct to FNA smears in diagnosis of superficial palpable head and neck lesions.

Vitamin D Deficiency and Adverse Results in COVID-19

Aim: The goal of this study is to find out how common vitamin D deficiency is in patients with corona virus disease and what the consequences are. Study Design: Observational /Prospective Place and Duration: Institute of Basic medical sciences, Khyber Medical University (KMU), Jan 2021-Oct 2021. Materials &amp; Methods: This study included 120 patients of both genders who had been diagnosed with covid-19. Patients ranged in age from 15 to 75 years. After receiving written agreement, demographically detailed such as age, sex, and BMI were recorded. All of the patients had a 5 mL blood sample obtained to check their vitamin D levels. 25(OH)D &lt; 25 nmol/L (10 ng/dL) was considered severe Vitamin D insufficiency. The prevalence of vitamin D insufficiency as well as negative effects were investigated. SPSS 23.0 was used to analyse the data. Results: The mean age of the 120 patients was 40.11±8.64 years, with 68 (56.7%) males and 52 (43.3%) females. There were 52 patients (43.3%) with severe vitamin D insufficiency. There were 17 deaths of the total number of patients in the study. Vitamin D deficiency was associated with a higher mortality rate in patients with covid-19 disease than in those who had normal levels of vitamin D, a finding that was statistically significant at the 0.05 level. Conclusion: It was found that severe deficiency of vitamin D and death in individuals with covid-19 illness had a strong association. Keywords: Mortality, Vitamin D Deficiency, Covid-19,

Two novel mutations of the γ‐secretase genes in Chinese acne inversa (hidradenitis suppurativa)

Acne inversa (AI, OMIM #142690), also called hidradenitis suppurativa (HS), is a chronic, inflammatory, recurrent and debilitating skin follicular disease that usually presents after puberty with painful, deep-seated, inflamed lesions in the apocrine gland-bearing areas of the body, most commonly the axilla, inguinal and anogenital regions. The estimated prevalence in Caucasian populations ranges from 0.1% to 1%1 but rarely reported in Chinese. About 35%–40% of AI patients have a familial history, which shows an autosomal-dominant inheritance pattern.2 In 2010, our group identified loss-of-function mutations in the NCSTN, PSENEN and PSEN1 genes in six Han Chinese families, thus first reported that haploinsufficiency of genes encoding γ-secretase components as the genetic basis for familial AI.3 To date, over 40 mutations in γ-secretase genes have been identified in familial AI patients from different populations, according to the Human Gene Mutation Database (HGMD, http://www.hgmd.cf.ac.uk/). In this letter, we reported two novel mutations in NCSTN and PSENEN in two Chinese AI families. Patient 1 is a 25-year-old male presented with recurrent inflammatory papules, painful nodules, pustules, cysts and scars on the back of neck, axillae, back, upper chest, forearms and buttocks for 6 years (Figure 1A–F). With these clinical features, a diagnosis of acne inversa was made. He had been treated with isotretinoin without significant improvement. He has no positive family history. After the written informed consent was obtained, an in-house panel-based targeted next-generation sequencing revealed a novel frame shift mutation c.1555dupA in NCSTN in patient 1 (Figure 1G). NCSTN encoding nicastrin, a glycoprotein acting as a γ-secretase complex stabilizer,4 is the most commonly mutated gene reported in familial AI. This mutation generated a premature termination codon (p.T519NfsX9), which was predicted to cause loss of function of NSCTN thereby causing the disease. In family 2, there were 1 male and 4 female patients (Figure 1H). The proband (III 4) was a 25-year-old female presented with recurrent inflammatory papules, pustules and painful nodules at the age of 11 years. Other patients in this family had similar clinical manifestations and fulfilled the diagnostic criteria of AI (Figure 1I–P). All patients had normal intellectual ability and no neuropsychiatric disorder and behaviour problems. By targeted sequencing, a heterozygous nonsense mutation, c.13C>T p.R3X, was identified in PSENEN, which was never reported before. Sanger sequencing confirmed this mutation in the proband and showed that her affected sister also carried the same mutation. PSENEN encodes presenilin enhancer protein 2 (PEN2), a member of the γ-secretase enzyme complex, in which loss-of-function mutations have been reported to cause familial AI. The nonsense mutation p.R3X was classified as “pathogenic” according to the ACMG/AMP 2015 guideline5 and should be responsible for the disease in this family. In conclusion, herein, we reported two novel mutations of γ-secretase genes in two Chinese families with AI, which expanded the mutation spectrum of γ-secretase genes underlying AI. The study was supported by the National Key Research and Development Programme of China [2016YFC0905100 to XZ], the CAMS Innovation Fund for Medical Sciences (CIFMS) [2016-I2 M-1-002 to XZ], the National Natural Science Foundation of China (NSFC) [81788101 and 81230015 to XZ] and the Natural Science Foundation of Beijing [7172167 to D-LM]. The authors wish to acknowledge the constructive comments and contributions of Wei Liu, Department of Dermatology, Peking Union Medical College Hospital, Jia-Wei Liu, Department of Dermatology, Peking Union Medical College Hospital, and Rong-Rong Wang, McKusick-Zhang Center for Genetic Medicine, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences and Chinese Academy of Medical Sciences & Peking Union Medical College. None declared. In the study, Y.T.Q. and M.X. are the co-first authors. D.L.M. and X.Z. are the co-corresponding authors and revised the manuscript and supervised the study. Y.T.Q. and D.L.M. cared for the patients. M.X. and K.Q.L. performed the next-generation sequencing and contributed to the interpretation of the results. Y.T.Q. and M.X. wrote the initial draft. All authors participated in the design of the study, clinical assessment and genomics research. All the authors take responsibility for acquisition, analysis and interpretation of the data. All authors have read and approved the final manuscript.

Worry and rumination predict insomnia in patients with coronary heart disease: a cross-sectional study with long-term follow-up.

Insomnia is highly prevalent and associated with anxiety and depression in patients with coronary heart disease patients. The development of effective psychological interventions is needed. Worry and rumination are potential risk factors for the maintenance of insomnia, anxiety, and depression that may be modified by psychological treatment grounded in the Self-Regulatory Executive Function model. However, the relationships between worry, rumination, anxiety and depression, and insomnia are not known. Therefore, we investigated these relationships both cross-sectionally and longitudinally among patients with coronary heart disease. A cross-sectional study consecutively included 1,082 patients in 2014-2015, and 686 were followed up after mean of 4.7 years. Data were gathered from hospital records and self-report questionnaires comprising assessment of worry (Penn State Worry Questionnaire), rumination (Ruminative Responses Scale), anxiety and depression (Hospital Anxiety and Depression Scale), and insomnia (Bergen Insomnia Scale). Insomnia correlated moderately with all other psychological variables (R 0.18-0.50, all P values < .001). After adjustments for anxiety and depression, odds ratios for insomnia at baseline were 1.27 (95% confidence interval 1.08-1.50) and 1.60 (95% confidence interval 1.31-1.94) per 10 points increase of worry and rumination, respectively. Corresponding odds ratios for insomnia at follow-up were 1.28 (95% confidence interval 1.05-1.55) and 1.38 (95% confidence interval 1.09-1.75). Depression was no longer significantly associated with insomnia after adjustments for worry and rumination, but anxiety remained significant. Worry and rumination predicted insomnia both cross-sectionally and prospectively, even after controlling for anxiety and depression, although anxiety remained significant. Future studies may test psychological interventions targeting these factors in patients with coronary heart disease and insomnia. Frøjd LA, Papageorgiou C, Munkhaugen J, etal. Worry and rumination predict insomnia in patients with coronary heart disease: a cross-sectional study with long-term follow-up. J Clin Sleep Med. 2022;18(3):779-787.

Restoration of Cerebellar Gray Matter Thickness by Methylcobalamin (6 Weeks Study)

Background: Methylcobalamin is essential vitamin required for DNA synthesis during cell division therefore maintain the architecture of nervous tissue distorted by soft metals such as Lithium Carbonate. Accurate documentation of the thickness cerebellar cortical thickness was required in subjects who were injected with methylcobalamin distorted by Lithium Carbonate. Aim: To provide data of cerebellar gray matter thickness distorted by Lithium Carbonate by the anti-oxidant effect of methylcobalamin. Methods: Fifteen albino rats were maintained on food and diet in Animal House of the Basic Medical Sciences Institute, JPMC Karachi for a period of 6 weeks. Results: The results obtained of the thickness of cerebellar gray matter distorted by Lithium Carbonate was restored by methylcobalamin in our study. Conclusion: To observe the neuroprotective effect of B12 on distorted cerebellar cortex treated by Lithium Carbonate. Keywords: Methylcobalamin, Lithium Carbonate, Gray Matter, Cerebellum

Correlation Between Serum Ferritin and Gonadotrophins and Sex Hormones in Patients with Transfusion Dependent â-Thalassemia

Background: Patients with transfusion dependent beta thalassemia major develop a number of complications of whichhypogonadism is the most common. In addition, raised serum ferritin level has been associated with hypogonadism.Objective: To determine a correlation between serum ferritin, gonadotrophins and sex hormones in patients with transfusiondependent â-thalassemia syndrome patients.Material and methods: This cross sectional study was designed and conducted at the Institute of Basic Medical Sciences (IBMS),Khyber Medical University (KMU) Peshawar and Fatimid Foundation, blood bank and hematological services Peshawar. Betathalassemia syndrome patients enrolled in the study were 97. Blood samples collected from the study subjects were analyzed atIBMS KMU using chemiluminescence immune assay for determination of serum ferritin and gonadal hormones such as FSH, LH,Estradiol and Testosterone.Results: The mean±SD age of patients was 18.93±3.6 years with a range of 15-32 years. There were 55 (56.7%) males and 42(43.3%) females. Overall hypogonadism was diagnosed in 39 (40.21%) patients. Although we did not find any association betweenserum ferritin level and gonadal function in our study, hypogonadism having males had a higher serum ferritin level (p = 0.02). Astatistically significant negative correlation was found between serum ferritin and serum level of LH, FSH and testosterone in males(p <0.05).Conclusion: The effect of iron overload on serum level of gonadotrophins and gonadal hormones is more pronounced in males ascompared to female thalassemic patients.Keywords: Beta Thalassemia syndrome, Chelation, Ferritin, Hypogonadism, Gonads, Sex Hormones

Effect of short duration moderate intensity physical activity on glycemic control and antioxidant status of prediabetic population.

Objectives:To determine the effect of moderate-intensity physical activity on glycemic control and antioxidant status in the prediabetic population.Methods:This experimental study was carried out in the Physiology Department, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan. A total of 50 adult prediabetic subjects having 22 females and 28 males with the age range of 18 to 35 years were included. Diagnosis of prediabetes was made by glycated hemoglobin falling in the range of 5.7-6.4%, and impaired fasting glucose (100-125 mg/dL). Anthropometric measurements and biochemical assays were carried out at pre and post-exercise intervention. The participants performed moderate exercise of 30 min with heart rate max 7% ± 5% for 5 days a week for 8 weeks, monitored with pedometer. Enzyme-linked immunosorbent assay was carried out for individual and total antioxidants.Results:Anthropometric parameters showed a significant decrease at post-exercise analysis. Similar changes were observed for fasting glucose (p<0.001) and glycated hemoglobin (p<0.001). Slight increase in uric acid (p<0.005) and total antioxidant concentration (p<0.001) were found. However, superoxide dismutase, glutathione peroxidase, vitamin C, and nitric oxide decreased (p<0.001).Conclusion:Moderate physical activity for 8 weeks significantly reduced the individual antioxidant levels, nominal increase in total antioxidant capacity and uric acid, and there was an explicit decline in the anthropometric and diabetic profile of prediabetic population.

RELATIONSHIP BETWEEN S-INSULIN AND CHROMIUM, MANGANESE, COBALT, AND ZINC EXCRETION IN THE URINE IN HEALTHY KHYBER PAKHTUNKHWA PERSONS

Objective: Clinical research has shown that mineral imbalances, including those involving zinc, cobalt, manganese,and chromium, are crucial for the onset and development of diabetes mellitus. To ascertain the function of these traceelements in pathogenesis and the advancement of type 2 diabetes, this investigation aimed to ascertain if there was alink, if any, between the urine excretion of these minerals and s-insulin levels.Study Design: Cross-sectional study.Place and Duration of study: From January to December 2013, this research was carried out at Khyber MedicalUniversity (KMU), Peshawar, at the Institute of Basic Medical Sciences (IBMS).Materials and Methods: This research comprised 200 healthy people from the seven divisions of Khyber Pakhtunkhwa (Abbottabad, Peshawar, Mardan, Bannu, Dera Ismail Khan, Malakand, and Kohat) with normal fastingblood sugar (FBS), creatinine, cholesterol, HDL, LDL, and TAG values. Anthropometric measures and demographicdata were recorded. Serum creatinine, serum insulin, lipid profile, and fasting blood sugar were measured using a bloodsample. Urine samples were taken early in the morning to measure zinc, cobalt, manganese, and chromium levels.Results: It was discovered that there was a near-to-significant negative connection (r: -0.127, p: 0.073) betweenmanganese and s-insulin and a considerably high negative correlation (r: -0.191, p: 0.007) between chromium ands-insulin. Thus, elevated chromium and manganese excretion in the urine in healthy persons may eventually causeT2DM to proceed if improperly managed.Conclusion: the present study revealed a significant correlation of s-insulin with urinary excretion of chromium only.Keywords: Type II diabetes mellitus, s-insulin, trace elements.

The frequency of vibrio cholera 01 EL TOR (Inaba And Ogawa) and its Resistance Pattern in Karachi.

Introduction: Cholera is an acute infectious disease of small intestine, caused by the bacterium Vibrio cholerae. More than 200 serogroups of V. cholerae have been identified. In Iran, Inaba strains were 75% resistant against trimethoprim-sulfamethoxazole in 2011, while during 2012-13 it was 100%. Ogawa strains showed 96% resistance against trimethoprim-sulfamethoxazole in 2011, whereas 100% resistant in 2012, while no resistance was seen in 2013 against the same antibiotic. &#x0D; Objective: To determine the frequency of vibrio cholera 01 EL TOR (Inaba And Ogawa) and its resistance pattern in Karachi.&#x0D; Methodology: Samples were collected from patients with acute diarrhea with rice-water stool from Medical Unit, JPMC and NICH, Karachi between October 2015 to August 2016. These samples were then transported to Microbiology Department, Basic Medical Sciences Institute, JPMC, Karachi and processed according to standard protocol.&#x0D; Results: No growth was noticed in 147 (66.81%) samples while a total of 28 (12.7%) were V. cholerae species, and 45 (20.45%) were other organisms. The distribution of V. cholerae serotypes, out of 28 V. cholerae species, 13 (46.4%) were of Inaba serotypes, 09 (32.1%) were of Ogawa serotypes while 06 (21.4%) were of Non-01 serotypes.&#x0D; Conclusion: The susceptibility results of tetracycline and trimethoprim-sulfamethoxazole are not very favorable. Involvement of multidrug resistant V. cholerae O1 serotypes in the community is a very serious public health concern. Such patients were observed to be very difficult to treat in the community.&#x0D;