Pakistani Patients Research Articles

Religiously Integrated Forgiveness Therapy: A Psychotherapeutic Tool for Depression and Pain Among Pakistani Patients with Chronic Widespread Pain.

Individuals experiencing chronic widespread musculoskeletal pain (CWP) frequently have comorbid depression. The presence of depression and pain-related outcomes in these patients are found to be positively correlated with inability to forgive or let go of interpersonal hurts and maltreatments. So for these patients, the current study aimed to apply a religiously integrated forgiveness intervention and to find out its efficacy in lessening depression and pain. The first part of research consisted of developing a religiously integrated forgiveness intervention by incorporating Islamic principles in Enright's process model of forgiveness. The other half was a randomized-control design where Depression Subscale of Depression Anxiety Stress Scale Urdu version as reported by Zafar (Urdu translations of the DASS, 2014) and Heartland Forgiveness Scale Urdu version (Butt in Interdiscip J Contemp Res Bus 4:769-792, 2012) were applied on a total of 272 adults (122 male and 150 female). After screening, 60 individuals (18 males and 39 females) were selected on the basis of high and low score on depression and forgiveness scales, respectively. Their ages ranged from 26 to 45years. Selected individuals were randomly assigned to be a part of either treatment or control group. Religiously integrated forgiveness therapy (RIFT) was applied on 30 individuals in comparison to the 30 participants from control group. Results indicated that in comparison with control group, from pretest to posttest participants in forgiveness intervention group scored lower on depression as well as pain and scored higher on forgiveness (p>.001). It was found that the religiously integrated model of forgiveness therapy was efficacious in enhancing forgiveness and in reducing depression among individuals with chronic widespread musculoskeletal pain.

Proteomic biomarkers profiling in Pakistani pancreatic ductal adenocarcinoma population: a retrospective cohort study.

Aim: Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive cancers. Research in various cancers suggests that investigating target biomarkers may provide directions to precision medicine. However, expression of biomarkers varies across different populations. The biomarker profile of Pakistani patients with PDAC remains unexplored.Materials & methods: We conducted a study on 109 patients to analyze a panel of four proteins (KRAS, p53, BRCA1 and APC) using formalin-fixed paraffin-embedded tumor samples. After confirmation of diagnosis and appropriate tumor content, tissues were processed with antibody specific immunohistochemistry experiments. Subsequently, independent microscopic observation was conducted by two pathologists using scoring criteria specific for each antibody.Results: Statistical analysis showed that negative expression of p53 was significantly associated with positive expression of BRCA1 (p=0.000) and APC (p=0.007). The expression of BRCA1 was also found significantly associated with APC (p=0.028). None of the protein showed association with overall survival or patient demographics. Moreover, KRAS expression was shown to be significantly associated with perineural invasion (p=0.005).Conclusion: This is the first study that investigates protein biomarker expression in a large cohort of Pakistani PDAC patients. The findings from the study may provide directions about the population specific biomarkers and targeted therapies for these patients.

Effect of antihypertensive drug classes in metabolic syndrome

Background: Metabolic syndrome (MetS) affects approximately 35% of the adult population of United States as well as categorized by the synchronized existence of hypertension, hyperglycemia, obesity and dyslipidemia. Now a days, this is the main cause of leading CVD (cardiovascular disease) risk in an individual. Raised blood pressure is the record common component of this syndrome and this incidence increases with age. Objective: This research was carried out to recommend the characterizations for the metabolic syndrome along with the occurrence of hypertension in this disorder. Additionally, indications concerning the properties of metabolic of the diverse antihypertensive drug modules and their consequence on metabolic syndrome will be demonstrated. Methods: A comprehensive trial in different patients were performed to identify data from clinical investigations for the occurrence, patho-physiology and treatment of hypertension in MetS. Results: Hypertension existing in almost 79% Pakistani patients alon with metabolic syndrome. The usage of thiazide diuretics, and beta-blockers salts, is dejected in the present community; though, latest signs recommend its use under precise circumstances. The Ca. channel inhibitors appear to apply a unbiased outcome on Metabolic syndrome. Whereas, renin angiotensin scheme inhibitors are supposed to be of the utmost advantage. Even though, variances occur among various agents of this class. Conclusion: Debate still exists about the ideal anti-hypertensive treatment in Metabolic syndrome. Due to the huge occurrence of hypertension in Pakistani community, still, further investigations and data is in dire need for this treatment.

Prevalence of Vitamin B12 Deficiency in Patients With Type 2 Diabetes Mellitus on Metformin Therapy: A Cross-Sectional Study.

Background Metformin is frequently prescribed as a first-line oral hypoglycemic drug to treat insulin resistance-causing type 2 diabetesmellitus (T2DM). Long-term metformin use results in vitamin B12 deficiency, which is frequently overlooked and undiagnosed. A severe deficit may cause severe anemiaand gastrointestinal, or neurological issues. Studies are scarce onthis issue in Pakistani patients with T2DM. The current study aimed to estimate the prevalence of metformin-induced vitamin B12 deficiency in T2DM patients and to explore how it relates to metformin dosage or duration of therapy. Methodology A descriptive cross-sectional study was conducted on 260 T2DM patients using metformin therapy for more than a year and attending the outpatient diabetes clinic and the medicine department of Sheikh Zayed Hospital, Rahim Yar Khan, Pakistan, from August 2022 to October 2023. All socio-demographic, clinical, and general characteristics were collected. Blood samples were taken to measure the serum vitamin B12 levels, and based on these levels, deficient and normal group characteristics were compared. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). Results Based on the serum levels of vitamin B12 of the studied T2DM on the metformin regimen, the overall prevalence of vitamin B12 deficiency was found to be 36.54% (95). The B12 deficiency was higher among the age group of 41-50 years (109, 41.9%), female gender (150, 57.7%, p-value=0.0035), urban residents (194, 74.6%), non-smokers (197, 75.8%), and with a history of chronic disease (131, 50.4%). There was a statistically significant difference in vitamin B12 levels based on T2DM duration (p=0.012), with a higher prevalence in patients with a longer diabetes history of more than two years. There was no discernible statistical relationship between patients receiving different dosages of metformin (odds ratio (OR)=0.8627; 95% confidence interval (CI) (0.5195, 1.4326); p-value=0.568), durations of metformin (OR=0.7400; 95% CI (0.442, 1.2325); p-value=0.247), or intake of vitamin B12 (OR=0.8532; 95% CI (0.5073, 1.4351); p-value=0.549). Conclusion The prevalence of vitamin B12 deficiency impacted more than one-third of T2DM patients using metformin (36.54%). The risk of vitamin B12 deficiency may increase in females with higher metformin dosages and longer durations of treatment. Furthermore, a statistically significant correlation exists between vitamin B12 deficiency and the longer duration of T2DM. These findings highlight the relevance of routinely monitoring serum levels of vitamin B12 among those with T2DM, especially when metformin is being given for over a year or at doses greater than 1000 mg per day. These preventive strategies will aid in the early detection of vitamin B12 deficiency, allowing patients to be treated with supplementation before problems such as anemia or neuropathies arise, resulting in improved quality of life and a lower socioeconomic burden.

Aortic root parameter analysis for transcatheter aortic valve implantation in the Pakistani population: a retrospective study

BackgroundTranscatheter aortic valve implantation (TAVI) is a growing treatment for aortic stenosis, but anatomical variations exist across populations. Asians tend to have smaller aortic annuli and higher bicuspid valve morphology compared to Westerners, potentially impacting TAVI valve selection and outcomes. This study analyzes aortic root parameters in Pakistani patients undergoing TAVI.ResultsWe conducted a retrospective analysis of 78 patients who underwent TAVI at the Peshawar Institute of Cardiology from January 2021 to March 2024. Pre-procedural CT scans were analyzed for aortic annulus diameters, area, and other relevant parameters. The mean age was 72.41 years (SD ± 11.99), and 61.5% were male. Aortic annulus diameters (minimum, mean, maximum) were 21.18 mm (SD ± 3.99), 24.21 mm (SD ± 3.93), and 27.49 mm (SD ± 4.43), respectively. Bicuspid aortic valves were present in 34.61% of patients.ConclusionsOur findings suggest that Pakistani patients undergoing TAVI may have aortic root dimensions comparable to Western populations, with a substantial prevalence of bicuspid valves. However, coronary heights were similar to those reported in Asian populations with smaller annuli. Further studies are needed to assess TAVI outcomes in Pakistani patients and determine if tailored valve sizing strategies are required.

Outcomes of Percutaneous Coronary Intervention in Patients With Prior Coronary Artery Bypass Grafting: A Two-Country Perspective.

Coronary artery disease (CAD) is a leading cause of mortality worldwide. Treatments such as percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are crucial for managing CAD. While CABG is often preferred for complex cases, many patients require PCI due to graft failure or new blockages post-CABG. This study evaluates PCI outcomes in Pakistani and Saudi patients with prior CABG, addressing the scarcity of regional data. The primary objective was to measure the success rate of PCI in post-CABG patients, defined as achieving less than 30% residual stenosis without major complications. Secondary objectives included assessing the incidence of restenosis, repeat revascularization, and major adverse cardiac events (MACEs) over one year. This one-year prospective cohort study was conducted at multiple tertiary care hospitals in Pakistan and Saudi Arabia, involving 246 participants aged 18 years and older who had previously undergone CABG. Participants underwent PCI using standard procedures. Data were collected on demographic information, clinical characteristics, procedural details, and follow-up outcomes. Statistical analysis was performed usingIBMSPSSStatistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States), with descriptive statistics summarizing the baseline characteristics. The chi-square test or Fisher's exact test compared categorical variables, and the t-test or Mann-Whitney U test was used for continuous variables. A p-value of less than 0.05 was considered statistically significant. The mean age of the participants was 63.5 ± 10.2 years, with 73.2% being male. The PCI success rate was 91.5% (95% CI: 88.2-94.8%), with most patients achieving less than 30% residual stenosis. There were 15 cases (6.1%) of MACEs, including five myocardial infarctions (2.0%) and 10 urgent revascularizations (4.1%). Restenosis occurred in 20 patients (8.1%; 95% CI: 4.7-11.5%), and repeat revascularization was required in 18 patients (7.3%; 95% CI: 4.0-10.6%).Kaplan-Meier survival analysis indicated no significant difference in MACE-free survival between patients with and without restenosis (log-rank test, p=0.423). The high success rate of PCI in post-CABG patients across both Pakistan and Saudi Arabia suggests that it is a viable option even in complex cases. These findings can inform clinical practice, emphasizing the importance of consistent follow-up and tailored interventions to enhance patient outcomes.

Prevalence of Adhesive Capsulitis in Patients With Type 2 Diabetes Mellitus: A Single-Center Cross-Sectional Study From Pakistan.

Background An inflammatory condition leading to stiffness and pain in the shoulder joint, adhesive capsulitis is associated with conditions such as diabetes mellitus, cervical spondylosis, thyroid dysfunction, autoimmune rheumatic diseases, and shoulder injury due to trauma, fracture, rotator cuff tear, surgery, or immobilization. Adhesive capsulitis may affect a notable proportion of the diabetic population. There are numerous studies that show that patients with type 2 diabetes mellitus are not only at higher risk of developing adhesive capsulitis but also suffer poor outcomes despite treatment, especially in patients with long-standing diabetes mellitus. Furthermore, there is significant variation in data regarding the prevalence of adhesive capsulitis in Pakistani patients with type 2 diabetes mellitus. Objective To determine the prevalence of adhesive capsulitis among patients with type 2 diabetes mellitus presenting to a tertiary care hospital in Bahawalpur, Pakistan. Methods The present observational cross-sectional study was carried out at the Department of Medicine, Bahawal Victoria Hospital, Quaid-e-Azam Medical College, Bahawalpur, Pakistan, from February 2024 to August 2024. Type 2 diabetes mellitus was labeled by HbA1c of more than 7.0%, or two random blood glucose levels of 200 mg/dL or more, or an existing diagnosis of diabetes mellitus, and/or use of anti-hyperglycemic therapy. Adhesive capsulitis was diagnosed clinically on the basis of history (gradual onset shoulder pain with limitation of movements) and examination (reduction in active and passive range of motion (ROM) of the shoulder, especially abduction, internal rotation, and external rotation) in the absence of significant abnormalities on shoulder X-ray. After ethical approval and obtaining informed consent, 430 patients with type 2 diabetes mellitus were included in the study using a non-probability consecutive sampling technique. Demographic information, diabetes control, and HbA1c levels were noted, and the patients were assessed for adhesive capsulitis. All the data was recorded and entered into IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, NY, USA), for analysis. Results Having a female preponderance (266, or 61.9%), the mean age of the participants was 54.0 ± 13.1 years. With regard to occupational status, 126 (29.3%) had a sedentary occupation, 45 (10.5%) were unemployed, and 259 (60.2%) had a non-sedentary occupation. The mean diabetes duration was 6.4 ± 5.3 years, and the majority of patients had poor diabetes control (322, or 74.9%). Adhesive capsulitis was present in 61 (14.2%) patients with type 2 diabetes mellitus. On stratification, no significant statistical association of adhesive capsulitis was seen with gender (p-value: 0.075), age (p-value: 0.465), occupation (p-value: 0.056), diabetes duration (p-value: 0.118), or diabetes control (p-value: 0.090). Conclusion Adhesive capsulitis was not an uncommon finding in our study, reported in almost one-fifth of the 430 patients enrolled. We recommend that treating physicians screen diabetic patients for adhesive capsulitis so that proper pain relief, physiotherapy, and rehabilitation may be provided timely and efficiently, thereby reducing morbidity and improving the quality of life for such patients.

CFTR Exon 10 deleterious mutations in patients with congenital bilateral absence of vas deferens in a cohort of Pakistani patients.

Congenital bilateral absence of vas deferens (CBAVD) is a urological syndrome of Wolffian ducts and is responsible for male infertility and obstructive azoospermia. This study is designed to explore the integrity of exon 10 of CFTR and its role in male infertility in a cohort of CBVAD patients in Pakistan. Genomic DNA was extracted from 17 male patients with CBAVD having clinical symptoms, and 10 healthy controls via phenol-chloroform method. Exon 10 of the CFTR gene was amplified, using PCR with specific primers and DNA screening was done by Sanger sequencing. Sequencing results were analyzed using freeware Serial Cloner, SnapGene, BioEdit and FinchTV. Furthermore, bioinformatics tools were used to analyze the mutations and their impact on the protein function and stability. We have identified 4 mutations on exon 10 of CFTR in 6 out of 17 patients. Two of the mutations were missense variants V456A, K464E, and the other two were silent mutations G437G, S431S. The identified variant V456A was present in 4 of the studied patients. Whereas, the presence of K464E in our patients further weighs on the crucial importance for its strategic location to influence the gene function at post-transcriptional and protein level. Furthermore, Polyphen-2 and SIFT analyze the mutations as harmful and deleterious. The recurrence of V456A and tactically conserved locality of K464E are evidence of their potential role in CBAVD patients and in male infertility. The data can contribute in developing genetic testing and treatment of CBAVD.

Exploring ethnic diversity and clinical outcome variabilities in well-differentiated thyroid cancer among the Asian population

BackgroundWell-differentiated thyroid cancer includes papillary thyroid, follicular thyroid, and Hurthle cell cancers, comprising approximately 95% of all thyroid cancers in the United States. This study aims to understand well-differentiated thyroid cancer in the Asian population. MethodsWe analyzed the National Cancer Database from 2004 to 2019, categorizing the Asian population based on the available ethnicities. Multivariable logistic regression assessed the associations between ethnic groups and disease stage/nodal positivity. Survival outcomes were evaluated using the Kaplan-Meier and Cox regression analyses. ResultsA total of 364,604 adult patients were analyzed. The Asian ethnic groups included were Chinese (n = 3,851), Japanese (n = 740), Filipino (n = 3,466), Korean (n = 1,567), Vietnamese (n = 1,517), Laotian (n = 101), Hmong (n = 50), Kampuchean (n = 166), Thai (n = 160), Asian Indian (n = 1,526), Pakistani (n = 167), and Pacific Islander (n = 446). Japanese, Korean, and Laotian had higher percentages of stage III disease, whereas Japanese, Filipino, and Laotian had higher proportions of stage IV disease than the White population. Most Asian ethnicities had more patients with metastasis than the White population. Korean patients exhibited a 15% increased likelihood of metastasis (odds ratio: 1.15, confidence interval: 1.03–1.28, P < .05), whereas Pakistani patients were at 40% higher odds (odds ratio: 1.40, confidence interval: 1.03–1.91, P < .05), compared with White patients. Japanese, Laotian, and Kampuchean patients experienced worse 5- and 10-year overall survival than the White population. ConclusionOur study revealed substantial variation in well-differentiated thyroid cancer characteristics and outcomes among diverse Asian ethnicities. This challenges the notion of Asians as a homogeneous population, emphasizing tailored disease management for this heterogeneous group of patients.

Association of OAS1 and MxA variants with COVID-19 in Pakistani patients.

Coronaviruses, a family of enveloped RNA viruses, have been implicated in various clinical disorders including coronavirus disease 2019 (COVID-19). Host genetic factors, including the OAS1 and MxA gene variants may have a role in determining susceptibility to viral infections. Understanding the genetic factors involved in unraveling COVID-19`s diverse clinical outcomes is critical for disease management. This study investigated the impact of OAS1 rs2660 and MxA rs2071430 genotypes on COVID-19 susceptibility and severity among Pakistani patients. This was a comparative cross-sectional study. Fifty patients diagnosed with COVID-19 and 50 controls were recruited and genotyped for the selected gene variants. The OAS1 gene rs2660 exhibited an association with COVID-19 susceptibility in various genetic models. The risk decreased with AG genotype (OR = 0.23, 95% CI = 0.09-0.58; p = 0.0011) compared to GG in codominant models. In dominant (OR = 0.35, 95% CI = 0.15-0.81; p = 0.013) and overdominant (OR = 0.21, 95% CI = 0.08-0.53; p = 0.0005) models, the single nucleotide variant (SNV) decreased COVID-19 susceptibility risk. There was no association of OAS1 rs2660 genotypes with COVID-19 severity. We did not find a significant association between MxA rs2071430 variant and COVID-19 susceptibility. OAS1 rs2660 AG genotype showed decreased risk of COVID-19 susceptibility among Pakistani patients. This study provides insight into the role of the OAS1 and MxA variants in COVID-19. This finding could aid researchers in understanding genetic susceptibility and severity in COVID-19 by identifying at-risk individuals and determining the optimal treatment.

Enhancing cancer care through addressing a neglected pillar: a narrative review on quality of life in Pakistani patients.

The current narrative review was planned to evaluate the quality of life of Pakistani cancer patients. Using relevant questionnaires and comparing global data over the last 2 decades, the review planned to explore artificial intelligence's role in cancer care, and to develop strategies for better outcomes. The review yielded poor results and exposed huge and neglected gaps in the overall approach towards the management of cancer patients based on different tumour types and categories. A few experimental interventions demonstrated promising results and echoed the need for further clinical and non-clinical experimentation for negating poor quality of life outcomes. Unsurprisingly, not a single study in the literature analysed, revealed a positive quality of life. A multi-pronged approach, therefore, must be brainstormed and safely implemented through experimentation of artificial intelligence and active coordination among healthcare bodies, finance/economic boards and welfare organisations that are active in countries like Pakistan to uplift the neglected quality of life domain among cancer patients, especially breast and oral cancers that have the highest incidences worldwide.

Sanger Sequencing Reveals Novel Variants in GLO-1, ACE, and CBR1 Genes in Patients of Early and Severe Diabetic Nephropathy.

Background and Objectives: Diabetes is a global health issue, with approximately 50% of patients developing diabetic nephropathy (DN) and 25% experiencing early and severe forms of the disease. The genetic factors contributing to rapid disease progression in a subset of these patients are unclear. This study investigates genetic variations in the GLO-1, CBR-1, and ACE genes associated with early and severe DN. Materials and Methods: Sanger DNA sequencing of the exons of CBR1, GLO1, and ACE genes was conducted in 113 patients with early and severe DN (defined as occurring within 10 years of the diagnosis of diabetes and with eGFR < 45 mL/min/1.73 m2) and 100 controls. The impact of identified genetic variations was analyzed using computational protein models created in silico with SWISS-Model and SWISS-Dock for ligand binding interactions. Results: In GLO1, two heterozygous missense mutations, c.102G>T and c.147C>G, and one heterozygous nonsense mutation, c.148G>T, were identified in patients. The SNP rs1049346 (G>A) at location 6:38703061 (GRCh38) was clinically significant. The c.147C>G mutation (C19S) was associated with ligand binding disruption in the GLO1 protein, while the nonsense mutation resulted in a truncated, non-functional protein. In CBR1, two heterozygous variations, one missense c.358G>A, and one silent mutation c.311G>C were observed, with the former (D120N) affecting the active site. No significant changes were noted in ACE gene variants concerning protein structure or function. Conclusions: The study identifies four novel and five recurrent mutations/polymorphisms in GLO1, ACE, and CBR1 genes associated with severe DN in Pakistani patients. Notably, a nonsense mutation in GLO1 led to a truncated, non-functional protein, while missense mutations in GLO1 and CBR1 potentially disrupt enzyme function, possibly accelerating DN progression.

Asymptomatic pediatric presentation of S-adenosylhomocysteine hydrolase deficiency.

S-adenosylhomocysteine hydrolase deficiency is an autosomal recessive inborn error of metabolism affecting methylation by disrupting the methionine cycle. Its clinical spectrum spans from severe perinatal encephalomyopathy and liver failure to asymptomatic course in patients with isolated hypermethioninemia. We present two new cases of S-adenosylhomocysteine hydrolase deficiency from Pakistani origin clinically asymptomatic at presentation. Both siblings showed mild chronic liver failure and elevation of creatine kinase. The older patient presented at 6 years of age with isolated verbal processing difficulty and mild diffuse leukodystrophy, reversible 12 months after introduction of methionine dietary restriction. The patient showed subtle atrophy in the muscle MRI at the age of 7 years. S-adenosylhomocysteine hydrolase deficiency was confirmed with homozygous missense variant c.146G>A (p.Arg49His) in the AHCY gene, a genotype previously reported in Pakistani patients with mild presentation. Dietary methionine restriction decreased plasma methionine but not plasma S-adenosylhomocysteine and S-adenosylmethionine. This work expands the mild spectrum of S-adenosylhomocysteine hydrolase deficiency with no noticeable clinical symptoms in children, highlighting a specific hotspot variant from South Asia. This mild form of the disease is likely underdiagnosed and raises the question of therapeutic management to prevent long-term complications documented in the literature, such as hepatocellular carcinoma and myopathy in early adulthood.

Role of Dietary Patterns in the Progression and Management of Heart Failure in Pakistani Patients: A Multicenter Study.

Heart failure (HF) is a chronic condition with increasing prevalence in Pakistan due to common cardiovascular risk factors. Dietary interventions are known to influence HF outcomes, but data specific to Pakistani patients are limited. This study aimed to evaluate the impact of dietary patterns on HF progression and management in Pakistani patients, alongside the effects on quality of life and biochemical markers. A prospective cohort study was conducted across four medical centers in Pakistan, enrolling 170 HF patients. Dietary patterns were assessed using a validated Food Frequency Questionnaire (FFQ) tailored to the South Asian population. The primary outcomes measured were changes in the ejection fraction, New York Heart Association (NYHA) class, and hospitalization rates. Secondary outcomes included changes in quality of life and biochemical markers. Multivariate logistic regression was used to adjust for confounding variables, and Bonferroni corrections were applied to account for multiple comparisons. Adherence to a heart-healthy diet significantly improved the ejection fraction (from 35% to 38%, p = 0.04), reduced hospitalization rates (22%, p = 0.03), and improved NYHA class (45%, p = 0.05). Subgroup analysis showed a 10% reduction in mortality among patients over the age of 65 (p = 0.01) and 18% in diabetic patients (p = 0.02). Dietary interventions play a critical role in HF management among Pakistani patients. Culturally tailored dietary guidelines should be integrated into clinical practice to improve patient outcomes.

Average Carbohydrate and CaLoric Intake of Patients with Type-2 diabetes at a tertiary care hospital in Pakistan: ACCLIP study.

Type-2 Diabetes Mellitus (T2DM) is one of the most common chronic non-communicable diseases and a serious health issue worldwide because of its rising prevalence amongst the young adults. Dietary diversity, rapid economic development and sedentary lifestyle are amongst the common factors contributing for the rapid rise of diabetes. Our objective was to assess the average carbohydrate (CHO) and caloric consumption and its association with obesity and disease status in patients with Type-2 diabetic patients in an outpatient setting. This study was performed at an outpatient department (OPD), of Hayatabad Medical Complex, Peshawar. Patients with T2DM were interviewed who completed dietary assessment using 24 hours dietary recall method. A total of 150 patients with Type-2 diabetes were interviewed. The mean carbohydrate intake was 400.3±106 mg/day, out of which 43.3 % participant's had carbohydrate intake above recommendations. The mean energy intake for all participants was 2504.5±587.4 Kcal/day. Majority of the participants were overweight and obese with mean BMI of 28kg/m2 ± 4.4. There was no significant difference in energy and carbohydrate intake between male and female participants. Majority of Pakistani patients with Type-2 diabetes consume foods rich in carbohydrate as well as have high caloric value. These finding were more in patients with no formal education compared to those who were well educated with a degree.

Exploring Neurocognitive and Emotional Outcomes of Long COVID: A Study Among Pakistani Patients.

Background and objective Coronavirus disease 2019 (COVID-19), primarily a respiratory illness, also significantly impacts neurocognitive and emotional health, particularly in its long-term manifestation known as long COVID. This study aimed to investigate the neurocognitive and emotional outcomes of long-term COVID-19 in Pakistani patients, to address the persisting symptoms and their effects on mental health and cognitive function. Methods A cross-sectional study involving 100 adult participants who had been COVID-19-free was conducted in Islamabad between March 2022 and March 2023. Participants were assessed using the Mini-Mental State Examination (MMSE), attention-deficit/hyperactivity disorder (ADHD) Self-Report Questionnaire, Satisfaction with Life Scale (SWLS), and Punishing Allah Reappraisal Scale. Data were analyzed using SPSS Statistics v26 (IBM Corp., Armonk, NY), employing chi-square tests, t-tests, and ANOVA. Results The study revealed significant correlations between COVID-19 symptoms and psychological variables. COVID-19 symptoms showed a negative correlation with MMSE scores (r = -0.04, p<0.01) and positive correlations with ADHD(r = 0.13, p<0.05), depression (r = 0.14, p<0.05), and anxiety (r = 0.25, p<0.05). Females reported higher levels of depression [mean: 1.21, standard deviation (SD): 0.83] and anxiety (mean: 1.33, SD:0.86) compared to males. Conclusions Our findings highlight the extensive impact of long-term COVID-19 on neurocognitive and emotional health, with significant gender differences observed in emotional outcomes. These results emphasize the need for integrated mental health services in post-COVID-19 care plans, as well as gender-sensitive interventions.

TKI Resistance in Pakistani Patients With CML and Frequency of T315I Mutation in These TKI-Resistant Patients

TKI Resistance in Pakistani Patients With CML and Frequency of T315I Mutation in These TKI-Resistant Patients

CML-632 TKI Resistance in Pakistani Patients With CML and Frequency of T315I Mutation in These TKI-Resistant Patients

CML-632 TKI Resistance in Pakistani Patients With CML and Frequency of T315I Mutation in These TKI-Resistant Patients

Evaluation of the clinical, biochemical, and molecular spectrum of Cobalamin C (CblC) defect in 33 patients from Pakistan

Background: Cobalamin C is the most common inborn error of intracellular cobalamin metabolism caused by biallelic pathogenic variants in the MMACHC gene, leading to impaired conversion of dietary vitamin B12 into its two metabolically active forms, methylcobalamin and adenosylcobalamin. Biochemical hallmarks are elevated plasma total homocysteine (HCYs) and low methionine accompanied by methylmalonic aciduria. This study aimed to evaluate the clinical, biochemical, and molecular analysis of Pakistani patients with CblC defect. Methods: Medical charts, urine organic acid (UOA) chromatograms, plasma amino acid levels, plasma tHcy and MMACHC gene results of patients presenting at the Biochemical Genetics Clinic, AKUH from 2013–2021 were reviewed. Details were collected on a pre-structured questionnaire. SPSS 22 was used for data analysis. Results: CblC was found in 33 cases (Male:Female 19:14). The median age of symptoms onset and diagnosis were 300 (IQR:135–1800) and 1380 (IQR: 240–2730) days. The most common clinical features were cognitive impairment (n = 29), seizures (n = 23), motor developmental delay (n = 20), hypotonia (n = 17), and sparse/hypopigmented scalp hair (n = 16). The MMACHC gene sequencing revealed homozygous pathogenic variant c.394C > T, (p.Arg132*) in 32 patients, whereas c.609G > A, (p.TRP203*) in one patient whose ancestors had settled in Pakistan from China decades ago. The median age of treatment initiation was 1530 (IQR: 240–2790). The median pre-treatment HCYs levels were 134 (IQR:87.2–155.5) compared to post-treatment levels of 33.3 (IQR: 27.3–44.95) umol/L. Conclusions: Thirty-three cases of CblC defect from a single center underscores a significant number of the disorder within Pakistan. Late diagnosis emphasizes the need for increased clinical awareness and adequate diagnostic facilities.

Impact of Proximal LAD Lesions on Long-term PCI Outcomes in Pakistani Patients

Impact of Proximal LAD Lesions on Long-term PCI Outcomes in Pakistani Patients