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Afzal M.N.,Shalamar Medical and Dental College
Journal of the Pakistan Medical Association | Year: 2010

Objective: To assess the predictive ability of leukocyte subtypes for mortality in patients with acute coronary syndrome (ACS). Methods: One hundred and thirty three consecutive patients of ACS were assessed in the study and were followed up for one year. Diagnosis was based on clinical characteristics and the laboratory data. The total leukocytes and its subtypes were counted by Sysmex automated cell counter. The predictive ability for death of total count of leukocytes, neutrophils, lymphocytes and monocytes was assessed using Cox regression analysis. Results: Univariate analysis revealed higher prevalence of total leukocytes (HR= 1.001, p=<0.001) and its subtypes, neutrophils (HR 1.001, p=<0.001) and monocytes (HR 1.006, p= <0.001), in patients of ACS. In multivariate modeling, after entering standard coronary risk factors, count of total and differential leukocytesneutrophils, lymphocytes, monocytes and cardiac biomarkers CK-MB, Trop I; the monocyte count (hazard ratio [HR] 1.004, CI 1.002-1.006, p<0.0001) was found to be independent predictor for ACS. A significance correlation between monocyte count and CK-MB, representing extent of myocardial damage, was also seen (r=0.301, p<0.0001). Conclusion: The increase in monocyte count is an independent predictor of death and prognostic marker of the extent of myocardial damage in patients with ACS (JPMA 60:548; 2010).

Maqsood M.,Shalamar Medical and Dental College
Pakistan Journal of Medical and Health Sciences | Year: 2014

Aim: To analyze the pattern of abdominal organ injuries in non- fatal cases of blunt trauma with respect to their epidemiological, medico-legal and clinic-pathological aspects. Study design: Retrospective study. Place & duration of study: Department to Surgery, Services Hospital from January, 2013 to December, 2013. Methods: This included 50 non-fatal cases from age group excluding children (<12years) but including both sex having history of blunt injuries of the abdomen brought through emergency. Results: Majority of victims were young adult males (92%) between 20-29 years of age group (36%). Road traffic accidents (84%) were the most common cause of blunt trauma abdomen comprising mostly of two wheeler occupants (52.3%). External injuries on the abdomen were found in 89.13% of cases. The most common abdominal organ injured was liver (36%) among solid organs and small bowel (32%) among hollow organs. Majority of cases were accidental (92%).

Ismail S.,Aga Khan University | Siddiqui S.,Dow Medical College and Civil Hospital | Shafiq F.,Aga Khan University | Ishaq M.,Shalamar Medical and Dental College | Khan S.,Aga Khan University
International Journal of Obstetric Anesthesia | Year: 2014

Background Increasing awareness of the risks of blood transfusion has prompted examination of red cell transfusion practice in obstetrics. A six-month prospective observational study was performed to examine blood transfusion practices in patients undergoing caesarean delivery at three hospitals in Pakistan. Methods In the three hospitals (two private, one public) 3438 caesarean deliveries were performed in the study period. Data were collected on patient demographics, indications for transfusion, ordering physicians, consent, associations with obstetric factors, estimated allowable blood loss, calculated blood loss, pre- and post-transfusion haemoglobin and discharge haemoglobin. Results A total number of 397 (11.5%) patients who underwent caesarean section received a blood transfusion. The highest transfusion rate of 16% was recorded in the public tertiary care hospital compared to 5% in the two private hospitals. Emergency caesarean delivery and multiparity were associated with blood transfusion (P < 0.05). More emergency caesarean sections were performed in the public compared to the private hospitals (85.4% vs. 41.6%). More multiparous patients underwent caesarean section in the public hospital (57.8% vs. 40.4%). Attending physicians took the decision for transfusion in 98% of cases. In 343 (86%) patients, blood transfusion was given even when the haemoglobin was >7 g/dL. The method for documenting the indication or consent for transfusion was not found in any of the three hospitals. Conclusion Blood transfusion was prescribed more readily in the public hospital. Identification of a transfusion trigger and the development of institutional guidelines to reduce unnecessary transfusion are required. © 2014 The Authors. Published by Elsevier Ltd.

Shahid A.,University of Health Sciences, Lahore | Shahid A.,Shalamar Medical and Dental College | Rana S.,University of Health Sciences, Lahore | Saeed S.,King Edward Medical University | And 3 more authors.
BioMed Research International | Year: 2013

Numerous studies confirmed the association of FTO (fat mass and obesity associated gene) common variant, rs9939609, with obesity in European populations. However, studies in Asian populations revealed conflicting results. We examined the association of rs9939609 variant of FTO gene with obesity and obesity-related anthropometric and metabolic parameters in Pakistani population. Body weight, height, waist circumference, hip circumference, and blood pressure (BP) were measured. BMI and waist-to-hip ratio (WHR) were calculated. Levels of fasting blood glucose (FBG), insulin, leptin, and leptin receptors were measured by enzyme linked immunosorbent assay (ELISA), and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. The results showed association of FTO gene, rs9939609, with obesity in females (>18 years of age). FTO minor allele increased the risk of obesity by 2.8 times (95% CI = 1.3-6.0) in females. This allele showed association with body weight, BMI, waist circumference, hip circumference, WHR, BP, plasma FBG levels, HOMA-IR, plasma insulin levels, and plasma leptin levels. In conclusion, FTO gene, rs9939609, is associated with BMI and risk of obesity in adult Pakistani females. Association of rs9939609 variant with higher FBG, plasma insulin, and leptin levels indicates that this polymorphism may disturb the metabolism in adult females and predispose them to obesity and type 2 diabetes. However, the above-mentioned findings were not seen in children or males. © 2013 Adeela Shahid et al.

Shahid A.,University of Health Sciences, Lahore | Shahid A.,Shalamar Medical and Dental College | Saeed S.,King Edward Medical University | Rana S.,University of Health Sciences, Lahore | Mahmood S.,University of Health Sciences, Lahore
West Indian Medical Journal | Year: 2012

Objective: Offsprings of Type 2 diabetics have increased risk of metabolic disturbances. The aim of the study is to assess the potential effect of family history of Type 2 diabetes (FHD) and parental consanguinity on fasting plasma glucose (FPG) levels. Subjects and Methods: Non-diabetic offsprings of one or both parents with Type 2 diabetes and healthy controls of comparable age, without a FHD were the subjects of this study. Family history of Type 2 diabetes was defined by the presence of Type 2 diabetes in one or both parents of the subject. Consanguinity was defined as history of marriage with a first cousin. Fasting plasma glucose levels were determined in cases and controls. Results: Impaired fasting glucose was identified in 42% of subjects with FHD and in 14% without FHD. We found a strong independent association of FHD with impaired fasting glucose in both males and females by logistic regression analysis after adjusting the data for age, gender and body mass index (BMI). Parental consanguinity modifies the effect of FHD on IFG. Conclusion: We concluded that family history of diabetes and parental history of consanguinity determine the risk for impaired fasting glucose in this study population.

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