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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

Editorial: World Must Know about the Gigantic Contribution of Muslim Scientists in Laying Down of Foundations of Modern Sciences

It is no exaggeration to say that modern sciences are standing on the solid platform established by the great Muslim scientists in the golden era of Muslim dominance (Dark ages in the West) (7th -14th centuries).1,2 Arabia which was baren till the end of 6th century became the center of excellence and accomplishments and the Arabs who were considered among the most backward in education and civilization suddenly became the pioneers and leaders in almost all fields of sciences and social sciences. Their inventions were peaceful and beneficial then and still profiting all human beings on this plant earth.
With a loud and thunderous big bang Arabia and entire Muslim empire suddenly became the most fertile land for education and research which literally produced hundreds of great scientists in almost all fields of sciences and social sciences over 7-8 centuries.1,2

Aloe Vera Gel for Streptozotocin Induced Diabetes Mellitus in Rats

Sobia Javed
Department of Pharmacology, Rawalpindi Medical University, Rawalpindi
ABSTRACT

Sobia Javed

Department of Pharmacology, Rawalpindi Medical University, Rawalpindi

ABSTRACT

Objective: To compare anti-diabetic effects of Aloe Vera gel with hypoglycemic agent, sitagliptin on streptozotcin induced diabetic rats.

Materials and Methods:

Study Design: Randomized Control Trial

Place and Duration of Study: The study was done in Department of Pharmacology, Islamic International Medical College, Rawalpindi in collaboration with NIH, Islamabad, Pakistan, from September 2019 to August 2020.

Methodology: 40, young Sprague Dawley rats were taken and randomly divided into Group A and group B.  After induction of type 2 diabetes with low dose streptozotocin, group B was subdivided with n=10 each as; GroupB1 (Diabetic Control), Group B2 (Aloe Vera gel treated), GROUP B3 (Sitagliptin treated).  FBS and HbA1c measured.  Statistical Analysis was done by applying SPSS version 25. One-way ANOVA test was used for assessing any difference in the mean values. Post-hoc Turkey analysis was conducted to compare any inter-group mean differences. P value of <0.05 was considered significant.

Results: On completion of study, at day 60, MeanFBS of Rats in Group A was 82.40 mg/dl, B1 498.40mg/dl, B2 95.70 mg/dl, B3 93.00mg/dl; Mean HbA1 of Group A was 3.71%, B1 11.84%, B2 4.17% , B3 3.73% respectively. Rats in Group B2 and B3 had significant reduction in FBS and HbA1c levels compared to Group B1, with no statistically significant intergroup difference in  Groups A, B2 and B3.

Conclusion:

Aloe Vera gel significantly decreased fasting blood glucose and HbA1c levels with almost similar efficacy to Sitagliptin in diabetic rats.

Potentiation of Hepatotoxic Effects of Methotrexate by Isoniazid in Mice; an Explorative Study

Aamna Khokhar1, Sadia Shaukat2, Aisha Qayyum3, Jawaria Iftikhar4, Rukhsana Munawar5

1Department of Pharmacology, Islamabad Medical and Dental college, Islamabad. 2Anatomy Department, Rehman Medical College, Peshawar. 3Department of Pharmacology, Fazaia Medical College, Islamabad. 4Department of Pharmacology, WATIM Medical and Dental College, Rawalpindi. 5Depmartment of Pharmacology, Islamic International Medical College, Rawalpindi. 

ABSTRACT

Objective: To evaluate the effect of isoniazid on methotrexate induced hepatotoxicity.

Study design: Laboratory-based experimental study

Place and Duration of Study: Department of Pharmacology Army Medical College, from November 2015 to November 2016.

Material and Methods: Thirty mice were randomly divided into five groups (n=6). Group Ⅰ was given 0.2 ml normal saline by intraperitoneal injection. Group Ⅱ received 0.2 ml of distilled water by oral gavage for 5 days a week for 4 weeks. Group Ⅲ received single intraperitoneal injection of methotrexate 20 mg/kg. Group Ⅳ received Isoniazid 25 mg/kg oral for 5 days a week for 4 weeks. Group Ⅴ received Isoniazid 25 mg/kg oral for 5 days a week for 4 weeks and methotrexate 20 mg/kg i.p after two weeks. Blood samples for measuring serum ALT, AST and ALP along with liver samples for hepatic histological H&E examination were taken after 24 hours of last dose.

Results: Serum ALT, AST, ALP levels were significantly raised in group V (MTX + INH) higher than all other groups exhibiting significant potentiation of MTX induced hepatotoxicity by INH. Histologically group III (MTX) and group IV (INH) showed mild to moderate inflammatory changes whereas group V (MTX + INH) were graded as severe hepatotoxicity with Central vein ischemic changes

Conclusion: It was concluded from results that Isoniazid Potentiates Hepatotoxic effects of Methotrexate in mice as evidenced by histological changes and elevated hepatic enzymes.

Seroprevalence of Dengue Virus Antibodies Among Blood Donors from Karachi: A Single Center Study

Rabbia Tariq1, Sehrish Khurshid2, Javeria Qureshi3, Raffia Mazhar4

1Consultant Hematologist, Department of Pathology, Isra University, Pakistan, 2Assistant Professor, Department of Pathology, Hamdard University, Pakistan, 3Senior Lecturer, Department of Hematology, Sindh Institute of Urology and Transplantation, Pakistan, 4Senior Resident, Department of Nephrology, Liaquat University of Medical and Health Sciences, Pakistan

ABSTRACT

Background: The risk of dengue virus transmission through blood transfusion has been dramatically raising a worry to ensure the safe blood supply. Each of the four serotypes is endemic in Pakistan. The aim of study is to determine the seroprevalence of dengue virus antibodies among blood donors.

Materials and methods: This was cross-sectional study performed in department of hematology, Sindh institute of urology and transplantation in Karachi. Four hundred and ten consecutive eligible blood donors participated in the study. All study participants were asked to fill the informed consent. The blood samples that were negative for infections with human immunodeficiency virus (HIV), Syphilis, hepatitis C virus (HCV), hepatitis B virus (HBV) and Malaria were analyzed for the detection of anti-dengue IgG and anti-dengue IgM  using a highly sensitive ELISA kit as well as for dengue NS1 antigen detection.

Results: A total of 410 healthy blood donors were enrolled in the study. 406 (99%) were males and 4 (1%) were female with the mean age being 28.8 ±7.2 years. Anti-dengue IgG was found to be positive in 61.4 % (252) of the study subjects while anti-dengue IgM was positive in 12.8% (53). Of them, 8.7% (36) showed dual positivity to both IgG and IgM while 4.1% (17) showed positivity for IgM alone. DENV-NS1 antigen was found to be positive in 3.6% (15) of the study subjects.

Discussion: Our results demonstrated high seroprevalence of dengue virus in potential asymptomatic blood donors and depicted the disease true burden. It is therefore necessary to implement the vigilant preventive strategies for ensuring safe blood transfusion and reducing the dissemination of dengue virus in an endemic region.

Comparison of Procalcitonin Levels with Different Micro-Organisms Recovered from Neonates with Suspected Septicemia

Sidra Liaqat1, Aneela Khawaja2

1Department of Clinical Microbiology, Post Graduate Medical Institute, Lahore. 2Depmartnet of Clinical Microbiology, Rehbar Medical College, Lahore.

ABSTRACT

Background: Septicaemia is a leading cause of mortality and morbidity in neonates. The aim of our study was to evaluate usefulness of serum PCT as a diagnostic marker of neonatal sepsis by taking blood culture as gold standard.

Material and Method: This study was conducted at tertiary care hospital in Lahore over a period of 6 months. 365 neonates with suspected septicaemia from NICU (Neonatal Intensive Care Unit) were enrolled in our study. Blood cultures and levels of serum procalcitonin were performed in all the neonates with clinically suspected  septicaemia. Different levels of Procalcitonin were measured and compared with the positive blood cultures by using three different cut-off values for PCT ≥0.5 ng/ml, ≥ 2 ng/ml and ≥10 ng/ml respectively. Different levels of procalcitonin were compared with different micro organisms recovered from blood culture.

Results:  Among neonates with suspected septicemia(n=356), 2.07% positive blood cultures had procalcitonin levels upto 0.5 ng/ml. 26.4% positive blood cultures had procalcitonin levels > 0.5-2.0 ng/ml. while 45.3 % and 100% blood cultures  had procalcitonin levels  >2-10 ng/ml and > 10 ng/ml respectively.

Among gram positive organisms (n=30) ,4(13.3%) blood cultures were negative for Procalcitonin levels and  12(40.0%) blood cultures were week positive.

No gram positive organism was strong positive for procalcitonin levels. Among gram negative organisms (n=38), 8(21.7%) organisms were mild positive for serum procalcitonin. 25(65.8%) gram negative organisms were moderate positive for serum procalcitonin while 5(13.1%) organisms were strong positive for serum procalcitonin levels.

2(100%) fugi were week positive for procalcitonin levels. Strong procalcitonin levels (>10 ng/ml) were 68.75% in ESBL producing strains of gram negative organisms and 31.25 % in Non ESBLs organismsConclusion: These findings support that serum procalcitonin levels can be useful in early detection and prompt treatment in neonatal sepsis.

A Molecular Based Approach to Characterize Untypable HCV Genotype

Sadia Zahid1,2,3, Saadia Andleeb1, Sadia Anjum1, Samia Afzal2, Iram Amin2,Muhammad Shahid2, Shazia Rafique2 and Muhammad Idress2

1Atta-Ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST) Islamabad. 2Division of Molecular Virology, National Centre of Excellence in Molecular Biology (CEMB), University of the Punjab, Lahore, 3Department of biotechnology, University of Okara.

ABSTRACT

Background: Hepatitis C virus has the highest morbidity and mortality ratios worldwide infecting around 10 million people/individuals in Pakistan. Due to very high mutation rate, HCV genome is highly diversified and it is evident from different studies that severity of disease, clinical profile and interferon therapy response depends on HCV genotype. In Pakistan, routine diagnostic tests of HCV genotyping by established protocols (Ohno et al. method) are performed in which untypable or mixed genotypes are not detected.

Aims and objectives: The aim of present study is to clone and characterize mutations prevailing in specific fragment of diagnostically detected untypable HCV core; part of the genome involved in genotyping. The current study is based on speculation that a significant HCV variant might be circulating in the population that is not detectable by current genotyping method.

Methodology: In our study we characterized untypable HCV samples by cloning, sequencing and in silico study. Phylogenetic analysis was done to estimate evolutionary relationship of untypable samples with other HCV genotypes and quasispecies.Conclusion:  This study suggests that new more accurate and advanced genotyping methods using genotype specific primers should be design to resolve the untypable HCV anomaly

Association of Pituitary Hormones and Anthropometric Parameters in Obese Infertile Women

Farheen Aslam1, Shakila Yasmin2, Sara Reza3, Amna Shahid4, Maria Mahmud5 and Ayesha Mahmud6

1,3Department of Pathology, Quaid-e-Azam Medical College, 2,4Bahawalpur. Department of Obstetric and Gynecology, Quaid-e-Azam Medical College, Bahawalpur. 5Medical lab Ottawa.

6Shahida Islam Medical College, Lodharan.

ABSTRACT

Introduction: World Health Organization (WHO) has acknowledged infertility as a public health problem because it challenges medical, economic and psychosocial aspects of society. Obesity has a definite impact on ovulatory function that can result in menstrual abnormalities, recurrent miscarriage and infertility. The objective of this study was to compare hormone and anthropometric parameters between primary and secondary obese infertile women and to appraise any association between these two indices in primary and secondary obese infertile females.

Material and Method: This cross sectional study was carried out from January 2020 to December 2020 in infertility clinic of Bahawal Victoria Hospital. Out of 135 obese females, 90 were included in this study and secondary infertility was found in 57 of females while 33 had primary infertility. Serum FSH, LH, LH/FSH and prolactin were measured on day 3rd of menstrual cycle and BMI, waist and hip circumferences and Waist to hip ratio was calculated in both groups.

Results:  Serum prolactin and LH/FSH ratio was statistically raised in obese secondary infertile group. In both groups, serum FSH and central obesity indices comprising of waist circumference and waist hip ratio exhibited significant positive association. In primary infertility, serum FSH demonstrated positive association with BMI and hip circumference while in secondary infertile women, prolactin level and BMI manifested positive association. 

Conclusion: There was a link between hormonal derangement and obesity indices that can lead to infertility. Hence weight reduction should be considered important part of infertility treatment.

Seroprevalence OF Antibodies against SARS-COV2

Mehveen Iqbal1, Atiya Batool Gardezi1, Shanila Feroz2, KauserMehmood2, Sabiha Mirza3 and Ejaz Ahmed1

United Medical and Dental College1, Creek General Hospital2, Fatima Medical and Dental College3

ABSTRACT

Study Background: The novel corona virus (COVID -19) is a known virus in current pandemic. Clinical presentation ranges from asymptomatic to severe respiratory and multiple organ failure2.Large number of SARS-COV2 cases are documented as asymptomatic or with mild illness. To determine the extent of infection, serological evidence of SARS-COV2 antibodies is warranted

Objectives of the Study: To study the Seroprevalence of covid-19 antibodies among hospitalized patients and to determine the cumulative immunity in hospitalized patients.

Methodology: This cross-sectional observational study was conducted at United hospital and Creek General Hospital, Karachi during the duration from December 2020 to February 2021. The study was approved by institutional ethical review board. Probability convenience method of sampling was used to collect blood samples. Patients of both genders having age group ranging from 1-80 years or above were included. These patients were asymptomatic and admitted due to non- COVID 19 reasons. Rapid test was used to detect SARS-COV2 IgM/IgG antibodies. Statistical analysis of data was performed by using SPSS-22. Age is organized into different subgroups. Chi-square test was applied to determine the significance between age groups and seropositive cases.

Results: 800 blood samples were collected from different age groups of hospitalized patients and analyzed. 18.8% (n=151) cases were observed seropositive. 25.7% (n=61) seropositive cases were in age group 16-30 years followed by 19.5% in age group from 61-75 years. Statistical significant correlation was observed among seropositive IgG cases and age group ranging between 16-45 in female and above 45 in males. Conclusion: This study concluded 18.8% seroprevalence among asymptomatic admitted patients. The criteria of herd immunity is not fulfilled but it can be used for further research. The chance of seropositivity in females during reproductive age group is more as compared to other age groups

Evaluation of Anti Erythropoietin Antibodies in Chronic Renal Failure Patients Undergoing Haemodialysis

Amnah Shaukat 1, Zahida Qasim 1,2, Najma Majid 3, Ashfaq Ahmed 4, Farooq Ahmed Noor 5 and

Ayesha Shaukat 6

1 Department of Pathology, Benazir Bhutto Shaheed Medical College, Mirpur, AJ&K, 2 Pathology Department, Divisional Headquarters Teaching Hospital, Mirpur, AJ&K, 3 Department of Biochemistry, Benazir Bhutto Shaheed Medical College, Mirpur, AJ&K, 4 Department of Urology, Divisional Headquarters Teaching Hospital, Mirpur, AJ&K, 5 Department of Community Medicine, Benazir Bhutto Shaheed Medical College, Mirpur, AJ&K,

6 Riasat Hospital, Mirpur, AJ&K

ABSTRACT

Introduction: Anemia is frequently seen in CKD patients on dialysis as a complication due to anti-EPO antibodies.

Objective: Present study was planned to detect the anti-EPO antibodies in CRF patients undergoing haemodialysis and study its correlation with baseline parameters such as Hb, retic count and iron markers (serum Iron, Ferritin, TIBC)

Study Design: Cross-sectional study. Setting: Haematology Department of University of health sciences Lahore in collaboration with the dialysis centre of Sheikh Zayed Hospital, Lahore.

Study Period: Six months from January to June 2016.

Materials & Methods: Total eighty six (86) patients, selected from haemodialysis centre of Sheikh Zayed Hospital Lahore were included in the study. Complete blood count, retic count, anti- EPO Antibodies, Serum Ferritin, Serum Iron, TIBC were performed after clinical history, physical exam and written consent. Data was analysed by using SPSS 20.0 version.

Results: Our results showed that 51 patients were positive for anti-EPO antibodies and 35 were negative for anti-EPO antibodies. In our study, these might be non-neutralizing antibodies because they did not have any correlation with Hb and reticulocyte count.

Independent sample t-test and Mann Whitney-U test applied, showed a statistically insignificant difference (p=>0.05) regarding baseline parameters (Hb, Hct, Urea and Creatinine) between positive and negative anti-EPO antibodies. Correlation analysis showed that anti-EPO antibodies did not significantly correlated with Hb, Hct, Urea, Creatinine, serum iron, ferritin, TSAT% and reticulocyte count. However, a significant correlation of anti-EPO antibodies (p=0.01) was observed only with TIBC but this was a negative correlation.Conclusion: Our study shows that early detection of these antibodies is important to reduce morbidity and improve patient´s quality of life.

Need of Small Group Teaching and Hybrid Models in Medical Colleges to Combine Problem Based Learning (PBL) and Traditional Methods in Curriculum

Abdul Khalid Awan and Anwar Ul Haque

During the last five decades, new understanding has emerged from cognitive science research about the nature of learning. There has been more emphasis on teaching in small groups instead of traditional large group lectures. The introduction of problem based learning (PBL) is a paradigm shift in pedagogy from teaching to active learning7. There are few medical institutions in Pakistan which have incorporated PBL in the curriculum. The traditional teaching is still the main teaching methodology in large majority of medical colleges in Pakistan. It may not be possible for all medical institutions to adopt PBL curriculum as it needs allocation of space, huge financial and human resources for its implementation. At the same time keeping the traditional methods as the main teaching strategy will not satisfy and meet the needs of medical students. It is only about 5% which can be retained from what is taught even in the most charismatic and inspirational lecture. In prevailing circumstances there is need of hybrid curricula to combine the PBL and traditional methods. It is especially useful for those colleges that want to benefit from the advantages of PBL methodology but do not want a complete reform to switch to an entirely PBL-based curriculum.