Thesis/Dissertation Repository Medical and Dental College
http://hdl.handle.net/123456789/52
Bahria University BUMDC Karachi Campus2024-03-29T05:22:56ZCORRELATION OF XENIN WITH INHERITANCE AND EXISTENCE OF POLYCYSTIC OVARY SYNDROME IN FERTILE WOMEN
http://hdl.handle.net/123456789/16866
CORRELATION OF XENIN WITH INHERITANCE AND EXISTENCE OF POLYCYSTIC OVARY SYNDROME IN FERTILE WOMEN
DR MISBAH RIAZ (06-116212-004)
Polycystic Ovary Syndrome (PCOS) is a condition in which numerous
small cysts are formed in the ovaries of a woman resulting in an increased production of
androgens (male sex hormones). National health services (NHS) has reported a few
common symptoms like oily skin, weight gain, complications in conceiving and irregular
periods. In most cases, it shows irregular hair growth on different areas such as the chest,
face and back. Studies have revealed that the main causes or factors that resulted in PCOS
prevalence are still unknown. South Asian women, especially Pakistani women, suffers
more from PCOS (around 52%) as compared to white population in UK (20 - 25%). This
study is an attempt to contribute towards research/ studies that are trying to establish exact
cause for prevalence of PCOS. The objectives of the study were to compare the
biochemical parameters and plasma xenin levels in PCOS diagnosed group, probable
group and control group. This was a case control study. All women between age 15 - 45
years who fulfilled the inclusion criteria were included. The calculated sample size of 105
subjects were divided into three separate study groups (control group, PCOS diagnosed
patients and probable group). Venous blood sample was taken for measuring different
parameters like FSH, LH, Prolactin, Testosterone, Fasting blood sugar, Fasting Insulin,
HbA1c and serum Xenin after taking ethical approval from Bahria University Health
Sciences Karachi (BUHSCK). Ultrasound pelvis was done. For statistical analysis SPSS
v26 was used. Descriptive statistics were presented in terms of frequency with
percentages and mean with standard deviation. ANOA was applied for mean comparison.
Cut off values were identified using ROC curve. The P value <0.05 was considered as
statistically significant. Mean age for cases, controls and probable group was 30.82±6.60
years, 27.88±6.43 years and 25.94±5.47years. BMI in cases, controls and probable group
was 30.91±5.66 kg/m2, 22.69±5.07kg/m2 and 26.08±7.36 kg/m2. Serum FSH in cases,
controls and probable groups were 5.68±1.23mIU/ml, 7.59±0.97mIU/ml and 6.56±0.80
mIU/ml S. LH in cases, controls and probable group were 11.35±1.87mIU/ml,
10.19±1.44mIU/ml and 10.70±1.22mIU/ml. Serum LH : FSH was 2.02±0.23, 1.34±0.11
and 1.64±0.18 respectively. Serum Testosterone (nmol/L) was 1.20±0.42, 0.78±0.45 and
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1.02±0.33. Serum prolactin (μg/L) in cases, control and probable group was 24.40±9.50,
15.34±3.07 and 17.93±4.18. Fasting blood sugar (nmol/L) was 5.55±0.91, 4.98±0.40 and
4.76±0.38 respectively. Fasting insulin levels (mIU/L) were 11.63±5.65, 5.85±2.91 and
7.85±4.19. HbA1c was 5.54±0.78, 5.09±0.39 and 4.94±0.31 respectively. Mean serum
xenin was 31.25±2.86 pg/ml in cases, 23.58±3.36 pg/ml in controls and 26.93±3.94 pg/ml
in probable with significant mean difference (p=0.000). By ROC Curve, Cut offs values
of serum xenin was 27.18 (Sen=82.9%), 27.41(Sen=82.9%) and 27.96(Sen=82.9%) for
cases while the cut offs values for serum xenin for proable group was 22.93(sen=82.9%)
and 23.01(sen=80%). Increase levels of Xenin were found in cases and probable group
than controls
Supervised by Prof,Dr.Hassan Ali
2023-10-01T00:00:00ZASSOCIATION OF CONGENITAL MALFORMATIONS WITH MATERNAL RISK FACTORS
http://hdl.handle.net/123456789/16864
ASSOCIATION OF CONGENITAL MALFORMATIONS WITH MATERNAL RISK FACTORS
DR JAWARIA ASLAM AWAN (06-113212-002)
Congenital malformations (CMF) are structural or functional defects of the human
body that arise during development. These malformations can be detected during
antenatal examination, at birth or at times can also be discovered in early childhood. The
occurrence of congenital malformations in developing countries is close to that seen in
developed countries, however, it has a severe impact in middle and low income countries.
Every year, around three million children under the age of five die as a result of birth
abnormalities worldwide, around 3.2 million live-born infants are physically or
intellectually challenged for life, and approximately 270,000 newborns die during the first
twenty-eight days of life due to congenital abnormalities. The objectives of this research
were to determine the association of congenital malformations with maternal risk factors
in different ethnicities and to determine the association of craniofacial congenital
malformations with anomalies of other systems. At the Jinnah Postgraduate Medical
Centre (JPMC) and Tanveer Ultrasound Clinic in Karachi, this observational, case control research was carried out. A total of one hundred and twenty pregnant women
between the age of 18 - 45 years were included in the study, of them, 60 (the case group)
had fetuses with structural abnormalities and 60 (the control group) had fetuses with
normal structural development. The Participants were categorised into five groups based
on their ethnicity (Balochi, Pashtun, Punjabi, Sindhi and Urdu speaking). An informed
and understood consent was obtained and a detailed history followed by a thorough
obstetric ultrasound was performed by a consultant radiologist to evaluate the type of
congenital malformations. All the findings were noted in the subject evaluation form. Age
of the mother, level of education, social status, body mass index, systolic and diastolic
blood pressure, parity, multiple pregnancies, consanguinity, diabetes mellitus,
hypertension, thyroid diseases, cardiac diseases, epilepsy, asthma, psychiatric diseases,
kidney diseases, family and past history of congenital anomaly, exposure to rubella,
maternal use of folic acid supplement/antenatal supplements and use of medicine (other
than antenatal supplements) considered as risk factors were evaluated. Anomalies of the
central nervous system (CNS) were most often identified. 26.7% (32), followed by
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genitourinary anomalies 17.5 % (21) miscellaneous anomalies 9.2% (11),
craniofacial anomalies 6.7% (8), musculoskeletal anomalies 5% (6), anomalies of GIT
2.5% (3), anomalies of abdominal wall 1.7% (2) and, finally, cardiovascular defects 0.8%
(1). Maternal age (25 – 29 years) (OR = 3.043, 95% CI = 1.010 – 9.163), education
(secondary level) (OR = 11.500, 95% CI = 2.345 – 56.393), family income (OR = 3.348,
95% CI = 1.122 – 9.994), use of medications (other than antenatal supplements) (2nd
trimester) (OR= 6.696, 95% CI = 2.069 – 21.671), history of consanguinity (OR = 3.429,
95% CI =1.582 – 7.433) and family history of birth defects (OR = 5.535, 95% CI = 1.736
– 17.646) were significantly associated with an increased risk of congenital
malformations. Our study further showed a significant association between congenital
malformations of central nervous system and Urdu speaking mothers (p = 0.016)
compared to Balochi, Pashtun, Punjabi, and Sindhi, however the results cannot be
generalized to the population as a whole due to the small sample size and time constraints.
There was also a significant association between craniofacial congenital anomalies and
the central nervous system (p = 0.000), the musculoskeletal system (p = 0.004), and
miscellaneous congenital abnormalities (p = 0.030)
Supervised by Prof,Dr.Asiha Qamar
2023-10-01T00:00:00ZCORRELATION OF CLINICOPATHOLOGICAL FINDINGS AND C5AR2 EXPRESSION IN BREAST CANCER
http://hdl.handle.net/123456789/16865
CORRELATION OF CLINICOPATHOLOGICAL FINDINGS AND C5AR2 EXPRESSION IN BREAST CANCER
DR. ERUM KHALIQ 06-114212-001
The breast cancer is the most prevalent cancer among females worldwide.
According to Shaukat Khanum Memorial Hospital statistics during the year 2022, breast
cancer was the leading cancer among the top ten malignancies in adult females
accounting for almost 1/2 of the cancer cases alone (51.1%) (Shahid, et al.,2023). The
tumor microenvironment plays a central role in tumor proliferation and invasion via
cancer-associated fibroblasts, macrophages, and various other mediators like
complement, chemokines. Complement component C5a is a potent anaphylatoxin and
chemotactic agent. Its receptor C5aR2-mediated inflammatory response is partly
responsible for tumorigenesis. The C5aR2 mRNA is detected in human peripheral blood
leukocytes, platelets, bone marrow, spleen, and other organs of which neutrophils are
the most abundant source of C5aR2 (Ting, Malgorzata, Ke li, 2017). Objectives were to
evaluate the expression of C5aR2 (GPR77) expression in stromal and epithelial cells of
breast carcinoma and to determine the correlation of C5aR2 (GPR77) expression in
breast carcinoma with clinicopathological parameters. It was a cross-sectional study
carried out at PNS Shifa Hospital, Karachi, for a period of six months. 128 formalin fixed paraffin-embedded tumor specimens of breast cancer patients were selected and
examined for immunohistochemical expression of C5aR2, using Rabbit polyclonal
C5aR2 antibodies IgG type, in breast cancer cells and stromal cells. Clinical and
pathological records were reviewed for data collection. The results of
immunohistochemistry were correlated with clinicopathological parameters of breast
cancer. This study was conducted to determine the correlation of complement receptor
C5aR2 with clinicopathological parameters of breast cancer (age, receptor status, stage,
grade, proliferation marker Ki-67), using a simplified protocol. The results revealed
increased C5aR2 expression in tumor cells as compared to stromal cells. An
upregulation of C5aR2 expression was observed in old age. The expression of C5aR2
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increased with the increasing grade and advancing stage. This experiment showed a
strong association of C5aR2 with hormone receptors and HER2. In tumor cells,
Luminal B showed the highest C5aR2 expression whereas in stromal cells C5aR2
expression was frequently linked with TNBC. Increased C5aR2 expression was
identified in tumors with poor treatment response while decreased C5aR2 expression
was observed in definite tumor response. High levels of Ki-67 were frequently
associated with elevated C5aR2 expression in tumor cells.C5aR2 was also found to be
correlated with the infiltration of immune cells, especially macrophages. The current
study also revealed overexpression of C5aR2 in the endothelium of blood vessels found
in the stroma of breast cancer. In conclusion, our study highlights the significance of
C5aR2 expression in tumor and stromal cells of breast cancer, its involvement in
chemoresistance, and immune infiltration. Thereby indicating its potential as a valuable
prognostic marker and therapeutic target in breast cancer management.
Supervised by Dr.Summayya Shawana
2023-10-01T00:00:00ZC-REACTIVE PROTEIN (CRP) AS A BIOMARKER OF INFLAMMATION IN OBESE AND NON-OBESE TYPE 2 DIABETES MELLITUS PATIENTS WITH METABOLIC SYNDROME
http://hdl.handle.net/123456789/16862
C-REACTIVE PROTEIN (CRP) AS A BIOMARKER OF INFLAMMATION IN OBESE AND NON-OBESE TYPE 2 DIABETES MELLITUS PATIENTS WITH METABOLIC SYNDROME
DR RABIA SIDDIQUI (06-117212-004)
Obesity, particularly abdominal obesity when associated with end-organ resistance to
insulin, raised blood sugar, deranged lipid profile and high blood pressure is collectively
called “Metabolic Syndrome”. Metabolic Syndrome increases the risk of developing type 2
diabetes mellitus(T2DM). Metabolic syndrome represents a range of disorders related to
blood pressure, lipid profile, blood sugar and obesity related inflammation. Screening for
Metabolic Syndrome is important because obesity related manifestations are associated
with the deranged values of five components of Metabolic Syndrome. C-Reactive Protein
(CRP) is a known biomarker associated with many metabolic disorders with underlying
acute and chronic inflammation. Its use as a potential biomarker of disease states such as
diabetes, hypertension and Metabolic Syndrome need to be investigated. Therefore,
association of Type 2 diabetes mellitus patients with metabolic syndrome with a
proinflammatory state can be confirmed by higher levels of CRP. To investigate the
association of serum CRP levels with obese and non-obese type 2 diabetes mellitus
patients with metabolic syndrome. A comparative cross-sectional study was performed in
120 subjects divided into 2 groups (60 obese >30kg/m2
and 60 non-obese <30kg/m2
) type
2 diabetes mellitus patients with Metabolic Syndrome. The participants were recruited
from Medical OPD National Medical Center, Karachi for a duration of six months period.
The 2005 revised NCEP-ATP III criteria were used to determine participants with
Metabolic Syndrome in type 2 diabetic patients. The conditions included in diagnostic
criteria for Metabolic Syndrome are high blood pressure, high blood sugar, abnormal
cholesterol levels (low HDL or high triglycerides), and increased fat deposits in the
abdominal area. After taking informed consent and an overnight fast, fasting venous
samples were sent for Fasting Blood Glucose (FBG), Triglycerides (TG), Total cholesterol
(TC), Low density Lipoprotein (LDL-C), High density Lipoprotein (HDL-C) and C Reactive Protein (CRP). 75% of type 2 diabetes mellitus patients had metabolic syndrome.
The association of Metabolic Syndrome with Marital status and Education was found
statistically significant with p<0.05. Independent sample t test gave significant mean
differences for waist circumference, systolic blood pressure, fasting blood sugar, and
triglycerides between metabolic syndrome and non-metabolic syndrome samples with
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p<0.05. The Multivariate linear regression analysis, results showed increase in WC giving
0.13-time positive impact on CRP (p<0.01). The difference in median CRP of obese and
non-obese samples of metabolic samples was also statistically significant with p=0.01
using Mann Whitney U test. Pearson Chi Square test did give a significant association of
metabolic syndrome with SBP, FBS, HbA1C, and TG with p<0.05. The laboratory
parameters showed higher SBP, DBP, FBG, TG and low HDL-C levels in subjects. CRP
levels were higher in obese than non-obese type 2 diabetic patients with Metabolic
Syndrome
Supervised by Prof,Dr.Nighat Rukhsana
2023-10-01T00:00:00Z