Stages of chronic kidney disease and soluble Transferrin Receptor (sTfR), Ferritin, ratio

Objective: To assess the ratio of soluble transferrin receptor to ferritin in different stages of chronic kidney disease.Methods: This case-control study was conducted at the Aga Khan University Hospital and the Jinnah Postgraduate Medical Centre, Karachi, from January to September 2014, and comprised chronic kidney disease patients and healthy controls. Group 1 comprised controls, whereas groups 2, 3 and 4 had patients based on their mean glomerular filtration rate. SPSS 19 was used for data analysis.Results: Of the 170 participants, 126(74.1%) were cases and 44(25.9%) were controls. The overall mean age was 55.87±3.48 years and the mean body mass index was 24.25±2.9 kg/m2. Decreased levels of iron and haemoglobin were observed in cases compared to controls (p\u3c0.001), while high serum ferritin was seen in cases compared to the controls (p\u3c0.001). Correspondingly, the soluble transferrin receptor-to-ferritin ratio was significantly decreased in groups 2, 3 and 4 (p\u3c0.001).Conclusions: The ratio of soluble transferrin receptor to ferritin was lower in higher stages of chronic kidney disease

Increased body mass index may lead to hyperferritinemia irrespective of body iron stores

Objective: Obesity causes subclinical inflammation which results in the secretion of various bioactive peptides that are key players in metabolic regulation of iron homeostasis. We sought to establish correlation of one such peptide (ferritin) with marker of subclinical inflammation (CRP) in various BMI.Methods: Total 150 subjects between the ages of 20-60 years were included in the cross-sectional study conducted at Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre, Karachi, Pakistan. Body Mass Index (BMI) was calculated by weight (kg) /height (m(2)). The given values were used as reference for Group A: normal weight (18.0-22.9 kg/m2), Group B: overweight (23.0-24.9 kg/m2), Group C: obese ( \u3e 25.0 kg/m2) according to South Asian criteria. Serum Iron, Total Iron Binding Capacity, serum Transferrin Saturation, serum Ferritin and C-reactive protein were measured by commercially available kits. ANNOVA with Tukey\u27s minimum significant difference and Spearman Rho correlation were used considering p \u3c 0.05 significant.Results: The results identified an increased serum Ferritin and CRP in obese versus lean subjects (p \u3c 0.001). BMI showed significantly positive correlation with serum CRP (r = 0.815; p-value \u3c 0.01) and Ferritin (r = 0.584; p-value \u3c 0.01). However, serum Iron levels and Transferrin saturation decreased in obese versus normal weight individuals (p \u3c 0.001).Conclusion: This integrated new data reveals that individuals with high BMI had high levels of Serum Ferritin despite low levels of iron with high levels of C- reactive protein. This might be caused due to inflammatory conditions prevailing in the presence of increased adipose tissue

Association of oxidative stress with female infertility - a case control study

Objective: To compare stress markers and reproductive hormones in fertile and infertile females, and to relate the markers with age, duration and cause of infertility, and body mass index..Methods: The case-control study was conducted at Aga Khan University Hospital, Karachi, from March 2017 to February 2018. Females aged 16-50 years regardless of ethnic background were recruited from the Australian Concept Infertility Medical Centre, Karachi, and were equally divided into infertile cases group A, and fertile controls group B. Serum follicular stimulating hormone, luteinizing hormone, estradiol, glutathione reductase and cortisol were measured using enzyme-linked innmunosorbent assay. SPSS 19 was used for statistical analysis..Results: There were 328 female subjects divided into two equal groups of 164(50%). Serum luteinizing hormone and cortisol was higher in the group A than in group B (p\u3c0.001). Serum glutathione reductase was low in group A compared to group B (p\u3c0.001). Duration of infertility, serum levels of glutathione reductase and cortisol were also significantly different among infertile females when distributed on the basis of cause of infertility (p\u3c0.05). Serum cortisol had negative correlation with glutathione reductase (p\u3c0.001). Age and body mass index had a positive correlation with serum cortisol (p=0.035; p=0.63), while there was a negative correlation with glutathione reductase (p = -0.732)..Conclusions: Prolonged duration of infertility, age of females and body mass index enhanced the production of stress hormones and decreased antioxidant activity which augmented the risk of infertility

AHSG rs4918 Polymorphism poses a weak predisposition to insulin resistance during pregnancy

Objective: To identify the association between Fetuin-A levels and genetic polymorphism with gestational diabetes mellitus among pregnant women visiting a tertiary care centre. Methods: This cross-sectional case-control study was conducted at Aga Khan University Hospital, Karachi, from December 2015 to September 2016, and comprised pregnant women in their second trimester. Those with gestational diabetes mellitus were considered the cases while the rest acted as controls. The enzyme-linked immunosorbent assay was used to quantify Fetuin-A levels while genotyping for alpha-2-Heremans-Schmidglycoprotein rs4918 was performed using restriction fragment length polymorphism technique. Blood samples were collected and serum and deoxyribonucleic acid were extracted and stored at -80°C. SPSS 21 was used to analyse the findings. Results: Of the 88 subjects, there were 44(50%) in each group. Serum Fetuin-A concentration was higher in cases compared to the controls (p\u3c0.01). The genotype data for the cases was 0.668 and for the controls 0.840 (p\u3e0.05). However, the G allele showed a weak risk or predisposition towards gestational diabetes mellitus (p=0.038). Conclusion: Increased Fetuin-A levels were found to be related to the occurrence of gestational diabetes mellitus, indicating that Fetuin-A possibly contributes towards insulin resistance

Issues of Sukuk Ijarah

Sukuk Ijarah is the most popular sukuk that increase in over the world since its start to introduce in 2001.  Not only Muslim country who issued this sukuk, so do Non-Muslim Country such as Germany, Japan and China. However, there is issue that come up due to the non-existence of Shariah compliance in this structure such as the requirement of sukuk doesn’t meet Maqasid Shari’ah perspective. Therefore, the aims of this paper to discuss some issue in sukuk Ijarah and give solution in order to develop Islamic capital market

Influence of body mass index and polycystic ovarian syndrome on ICSI/IVF treatment outcomes: A study conducted in Pakistani women

Background: Obesity may establish a crucial barrier for effective fertility treatment in polycystic ovary syndrome (PCOS) females.Objective: To compare results of intra-cytoplasmic sperm injection (ICSI) in females with and without polycystic ovarian syndrome and further appraise the effect of obesity in PCOS females.Materials and methods: A cross-sectional study from June 2015 to July 2016 included non-PCOS and PCOS (recognized by Rotterdam criteria) females who underwent ICSI. The PCOS were further stratified into non-obese and Obese according to the South Asian criteria for body mass index. Results were categorized on the basis of beta-human chorionic gonadotropin (β-hCG) and transvaginal scan into non-pregnant (β-hCG /ml), preclinical abortion (β-hCG \u3e25 mIU/ml with no fetal cardiac activity) and clinical pregnancy (β-hCG \u3e25 mIU/ml with fetal cardiac activity on transvaginal scan). In addition, reproductive outcomes; implantation rate, clinical pregnancy rate and miscarriage rate among obese and non-obese PCOS and non-PCOS patients were compared.Results: Our results revealed 38.5% clinical pregnancy rate in non-PCOs females, 23.8% in non-obese PCOS females whereas 26.4% in obese PCOS. Preclinical abortions were found to be highest (31.5%) in non-obese PCOS females and were the lowest (26.2%) in non-PCOS females. In non-PCOS group and non-obese PCOS females 35.4% and 44.6%, respectively, failed to become pregnant.Conclusion: The success after ICSI in terms of number of clinical pregnancies was more in non-PCOS patients as compared to PCOS. Increase in body mass index reflected a negative impact on the reproductive outcome in PCOS patients