Activity of Indoleamine 2, 3 Dioxygenase (IDO) in Type 2 Diabetes Mellitus Patients in Pakistan

To assess the activity of Indoleamine 2, 3 Dioxygenase (IDO) in Type 2 Diabetes Mellitus Patients in PakistanMethods: In this prospective study, activity and expression of IDO , was assessed in sera of diabetics and healthy controls (n=28). Colorimetric Assay was performed to analyze IDO activity in samples.Results: A significant difference was observed between the means of control and diabetic patients with a p-value of 0.0001.Conclusion: IDO concentrations were significantly higher in the serum of samples of diabetes mellitus patients as compared to contro

Clinically significant contrast induced acute kidney injury after non-emergent cardiac catheterization--risk factors and impact on length of hospital stay.

Objective: To evaluate the frequency and risk factors associated with clinically significant contrast-induced nephropathy(CIN) in patients undergoing non-emergent coronary angiography. Study Design: Descriptive study. Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 2005 to December 2007. Methodology: Case records of patients who underwent coronary angiography with a serum creatinine of ≥ 1.5 mg/dl atthe time of procedure were evaluated. Clinically significant contrast induced nephropathy (CSCIN) was defined as either doubling of serum creatinine from baseline value within a week following the procedure or need for emergency hemodialysis after the procedure.Results: One hundred and sixteen patients met the inclusion criteria. Mean age was 64.0 ± 11.5 years, 72% were males.Overall prevalence of CIN was 17% (rise of serum creatinine by ≥ 0.5 mg/dl) while that of clinically significant CIN (CSCIN) was 9.5% (11 patients). Patients with CSCIN had significantly lower left ventricular ejection fraction (p = 0.03, OR: 0.24;95% CI = 0.06 – 0.91) and higher prevalence of cerebrovascular disease (p \u3c 0.001, OR: 14.66; 95% CI = 3.30 – 65.08).Mean baseline serum creatinine was significantly higher, 3.0 ± 1.5 vs. 2.0 ± 1.1 mg/dl (p = 0.03, OR: 1.47; 95% CI =1.03 – 2.11) whereas mean GFR estimated by Cockcroft-Gault formula was significantly lower at 25 ± 7.4 vs. 41.0 ± 14.6ml/minute (p = 0.001, OR = 0.89, 95% CI = 0.84 – 0.95) at the time of procedure in patients with CSCIN. Mean length ofhospital stay was significantly higher in this group compared to those without CIN, 9.0 ± 5.1 vs. 3.0 ± 3.2 days (p = 0.001,OR = 1.31, 95% CI = 1.12 – 1.54). Multivariate analysis revealed low GFR (p = 0.001, OR = 0.88; 95% CI = 0.82 – 0.95)and low ejection fraction (p = 0.03, OR = 0.20; 95% CI = 0.04 – 0.91) to be independent factors associated withCSCIN. No significant differences were noted between the two groups in patients with hypertension, diabetes andheart failure. Conclusion: CSCIN is a significant concern in high risk groups despite prophylaxis. Patients with lower EF, cerebrovascular disease and low GFR at the time of procedure are more likely to have CIN

Non-diabetic renal disease in patients with type-2 diabetes mellitus

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease in diabetics worldwide, yet most patients with type-2 diabetes mellitus are not formally evaluated with a renal biopsy. The diagnosis is almost always based on clinical grounds. A wide spectrum of non-diabetic renal disease (NDRD) is reported to occur in patients with type-2 diabetes. It has been estimated that up to one-third of all diabetic patients who present with proteinuria are suffering from NDRD. The aim of this analysis was to evaluate the prevalence and etiology of NDRD in patients with type-2 diabetes. We retrospectively reviewed the medical records of patients with type-2 diabetes who underwent kidney biopsy on clinical suspicion of NDRD (absence of diabetic retinopathy and/or neuropathy; short duration of diabetes, i.e. less than five years) from January 2003 through December 2007 at the Aga Khan University Hospital, Karachi. Based on the biopsy findings, patients were grouped as Group-I, isolated NDRD; Group-II, NDRD with underlying DN; and Group-III, isolated DN. Of 68 patients studied, 75% were males and the mean age was 56 years. The mean duration of diabetes was nine years. Group-I included 34 patients (52%), Group-II included 11 patients (17%) and Group-III included 23 patients (31%). Among the Group-I patients, the mean age was 56 years (41-77 years). The most common NDRDs were acute interstitial nephritis (32%), diffuse proliferative glomerulonephritis (17%); membranous nephropathy (12%) and crescentic glomerulonephritis (12%). Among Group-II, the mean age was 60 years (46-71 years), and the most common lesion was interstitial nephritis superimposed on underlying DN (63% cases). Among Group-III, the mean age was 53 years (42- 80 years). The mean proteinuria was 5, 6.3 and 7.3 g/24 h of urine collection in Groups I, II and III, respectively (P = NS). The mean duration of diabetes was 7.3, 11.7 and 10.7 years in Groups I, II and III, respectively. The duration of diabetes was significantly less in Group-I compared with Group-II and Group-III (P = 0.04). Our study suggests that the prevalence of NDRD (either isolated or superimposed on underlying DN) is high in appropriate clinical settings. Performing renal biopsy in diabetics with no extrarenal end organ damage other than nephropathy helps to diagnose and treat NDRD. This is the first report from Pakistan documenting the prevalence of NDRD in patients with type-2 diabetes

Advertising Styles’ Impact on Attention in Pakistan

The topic was selected after giving consideration to the modern environment and the use of media by advertisers for attention purposes of their products. It was also observed that the number of channels especially in the electronic media have also geometrically increased over the last two decades. It is now becoming difficult for advertisers to get the attention of their products in the minds of their viewers. The methodology used in the research was focus group and ads of different products were shown to them which included humorous and serious appeals. As the literature review revealed that these two types of appeals have significant difference when measuring attention between humorous and serious advertisements. At the end of the research it was established that there is a significant difference between the attention of humorous and serious appeals. Initially the idea was taken form a research conducted in Sweden. Same parameters were analyzed in Pakistan. We concluded that the reaction of two different societies have almost the same response for humorous and serious advertising appeals.Humorous Appeals, Serious Appeals, Attention

An Analysis of the Garment sector of Pakistan within a Global Value Chain Framework

The textile industry is Pakistans largest and one of the oldest manufacturing industries. Widely available local cotton and continuous public support have been important factors in the growth of the textile industry. However, the garment sector in Pakistan is trapped at a low-equilibrium in a high value-added categoryproducing low-price items for mass retailers. The objective of this paper is to identify the main reasons for the relative stagnation and lack of competitiveness of Pakistans garments sector in light of survey data collected form 234 garments manufacturers. We use Global Value Chain (GVC) framework to analyze Pakistans garment industry. To come out of low-equilibrium and move up the garments value chain, the sector requires continual investment in state of the art technology, a trained workforce, and agglomeration economies or intra-cluster spill-overs

Evaluation of antibiotic use in pediatric intensive care unit of a developing country

Background: Pediatric Intensive Care Unit (PICU) patients are often prescribed antibiotics with a low threshold in comparison to patients elsewhere. Irrational antibiotics use can lead to rapid emergence of drug resistance, so surveillance of their use is important.Objectives: To evaluate the use of antibiotics in relation to bacteriological findings in PICU of a Tertiary Hospital.Methods: Retrospective review of medical records of all children (age 1 month-16 years) admitted in our closed multidisciplinary-cardiothoracic PICU from January to June 2013 was performed, after approval from Ethical Review Committee. For each antibiotic, indication (prophylactic, empiric, therapeutic) and duration of use were recorded. All diagnoses of infections were recorded according to diagnostic criteria of IPSCC 2005. Results are presented as frequency and percentages and median with inter quartile range using SPSS version 19.Results: All of the total 240 patients admitted in PICU during the study period received antibiotics: 43% (n = 104) prophylactically, 42% (n = 102) empirically, and 15% (n = 15) therapeutically. Median number of antibiotic use per patient in PICU was 3, with range of 1-7. 25% received 1 antibiotic, 23% received 2 antibiotics, 29% received 3 antibiotics, and rest received ≥4 antibiotics. Most commonly used antibiotics were cefazolin, meropenem, vancomycin and ceftriaxone, and most frequently used combination was meropenem and vancomycin. In majority of the cases, (70%) empiric antibiotic combinations were stopped in 72 h.Conclusion: This is the first report of antibiotics use in PICU from our country, which shows that antibiotics are prescribed universally in our PICU. Strategies to assess the need for antibiotic use are needed

Advertising Styles’ Impact on Attention in Pakistan

The topic was selected after giving consideration to the modern environment and the use of media by advertisers for attention purposes of their products. It was also observed that the number of channels especially in the electronic media have also geometrically increased over the last two decades. It is now becoming difficult for advertisers to get the attention of their products in the minds of their viewers. The methodology used in the research was focus group and ads of different products were shown to them which included humorous and serious appeals. As the literature review revealed that these two types of appeals have significant difference when measuring attention between humorous and serious advertisements. At the end of the research it was established that there is a significant difference between the attention of humorous and serious appeals. Initially the idea was taken form a research conducted in Sweden. Same parameters were analyzed in Pakistan. We concluded that the reaction of two different societies have almost the same response for humorous and serious advertising appeals

Mentoring and its Effects on Turnover Intensions in Perspective of Pakistan’s Telecom Sector

In today’s era of towering competition the retention of workforce is highly desirable for long term success of any organization. The employees serve as backbone for any organization and are responsible for attaining the laid down objectives of the organization. The ongoing study investigates the effects of mentoring on turnover intensions of employees working in telecom sector of Pakistan. Researchers retrieved data with the help of questionnaires based on five point likert scale from almost 300 employees working in telecom organizations of Pakistan. Multiple regressions were used to analyze the collected data. Result shows that mentoring mostly is negatively associated with turnover intension because employee was not satisfied with mentoring and commitment in employees is only due to experienced learning which helps to develop additional skills in employee

Relationship between risk perception and employee investment behavior

nvestment behavior of an investor depends on his/her risk perception and risk attitude. This paper attempts to explore that how the perception of an investor who is also the employee of that organization differs from other investors. Does he/she perceives risk similarly as other common investors or his relationship with the organization as an employee has any impact his/her risk perception, attitude and investment behavior. This research study is conceptual in nature and mainly based on previous literature findings and evidences. Findings of this study suggested that employees risk perception is directly related with investment behavior and there is strong relationship between them. This can help the management to make special offers of shares to employees, this will further strength the bond of employees with the organization

Epidemiological Data of Neurological Disorders in Pakistan and Neighboring Countries: A Review

Neurological disorders are the impairments of nervous system and are an important and growing cause of morbidity, mortality, and disability. In addition to health costs, those suffering from these conditions are also frequently victimized of stigmatization and discrimination. Stigmatization further minimizes the patients\u27 access to treatment and social activities. These disorders, therefore, require special attention particularly in developing countries where unfortunately, the burden of these disorders remains largely unrecognized. Moreover, the burden imposed by such chronic neurological conditions in general can be expected to be particularly devastating in poor populations. These conditions are emerging as severe public health concerns in the developing countries due to the facts such as unawareness, Illiteracy, large numbers of people who are untreated, and unavailability of inexpensive but effective interventions. Regrettably, reliable population-based data from developing countries including Pakistan on the epidemiology of neurological disorders are extremely limited. Although, some information on epidemiological aspects of neurological diseases are available from some developing countries (Pakistan, Iran, India, Sri Lanka, Saudi Arabia and China) but disease prevalence and pattern are based on geographical, social, cultural, religious, and ethnic factors. In this review, w e critically analyzed data of 209 studies regarding the burden and prevalence of hypertension, depression, Stroke, Alzheimer\u27s disease (AD), epilepsy, and Parkinson\u27s disease (PD) in Pakistan and neighboring countries