ACUTE MYOCARDIAL INFARCTION;

Objective: To assess the reliability of the first set of CK-MB in establishing diagnosis of acute myocardial infarction in different subgroups of the patients according to their time of presentation after symptom onset. Material a n d m e t h o d s : Prospective observational study was carried out in Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD) Rawalpindi, from April to September 2005. We studied 300 consecutive cases presenting with typical electrocardiographic changes of acute ST Elevation Myocardial Infarction to the Emergency &amp; Reception department of AFIC/NIHD (confirmed later on as acute STEMI with raised serial serum cardiac enzymes levels). We documented values of CK-MB at the time of presentation in different subgroups of the patients according to duration of symptom onset. R e s u l t s : This study was predominantly male dominated (approximately 78%), with a mean age of 58 +11 years. Majority of patients i.e.216 (72%) presented within first 6 hours of onset of symptoms, 60 (20%) within 6-12 hrs, 6 (2%) within 12-24 hrs and 18 (6%) after 24 hrs of onset of symptoms. Overall serum cardiac enzymes sent at the time of presentation revealed that 126 (42%) patients had normal CK-MB (&lt;24U/L) and another 66 (22%) had a minimal rise in CK-MB (25-49 U/L). Only 108 (36%) patients 3 had serum CK-MB levels more than double the normal value. Amongst the patients presenting within the first 6 hours of onset of symptoms, 104 (48%) had normal CK-MB values, 48 (22%) had a minimal rise (&lt;49 U/L) and only 64 (30%) had a significant rise in CK-MB levels i.e. more than double the normal values or more than 5% of CK value. Out of 60 patients who presented within 6-12 hours of onset of symptoms, 54(90%) had more than double the normal value of CK-MB and 6(10%) had mild rise in CK-MB. All the patients (100%) who presented within 12-24 hours of onset of symptoms i.e. 6(2%) and more than 24 hours 18(6%) had significant rise in CK-MB. C o n c l u s i o n : This study shows that the first set of CK-MB alone has very little value in diagnosing acute myocardial infarction especially in the patients who presented within 6 hours of onset of symptoms. Reliability of CK-MB in diagnosing acute myocardial infarction greatly improves to the maximum in those patients who present more than six hours after symptom onset.</jats:p

2- Evaluation of the Policy of Quality Assurance in Public and Private Sector Universities in Pakistan

Quality assurance is increasingly becoming an important aspect of universities in developing countries. Development and implementation of quality assurance in universities is a challenge. The objectives of the study were to evaluate policy of quality assurance in public and private sector universities in Pakistan, to assess the practices of quality assurance in public and private sector universities in Pakistan, to find out the gap in policy and practices of quality assurance in public and private sector universities in Pakistan. Research design of the study was descriptive. The population of the study was 22 directors of quality enhancement cells, 3265 Ph.D. teachers and 288 heads of the department in sixteen public and six private sector universities in Islamabad. Through stratified random sampling technique, the sample of the study included 515 teachers, 215 HODs and 20 directors of QECs from the sixteen public and six private sector universities in Islamabad. Policy and practices of quality assurance in public and private sector universities was evaluated through questionnaire and interviews. Quantitative data were analyzed with the help of SPSS, Mean score, t-test and percentage. Public sector universities’ staff was more skilled and performing their duties according to required standard. Public sector universities promote research culture among faculty and students. It was recommended by the researcher that local and international training on policy and practices of quality assurance should be given to QECs staff, HODs and faculty members</jats:p

Association between single nucleotide polymorphisms of DNA damage response pathway genes and increased risk in breast cancer

Aim: We aimed to evaluate the role of selected single nucleotide polymorphisms of DNA damage response pathway genes in breast cancer (BC). Materials &amp; methods: In present study, 500 BC patients and 500 controls was used to estimate the frequency of single nucleotide polymorphisms of DNA damage response pathway genes. Tetra-amplification refractory mutation system-PCR technique was used for screening of the six selected polymorphisms. Results: Logistic regression analysis showed that heterozygous mutant genotype of rs1800057 (p &lt; 0.0001) and homozygous mutant genotype of rs1801516 (p &lt; 0.0001) was associated with significant increased risk of BC. In the ATR gene, heterozygous mutant genotype of rs2227931 (p &lt; 0.0001) was associated with significant increased risk of BC. However, significant decreased risk of BC was found associated with heterozygous mutant genotype of rs2227928 (p &lt; 0.0002) and homozygous mutant genotype of rs2229032 (p &lt; 0.0001) in patients compared with controls. Conclusion: The present results showed that alteration in DNA damage response pathway gene ( ATM &amp; ATR) results in increased BC risk. </jats:p

Door to Needle Time and its Impact on Successful Thrombolysis

Background: To evaluate the Door to needle time andits impact on successful thrombolysis .Methods : In this cross sectional study all patientsadmitted with Acute Myocardial Infarction (AMI), whowere candidates for fibrinolysis, were included.Streptokinase 1.5 million units i.v was given over one hourto all the patients. Door to needle time was calculated.Successful thrombolysis was considered as resolution ofchest pain with 70 % ST-segment resolution 60–90 minutesafter thrombolysis.Results : Ninety four patients with acute myocardialinfarction eligible for thrombolysis were givenintravenous streptokinase.Majority (87.2%)were male.Successful thrombolysis was attained in 62.9% ,amongthose who received streptokinase within 30 minutes ofonset of pain and in 16.7% of those who receivedstreptokinase after more than 30 minutesConclusion: Timing of streptokinase infusion afterfirst medical contact is an important predictor of successfulthrombolysis

Linkage disequilibrium and haplotype analysis of<i>Src</i>and<i>Yes1</i>genes in thyroid cancer

Purpose: This study was planned to examine the effects of Src and Yes1 single nucleotide polymorphism (SNPs) on the risk of thyroid cancer in 499 patients and 500 controls. Materials &amp; methods: Three SNPs of Src gene and three SNPs of Yes1 gene were analyzed using Tetra-primer ARMS-PCR followed by sequencing. Results: rs121913314 of Src gene genotype TT showed 32-fold increased risk of thyroid cancer and rs2305994 of Yes1 genotypes TT and CT showed 2.7-fold and 16-fold increased risk in thyroid cancer (p &lt; 0.0001). Haplotype analysis revealed that CATGCC, CATGCT, CATGTC, CATGTT, TATGCC and TATGTTA haplotypes are associated with thyroid cancer risk. Conclusion: Results showed that genotypes and allele distribution of Src and Yes1 genes are significantly linked with increased risk of thyroid cancer.</jats:p

Relationship of single nucleotide polymorphisms and haplotype interaction of mitochondrial unfolded protein response pathway genes with head and neck cancer

Aim: In this study, we evaluated the effect of selected polymorphisms of mitochondrial unfolded protein response (UPRmt) pathway in 500 head and neck cancer (HNC) patients and 500 healthy controls from Pakistan. Materials &amp; methods: The experiments were conducted using tetra-ARMS PCR followed by DNA sequencing. Results: Multivariate analysis showed that AA genotype of rs3782116 showed fivefold, GG genotype of rs6598072 approximately twofold and CC genotype of rs4946936 and TT genotype of rs12212067 showed twofold increased risk of HNC. Furthermore, haplotype analysis showed that certain haplotypes of UPRmt pathway single nucleotide polymorphisms have significant association with increased HNC risk. Conclusion: These results show that genetic aberrations in UPRmt pathway genes have association with increased HNC risk and can be an indicator of advance clinical outcome especially invasion and metastasis. </jats:p

Association of DDR pathway proteins and breast cancer risk in a Pakistani population

Introduction Breast cancer, due to its heterogeneous nature and variable response to current systemic treatment, can be a great concern. Deregulation of the DNA Damage Response (DDR) pathway genes due to mutation and expression increases cancer risk, progression, and metastasis. The current study was designed to check the expression deregulation patterns of the selected DDR pathway genes (ATM, CHEK1, and CHEK2) at the protein level. Material & method Immunohistochemistry-based expression profiling was conducted in 102 histopathological confirmed breast cancer-diagnosed tissues and their adjacent uninvolved control tissues. Results Downregulated expression of the selected DDR pathway (ATM, CHEK1, and CHEK2) proteins was observed in breast tumor tissues compared to control tissues. Downregulated protein expression of the DDR pathway genes (ATM, CHEK1, and CHEK2) correlates with aggressive breast cancer phenotypes and increased tumor burden. The selected proteins showed significant diagnostic potential having strong area under curve values for CHEK2 (0.828, p < 0.0001), CHEK1 (775, p < 0.0001) and ATM (0.725, < 0.0001) proteins. Conclusions Kaplan–Meier analysis showed that dysregulated expression of these three proteins leads toward poor survival outcomes, suggesting their role to be used as a better and more effective diagnostic and prognostic marker for early diagnosis and effective treatment of breast cancer patients

Role of <i>Chk1</i> gene in molecular classification and prognosis of gastric cancer using immunohistochemistry and LORD-Q assay

Purpose: The aim of the current study was to assess the prognostic value of the  Chk1 gene in the DNA damage response pathway in gastric cancer (GC). Methods: Expression levels of the Chk1 were measured in 220 GC tumor tissues and adjacent healthy/noncancerous tissues using real-time PCR and immunohistochemical staining. Genomic instability in GC patients was measured using the long-run real-time PCR technique for DNA-damage quantification assay and comet assay. Results: Significantly downregulated expression of Chk1 was observed at the mRNA level (p &lt; 0.0001) and protein level (p &lt; 0.0001). Significantly increased frequency of lesions/10 kb and comets was observed in tumor tissues compared with control tissues. Conclusion: The data suggest that downregulated expression of Chk1 and positive  Heliobacter pylori infection status may have prognostic significance in GC. </jats:p