Objectives: To determine serum levels of antistreptolysin O titre (ASOT) and C-reactive protein (CRP) and their association with clinical manifestations of Acute rheumatic fever (ARF). Study Design: Descriptive study. Setting: Department of Diagnostic Immunology and Serology, Children’s Hospital and Institute of Child Health, Lahore. Period: Jan 2015 to Jan 2016. Material & Methods: Fifty clinically confirmed patients of ARF were included in this descriptive study. The samples were taken from Children hospital and Institute of child health Lahore after written informed consent. The sampling technique was convenient sampling. Results: Out of 50 enrolled patients, males were 32(64%) and women 18(36%). Only 5(10%) patients had normal ASOT levels, 20(40%) patients were with borderline ASOT, and 25(50%) patients had titres above 200 IU/ml. There was no significant association of ASOT with gender, age and arthralgia with p-value = 0.060, 0.875 and 0.473, respectively. However, a significant association was found in ASOT with carditis and C-reactive protein (p-value = 0.028 and 0.014, respectively). Only 3 (6%) patients had CRP levels below 6mg/l, whereas 43 (86%) patients were with CRP levels above 6. Only 4(8%) patients had borderline value of CRP titer. There was no significant association between C-reactive protein with gender, age and arthralgia (p-value = 0.148, 0.184 and 0.574, respectively). Moreover, there was a significant association between C-reactive protein with carditis and AOST (p-value = 0.020 and 0.014, respectively). Conclusion: ASOT and CRP are important laboratory parameters reflecting undergoing infection (mainly caused by Streptococcus pyogenes A) and inflammation in patients of ARF. Rising levels of ASOT and CRP in ARF patients might be used as an indicator of involvement of heart tissues and therefore can be used to monitor transition of rheumatic carditis into Rheumatic heart disease.

Objectives: The study is designed to get useful information and epidemiological data for clinical practice and investigations regarding glomerular disease frequencies in Madina region.  Study Design & Setting: Single-center retrospective study at King Fahd Hospital Madina. Period: 01 year (March 2016- March 2017). Methods: All native renal biopsies were studied for the period of 1 year (March 2016- March 2017). Only glomerular disease patterns were analyzed. The diagnosis of each case was based on histological, immunopathological and clinical features. Results: A total of 44 biopsies were Included. Primary glomerular diseases in 52.27% of all biopsies studied. The most common primary disease was Membranous Nephropathy which accounts for 20.45%. Focal and Segmental Glomerulosclerosis (FSGS) (9%), Minimal change disease (4.54%), C3 glomerulopathy  (4.54%), IGA Nephropathy (4.54%), Non-IgA Mesangial Proliferative GN(2.27%), Crescentic Glomerulonephritis (GN) (2.27%), Post lnfectlous GN(2.27%), Thin Basement Membrane Nephropathy(2.27%)  as primary GN. Secondary glomerular diseases in 47.73%. Lupus Nephritis corresponded to 34.09% of the entire series. Conclusions: FSGS has been the most frequent type of glomerulopathy in Saudi Arabian population according to previously available data from local studies but in our study the cases of Membranous Nephropathy were high .Lupus Nephritis remain above the list as a cause of secondary glomerular disease. The reasons for these findings are unclear but this information is an important contribution towards understanding the prevalence of renal diseases In Saudi Arabia.

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CKD-5 treatment is expensive and inaccessible for the majority of the Pakistani population. QOL is a valuable research tool in assessing the outcome of therapeutic interventions in chronic diseases. Unfortunately, there is no information available on the QOL in CKD-5 patients in Pakistan. In this present study, we sought to compare the difference between the quality of life in hemodialysis patients and kidney transplant recipients. The study was conducted on hemodialysis patients and kidney transplant recipients at Pakistan Kidney and Liver Institute and Research Centre (PKLI&RC). The study subjects were selected by Convenient Sampling. A comparative study was done to assess the HRQOL between hemodialysis and renal transplant recipients. The Urdu version of the WHOQOL-BREF was used. The mean score of items within all 4 domains was used to calculate the domain score. Descriptive analysis included calculation of frequency, percentage and mean for presentation of socio-demographic and WHOQOL-BREF scores in hemodialysis patients and kidney transplant recipients. The sociodemographic characteristics were significantly different between the two groups. KTRs were younger than HD patients and were generally more educated. A larger number of people in the hemodialysis group as compared to those in the KTR group were found to be unemployed. Patients in KTR group had a much better perception of quality of life (77.5 vs 58) and health (85 vs 63.5) as compared to the hemodialysis patients. KTRs had significantly higher HRQOL scores than HD patients in all 4 domains with the greatest difference seen in physical domain. KTRs also reported fewer ER visits and hospitalizations. The QOL scores of KTRs were better than hemodialysis patients in all four domains: Physical, psychological, social relationship, environmental health. Hence, renal transplant services should be encouraged for people with ESRD and should be made easily available to patients.

Introduction: Vitamin D deficiency is pretty common among the patients withCKD some studies suggesting it to be starting from CKD 3 when the egfr start falling from60 ml/min. The cause can be due to different reasons including race, obesity, nutrition, lackof exposure to sun, and not the least, decrease in 1,alpha hydroxylase once the gfr starts tofall significantly. Objectives: The hypothesis was that lower Vitamin D level will be associatedwith increased inflammatory burden and decreased immunological response. Study Design:This was a cross-sectional study looking at the relationship between Vitamin D level andinflammatory markers in CKD 4 Pts when egfr started falling from 30 ml/min. Study Design andDuration: The study was started in March 2016 and finished in May 2016 among consecutive100 CKD 4 patients coming to the clinic who were identified to be eligible for the study. Materialsand Methods: We looked at the relationship between Vitamin D level and markers of mineralbone disorder, similarly we also looked at the relationship between erythropoietin dosage,hemoglobin and Vitamin D levels. Erythropoietin dose, hemoglobin, transferrin saturation,were used to study the link between Vitamin D and markers of anemia. Hepatitis B surfaceantigen antibodies were measured to study the response between Vitamin D level and immuneresponse to Hep B vaccine. Results: Vitamin D levels were significantly lower in diabeticscompared to non-diabetics (P = 0.02) and lower in females compared to males (P = 0.009).No statistical significance was observed between Vitamin D levels and immune response tohepatitis B vaccine (P = 0.89), phosphate level (P= 0.1), calcium levels (P = 0.79), parathyroidhormone (PTH) levels (P = 0.57), C-reactive protein (P =0.19), serum albumin (P = 0.17),hemoglobin level (P = 0.18,) and erythropoietin requirement (P = 0.87).Conclusions VitaminD deficiency is highly prevalent in advanced CKD in Saudi Arabia. A RCT is recommendedregarding response to vitamin D supplementation.