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Objective-To examine variants at the 9p21 locus in a case-control study of acute myocardial infarction (MI) in Pakistanis and to perform an updated meta-analysis of published studies in people of European ancestry. Methods and Results-A total of 1851 patients with first-ever confirmed MI and 1903 controls were genotyped for 89 tagging single-nucleotide polymorphisms at locus 9p21, including the lead variant (rs1333049) identified by the Wellcome Trust Case Control Consortium. Minor allele frequencies and extent of linkage disequilibrium observed in Pakistanis were broadly similar to those seen in Europeans. In the Pakistani study, 6 variants were associated with MI (PϽ10 Ϫ2) in the initial sample set, and in an additional 741 cases and 674 controls in whom further genotyping was performed for these variants. For Pakistanis, the odds ratio for MI was 1.13 (95% CI, 1.05 to 1.22; Pϭ2ϫ10 Ϫ3) for each copy of the C allele at rs1333049. In comparison, a meta-analysis of studies in Europeans yielded an odds ratio of 1.31 (95% CI, 1.26 to 1.37) for the same variant (Pϭ1ϫ10 Key Words: myocardial infarction Ⅲ 9p21 Ⅲ Pakistanis Ⅲ risk factor Ⅲ South Asia Ⅲ meta-analysis V ariants at the 9p21.3 locus have been established as among the strongest common genetic factors associated with the risk of coronary artery disease (CAD) in people of European continental ancestry. [1][2][3][4][5] These variants are in highlinkage disequilibrium (LD) and span a 58-kb region that has multiple neighboring genes (CDKN2A, CDNK2B, and MTAP), without annotating to any single protein sequence. 5 An RNA coding gene, ANRIL, that overlaps with the risk To our knowledge, we report the first large-scale study of variants at the 9p21 locus in relation to risk of acute myocardial infarction (MI) in Pakistanis. This study involved 1851 patients with confirmed diagnoses of first-ever MI and 1903 control subjects from the Pakistan Risk of Myocardial Infarction Study 8 (PROMIS). Genotyping was conducted on 89 tagging single-nucleotide polymorphisms (SNPs) at the 9p21.3 locus, including the lead variant (rs1333049) identified by the Wellcome Trust Case Control Consortium in association with CAD. 1,2 To place our findings in context, we also report a literaturebased meta-analysis of relevant studies, encompassing information on 23 variants at the 9p21 locus in up to 38 250 CAD cases and 84 820 controls. The current meta-analysis substantially updates a previous relevant review, 5 involving data from an additional 82 117 participants and 20 additional variants. Methods Study DesignThis article follows the reporting recommendations of STrengthening the REporting of Genetic Association studies. 9 PROMIS is a casecontrol study of acute first-ever MI in urban Pakistan. 8 Patients with MI experienced the following: (1) symptoms within 24 hours of hospital presentation, (2) typical ECG characteristics (eg, Ն1-mm ST elevation in any Ն2 contiguous limb leads or new-onset left bundle branch block), and (3) a positive troponin test result (Ͼ1 ng/mL). Controls were indi...

Background A pattern of both clinical and biochemical abnormalities is associated with dengue virus infection (DVI). Among the various DVI-related biochemical defects, electrolyte imbalance is one that can alter the morbidity and mortality among patients. However, there is a dearth of evidence to assess the relationship between electrolyte imbalance and the length of stay or mortality in dengue-infected patients in Pakistan. In the current study, we aimed to investigate the association between electrolyte imbalance at the time of admission and the length of stay and mortality among dengue-infected patients. Methods We conducted a retrospective study at a large tertiary care hospital from November 2018 to November 2019. All patients with known chronic diseases and coinfections or those who were taking diuretics therapies or angiotensin-converting enzyme inhibitors were excluded. Our main exposure of interest was electrolytes imbalance and the outcome measure was the length of stay and mortality. Results A total of 1,008 dengue patients were enrolled with a mean length of stay of 2.56 days. Around 29.3% had hyponatremia and 23.2% had hypokalemia at the time of admission, and 21.9% of patients had a stay beyond three days. In multivariable analysis, hyponatremia [adjusted odds ratios (aOR) = 1.29; 95% confidence interval (CI): 0.59-2.84] and hypokalemia (aOR = 2.36; 95% CI: 0.91-6.10) were not found to be associated with the length of stay. However, patients with high troponin levels at admission had a prolonged stay beyond three days (aOR = 5.74; 95% CI: 2.34-14.11). There was a statistically significant association of creatinine levels (aOR = 14.74; 95% CI: 4.19-15.85) and diabetes mellitus (DM) (aOR = 4.36; 95% CI: 1.21-15.74) with mortality after controlling for potential confounders. Conclusion Electrolyte imbalance at admission is not a predictor of length of stay or fatalities in the hospital among patients with DVI. However, troponin levels at admission can increase hospitalization days whereas DM and renal injury have been found to worsen mortality rates.

Radiofrequency ablation performed at our centre was a safe and effective procedure with low complication rates and durable RFS. Tumour characteristics, comorbidities and learning curve were not associated with local recurrence.

BackgroundBlood groups are considered to have an impact on the occurrence and severity of coronavirus disease. While among Chinese and Caucasian, blood group O individuals were less and group A were more likely to have severe disease and mortality, data on South Asians aren't available. ObjectiveThis study aimed to find out the association of disease severity with blood group among coronavirus disease 2019 (COVID-19) patients. Materials and methodologyData were collected on a predesigned questionnaire containing details of patient demographics, medical comorbidities, clinical presentation, and laboratory parameters. Multiple logistic regression was used to determine the association of the blood group with the severity of coronavirus disease. ResultAmong the study participants, blood group B has the highest distribution (39.8%), followed by O (30.0), A (21.9%), and AB (8.1%). About three-fourths (69.9%) had mild to moderate disease while 30.0% had severe disease. Age, gender, hypertension, diabetes mellitus, and hemoglobin level were all associated with disease severity among COVID-19 patients in univariate analysis on P-value for selection (<0.25). The final model showed that the odds of disease severity is 3.62 times higher among males (OR: 3.62, 95% CI: 2.15-6.08) and 2.00 times higher among diabetic patients (OR: 2.00, 95% CI: 1.10-3.01) as compared to female and nondiabetic respectively. However, there was no significant association found between blood group and disease severity. ConclusionBlood groups don't have any role in forecasting the severity of coronavirus disease. However, the male gender and diabetics are prone to have severe disease.