Objective: To study, analyse and compare the effects of Silymarin on glycemic control and insulin resistance in newly diagnosed type 2 diaebtes mellitus (T2DM) subjects. Study Design: Observational study. Setting: Suleman Roshan Medical College Hospital. Period: March 2019 to February 2020. Material & Methods: A sample of 200 newly diagnosed cases of T2DM were recruited accroding to inclusion criteria selected by non-probability convenient sampling. Subjects were divided into 2 groups; OHA- oral hypoglycemia agent and OHA+ Sillymarin (200 mg). Baseline fasting (FBG) and random blood glucose (RBG), glycated HbA1 (A1C), fasting insulin (FI) and insulin resitance (HOMA-IR) were detected. Silymarin therapy was continued for 3 months. Study variables were analysed after 3 months. Data was analyzed on SPSS (ver.19) at 95% confidence interval (P≤0.05) considered statistially significant. Results: Age of diabetics taking oral hypoglycemic agents (OHA) and diaebtic taking OHA+ Silymarin supplementation was noted as 50.3±13.3 49.9±14.5 years (P=0.91). 3 months Silymarin supplementation improves the fasting blood glucose, random blood glucose, glycated hemoglobin A1 (A1C), fasting insulin and insulin resistance (HOMA-IR) (P=0.0001). Conclusion: Silymarin improves blood glucose levels in type 2 diabetics that is mediated through reduction of insulin resistance.

Objective: Determine the frequency of vitamin cobalamin deficiency in macrocytic anemia cases reporting at tertiary care hospital. Study Design: Cross Sectional study. Setting: Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Sindh Pakistan. Period: January 2017 to October 2018. Material & Methods: 450 cases of both genders, diagnosed as macrocytic- megaloblastic anemia were studied for the vitamin Cobalamin levels. Cases were collected through non- probability convenient sampling by inclusion and exclusion criteria. Consenting volunteers were asked for blood sampling. 5 mL blood was taken from ante – cubital fossa. Samples were centrifuged and sera were collected for the estimation of vitamin cobalamin by ELISA – assay kit. Continuous and categorical variables were entered in SPSS (version 21.0) and analyzed by Student t-test and Chi-square test respectively at 95% CI (P ≤ 0.05). Results: Male and female comprised 225 (43.3%) and 294 (56.6%) of 519 subjects. Male to female ratio was noted 1.30:1. MCV, MCH and MCHC show statistically significant difference between male and female (P<0.05). MCV in male was 96.8±9.92 fl vs. 105.5±12.04 fl in female (P=0.0001). Normal cobalamin was noted in 15.2% (n= 79) and any type of cobalamin deficiency was noted in 84.7% (n= 440) (P=0.0001). Conclusion: The present study reports frequency of 84.7% Cobalamin deficiency in macrocytic anemia reporting at Indus Medical College Hospital. Further studies are recommended by the treating physicians.

Background:Smoking plays a key role in increasing the inflammatory marker C-reactive protein (CRP).Aims:To examine inverse correlation between CRP and magnesium levels in smokers and nonsmokers.Materials and Methods:A total of 192 healthy adult male subjects were included in the present study, out of which 96 were smokers and the remaining 96 were nonsmokers having age range from 20 to 40 years, and all the subjects belonged to District Matyari of Hyderabad. Serum CRP was measured by NycoCard standard kit method and magnesium levels by DiaSys standard kit method in smokers and nonsmokers.Results:The levels of serum CRP in smokers (14.62 ± 0.16 mg/L) is high as compared to nonsmokers (4.81 ± 0.38 mg/L), which is highly significant (P < 0.001). However, inverse results were seen for serum magnesium levels which were significantly higher (P < 0.001) in nonsmokers (2.52 ± 0.18 mg/L) as compared to the smokers (1.09 ± 0.38 mg/dL). A significant (P < 0.001) inverse relationship between serum CRP and magnesium concentrations were seen in smokers.Conclusion:This result shows that smoking increases serum CRP, an inflammatory marker parallel to decrease in serum magnesium levels in smokers having 20-40 years of age.

Methodology: A sample of 109 subjects including Helicobacter pylori positive subjects and controls were selected according to study criteria. Centrifugation of blood was performed at 4000 rpm for 10 minutes and sera were stored at -20 o C. Blood sera were used for H. pylori serological testing. Blood counting was performed on hematoanalyzer. Cobas e411 analyzer was used for detection of cobalamin. 64 kD H. pylori antigens was detected by ELISA. The data was entered into SPSS version 21.0. (IBM, Incorporation, USA) A 2-tailed p-value of ≤0.05 was considered significant for statistical analysis. Results: Of total 109, 54.1% (n=59) were H. pylori seropositive cases and others were controls i.e. 45.9% (n=50). Cases and controls showed cobalamin levels of 290±49.3 vs. 351±32.9 pg/ml respectively (p=0.0001). Red blood cell indices were found to show statistically significant difference between cases and controls (p=0.001). Conclusion: Serum cobalamin deficiency was noted in both Helicobacter pylori positive and controls, however deficiency was more pronounced in Helicobacter pylori positive subjects.

Objectives: To analyze the effects of Examination stress on heart rate, blood pressure and white blood cells among medical college students. Study Design: Observational study. Setting: Department of Pathology, Indus Medical College, Tando Muhammad Khan Sindh. Period: September 2018 to April 2019. Material & Methods: 200 medical students were selected according to inclusion and exclusion criteria. Heart rate was measured manually. Systemic Blood pressure (BP) was recorded by Sphygmomanometer. Mean arterial BP was calculated as diastolic BP+1/3 of pulse pressure. Blood slides were stained with Leishman`s stain and white blood cells were counted using microscope.  Data was analyzed by using Statistical Package for Social Sciences (ver 22.0) for windows Microsoft. Results: Age of study subjects was noted as 20.23±1.23 years.  Body weight and Body mass index (BMI) were noted as 64.93±7.53 Kg (P=0.0001) and 27.5±5.3 (P=0.67). Of total 200, 109 (54.5%) were male and 91 (45.5%) were female (P=0.0001). Heart rate, Systolic, Diastolic and Mean arterial BP differed significantly before and after examination stress (P<0.05). White blood cells before examination were found as 7310.43±708.5 x103/µL compared to 8202.39±677.26 during examination stress (P=0.0001). Conclusion: Examination stress perturbs the physiological homeostasis as changes in heart rate, blood pressure and White blood cells are noted among medical students. Psychological and physical strategies for coping the stress should be considered for the young medical students.