ISSN 2415-1297 (Online)   ISSN 2415-1300 (Print)
Volume : 26 Issue : 4 Year : 2018
Med J Islamic World Acad Sci: 18 (2)
Volume: 18  Issue: 2 - 2010
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1.Prevalence of (Lada) among Clinically Diagnosed Type 2 Diabetic Patients
Meroj A. Jasem, Alia A. Al-ubaidi, Anni Admon, Khadeja N. Zwaer
Pages 49 - 54
Identification of LADA represents a major interest for many diabetologists, because its prevalence is relatively high and seems to be underestimated. Also, correct diagnosis of LADA patients allows an early and accurate therapeutic intervention.
The purpose of this study was the evaluation of the prevalence of latent autoimmune diabetes in adults (LADA) among group of clinically diagnosed type2 diabetic patients.
Seventy four type 2 diabetic patients were tested for the presence of autoantibodies ICA, GAD, IA-2. All patients were also characterized according to clinical symptoms preceeding the onset of the disease, age, BMI. ICA were measured by indirect immunofluorescence on cryostat sections of human pancreas of blood group O. GADab and IA-2ab were measured by ELISA assay.
The presence of at least one autoantibody was revealed in 14/74 patients. That allowed us to recognize LADA in these cases. The coexistence of two antibodies was observed in 3/14 patients. None of the patients had three examined autoantibodies. GADab were detected more frequently (12/14) than GADab and IA-2ab, which were found with the same frequency (2/14) (P < 0.004).
Among patients with diagnosed type2 diabetes there is a group with autoimmune diabetes, called LADA. Phenotype similarity between diabetes type 2 and LADA makes the proper diagnosis impossible without more specific tests. The diagnosis of LADA is based on the presence of autoantibodies.

2.Frequency of Aberrant Expression of CD Markers in Cases of Acute Leukemia
Muhammad M. Khurram, Saghir A. Jafri, Abdul Mannan, Aftab Nadeem, Asif Jamal
Pages 55 - 60
In the present study 100 patients of acute leukemia were studied to find out the frequency of aberrant antigens in AML, B-ALL and T-ALL of which 73% cases were of lymphoid lineage and 27% cases were of myeloid lineage. 74% cases showed expression of lineage specific markers and were considered as conventional immunophenotypes while 26% cases showed expression of CD antigens which were not of that lineage upon which they were expressing. Some myeloid lineage associated antigens were present on acute lymphoblastic leukemia cases and lymphoid associated antigens showed their expression on acute myeloid leukemia cases. These cases were considered as aberrant immunophenotypes. The cases of acute lymphoblastic leukemia were further subcategorized as B-cell and T-cell acute lymphoblastic leukemia. The data from this study suggested that either the commonly described myeloid, B-cell and T-cell differentiation pathways are incorrect or blasts from cases of acute leukemia do not represent their normal counterparts. To explain these mixed immunophenotypes it is suggested that leukemic cells may have aberrant markers because of their abnormal genetic programme resulting in lineage infidelity. In this scenario the precursor cells may retain features of one lineage that they should have lost during commitment to another cell line. As a result of the leukemic process cells with aberrant immunophenotypes are immortalized in a precommitment phase of differentiation resulting in lineage promiscuity. This study strengthens the theories of lineage infidelity and lineage promiscuity by taking a critical and comparative approach of frequencies of aberrant antigens in acute leukemia in population of Pakistan.

3.Performance Equivalence Study of Sodium Starch Glycolate, Modified Maize Starch and Maize Starch as Disintegrants in Paracetamol Tablet Formulation
M. A. Mustapha, C. I. Igwilo, B. O. Silwa
Pages 61 - 67
Fierce price competition informed the reappraisal and reformulation of paracetamol tablet. Sodium starch glycolate (SSG) was implicated in the high cost and needed to be replaced. The use of modified maize starch (MMS) produced by cold, dilute acid hydrolysis of maize starch (MS) offered good and cheaper alternative.
Evaluation of different disintegrants using 5 batch formulations coded SSG-3, MS-3, MMS 3, MMS-6 and MMS-9 and characterization of resultant tablets showed that interchanging SSG with MMS resulted in no deleterious therapeutic consequences. Inclusion of 6% MMS in the paracetamol formulation gave tablets that exhibited good mechanical and dissolution properties comparable to the tablets produced with 3% sodium starch glycolate.
Indeed, at 95% confidence level, t-test which compares the p-value (?0.05) of dissolution of the batch formulations returned values of 0.000056 for MS-3, 0.0182 for MMS-3, 0.0965 for MMS-6 and 0.1433 for MMS-9. The values confirmed the significant differences between batch SSG-3 and batches MS-3 and MMS-3 and no difference of any significance
in batches MMS-6 and MMS-9. Hence MS and MMS at 3% level can not effectively replace SSG at 3% level. The poor friability (1.12%) as well as higher disintegration time (16 minutes, 54 seconds), both higher than official limits of <1% and ?15 minutes respectively, would not also allow the use of MMS at 3 and 9% level as substitutes for 3% SSG. Thus, only MMS at 6% inclusion level can interchange with SSG 3%.
Cost - benefit analysis showed that over 9% cost reduction is achieved by the replacement without compromising both physical and chemical qualities of the resultant tablets which include mean dissolution time (MDT) 50% of 4.5 minutes and dissolution of 103.87% in 30 minutes.

4.Principal Causes of Coma in Medical Units of A Tertiary Care Hospitals of Peshawar
Hamzullah Khan, Muhammad Zarif, Mumtaz Ali
Pages 69 - 74
To determine the principal causes of coma in patients admitted to the medical units of a tertiary care hospital of Peshawar.
This cross sectional study was conducted at department of medicine, Khyber teaching hospital Peshawar, from July 2006 to August 2007. All patients were randomly selected. Relevant information's were recorded on a questionnaire prepared in accordance with the objectives of the study.
A total of 124 patients with coma, 96(77.41%) males and 28(22.58%) females were included in the study. The age range of patients was from 12 years to 72 year with mean age of 50.5 years. The principal causes of coma were: cerebrovascular accident (CVA) 73.38% (n=91), epilepsy in 10.48% (n=13), injury head 5.64% (n=11), hepatic coma 2.41% (n=3), central nervous system (CNS) infections 2.41% (n=3), metabolic acidosis, drug abuse (1.61%) (n=2) each and cerebral malaria, hypoglycemia and uremia 0.8%(n=1) each. Risk factors for stroke recorded were hypertension in 46.2% (n=42/91), diabetes in 15.4% (n=14/91), ischemic heart disease 12.1% (n=11/91), smoking 5.5% (n=5/91), hyperlipedemia 3.3% (n=3/91) and atrial fibrillation 1.1% (n=1/91). Scoring on Glasgow coma scale showed that 74.2% (n=92) patients scored 3-8, 25.8% (n=32) scored 9-12 and none of the patients scored 13-15.
In our setup CVA is the most common cause of coma followed by epilepsy, and trauma head. Other minor causes recorded were metabolic acidosis, drug abuse, central nervous system infections, cerebral malaria, hypoglycemia and uremia.

5.Genetic Transformation in Antibiotic Resistant Escherichia Coli O157: H7
Ameena S.M. Juma
Pages 75 - 84
Five hundred stool samples were collected from patients with diarrhea (infants and children under ten years of age) admitted to the Pediatric and Maternity Hospital in Erbil City from March 2007 to September 2007. The samples were cultured on different culture media and according to the colony morphology, biochemical reactions and by the use of API 20E system, 35 (7%) were diagnosed as E.coli I, 8 (1.6%) E.coli II, 17 (3.4%) E.coli III, 22 (4.4%) E.coli IV, 8 (1.6%) Shigella dysenteriae, 16 (3.2%) Salmonella arizonae, 12 (2.4%) Salmonella typhi and 6 (1.2%) Vibrio cholerae. In addition, cases of Entamoeba histolytica 175 (35%), Giardia lamblia 102 (20.4%) and Hymenolepis nana 2 (2.4%) were identified. No infectious agents were found in 75 (15%) of the samples. 22 (4.4%) of the samples had mixed infections. The sensitivity of E.coli O157: H7 isolate to different antibiotics was performed. There was a variation in the resistance ranging from 8.5-90%. The determination of the site of genes responsible for the antibiotic resistance in E.coli O157: H7 was performed using the genetic transformation method for E.coli DH5 laboratory strain with the DNA that is absent from the highly resistant strains, E.coli O157: H7 4 and E. coli O157: H7 6. The transformation process succeeded when using the plasmid DNA for strain 4 and failed when using strain 6. It was evident that the genes responsible for resistance to the following antibiotics were located on the plasmid DNA: amoxicillin, amoxiclav, ampicillin, cephalexine, cefixime, cefotaxime, doxycyclin, gentamycin, nalidixic acid, nitrofurantoin, rifampicin, streptomycin and tetracycline. Whereas the genes responsible for the following antibiotic resistance were located on the chromosome: amikacin, erythromycin, chloramphenicol, ciprofloxacin, tobramycin and trimethoprim.

6.An Inquiry into The Cosmic Origins of The Human Life and Interpretation of The First Seven Ayahs of Holy Quran's Chapter
Muhammad Nafees
Pages 85 - 90
This research article briefly reviews the current literature and ideas from the sciences of Astronomy, Astrobiology and Astrochemistry, regarding the synthesis of the Basic Chemical Elements. The elements heavier than He are synthesized in the large stars and these elements are ejected into space, to far distances, through Supernovae explosions. These stars are the factories of the "Stardust" which provide the materials necessary for the creation of Life and hence us Humans! Although these concepts have taken concrete shape very recently due to the advent of ultramodern theories, equipment, and discoveries, it is proposed here that the Holy Quran has pointed to the same phenomena, about one and a half millennia ago.


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