MicroRNAs (miRNAs) play a key role in the regulation of genes for normal metabolism in the liver. Dysregulation of miRNAs is involved in the development and progression of non-alcoholic fatty liver disease (NAFLD). We aimed to explore changes in circulating miRNA expression in response to delta-tocotrienol (δT3) and alpha-tocopherol (αTF) supplementation and correlate them with relevant biochemical markers in patients with NAFLD. In total, 100 patients with NAFLD were randomized to either receive δT3 (n = 50) 300 mg or αTF (n = 50) 268 mg twice/day for 48 weeks. Plasma expression of miRNA-122, -21, -103a-2, -421, -375 and -34a were determined at baseline, 24 and 48 weeks of intervention using RT-qPCR. Both δT3 and αTF significantly downregulated expression of miRNA-122, -21, -103a-2, -421, -375 and -34a. Moreover, δT3 was more effective than αTF in reducing expression of miRNA-375 and -34a. A significant correlation was observed between miRNA expression and biochemical markers of hepatic steatosis, insulin resistance (IR), oxidative stress (OS), inflammation and apoptosis. δT3 and αTF exert hepato-protective effects by downregulating miRNAs involved in hepatic steatosis, IR, OS, inflammation and apoptosis in patients with NAFLD. Furthermore, δT3 has more pronounced effects than αTF in reducing miR-375 and miR-34a, which are linked to regulation of inflammation and apoptosis.
Objective: To study thrombocytopenia and elevated ALT levels in malaria patients reporting to Pak Med Level II+ Hospital XII and XIII, UN Mission Liberia, West Africa. Study Design: Cross sectional study. Place and Duration of Study: Departments of Pathology and Medicine, Pak Med Level II+ Hospital XII and XIII, UN Mission Liberia, West Africa, from Feb 2015 to Dec 2016. Methodology: In total of 100 febrile patients of both gender and all ages reported to Pak Med Level II+ Hospital XII and XIII, Liberia with clinical features of malaria and having positive malarial parasite (MP) on any of the methods of immune chromatography (ICT) or microscopic film were included. The febrile patients with typical clinical features of malaria but having negative MP both on ICT and microscopic methods were excluded.Pretreatment whole blood in EDTA was collected for testing MP on ICT and by microscopic method including MP index and platelets, while serum for ALT. Results: Out of total 100 patients, 75 were males, 25 females with mean age of 38 ± 5 years. MP was found positive on MP film in 95% and on ICT in 88% cases. Thrombocytopenia was found in 69% and ALT was elevated in 60% cases. Mean and SD for platelets count was 129 ± 72 x 109/L and of ALT 76 ± 66 U/L. Mean of MP index was 0.49 ranging from 0 to 3.5%. Correlation of MP index with platelets and ALT was found insignificant, although in malaria patients, platelets and ALT was inversely correlated significantly with each other showing low platelets along with elevated ALT levels. Conclusion: In malaria patients, thrombocytopenia and elevated ALT are frequent findings, which may not definitely correlate with MP index. So it is advisable to test for platelet count and ALT in all patients of malaria for early diagnosis and better management.
Objective: To determine the frequency of disorders leading to sudden cardiac death (SCD). Study Design: Cross-sectional study. Place and duration of study: Pathology Lab in collaboration with the Cardiology Department, AFIC & NIHD, Rawalpindi Pakistan, from Jan 2017 to Dec 2018. Methodology: A total of 305 cases of sudden cardiac death reported within the last 24 hours of a death to AFIC Rawalpindi were included consecutively. Cases with a history of extracardiac diseases leading to sudden death were excluded. Most of the included cases were diagnosed phenotypically based on clinical examination, biochemistry, ECG, echocardiography, angiography, thallium scan, electro-physiological studies, cardiac CT scan, MRI and routine autopsy whenever recommended. Results: Out of 305 cases, 197 (65%) were males and 108 (35%) females. Disorders leading to SCD were found in 178 (58.3%) cases due to ischemic heart disease (IHD), aortic dissection (0.7%), hypertrophic cardiomyopathy (HCM) (0.3%), dilated cardiomyopathy (DCM) (10.5%), congenital heart disease (12.1%) and valvular heart disease (7.9%). While in cardiac channelopathies, catecholaminergic polymorphic ventricular tachycardia (CPVT) in 5 (1.6%) and congenital long QT syndrome (LQTS) in 2 (0.7%) cases. However, 24 (7.9%) cases remained as sudden unexplained deaths (SUD). Conclusion: In our setup, ischemic heart disease and dilated cardiomyopathy were the commonest causes of sudden cardiac death, followed by congenital heart disease and valvular heart diseases.
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