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.

Objective: This study was conducted to evaluate the pancreatic cells regeneration with interleukin 1 inhibitor drugs (diacerein) of natural source. Material & Methods: This experimental study was conducted at the Isra University animal house in which 60 albino rats were divided into 4 subgroups of 10 in each. Experimental group of them given alloxan and induced diabetes. interleukin 1 inhibitor (diacerein) was given to 2 experimental groups, diabetic experimental C and D respectively, in dosages of 30 mg/kg and 50 mg/kg for 21 days. After the completion of the experiment, rats were sacrificed by cervical dislocation. The pancreas of rats was removed and set in 10% formalin for fixation after being washed with normal saline. For appropriate fixation, the slides were placed on a hot plate. Hematoxylin and eosin were used to stain the slides, and under the light microscope, stained slides were examined. The study proforma was used to document all of the data. Results: Diabetic rats showed sustained hyperglycemia, total destruction of beta cells histologically. However, diabetic group rats showed degenerative changes of the pancreatic characterized by ultra-structural changes, shrinkage of beta islet cells, and showing RBCs and fibrosis of regions of endocrine glandular epithelial cells. Beta cells were showing mild regeneration with proliferative changes in the beta cells of islets as well as dilatation of ducts seen in treated groups with interleukin 1 inhibitor with lab findings of improving to euglycemic levels. Conclusions: Pancreatic tissue of diabetic rats showed ultra-structural changes and regeneration, as well as reduction in inflammatory markers as well as obvious effects on D.M., hence would be used as a cheap, safe drug to control and reduce the oxidative injury of pancreatic cells and its regenerative effects. Keywords: Diacerein, interleukin 1 inhibitor, regeneration of pancreas hyperglycemia, diabetes mellitus

ABSTRACT… Objectives:This study aimed to determine the platelet count in diagnosed chronic renal failure patients and to find out the association of platelet count with glomerular filtration rate. Study Design: Case control study. Place of study: Diagnostic and research laboratory Liaquat University Hospital Hyderabad and Nephrology Unit, Isra University Hospital Hyderabad. Duration of study: January 2015 to July 2015. Materials and methods: Total of one hundred and twenty subjects (n=120) were divided into two groups. The healthy controls (n=60) were included in group-I whereas patients with chronic renal failure (n=60) were kept in group-II. 5 ml of blood was drawn and sent to laboratory for estimation of serum platelet count, blood urea nitrogen and serum creatinine levels. Results: The present study showed highly significant difference with marked decrease in the platelet counts seen in the CRF patients with 223.9±89.1 million/µL in comparison to the 347.60±55.9 million/µl platelets in control individuals. Also the results of BUN in CRF patients showed highly significant differences with 27.67±7.68 mg/dl when compared to controls having BUN 8.95±1.02 mg/dl. The comparison between GFR with mean platelet count showed negative correlation (r = -0.27) in CRF patients. Conclusion:The present study shows weak negative correlation of platelet count with GFR. Key words:platelet count, Glomerular filtration rate, chronic renal failure

Background: The hepatitis C virus (HCV) is a leading cause of chronic liver disease, including hepatic cirrhosis and hepatocellular cancer (HCC). Drugs that act directly on the virus, like as direct-acting antivirals (DAAs), are associated with improved long-term virologic responses and reduced treatment time. Pakistani patients with HCV-related cirrhosis receiving DAA medication were studied to see if they had an increased risk of hepatocellular carcinoma (HCC). Material and Methods: We conducted a prospective observational study at Isra University Hospital Hyderabad from July 2019 to August 2020. Three hundred fourteen patients met the inclusion criteria and were included. We recorded baseline demographic characteristics, Child-Pugh class, model for end-stage liver disease (MELD) score, alpha-fetoprotein level, and abdominal ultrasound/computed tomography (CT) scan before and after treatment. Results: Three hundred-fourteen individuals took part in the research. The average age of participant with hepatocellular carcinoma was 46.7 years. Twenty (sixty-nine) of the participants developing hepatocellular carcinoma were men, while nine (thirty-one percent) were women (p=0.221). Five (17.2%) of the HCC participants were diabetics, and seventeen (58.6%) were tobacco users (p=0.001). Twenty individuals (69%) developed HCC after receiving a combination of sofosbuvir and daclatasvir. A sofosbuvir/velpatasvir combination led to the development of HCC in nine (31%) of individuals (p=0.1). HCC was diagnosed in eight individuals under the age of forty (27.6%), but in 21 patients beyond the age of forty (72.6%) (p=0.55). HCC was found in 65.6 percent of Child-Turcotte-Pugh class A participants. Conclusion: DAAs have been linked to a higher risk of HCC. Participants receiving a combo of sofosbuvir/daclatasvir were more likely to develop HCC than those who received sofosbuvir/velpatasvir alone. Keywords: Velpatasvir, Hepatocellular carcinoma, Sofosbuvir, Cirrhosis,

Objectives: This study aimed to determine the platelet count in diagnosedchronic renal failure patients and to find out the association of platelet count with glomerularfiltration rate. Study Design: Case control study. Place of study: Diagnostic and researchlaboratory Liaquat University Hospital Hyderabad and Nephrology Unit, Isra University HospitalHyderabad. Duration of study: January 2015 to July 2015. Materials and methods: Total ofone hundred and twenty subjects (n=120) were divided into two groups. The healthy controls(n=60) were included in group-I whereas patients with chronic renal failure (n=60) were kept ingroup-II. 5 ml of blood was drawn and sent to laboratory for estimation of serum platelet count,blood urea nitrogen and serum creatinine levels. Results: The present study showed highlysignificant difference with marked decrease in the platelet counts seen in the CRF patientswith 223.9±89.1 million/μL in comparison to the 347.60±55.9 million/μl platelets in controlindividuals. Also the results of BUN in CRF patients showed highly significant differences with27.67±7.68 mg/dl when compared to controls having BUN 8.95±1.02 mg/dl. The comparisonbetween GFR with mean platelet count showed negative correlation (r = -0.27) in CRF patients.Conclusion: The present study shows weak negative correlation of platelet count with GFR.