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.

Objective: To find out the Modified Marsh type of celiac disease (CD)patients on histopathological examination of duodenal (D2) biopsies and to correlate it withtissue transglutaminase IgA levels. Study Design: Cross sectional study. Place of Study:Histopathology laboratory (Department of Pathology), Isra University Hospital and AsianInstitute of Medical Sciences (AIMS), Hyderabad. Duration of Study: July 2013 to December2013. Materials and Methods: 96 patients with a history of malabsorption or atypical symptomswith clinical suspicion of CD were subjected to endoscopy. Endoscopic duodenal (D2) biopsieswere taken regardless of age and gender. D2 biopsies were processed for histopathologicalexamination under light microscopy. Results: Out of 96 patients, 45 (46.9%) patients hadmoderate type of lamina propria inflammation along with highly significant p-value (0.0001).CDtype 3a was observed in 34 patients (35.4%). In this study the comparison of serological level oftissue Transglutaminase IgA (tTGA) and histological severity revealed significant correlation. AllModified Marsh types of CD with tTGA level seen in our study were highly significant (p-value0.001). Conclusion: In this study strong correlation was observed between the serologicaltTGA level and histological findings by Modified Marsh classification along with lamina propriainflammation of duodenal mucosa in CD patients.

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The aim of this study was to see the correlation between hepatic steatosis inchronic HCV infection and HCV genotypes. Study Design: It was a prospective observationalstudy done. Setting: Isra University Hospital and histopathology laboratory. Period: May toNovember 2014. Material & Methods: The study was conducted on 87 liver biopsy specimensof patients infected with chronic HCV. The biopsy samples were collected from department ofPathology, Isra University. H&E stained sections of liver biopsies were evaluated to determineGrade and Stage of chronic hepatitis C and grade of steatosis. Blood samples of those patientswere collected from Isra University hospital and Asian Institute of Medical Sciences (AIMS),Hyderabad to determine the HCV genotype, platelet count and liver function test including ALT,AST and GGT. Results: It was found that majority of the patients 38 (43.6%) had genotype 3ainfection followed by 3b, 1a, 1b and Un-typeable genotypes. Hepatic steatosis was divided intocategories according to Brunt’s classification. It was found that 39 (44.8%) patients had grade0 steatosis while 48 out of 87 patients presented with steatosis. It was found that 29 (33%)presented with grade 1 steatosis followed by grade 2 and 3. Steatosis was most frequentlyseen with genotype 3a (26.4%) and presented with mild to moderate grade. Conclusions: Thepresent study concludes that hepatic steatosis is more frequent in genotype 3a and presentswith mild to moderate grade.