Biochemistry Publications (BUCM-IC)

Role Of IL-6, Αtnf And Calprotectin In Acpas Positive & Negative Patients Of Rheumatoid Arthritis

Wed, 01 Jan 2025 00:00:00 GMT

Role Of IL-6, Αtnf And Calprotectin In Acpas Positive & Negative Patients Of Rheumatoid Arthritis Humaira Kashif, Farhat Bano, Aymen Shahzad, Rehana Mushtaq Auto immune disease such as Rheumatoid Arthritis is the consequence of persistence imbalance between proinflammatory cytokines and anti-inflammatory immune mechanisms leading to chronic inflammation. In RA, many factors activate multiple pathways, all converging to enhance osteoclastogenesis, ultimately disturbing bone metabolism to bring about joint destruction. This study is aimed at finding levels of serum calprotectin, serum IL-6 and serum TNF-α in treatment naïve seropositive and seronegative RA patients. It also aimed at finding association of these parameters with RA disease in Pakistani population. Subjects and Methods A comparative cross-sectional study was carried out at RA patients of age 35-55 years, not yet started any treatment, divided into group 1 ACPA +ve (n=28) Group 2 ACPA -ve (n=28) and Group 3 healthy control (n=28). Blood samples were taken and processed for serum preparation and stored at -80˚C. The anthropometric profile (height, weight and body mass index) was recorded. ESR, CRP and serological record were taken from medical file of patient. Calprotectin, IL-6 and TNF-α were estimated by human ELISA kits. Data was analyzed by SPSS-21. Normality was checked and statistical tests were applied accordingly. A p value of < 0.05 was considered significant. Results Level of Serum calprotectin, IL-6 and TNF-α were significantly elevated in both ACPA +ve and ACPA -ve RA patients as compared to healthy controls (p value < 0.001), (p value < 0.001), (p value < 0.001) respectively. However, no significant difference in levels of calprotectin, IL-6 and TNF-α was noticed in ACPA +ve and ACPA -ve groups (p value < 0.179), (p value < 0.725), (p value < 0.629) respectively. A notable association of these parameters with DAS-28-ESR was also found. Both seropositive and seronegative groups of our study reported high DAS -28. Conclusion This study found that levels of serum calprotectin, IL-6 and TNF-α were significantly elevated in RA patients as compared to healthy controls and these high levels were associated with RA disease activity. These findings suggest their possible role in disease pathology and these parameters show notable association with disease severity. Moreover, the study concluded that, severity of disease is equally high in both seropositive and seronegative RA patients. Hence, seronegative RA patients cannot be ignored and should be treated promptly. Also, the study concluded that calprotectin has discriminatory capacity to predict disease activity in both groups equally. Assistant Professor Dr Humaira Kashif, Biochemistry BUCM

Mutational Analysis of Peroxisome Proliferator Activated Receptor Alpha (PPARα) Genes and Their Relationship with Lipid Profile in Diabetic Dyslipidemia Patient

Wed, 01 Jan 2025 00:00:00 GMT

Mutational Analysis of Peroxisome Proliferator Activated Receptor Alpha (PPARα) Genes and Their Relationship with Lipid Profile in Diabetic Dyslipidemia Patient Hajira Siddique, Aneela Shabbir; Maryam Wahid Objective: To explore the genetic variants of exon 5 of peroxisome proliferator activated receptors alpha (PPARα) genes in diabetic patients with and without dyslipidemia and healthy controls to define its genetic contribution to development of diabetic dyslipidemia and its relationship with serum lipid profile. Material and Methods: This was a cross-sectional study conducted in MDL of Army medical college from Jan 2021 to Jan 2022. A total of 90 participants were categorized into 3 groups having 30 members each. Group I, diabetic patients having dyslipidemia, group II. diabetic patients without dyslipidemia and group III of healthy controls. DNA template obtained from blood was amplified by PCR. After purification and sequencing PCR, sequencing was performed and analysis done by BIOEDIT software. Demographic along with clinical data was also collected and analyzed by SPSS version 22. Results: No significant mutation was found in the concerned exon of PPARα gene during the study in all three groups. Mean HDL-c (high density lipoprotein) was found to be significantly lower than that of controls. Mean total cholesterol, triglyceride (TG) and serum LDL-c values of group 1 & 2 were found significantly elevated than that of controls. Conclusion: Absence of any variant of this exon in our study suggests the involvement of other exons of PPARα gene to be the causative factors for the development of disorders in metabolic pathways. The levels of total cholesterol, TG, LDL-c and HDL-C are perturbed significantly among diabetic dyslipidemic patients as compared to diabetic non-dyslipidemic patients and normal healthy controls. Senior Professor Dr Maryam Wahid Biochemistry BUCM

Infectious Causes of Acute Meningoencephalitis Syndrome in Children: Insights from a Tertiary Care Hospital in Pakistan

Wed, 01 Jan 2025 00:00:00 GMT

Infectious Causes of Acute Meningoencephalitis Syndrome in Children: Insights from a Tertiary Care Hospital in Pakistan Shakeel Ahmad, Saddam Hussain, Sayed Ali, Waqar Ali Shah, Asad Riaz, Sherziyan Aftab Qazi, Khayyam Haider, Amna Hussain, Muhammad Ahmed, Muhammad Ali Hassan, Basharat Ullah, Avijeet Debnath, Furqan Ul Haq Background: Acute Meningoencephalitis Syndrome (AMES) remains a significant cause of morbidity and mortality in children worldwide, with diverse infectious etiologies varying by geography and resource availability. While vaccines have successfully reduced bacterial meningitis due to Streptococcus pneumoniae and Haemophilus influenzae type B (Hib) in developed regions, serotype replacement and antimicrobial resistance pose ongoing challenges. Objective: This study aimed to determine the frequency of infectious causes of AMES among children presenting to a tertiary care hospital in Khyber Pakhtunkhwa, Pakistan, providing essential epidemiological insights to guide diagnostic and preventive strategies. Methods: A cross-sectional study was conducted in the tertiary care hospital, Peshawar, from August 1, 2023, to January 31, 2024. 130 children aged 1–10 years with acute meningoencephalitis syndrome of ≤72 hours’ duration were enrolled. Lumbar puncture was performed for cerebrospinal fluid (CSF) analysis, and pathogens including Streptococcus pneumoniae, enterovirus, herpesvirus VI, Mycobacterium tuberculosis, Escherichia coli, and Group B Streptococcus were identified. Data were analyzed using Statistical Package for the Social Sciences version 23, with stratification by age, gender, and duration of symptoms. Results and conclusion: The most commonly identified pathogen was enterovirus (23.1%), followed by Group B Streptococcus (19.2%), Escherichia coli (17.7%), and Streptococcus pneumoniae (16.9%). Herpesvirus VI was detected in 12.3% of cases, while Mycobacterium tuberculosis was the least frequent (3.8%). Male patients accounted for 73.1% of cases. Age stratification indicated higher infection rates among younger children (1–5 years), although no statistically significant differences were observed across age groups, gender, or symptom duration. Viral etiologies, particularly enteroviruses, remain the predominant cause of pediatric AMES, aligning with global trends. However, the considerable burden of bacterial infections underscores the continued need for improved vaccination coverage and antimicrobial stewardship. The low detection rate of Mycobacterium tuberculosis likely reflects diagnostic limitations rather than its true prevalence. These findings highlight the importance of early diagnosis, targeted treatment strategies, and enhanced surveillance to improve outcomes in pediatric acute meningoencephalitis syndrome cases. Lecturer Dr Basharat Ullah, Biochemistry BUCM

A Narrative review of advancements in knee Arthroplasty: Analyzing diverse prosthetic materials and their implications

Wed, 01 Jan 2025 00:00:00 GMT

A Narrative review of advancements in knee Arthroplasty: Analyzing diverse prosthetic materials and their implications Shahzad Waqas Munazzam , Vikramaditya Rai , Shaista Nousheen , Basharat Ullah, Sajjal Sharif , Cara Mohammed Knee arthroplasty (KA) represents a transformative milestone in the management of degenerative knee conditions, significantly improving patient mobility and quality of life. Over the decades, material innovations have driven advancements in implant design, addressing challenges such as wear, biocompatibility, and longevity. This review provides a comprehensive evaluation of traditional and cutting-edge materials used in KA, analyzing their properties, clinical outcomes, and economic implications while identifying future research directions. Traditional materials, including cobalt-chromium and titanium alloys, ultra-high-molecular-weight polyethylene (UHMWPE), and ceramics, have been the cornerstone of knee implant technology. These materials offer durability, wear resistance, and compatibility with biological tissues, but long-term complications, such as polyethylene wear and aseptic loosening, have necessitated further advancements. Recent developments, such as highly cross-linked polyethylene (HXLPE) and vitamin E-infused polyethylene, have improved wear resistance and oxidative stability, thereby reducing revision rates. Similarly, ceramic materials, including zirconiatoughened alumina and silicon nitride, have emerged as promising alternatives due to their exceptional wear resistance and biocompatibility, although brittleness and higher manufacturing costs remain barriers to widespread use. Advancements in metallic alloys, such as oxidized zirconium and porous tantalum, have further refined KA implants. These materials exhibit superior osseointegration, reduced stress shielding, and improved implant fixation, enhancing patient outcomes. Additionally, the adoption of bioactive coatings like hydroxyapatite and the utilization of 3D-printed personalized implants have revolutionized the fabrication process, offering patientspecific solutions and improved bone integration. Innovations in smart technologies, including self-healing materials, antibacterial surfaces, and sensor-integrated implants, present exciting opportunities for real-time monitoring, infection prevention, and adaptive design. The biomechanical properties of these materials significantly influence joint kinematics, wear patterns, and implant survival rates. Materials with lower elastic moduli, mimicking the properties of natural bone, minimize stress shielding and improve load distribution. Advanced ceramics and polyethylene composites reduce debris generation and osteolysis, contributing to extended implant longevity. Biological responses, including reduced hypersensitivity and enhanced osteoblast differentiation, further underline the importance of material selection in KA. Clinical studies consistently demonstrate the efficacy of advanced materials in reducing revision rates and improving patient-reported outcomes. For instance, oxidized zirconium implants and ceramic-on-HXLPE bearings show superior long-term performance compared to traditional cobalt-chromium and metal-on-polyethylene counterparts. Furthermore, personalized implants have been associated with enhanced functional outcomes, natural joint feel, and improved quality of life. Despite higher upfront costs, advanced materials exhibit favorable cost-effectiveness due to reduced complications and extended implant lifespan. However, challenges persist, including the limited availability of long-term clinical data, manufacturing complexities, and accessibility disparities. Future research should focus on longitudinal studies evaluating the durability of novel materials, further development of bioactive and smart technologies, and the integration of computational modeling to optimize implant design. Additionally, addressing socioeconomic barriers is critical to ensuring equitable access to these innovations. Lecturer Dr Basharat Ullah, Biochemistry BUCM