ABSTRACT
Type-2 Diabetes Mellitus (T2DM) is presently the fastest growing disease and has been recognized to be caused by a collision between inherited parental genes and the environment. The current prevalence in Pakistan of type-2 diabetes mellitus is 26.3%. Out of them 19.2% had disease two to three decades back while 7.1% are recently diagnosed cases. Worldwide burden of disease was 415 million in 2015 and this number will increase to 642 million by 2040. Parental history of diabetes mellitus is a chief reason for the development of T2DM in children, but whether this association derives from shared genetic or environmental factors is unclear. Persistent high blood glucose levels can result in drastic outcomes like Diabetic Ketoacidosis and Hyperosmolar non ketotic syndrome. Genome-wide association analyses have uncovered multiple genomic regions associated with T2DM, but identification of the causal variants remains a challenge. This review will discuss the approach of diagnosing T2DM by analyzing the association of gene variants and family history.
ABSTRACT
Background:Telomere, the biological chronometer, has been found to be influenced by different parameters which are reprogrammed during fetal life.This study was designed to find out influence of education on relative telomere length (RTL) of the maternal and new born and to detect improvement in the genetic remodeling during the fetal life between low and high educational levels of mother.Methods:Pregnant females(18-37 years) and their newborns (n=250) were recruited from Karachi hospitals. In this cross-sectional study RTL (maternal and cord) was calculated by Quantitative real-time PCR. Statistical analysis used were chi square tests and Mann Whitney U test for variables with two categories and then Kruskal Wallis for variables with more than two categories to examine mean difference between relative telomere length(RTL) and maternal education. The relationship between predictor variable(education) and RTL was done by linearregression.Results: A significant association of education and RTL revealed shorter mean maternal RTL(base pair(bp)) 6380±1128 among females with low education and longer 6553±945 in high education females respectively (p=0.071) (B= 0.009 p= >0.05). Similarly, cord RTL were shorter 6600±1218 in low and longer 7154±1585 in high educationgroup(p=0.007)(B= 0.184 p = <0.05) at 95% confidence level.It was also found that newborn among high education with upper middle Socioeconomic status (SES) have significantly longest RTL 7262±1804(p=<0.05).Conclusion: Overall longer newborn RTL than mothers were observed among different levels of education in targeted population of Karachi where higher education have a shielding effect on telomere remodeling during the fetal development
ABSTRACT
HPV warts, non-cancerous, epidermal growths, are caused by the virus by generally entering the skin through areas where the skin is broken, fragile or extremely moist making the top layer of skin to grow rapidly, forming a wart. There are more than 200 genotypes of HPV and about 100 genotypes have been identified in different types of warts. Generally, HPV infection, in most people resolves itself within two years without causing any serious health issue but when HPV becomes active it may invade mucous membrane leading to warts or other serious consequences. Since prevalence of HPV varies significantly and exact genotype distribution of HPV in different warts is still not clearly defined, this review aims to assess the distribution of HPV genotypes in different warts, their clinical presentation, diagnosis and treatment.
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Background: Salivary flow rate and pH may be altered by chewable tobacco, the habit which is becoming a threat for oral cancer epidemic. The objective of the study was to find out the relationship between alterations in resting salivary flow rate (RSFR) and pH, which are early signs of oral health deterioration, with different forms of chewing tobacco products. Methods: A total of 354 healthy male subjects, consuming any form of chewable tobacco, belonging to low socioeconomic areas of Karachi were selected for this cross sectional study. A questionnaire was used to collect demographic data and details of chewing habits (using since, pack/day, duration of exposure etc.). Resting saliva of every subject was collected for 5min and RSFR was expressed in ml/min. Salivary pH was determined by using pH strips (pH 0-14). Data was analyzed on SPSS version 20. Results: Of 354 subjects, 27.4% were gutka, 24.3% niswar, 24.3% paan and 24% multiple users with mean RSFR as 0.40±0.30, 0.65±0.32, 0.64±0.39 and 0.41±0.25 respectively. Mean resting salivary pH was 6.58±0.78 with the lowest pH; 6.16±0.65 in multiple users. RSFR and pH significantly decreased with increase in packs consumed/day, duration of exposure and duration of usage. Conclusion: A significant negative correlation was found between RSFR and pH with tobacco chewing.
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Aims: To find out an association between Human Papilloma Virus and IL 6 gene polymorphism in Oral Squamous Cell Carcinoma patients. Study Design: Cross-sectional study. Place and Duration of Study: Ziauddin Hospital (Dental OPD), Karachi, Pakistan. In between the period of January 2014 to May 2015. Methodology: This cross-sectional study consisted of a total of 140 oral squamous cell carcinoma patients of 18 years and above (104 males and 36 females). Detailed questionnaire followed by sample collection from each patient was done. These samples were analyzed by polymerase chain reaction for human papilloma virus and IL 6 gene polymorphism was analyzed through restriction fragment length polymorphism. Results: Mean age of the patients was 43.5±11.84 years (range 31-40 years). Most of the patients (45; 32.1%) belonged to the Urdu speaking ethnic group. Pan (87; 62.1%) and Gutka (82; 58.6%) were used by most of the patients. (17;12.1%) patients had history of systemic disease (e.g hypertension, diabetes). And (3021.4%) patients had a positive family history of OSCC. The most common site of OSCC was buccal mucosa (86; 61.4%) in these patients. Majority of the patients (77; 55%) had histologically moderately differentiated OSCC, and more than half of these patients (78; 55.7%) had Group B (stage III & IV) of OSCC. (12;8.6%) out of 140 samples tested positive for human papilloma virus gene and the following pattern was observed for IL 6 gene polymorphism, GG: (46.4%), GC (39.3%), CC (14.3%). A positive association was observed for Group B (stages III & IV) of oral squamous cell carcinoma with IL 6 genotypes: GC heterozygote (OR=3.819, 95% CI=1.782-8.183, P=0.001) and CC homozygote (OR=6.833, 95% CI=2.046-22.822, P=0.002), and also a strong positive association was found between human papilloma virus and CC homozygote genotype (OR=21.333, 95% CI=2.318-196.311, P=0.007). Conclusion: Human papilloma virus association with IL 6 gene polymorphism in oral squamous cell carcinoma patients suggests rapid and aggressive progress of oral carcinogenesis.
ABSTRACT
Background: The Human Papilloma Virus (HPV) has evolved as a new culprit of malignant and pre malignant oral lesions. The objective of this study was to find out the frequency of HPV and its high risk genotypes in different lesions of oral cavity of tobacco chewers. Methods: From 492 subjects (421 males and 71 females), 20 ml of oral rinse sample was collected after obtaining an informed consent. Normal subjects with no chewing habits (250) including 135 males and 115 females were also taken from same setting. Gentle brushings over the lesions with the help of dental floss brush was done which was left in the oral rinse and stored at 4°C until DNA extraction. DNA was extracted and PCR was performed using HPV consensus primers Gp5+/Gp6+ and HPV 16, 18 specific primers for genotyping. Categorical data was calculated as frequencies and percentages. Results: Oral pre-malignant lesions were present in 421 (86%) males and 71(14%) females having leukoplakia (173, 35%), erythroplakia (60, 12%), submucous fibrosis (192, 39%) and L/E (67, 14%). Total number of HPV positives were 128 (26%), having HPV 16 (13%) and HPV 18 (11%) whereas, 76% had other genotypes. Among Submucous fibrosis 82(46%) were HPV positive. Out of total 128 HPV patients 92% were males and 8% were females. All controls were found to be HPV negative. Conclusion: Frequency of HPV was found high (26%) in oral lesions with HPV16/18 as 13% and 11% respectively. The patients with submucous fibrosis are at greater risk of having HPV. Other HPV genotypes causing premalignant lesions require further investigation.