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Medical Break-
through: Pakistani Youth Comes of Age

For the record
Science &
Medical breakthrough
Internet 2000
Hanif S. Kalia
Hamdard University

From Diana J. Choyce
Jan 17 - 23, 2000

Pakistan has produced a shining example of persistence and tenacity in Dilnaz Panjwani. The talented 18 year old college student, has discovered a possible diagnostic blood test for several related illnesses that is considered a major medical breakthrough. And given that millions of people are stricken with these illnesses, she has also brought hope to many. Pakistan should be very proud.

Dilnaz is a student at Branksome Hall in Toronto Ontario, Canada. It is said the enterprising youth gets at 4 a.m. on school days to go rowing in Lake Ontario and often works past midnight. In addition, she plays the clarinet, is on the school swim team, is a passionate debater and is involved in, among other things a project to help an all-girls school in Pakistan with class supplies. She is a previous winner of the Metro Toronto Regional Science Fair with her 15-year-old sister Dilnoor and the recipient of a special international team award from the American Psychological Association for a study on professional burn-out. In 1998 she won a top prize at the Canada-Wide Science Fair in Timmins. This win gave her the chance to compete in Intel's Annual International Science and Engineering Fair (ISEF) in May of 1999. This fair is the Olympics and the World Series of science competition held in Philadelphia, Pennsylvania. Among more than 1,200 students from 48 states and 47 nations competing, Dilnaz won the Second Place Grand Award, for Medicine and Health.

Her research is centered on three related illnesses which until now do not have a specific diagnostic test. Normally they are diagnosed by "excluding" other causes and by a specific list of present symptoms. As a result it can take many months or years for a final diagnosis, causing the conditions to become chronic. The illnesses are known as Fibromyalgia (FM), Chronic Fatigue Syndrome (CFS), and Multiple Chemical Sensitivity (MCS). They affect millions of adults and children around the world and affect the brain, muscles and the immune system, causing a wide range of disabilities. The study, which was supervised by her father, Dr. Dilkhush Panjwani, identified the red blood cell metabolite 2,3-diphosphoglycerate (2,3-DPG) as a promising diagnostic biological marker. The people suffering from these illnesses had abnormal concentrations of the red blood cell metobolite 2,3-DPG. This could explain the pathophysiological basis and the body's adaptive process to compensate for the tissue hypoxia (lack of oxygen available to the tissues). Ms Panjwani also confirmed that there is a considerable overlap of clinical features among the three illnesses.

Judith Spence, The Environmental Illness Society of Canada spokesperson has said that "Dilnaz has proven what patients have known all along , they are sick and they need treatment, research, dignity and most importantly they need hope". To date, researchers have not found a specific cellular marker or a cure. In discovering a physiological basis Dilnaz has torn research opportunities wide open. Panjwani said her inspiration came from a 1971 report by a U.S. researcher named William Oski, who speculated that low levels of the 2,3-DPG enzyme in one of his patients might be linked to chronic fatigue. Using his hypothesis she started with a group of 13 patients and followed up with another group of 18 to replicate her results. The study was guided by physicians from the Homewood Health Centre in Guelph and her father, a well known psychiatrist in Canada.

Dilnaz recalled the growing excitement she felt late one night as she began to compute results of a blood test conducted by MedCam, a Toronto laboratory which used special kits from California as no Canadian lab had previously been equipped to test the blood enzyme. "I just kind of looked at (the statistical printout) and I looked more carefully at it, showed my father and my sister and I got more excited when I realized what had happened," Panjwani said. "I was really excited and happy that all my hard work paid off," she said. "Being an athlete, I have friends who suffer from chronic fatigue syndrome and everything they've worked towards goes to waste with it," Panjwani said, explaining why she chose to focus on the study, which took more than 100 hours to complete. Dilnaz hasn't decided whether to pursue medicine and research or law and politics, but hopes that other researchers may take her work further and quicker. But she says she's "glad this was originally my idea and I came out with the enzyme first." There are plans to replicate Ms Panjwani's research by a prominent Toronto Hospital with research funds hopefully coming from a number of Canadian and American sources.

As the beginning of this new millennium unfolds, Dilnaz gives us all hope of the many wonderful discoveries to come. And to have a teen go where no adult has managed to go is especially sweet. For it is in our youth that our most fruitful hopes and dreams will come to be realized. And this should give us cause to strengthen our resolve to train and educate our youth so that they may carry on where we leave off. Our future may indeed lie in the hands of our youth, but it is only through us that they will be able to achieve the greatness we can only dream off. Yes, Pakistan should be very very proud!