Serum B[12] and folate levels in patients with megaloblastic change in the bone marrow

Vitamin B12 and folic acid are essential components of DNA synthesis in red cell precursors. Folic acid is directly involved and Vitamin B12 [methyl cobalamine] participates as a cofactor. A deficiency of Vitamin B12 causes the same symptoms as folic acid deficiency. The study was carried out to find the cause of megaloblastic anemia. In this descriptive study, we evaluated clinical and morphological features of 80 consecutive patients with a megaloblastic change in bone marrow from 2008-2010. The study was carried out in the Hematology Laboratory, Services Institute of Medical Sciences, Lahore. Eighty patients with a megaloblastic change in bone marrow were studied. There were 32 males [40%] and 48 females [60%]. The most common clinical presentation was pallor and fatigue [67 patients, 84%]. Out of the 80 patients, 50 [62.5%] were deficient in folic acid and 24 patients [30%] were Vitamin B12 deficient. 6 patients [7.5%] were Coomb's positive, indicating Immunemediated Hemolytic Anemia as the cause of megaloblastic anemia. Folic acid deficiency was the most common cause of megaloblastic anemia [62.5%] in the given population. Vitamin B12 deficiency was the next most common cause [30%]. 6 patients [7.5%] had normal levels of Vitamin B12 and Folic acid and were Coomb's positive showing that Immune - mediated hemolytic anemia can also be a cause of megaloblastic change in the bone marrow

Association of blood group types to Hepatitis B and Hepatitis C virus infection

Frequency of Hepatitis B Surface Antigen [HBsAg] and Hepatitis C Virus Antibodies [Anti-HCV] among blood donors of Lahore and their association with blood group types. To study the frequency of Hepatitis B Surface Antigen [HBsAg] and Hepatitis C Virus Antibodies [Anti-HCV] in blood donors of Lahore and to assess the association with blood group types. The design of study will be cross sectional descriptive study. It was held in the Pathology Department, Nawaz Sharif Social Security Hospital, Lahore, during the period January, 2006 to December, 2008. A total of 16695 blood donors were screened for HBsAg and Anti-HCV by rapid test devices based on immuno-chromatographic technique following the instruction given by the manufacturer. In the present study, devices manufactured by Acon, USA were used. The specimens reactive on screening by devices were confirmed on ELISA. The results were subjected to chi-square analysis for determination of statistical difference between the values among different categories. Among 16695 blood donors, 467 [2.79%] were positive for HBsAg and 1326 [7.94%] were positive for Anti-HCV. The frequency of HBsAg was seen to decrease significantly [p < 0.01] from 2006 to 2008 [4.23% to 2.31%]. However, frequency of anti-HCV was seen to rise significantly [< 0.01] from 2006 [6.69%] to 2008 [7.82%]. Comparison of HBsAg and anti-HCV positivity among RhD positive and RhD negative donors showed that there was no significant difference for HBsAg positivity [2.79% vs 2.85%]. However, significantly higher number of RhD positive donors had HCV infection as compared to RhD negative donors [8.25% vs 3.66%]. High frequency of HCV infection in blood donors need implementation of strict screening policy for donors and public awareness campaigns about preventive measure to reduce the spread of this infection as well as other transfusion transmissible infections. Association of HCV infection with blood group types needs more studies to get more knowledge about this aspect

Quantitative Analysis of circulating tumour markers in epithelial malignancies

The present study evaluates the efficacy of combined estimation of two important markers of epithelial malignancies I.e. Carcinoembryonic Antigen [C.E.A] and Tissue Polypeptide Antigen [T.P.A.] with regard to their relation with clinical stage of the patients and effect various treatment modalities. Serial marker levels were estimated in 65 patients suffering from epithelial malignancies in different locations including carcinoma of cervix [n =14] breast [n=20],Colorectal region [n=15] and urinary bladder [n=16]. Raised C.E.A. and T.P.A levels were seen in 76%, 65%, 73% and 75% cases of carcinoma of cervix, breast, colorectal and urinary bladder respectively. During follow up serial tumour marker estimations showed that effective therapy resulted in raised marker levels returning to normal while subsequent elevation developed with tumour recurrence or spread. Combination of C.E.A. and T.P.A. is complimentary as they reflect two different aspects of tumour growth and their combined use improves the diagnostic value in the management of cancer patients