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Objective: The aim of this study was to determine frequency of secondary modifiers in non-transfusion dependent thalassemia. Methods: This descriptive cross sectional study was done at Fauji Foundation Hospital Islamabad. Seventy diagnosed patients of thalassemia intermedia were included. Deoxyribonucleic acid (DNA) was extracted using Chelex method. The Xmn-1 and BCL11A polymorphisms were analyzed by Amplification Refractory Mutation System (ARMS) and Restriction Fragment Length Polymorphism (RFLP) PCR. The PCR amplified products were run on Polyacrylamide Gel Electrophoresis (PAGE). Results: The Xmn-l polymorphism was seen in 26/70 (37.1%) and BCL11A polymorphism was seem in 50/70 (71.4%) of the patients. Conclusion: BCL11A and Xmn-l polymorphisms are important secondary modifiers in patients with thalassaemia intermedia in Northern Punjab.
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Background: The reference interval (RI) is an interval between two limits derived from distribution of the results obtained from a sample of the reference population. These population based RIs are of paramount significance for the accurate clinical understanding of the patient's health status. Haematological RIs are heavily influenced by a variety of geographical and environmental factors. Therefore, accrediting bodies also mandate that each laboratory should establish its own RIs in its own population. Methods: This cross-sectional study was conducted at the Department of Pathology and Laboratory Medicine, the Aga Khan University Hospital, Pakistan.Twenty-one routine and special quantitative analytes were measured in adults aged 18-60 years who passed the initial health screening questionnaire. All samples were handled strictly following standard operating procedures. Microsoft Excel and EP Evaluator software were used for statistical analysis. Nonparametric CLSI EP28-A3C method was used to establish upper and lower confidence limits at 90% significance. Results: A total of 323 participants passed the questionnaire and were short-listed for blood collection. There were 147 males and 176 females. Reference intervals were established in 297 participants after exclusion of 26 outliers with grossly abnormal test results. Analytes included: 8 red, and 12 white blood cell parameters, platelet count, immature platelet fraction, erythrocyte sedimentation levels, haemoglobin A and A2 levels and glucose-6-phosphatase dehydrogenase levels. Conclusion: Routine and special haematology RIs established in this study reflect significant differences from RIs in Caucasian population. For meaningful interpretation of test results, each haematology laboratory should establish or verify RIs in the population it serves.
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Background & Objective: Undiagnosed malarial infectionis associated with significant mortality and morbidity. Laboratory investigations leading to rapid, accurate and timely diagnosis of malaria is still a challenge. This study was done to assess the utility of abnormal White blood cell differential fluorescence (WDF) scattergram for diagnosis of malaria. Our aim was to study the utility of WDF scattergram for early detection of malarial parasite. Methods: All EDTA anti-coagulated blood samples received in laboratory during a period from Dec 2019 to May 2020 were analyzed on anautomated hematology analyzer, Sysmex XN 1000. All abnormal WDF scattergrams pertaining to plasmodium specie were critically evaluated and recorded. Review of Leishman-stained peripheral smears as well as immune-chromatographic assay by rapid test devices (RTD) was done. Accordingly, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detection of malaria by abnormal scattergram were calculated. Results: Out of total 1, 26,000of samples analyzed, abnormal WDF scattergrams were detected in 96 cases. Amongst these, 95.8% (92) were positive for MP on Leishman-stained peripheral smear as well as on ICT with a p-value of 0.05. WDF scattergram abnormalities typical of malaria showed a sensitivity of 80% and specificity of 93.26%. Positive predictive value of 95.8% whereas negative predictive value of 99.9% was detected. Significant findings of hemolysis, platelet clumps, nucleated RBCS (NRBCs) and RBC agglutination were noted in cases (n=4) with abnormal WDF scattergram negative for malaria on peripheral smear. Conclusion: Interpretation of abnormal WDF scattergram not only increases the early detection rate for malarial parasite but isa strong indicator for presence of hemolysis, RBC agglutination, platelet clumps and leucoerythroblastic blood picture as well.
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Background Blood donated by healthy people is extremely important as it is integral in emergent situations. The authors aimed to address and highlight the main causes of the wastage of donated blood and its components. Methodology A cross-sectional study was conducted at a blood bank of a tertiary care center between January 2019 and March 2020. All the information regarding blood donated and blood components during the study period was documented on a predefined proforma. The blood bags which were seropositive, reached their shelf-life expiry, expired due to non-utilization, or quantity was non-sufficient were discarded. Blood showing any changes of either hemolysis or turbidity was also discarded. Other reasons for discarding blood units included leakage (damage to or fault in the blood bag), hemolytic reasons, or miscellaneous reasons. Results A total of 9308 blood donations were received as donations during the study period. Out of the total donations, 7,988 (85.8%) were subjected for component formation including red cell component (RCC), fresh frozen plasma (FFP), and platelets. A total of 23,964 components were prepared using the donated blood. Out of these 2128 (8.87%) units were discarded. Upon stratifying the discarded blood according to the type of component, it was found that platelets made up 1148 (53.9%) units, red cell component composed 324 (15.2%) units, and fresh frozen plasma composed 313 (14.7%) units of discarded blood. Seropositive was reported to be 32.3%. Of this, the red cell component made up 276 (85.2%) units. Conclusion The present study reported a discard rate of 8.87%. Of these, the majority was composed of platelets due to the shortest shelf life. Leakage of blood bags remained a predominant cause for the discard of blood components. Seropositivity for hepatitis B, C, and human immunodeficiency virus (HIV) was reported in almost 30% units of donated blood. Further large-scale studies should be conducted to reassess how wastage of donated blood can be minimized.
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BACKGROUND: Non-Hodgkin lymphoma (NHLs) are a heterogeneous group of lymphoid neoplasms, characterized by an irregular pattern of spread and may present with extranodal involvement This study was conducted to determine the frequency and pattern of Bone marrow involvement on trephine biopsy in cases of Non-Hodgkin lymphoma (NHL). METHODS: This cross sectional study was conducted in Pathology department of Fauji Foundation Hospital (FFH)/Foundation University medical college (FUMC) Rawalpindi, from14th December 2010 to 14th December 2011. One hundred and six patients with histopathologically confirmed Non-Hodgkin lymphoma on lymph node (LN) biopsy, who had not received any chemotherapy were selected and Bone Marrow (BM) trephine biopsies for staging were performed on them. RESULTS: Out of one hundred and six patients, forty five (42.5%) were diagnosed to have Bone Marrow involvement on staging. The most common pattern was diffuse, i.e., 44.44%, followed by the interstitial infiltrate in 28.89%, focal and mixed constituted 11.11% each, and paratrabecular pattern was found in 4.44%. CONCLUSIONS: This study highlights the high incidence of involvement and diffuse pattern in the Bone marrow biopsies of newly diagnosed Non-Hodgkin lymphoma, both of which indicate poor prognosis..
