Cytogenetic abnormalities in patients with hematological malignancies in Lahore city, Pakistan / Anormalidades citogenéticas em pacientes com neoplasias hematológicas na cidade de Lahore, Paquistão

Abstract Hematological and hematopoietic cells malignancies of the genes and hematopoietic cells are associated with the genetic mutation, often at the chromosomal level. The standard cytogenetic study is widely accepted as one of the main diagnostics and prognostic determinants in patients. Therefore, the current descriptive and cross-sectional study sought to determine the cytogenetic analysis of frequent hematological malignancies in Pakistan. A total of 202 peripheral bone marrow or blood samples from patients with benign and malignant hematological malignancy were taken using a conventional G-banding technique. Among enrolled patients, the mean age was 21.5 years ± 23.4, and gender-wise distribution showed a marked predominance of the male 147 (73%) population compared to the female 55 (27%). Patients in the age group (2-10 years) had the highest frequency, 48 (24%), of hematological neoplasms, followed by age (11-20 years) with 40 (20%). Normal karyotypes (46, XX/46, XY) was found in 51% (n=103) patients. Furthermore, the frequency of complex karyotype was 30 (15%), while normal was seen in 171 (85%) patients. Pre-B Acute Lymphoblastic Leukemia (Pre-B ALL) was the most prevalent malignancy of 66 (33%), followed by Chronic Myelogenous Leukemia (CML) of 41 (20%) and Acute Lymphocytic Leukemia of 29 (14%). Translocation was the most prevalent 50 (25%), followed by hypotriploidy 14 (7%) and monosomy 8 (4%) on chromosome aberration analysis. In addition, t(9:22) translocation was found to be 20 (10%) in CML, with the majority in the age group (31-40 years). This study recommends that karyotyping should be tested frequently in hematological conditions because it may provide insight into the relative chromosomal changes associated with particular malignancies.

Resumo As neoplasias hematológicas e de células hematopoiéticas dos genes e as células hematopoiéticas estão associadas à mutação genética, geralmente em nível cromossômico. O estudo citogenético padrão é amplamente aceito como um dos principais determinantes diagnósticos e prognósticos em pacientes. Portanto, o presente estudo descritivo e transversal buscou determinar a análise citogenética de neoplasias hematológicas frequentes no Paquistão. Um total de 202 amostras de medula óssea periférica ou sangue de pacientes com malignidade hematológica benigna e maligna foi coletado usando uma técnica convencional de banda G. Entre os pacientes inscritos, a média de idade foi de 21,5 anos ± 23,4, e a distribuição por gênero mostrou uma marcada predominância da população masculina de 147 (73%) em comparação com a feminina de 55 (27%). Pacientes na faixa etária (2-10 anos) tiveram a maior frequência, 48 (24%), de neoplasias hematológicas, seguida da idade (11-20 anos) com 40 (20%). Cariótipos normais (46, XX / 46, XY) foram encontrados em 51% (n = 103) dos pacientes. Além disso, a frequência de cariótipo complexo foi de 30 (15%), enquanto normal foi observada em 171 (85%) pacientes. Leucemia linfoblástica aguda pré-B (LLA Pré-B) foi a doença maligna mais prevalente de 66 (33%), seguida por leucemia mieloide crônica (LMC) de 41 (20%) e leucemia linfocítica aguda de 29 (14%). A translocação foi o 50 mais prevalente (25%), seguido por hipotriploidia 14 (7%) e monossomia 8 (4%) na análise de aberração cromossômica. Além disso, a translocação t (9:22) encontrada foi de 20 (10%) na LMC, com a maioria na faixa etária (31-40 anos). Este estudo recomenda que o cariótipo deve ser testado com frequência em condições hematológicas porque pode fornecer informações sobre as alterações cromossômicas relativas associadas a doenças malignas específicas.

Episode of Hepatitis C viral infection in the people of Swat, Pakistan / Episódio de infecção viral por Hepatite C no povo de Swat, Paquistão

Infectious agents cause serious diseases in humans worldwide and are responsible for the high rate of morbidity and mortality. The prevalence and epidemiology of infectious disease (HCV) in the hospital visited patients referred by the physicians through the initial findings and their associated risk factors were studied in Swat. The data of 174 infected patients were collected during the period of 2015 to 2017 from two clinical laboratories of Tehsil Matta Swat. Inform consent form was taken before blood collection. After taking informed consent blood samples were collected and ICT test was performed and then ICT positive cases were conform through PCR. A total of 174 ICT positive samples [106 male and 68 females] were included in this study. Age was considered from 10 to 72 years. Of the 174 ICT strip positive, 99 [63 males, 36 females] were confirmed through PCR. The prevalence rate was recorded 56.89%. I.V/I.M injection was recorded in 100% of the individuals. Visits to the barber shop was reported in (58%) of the individuals, married individuals were (81.0), surgical operation was reported in (44.8%), sharing toothbrush was observed in (29.9%), piercing was reported in (39.7%), family history was reported in (26.4%), dental treatment was observed in (21.8%), jaundice were (13.2%) and tattooing was (1.7%). Blood transfusion, surgical operations, Jaundice, family history and dental treatment were found significant risk factors for acquiring HCV infection. It was concluded that proper implementation of precautionary measures should be needed to control the spread of HCV in far near future.

Agentes infecciosos causam doenças graves em humanos em todo o mundo, e são responsáveis pelo alto índice de morbimortalidade. A prevalência e a epidemiologia das doenças infecciosas no hospital que atendeu pacientes encaminhados pelos médicos por meio dos achados iniciais e seus fatores de risco associados foram estudadas em Peshawar. Os dados de 174 pacientes infectados foram coletados durante o período de 2015 a 2017 oriundos de dois laboratórios clínicos de Tehsil Matta Swat. O formulário de consentimento informado foi obtido antes da coleta de sangue. Após a obtenção do consentimento informado, foram coletadas amostras de sangue e foi realizado o teste ICT e, em seguida, os casos ICT positivos foram confirmados por PCR. Um total de 174 amostras ICT positivas [106 homens e 68 mulheres] foi incluído neste estudo. A idade considerada foi de 10 a 72 anos. Das 174 tiras de ICT positivas, 99 casos [63 homens, 36 mulheres] foram confirmados por PCR. A taxa de prevalência foi de 56,89%. A injeção IV / IM foi registrada em 100% dos indivíduos. A visita à barbearia foi relatada em (58%) dos indivíduos, os números de casados foram (81,0%), e a operação cirúrgica foi relatada em (44,8%), o compartilhamento de escova de dente foi observado em (29,9%), o piercing foi relatado em (39,7%), antecedentes familiares foram relatados em (26,4%), tratamento odontológico em (21,8%), icterícia (13,2%) e tatuagem em (1,7%). Transfusão de sangue, operações cirúrgicas, icterícia, histórico familiar e tratamento odontológico foram fatores de risco significativos para adquirir infecção por Vírus da Hepatite C (VHC). Concluiu-se que a implementação adequada de medidas de precaução deve ser necessária para controlar a propagação do VHC em um futuro próximo.

Um levantamento transversal sobre a soroprevalência da hepatite B e hepatite C entre a população geral dos distritos rurais de Sindh, Paquistão / A cross-sectional screening survey on the seroprevalence of hepatitis b and hepatitis c amongst the general population of rural districts of sindh, pakistan

ABSTRACT BACKGROUND: Viral hepatitis is a global phenomenon, with the disease burden varying on a daily basis. Amongst chronic infections, hepatitis B virus and hepatitis C virus (HCV) are egregiously linked to severe health-related complications, with a worldwide prevalence of 248 million and 71 million respectively. Amongst the developing world, a hand full of countries are exhibiting a gross decline in chronic viral infection prevalence, like Bangladesh. While countries such as India have a consistent prevalence, Pakistan bears one of the largest proportions of chronic viral hepatitis globally with increasing trends shown year-by-year. Various old literature texts have stated an approximate national prevalence rate around 2.6% and 5.3% of hepatitis B and C respectively. OBJECTIVE: The objective of this study was to determine the current seroprevalence rates of chronic viral hepatitis amongst the general population of rural Sindh using a screening program to determine the current disease burden. METHODS: An observational, cross-sectional survey based on a screening program was conducted in 5 districts with a combined population of over 6.5 million. The screening was carried out via the administration of various camps with the assistance of local social workers and welfare organizations. A total of 24,322 individuals met the inclusion criteria and were screened through (HBsAg/HCV) rapid test cassette (WC) Imu-Med one-step diagnostic test. RESULTS: Hepatitis B was found positive in 964 (3.96%) individuals including 421 (43.67%) males and 543 (56.32%) females, while hepatitis C was positive in 2872 (11.80%) individuals including 1474 (51.32%) males and 1398 (48.67%) females. The prevalence amongst the districts varied between 0.97% and 9.06% for hepatitis B, and 1.61% and 29.50% for hepatitis C, respectively. Umerkot was found to be the most prevalent district amongst rural Sindh, while Badin had the least number of seropositive people. The second most prevalent district of the study population was found to be Tando Allahyar followed by Mirpur Khas. The combined seroprevalence of 15.76% was calculated for hepatitis B and C together amongst the five studied districts of rural and peri-urban Sindh. CONCLUSION: The alarmingly high prevalence rates revealed in our study warrant the urgent need to generate multiple effective strategies in the region to enhance awareness amongst the general population regarding screening, prevention, and prompt treatment of the disease.

RESUMO CONTEXTO: A hepatite viral é um fenômeno global, com a intensidade da doença variando diariamente. Entre as infecções crônicas, o vírus da hepatite B e o vírus da hepatite C (VHC) estão fortemente ligados a complicações graves relacionadas à saúde, com prevalência mundial de 248 milhões e 71 milhões, respectivamente. Entre o mundo em desenvolvimento, uma quantidade de países está exibindo um declínio bruto na prevalência de infecção viral crônica, tal como Bangladesh. Embora países como a Índia tenham uma prevalência consistente, o Paquistão tem uma das maiores proporções globais de hepatite viral crônica, com tendências crescentes mostradas ano a ano. Vários textos da menos recentes têm declarado uma taxa de prevalência nacional aproximada em torno de 2,6% e 5,3% da hepatite B e C, respectivamente. OBJETIVO: O objetivo deste estudo foi determinar as atuais taxas de soroprevalência da hepatite viral crônica entre a população geral do Sindh rural utilizando um programa de triagem para determinar a carga atual da doença. MÉTODOS: Foi realizada uma pesquisa observacional e transversal baseada em um programa de triagem combinada em cinco distritos com população de mais de 6,5 milhões. A triagem foi realizada por meio da administração de diversos acampamentos com o auxílio de assistentes sociais locais e organizações de assistência social. Um total de 24.322 indivíduos atenderam aos critérios de inclusão e foram examinados através do teste rápido (HBsAg/VHC) Imu-Med em uma etapa. RESULTADOS: Hepatite B positiva foi encontrada em 964 (3,96%) indivíduos incluindo 421 (43,67%) homens e 543 (56,32%) mulheres, enquanto hepatite C foi positiva em 2.872 (11,80%) indivíduos incluindo 1.474 (51,32%) homens e 1.398 (48,67%) mulheres. A prevalência entre os distritos variou entre 0,97% e 9,06% para hepatite B, e 1,61% e 29,50% para hepatite C, respectivamente. Umerkot foi encontrado como o distrito mais prevalente entre Sindh rural, enquanto Badin tinha o menor número de pessoas soropositivas. O segundo distrito mais prevalente da população de estudos foi encontrado como Tando Allahyar, seguido por Mirpur Khas. A soroprevalência combinada de 15,76% foi calculada para hepatite B e C em conjunto entre os cinco distritos estudados do Sindh rural e periurbano. CONCLUSÃO: As taxas de prevalência alarmantemente reveladas em nosso estudo justificam a necessidade urgente de gerar múltiplas estratégias efetivas na região para aumentar a conscientização da população em geral sobre rastreamento, prevenção e tratamento rápido da doença.

Epidemiological study of dengue fever in District Swabi, Khyber Pakhtunkhwa, Pakistan / Estudo epidemiológico da dengue no distrito Swabi, Khyber Pakhtunkhwa, Paquistão

Dengue is a viral disease which is serious health concern from last few decades and the infection transmitted through mosquito bite into human. This study was conducted to carry out prevalence of dengue fever in District Swabi. A total of 196 blood sample were collected from patients with age ranges (0-80 years) having dengue fever on the basis of physical symptoms from Bacha Khan Medical Complex Swabi during August to October 2017. Serological test were performed for detection of IgM, IgG and NS1 (Non structural protein antigen of virus) against dengue. Out of total 196 confirmed dengue cases the most prone gender was male 123(62%) while 73(38%) were female. Among the age groups; 21-30 years group 62 (31.6%) was found the most predominated age group. The higly affected areas in district Swabi were Topi (40.8%) followed by Main Swabi (27%), Maneri (8.2%), Marghuz (6%), Shawa Ada (5.1%), Shah Mansoor (5.1%), Gohati (4.1%), and Chota Lahore (3.6%). Therefore, the health department should take actions by educating the public about basic cleanliness of the environment. The community should be encouraged to participate in the control of such vector based diseases/infections.

A dengue é uma doença viral que é um sério problema de saúde das últimas décadas e a infecção transmitida através da picada de mosquito em humanos. Este estudo foi realizado para realizar a prevalência da dengue no distrito de Swabi. Foram coletadas 196 amostras de sangue de pacientes com faixa etária (0 a 80 anos) com dengue com base nos sintomas físicos do Complexo Médico Bacha Khan de Swabi, no período de agosto a outubro de 2017. Foram realizados testes sorológicos para detecção de IgM, IgG e NS1 (antígeno proteico não estrutural do vírus) contra a dengue. Do total de 196 casos confirmados de dengue, o sexo mais propenso foi o masculino 123 (62%), enquanto 73 (38%) eram do sexo feminino. Entre as faixas etárias; A faixa etária de 21 a 30 anos 62 (31,6%) foi a faixa etária mais predominante. As áreas altamente afetadas no distrito de Swabi foram Topi (40,8%), seguidas por Main Swabi (27%), Maneri (8,2%), Marghuz (6%), Shawa Ada (5,1%), Shah Mansoor (5,1%), Gohati (4,1%) e Chota Lahore (3,6%). Portanto, o departamento de saúde deve tomar ações educando o público sobre a limpeza básica do meio ambiente. A comunidade deve ser incentivada a participar do controle de tais doenças / infecções baseadas em vetores.

Cross-sectional epidemiological investigations of Giardia lamblia in children in Pakistan

ABSTRACT BACKGROUND: The prevalence of Giardia lamblia in Pakistani children is currently unknown. The aim here was to evaluate the prevalence and risk factors of Giardia lamblia in children exhibiting diarrhea. DESIGN AND SETTING: Cross-sectional study at different district healthcare hospitals in Pakistan. METHODS: A total of 800 samples were collected from children aged 0-10 years. Information regarding personal data, demographic data and supposed risk factors was collected through a structured questionnaire. Giardia lamblia was detected through direct microscopy and antigens through the enzyme-linked immunosorbent assay (ELISA). RESULTS: The prevalence of Giardia lamblia was 2.75% through direct microscopy and inflated to 9.5% through ELISA. The demographic factors positively associated with occurrences of giardiasis were age (P = 0.035; odds ratio, OR = 1.96; 95% confidence interval, CI = 1.094-3.533), mother's educational level (P = 0.031; OR = 2.67; 95% CI = 1.186-6.045) and father's educational level (P = 0.004; OR = 3.56; 95% CI = 1.612-7.899). Similarly, among the supposed risk factors, rural residency (P = 0.032; OR = 1.76; 95% CI = 1.098- 2.851), absence of proper sewerage system (P = 0.000; OR = 6.60; 95% CI = 4.029-10.841) and unavailability of safe drinking water (P = 0.000; OR = 4.08; 95% CI = 2.207-7.547) were the factors strongly connected with giardiasis. Abdominal discomfort was a prominent clinical sign with 46% frequency. CONCLUSION: Various risk factors were associated with occurrences of Giardia, thus emphasizing the importance of parents' education, safe drinking water and proper sewerage systems for Pakistani children's health.

Dengue seroprevalence and its socioeconomic determinants in Faisalabad, Pakistan: a cross-sectional study

Abstract INTRODUCTION: Socioeconomic disparities in the community make some groups more vulnerable to dengue infection. METHODS: Fourteen dengue cases (IgM positive) served as index cases for the positive geographic cluster investigations. RESULTS: Of 292 individuals, the overall dengue seroprevalence was 22.9% (IgM positive 4.8%; IgG positive 18.1%). The highest (45%) seroprevalence was reported in the most socioeconomically vulnerable lower class, followed by the middle class (39%). Orthogonal comparisons showed that socioeconomic factors play a significant role in the prevalence of dengue. CONCLUSIONS: An integrated approach is required to control the menace through vector control strategies and improvement of socioeconomic conditions.

Prevalence and antibiogram of methicillin resistant Staphylococcus aureus isolated from medical device-related infections; a retrospective study in Lahore, Pakistan

Abstract INTRODUCTION: With the advancement of medicine and surgery, various types of medical devices have become part of treatment strategies. METHODS: Identification and antimicrobial sensitivity testing were done according to CLSI guidelines following standard microbiological practices. RESULTS: Urinary catheter infections (31%) were most frequent followed by central venous catheter (18%) and orthopedic implants (15%). Methicillin resistant Staphylococcus aureus (MRSA) was a major cause of device-related infection after Escherichia coli (21%); other pathogens were Klebsiella pneumoniae (14%), Pseudomonas spp. (10%), Acinetobacter spp. (8%) and Candida species (7%). None of MRSA was resistant to vancomycin (MIC ≥16µg/mL). Resistance rates were 98% and 97% for ofloxacin and ciprofloxacin, respectively. CONCLUSIONS Escherichia coli and MRSA are major pathogens of medical device-related infections.