Epidemiologic and HLA antigen profile in patients with aplastic anemia

To analyze patients suffering from aplastic anemia [AA, peripheral pancytopenia and hypocellular bone marrow in the absence of dysplasia, infiltration and fibrosis] for documenting patient's baseline characteristics and association with various human leucocyte antigens. An observational, cross-sectional study. The National Institute of Blood Disease [NIBD], Karachi, from March 2003 to August 2008. All consecutive patients with confirmed diagnosis of AA were evaluated. Data included the baseline characteristics, complete blood counts [CBC], bone marrow biopsy findings, severity of disease, exposure to drugs or chemicals, viral serology and their HLA expression. The data was analyzed on SPSS programme and frequencies were documented. Among 318 patients, there were 236 [74.21%] males and 82 [25.78%] females. Median age was 16 and 70% belonged to urban population. Drug exposure could be established in 23 [7.23%] of cases, while 4 [1.25%] were HBV surface antigen positive and 7 [2.2%] were HCV antibodies positive. In all, 73 [22.9%] had very severe AA, 195 [61.32%] had severe AA while 50 [15.7%] cases had non-severe AA. HLA B5 [52] showed high expression in 83 patients [26%] in comparison to 5.9% reported in healthy population. AA was found to affect young adult males living in urban areas. HLA B5 [52] showed higher expression in patients with aplastic anemia

Complications of nose and paranasal sinus disease

Background: Diseases of nose and paranasal sinuses can complicate to involve the orbit and other surrounding structures because of their close proximity. These diseases are usually infective or can be neoplastic in origin. Method: All the patients presenting in ENT or Eye Departments of Ayub Teaching Hospital during the one year study period who had complicated nose or paranasal sinus disease were included in the study. A detailed history and examination followed by CT scanning and laboratory investigations to assess the type and extent of the disease, was carried out. Results: Infections were the most common cause of complicated sinus disease 11 [75%]. The rest of the 4 [25%] cases were tumours. 12 [80%] of the cases presented with proptosis. In 1 of these 12 cases, there was complete blindness. In 2 [13%] of the cases there was only orbital cellulitis. Two of these patients had facial swelling and 2 had nasal obstruction and presented as snoring. Two patients presented with history of weight loss and these patients had malignant tumour of the paranasal sinuses. One patient presented with early signs of meningitis. In 1 case subperiosteal scalp abscess [Pott's puffy tumour] was the only complication noted. Conclusion: Nose and paranasal sinus diseases can complicate to involve mostly the orbit, but sometimes brain, meninges and skull bones can also get involved