Reference range variation in haematological indices amongst five different age groups of less than one year in Islamabad, Pakistan

Objective: The objective of the current study was to establish the reference ranges of haematological indices amongst five healthy infantile [< 1 year] age groups

Methodology: It was a descriptive cross sectional study carried out at the Department of Haematology, Armed Forces Institute of Pathology [AFIP], Rawalpindi. Non probability convenience sampling was adopted for the proceedings for the study. A sample size was 2000 which was equally distributed as 400 samples for all the five age groups i.e. < 27 days, 3 month, 6 month, 9 month and one year. One thousands were males and 1000 were the females. An informed consent from the guardian was the pre requisite of study, while those candidates having an evidence of any systemic illness were not excluded

Results: The values of haematological indices i.e. MCV, MCHC, MCH, PCV and RDW varies with growing age of an infant. A decrease in all these values was observed from < 27days to one year of age infants

Conclusion: A decrease in all these values was observed from < 27days to one year of age infants. The values reported in this study can be used as a local reference for the newborn aged between <27 days and 1 year of age

meta analysis review of helicobacter pylori infection the diagnostic and management options

Objectives: To verify that the H. pylori infection predisposes to acid peptic disorders, and also find out the importance of non-invasive diagnostic approach. Moreover, to judge the need of quadruple therapy i.e. Amoxicillin, Metronidazole, Clarithromycin, and a proton pump inhibitor along with an appropriate duration in order to reduce the emergence of antibiotic resistance

Methodology: It was a Descriptive study. The data were collected through electronic means from the National and internationally published data by simple random sampling technique. The latest reports published by World Health Organization, Centre for Disease Control were considered for reference. The original and review articles published in different National and International Journals and available online on Pubmed and Medscape were also taken for reference. While some aspects were also searched from other medical related websites and Google. The Selection criteria for this meta-analysis were the data related to positive cases of H. pylori in patients having acid peptic disorders especially diagnosed through serological identification and were managed through quadruple therapy or by three drugs. The Quality criteria for the reference data was made sure through the authenticity of researches and reports published from recognized and indexed medical websites

Results: This Meta-analysis has shown that H.pylori is the leading cause of various acid peptic disorders. The adoption of non-invasive diagnostic approach should be the preferred one, proven to have the sensitivity and specificity of about 98.3% and 95.0% respectively. Moreover a quadruple therapy i.e Amoxicillin, Clarithromycin, Metronidazole, and a Proton pump inhibitor given for at least 7 to 10 days, has proven to be the best management strategies

Conclusion: There is a dire need to early/accurately diagnose the infection and adoption of quadruple therapy regimen in order to minimize the emergence of drug resistant cases

Value of bone marrow examination in diagnosis of patients having different types of fever at a tertiary care hospital of rawalpindi

AIMS AND OBJECTIVES: To highlight the importance of bone marrow examination in order to assess different causes of fever especially pyrexia of unknown origin

STUDY DESIGN: It was a Descriptive cross sectional study

PLACE OF STUDY: The study was conducted at Haematology Department of Benazir Bhutto Hospital, Rawalpindi

PATIENTS AND METHODS: The retrospective information was gathered from the record saved in the official departmental registers. The data from June 2005 to June 2010 was included in the study. Both the males and females having the history of fever were included in the study. Data analysis was done by SPSS version 16.The frequency of occurrence of specific diseases was calculated in terms of percentages, while the mean values were calculated for ages and duration of illness

RESULTS: Chronic disorders [20.1%], followed by myelofibrosis [7.6%], and metastatic infiltrations [6.5%] are amongst the most common causes of PUO. Chronic disorders [33.12%] followed by mixed deficiency anaemia [15.95%] and megaloblastic anaemia [11.65%] were amongst the common causes of high grade fever. While chronic disorders [35.8%] followed by mixed deficiency anaemia [16.21%] were the common causes of low grade fever. The intermittent pattern of fever was found to be associated with underlying chronic disorders [28.26%] followed by mixed deficiency anaemia [13.86%]

CONCLUSION: Bone marrow examination should be considered in the early course of illness especially when other laboratory studies yielding the negative results

An Overview of Hepatitis C Viral Infection and its Management Options

Hepatitis C is an infectious disease of viral origin primarily affecting the liver, caused by the hepatitis C virus [HCV]

The infection is usually subclinical/ asymptomatic, but chronic infection can lead to scarring of the liver and ultimately to cirrhosis leading to liver failure, hepato cellular carcinoma or life-threatening esophageal and gastric varices. The route of acquiring infection is by an exposure to blood or blood products

The virus persists in the liver in about 85% of those infected patients. Persistent infection can be treated with various anti-viral medications like peginterferon and ribavirin. Theseare amongstthe current standard therapy. Overall cure rate is between 51-80%. Those who develop cirrhosis or liver cancer may require a liver transplant, and the virus universally recurs after transplantation

Medical importance of fungi with special emphasis on mushrooms

Fungi are playing a vital role in the Biological world. Their three forms [Yeasts, Molds and Mushrooms] are important in the preparation of certain foods [cheese, bread, liquors], antibiotics and anti-fungal drugs. They are also good sources of protein [mushrooms] and improve immunity. On the other sides Fungi cause destruction of crops, food commodities and also responsible for important human, animals and plant diseases

Strategies for the prevention of rheumatic fever and its complications

Rheumatic fever [RF] and Rheumatic Heart Disease [RHD] continues to be a global health problem since long. Moreover, it is a leading cause of morbidity and mortality especially in younger age group i.e. 3-18 years

RF is a non suppurative complication of Group a Streptococcus Pyogenes [GASP] pharyngeal infection observed in post streptococcus sequelae. The reason for this is the negligence of diagnosis and improper treatment. While if diagnosed early and treated well within 10 days of onset of pharyngitis, occurrence of this life threatening condition can be prevented

Apart from many virulent factors produced by GASP, the most important ones for the pathogenesis are the M proteins i.e. antigens and the Streptolysin O. Only M proteins of GASP have the strong rheumatogenic potential while the rises in Streptolysin O titer levels are suggestive of recent GASP pharyngeal infection. The significant level of ASO titer is >200

The current review article will provide update information regarding early diagnosis of GASP pharyngeal infection by ASO titers in different ages. Thus, by initiating early treatment, the morbidity and mortality rates due to RF and RHD can be reduced in under developed countries like ours