ABSTRACT
Objectives To determine the economic burden of thalassemia on parents of thalassemic children
Study design, settings and duration: Descriptive nonprobability, purposive sampling done in PHRC Research Centres of Multan, Lahore, Islamabad, Karachi, Peshawar and Quetta from July 2013 to June 2014
Patients and Methods: After taking informed written consent, parents/guardians of thalassemia major children were interviewed. All information was recorded on the pre-tested questionnaire. Data was entered and analyzed using SPSS version 11
Results: A total of 600 guardians/ parents of the thalassemic children were included in the study. There were 57% boys and 43% girls with a mean age of 9.40 +/- 5.66 years. Among them, 47.8% were from rural and 52.2 % from urban areas. Almost 71% children were transfusion dependent. The family history of cousin/interfamilial marriage was present in 78.2% while parental consanguinity was present in 72.8%. Only 1.7% parents got premarital screening for thalassemia. In private sector 56.8% had to pay nothing while others had to pay from Rs. 500 to Rs. 2000 per visit. Expenditure per month in private thalassemia centres showed that 57% had to bear no cost at all, 12.2% had to spend up to Rs. 1000, while 24.8% Rs. 1001 to 5000 and 6% had to pay more than Rs. 5000. In the government sector cost per visit in 35.5% was up to Rs. 500 while others had to pay between Rs. 501 to more than Rs. 2000. Monthly cost at government sector almost doubled. Total expenditure [private and government sector] per month was Rs. 9626 for each patient
Conclusion: Total cost [both direct and indirect] for the management of thalassemia was quite high and this cost puts significant economic burden on the affected thalassemic families. This disease puts social, financial and psychological impacts on suffering families, so prevention-based strategies like premarital screening, prenatal diagnosis and genetic counseling should be adopted in Pakistan. A national screening project for thalassemia is the need of the day
ABSTRACT
Objectives: HCV liver disease is associated with abnormal liver functions and often results in various haematological disorders. This study was conducted on 100 HCV positive patients in Mayo Hospital, Lahore
Material and Method: The objective of this study was to establish a relationship between severity of liver disease and subsequent haemostatic disorders. The severity of liver disease was assessed by ALT, AST, Albumin, AST/ALT ratio and APRI Score and Hemostatic disorder was evaluated by Platelet Count, PT, APTT and D-Dimers which showed a significant positive correlation between the severity of liver disease and the increasing hemostatic derangements
Results: The results of the study showed that mean age was 41.29 +/- 11.15 years with minimum and maximum ages being 21 and 66 respectively. There were 63% male and 37% female pts and male to female ratio was 1.70: 1. In this study the mean PLT count was 202.870 x109/L +/- 66.779 x109/Lwith minimum count being 35.000 x 109/L. The PLT count was lower than normal in 21% of the pts. The distribution of D. Dimers was < 0.5 in 42%, 0.5 1 in 55% and it was > 1 in 3% of the pts. The mean PT and APTT were 16 seconds +/- 1.81 seconds and 37 seconds +/- 4.28 seconds respectively. The PT was prolonged in 48% and APTTin 5% of the patients
Conclusion: The severity of liver disease was assessed by ALT, AST, Albumin, AST/ALT Ratio and APRI Score while the Hemostatic abnormality was checked by Platelet count, PT, APTT and D-Dimers. The results of liver function tests and the coagulation profile along with the levels of AST/ALT Ratio and APRI Score in this study have proved that as the liver disease advances, the hemostatic derangement also increases
ABSTRACT
Aims: The prevalence of heart failure with preserved ejection fraction [HFpEF] has increased in the past two decades. Although it has been demonstrated that left ventricular [LV] diastolic and vascular functional abnormalities are generally observed in HFpEF, it remains to be clinically elucidated how an asymptomatic stage progresses to symptomatic HFpEF. We aimed to identify risk factors associated with incident HFpEF and to compare it with systolic heart failure [SHF]
Methods and Results: The study included 100 patients of heart failure, 50 patients were having ejection fraction /=50%. We included patients of heart failure who were admitted in coronary care unit of services hospital Lahore or they had more than one visit to the outpatient clinic of services hospital Lahore and had en echocardiographic report recorded. Patients with serum creatinine >/= 2.0 mg/dL and patients with significant valvular heart diseases were excluded from the study. Mean age of patients was 53 +/- 9Y. Mean hemoglobin of patients was 11+/-2g/dl.62% patients were smokers and 38% were nonsmoker. 57% patients were female and 43% were male. 63% of all patients were suffering from coronary artery disease and 37% patients were not.66% patients were obese and 34% patients were not obese. 65% patients were suffering from Diabetes mellitus and 35% patients were not. 54% patients were hypertensive and 46% patients were not suffering from hypertension. 43% patients had restrictive dysfunction on echocardiography and 43% patients had non restrictive pattern on echocardiography. Among those with EF>/= 50 80% patients were smokers and 20% were non smokers [P=>0.00]. 75% patients of EF>/= 50 were female and 25% patients were male [P=0.001]. 35% patients were diabetics and 65% patients were non diabetics. [P=9] 65% patients were hypertensive and 35% patients were not. [p=0.028]. 36% patients were suffering from coronary artery disease and 65% patients were not suffering from coronary artery disease [P=0.00]. 46% of these patients were having restrictive echocardiographic abnormalities on mitral valve inflow interrogation [p=0.00]. 26% of these patients were obese [P=0.00]. Multiple logistic regression analysis revealed that obesity, female gender, age, smoking, and impaired LV compliance and history of hypertension were independently associated with the prevalence of HFpEF whereas anemia and diabetes mellitus was not
Conclusions: Female gender, history of hypertension, age, smoking and obesity was independently associated with the prevalence of HFpEF whereas anemia diabetes mellitus was not
ABSTRACT
Background: all cancer involves the production of abnormal cells are capable of irregular and independent growth that invades health body tissues. Metastases are a characteristic feature of all malignant tumors, which spread to distant areas of body via lymphatic system and blood stream
Material and Methods: this cross-sectional study included 50 patients with different Malignancies. The diagnosis of these patients had been established on the basis of Histopathology. These patients were taken from Oncology Department of lnmol Jinnah, Shaikh Zayed and Mayo Hospitals. Lahore. These patients underwent bone scan which was performed with technetium 99m methldipbosphonate. [99.m Tc-:-MDP]. Twenty five patients with positive bone scan findings were taken as group A and the other 25 patients with negative bone scan were marked as group-B. The metastatic involvement of these patients was found by performing bone marrow aspiration and trephine biopsy
Results: in our study, 9 out of 50 cases were positive for bone marrow infiltration. Out of these 5 cases [20%] were positive for bone marrow metastases in positive bone scan patients. Whereas 4 patients [16%] were positive for bone marrow metastases in negative bone scan patients
Conclusion: the study hence reveals that bone scan is a superior method for detection of bone marrow infiltration in patients with · malignant metastatic disease but bone marrow aspiration /trephine biopsy is also mandatory as it picked 4 patients [16%] out of 25 patients with negative bone scan