Peripheral Blood Smear Atypical Lymphocytes Association With Covid-19 Mortality

@#Introduction: COVID-19 disease is currently pandemic, and its prevalence in Saudi Arabia is concerning. The SARSCoV-2 virus primarily affects the lungs, but it also affects the haematopoietic system. The atypical lymphocytes on peripheral blood film that have a distinct morphological appearance were of particular interest in this study. Our goal was to see a link between atypical lymphocytes and COVID-19 patient mortality. Methods: This four-month single-centered prospective descriptive study was conducted in Makkah, Saudi Arabia. COVID-19 patients of both genders were randomly selected based on inclusion criteria. The data from the patient’s electronic medical record was extracted. All patients’ peripheral blood film parameters were recorded on days 3, 7, and 14 after admission. The statistical data was analysed using SPSS version 23. The Fisher’s exact test was used to determine the relationship with mortality. A p value of 0.05 was considered significant. Results: The total number of cases enrolled in the study was 226. The patients’ average age was 58 years (SD 0.5289). On the third day of admission, 88.2 % of patients with COVID-19 had atypical lymphocytes, with a mean of 2.35 ± 0.927. A significant correlation (p < 0.001) exists between atypical lymphocytes decreasing percentage number on the 3rd, 7th, and 14th days of admission and death. Conclusion: The decrease in the number of atypical lymphocytes on peripheral blood film has a significant association with the patients’ mortality. This fact can be used to develop a tailored management strategy based on the observation of peripheral blood film.

Formulation and in vitro evaluation of nateglinide microspheres using HPMC and carbopol-940 polymers by ionic gelation method

This study involves the design and characterization of Nateglinide [NAT] microspheres to enhance patient compliance. Ionic gelation technique was used to prepare Nateglinide Microspheres by using rate controlling polymers Carbopol-940 and Hydroxypropylmethyl cellulose [HPMC]. Shape and surface were evaluated with Scanning electron microscopy [SEM]. Percentage Yield, Particle size analysis, Encapsulating Efficiency, Micromeritic analysis, Fourier Transform Infra-Red Spectroscopy [FTIR], Differential Scanning Colorimetry [DSC] were done for characterization of Microspheres. Drug release studies were performed at pH 1.2 and 7.2 using USP dissolution type-2 apparatus and release rates were analyzed by the application of different pharmacokinetic models. The size of microspheres was found to be varied from 781 Micro m to 853 Micro m. Rheological studies proved excellent flow behavior while percentage yield was found to be varied from 72% to 79%. Absence of drug-polymers interactions was confirmed from FTIR and DSC results. The microspheres prepared with sodium alginate showed cracks while microspheres obtained from blend of Carbopol-940 plus sodium alginate were smooth and spherical. Maximum entrapment efficiency [71.4%] was achieved for Microspheres with Carbopol-940. The greater retardation in drug release was observed for microspheres containing Carbopol-940 and release pattern followed Higuchi kinetics model and negligible drug release was observed at pH 1.2

Painless myocardial infarction; its frequency in patients of acute coronary syndrome

To determine the frequency of painless MI in patients with acute coronary syndrome. Descriptive cross-sectional study. Setting and duration: This study was conducted at cardiology unit Nishtar Hospital Multan and Chaudhry Pervez Elahi Institute of Cardiology Multan. The study duration was 1 year starting from July 2011 to June 2012. This descriptive study included 331 patients of AMI of either sex and age which were admitted at "Cardiology unit Nishtar Hospital Multan and Chaudhry Pervez Elahi Institute of Cardiology Multan" using non-probability convenience sampling technique. Informed verbal consent was taken from each patient for participation. Out of these 331 patients 308 [93.1%] patients reported chest pain as the presenting complaint. Remaining 23[6.9%] presented with clinical feature other than chest pain. Of these 23 patients who presented without chest, minimum age was 30 years while maximum was 90 years with mean age 54.82 +/- 12.28 years. Patients with painless AMI presented with variety of symptoms. Most common symptoms seen in patients of AMI without chest pain were generalized weakness and cold sweats. Out of 23 patients with painless AMI, 15[65.22%] patients were male and 08[34.8%] were female. Diabetes mellitus was present as co-morbid condition in 16[69.56%] while 7[30.44%] patients were non diabetic. Hypertension was present in 8[34.78%] patients with painless AMI. Painless AMI or atypical presentation of AMI is seen in substantial proportion of ischemic heart disease patients. Absence of chest pain in AMI patients may misguide the doctors and diverts his attention towards other diagnosis which can lead to considerable delay in the essential therapies required in the management of AMI. It definitely affects morbidity and mortality of emergency department. Health care professionals particularly those working in emergency set up must keep in mind that absence of chest pain in suspected cases of ischemic heart disease does not necessarily rule out AMI. Features of AMI other than chest pain should also be kept in mind while dealing with a suspected case of ischemic heart disease. Further research work on painless AMI and presentation of AMI other than chest pain is needed

Prevalence of Hepatitis B, C and HIV infection in blood donors of Multan region

Acute and chronic viral hepatitis are common public health problems in Pakistan, and associated with serious complications. The carrier rate of HBsAg is quoted to be around 10% in general population while the prevalence of HCV in blood donors is 4.8%. Data regarding the prevalence of hepatitis B and C virus infections among healthy blood donors is well established in Karachi, Rawalpindi, Islamabad, Faisalabad, Lahore and Abbotabad areas, but similar data is not available for Multan population. Data regarding the epidemiology of HIV infection among blood donors is not available at most of the blood transfusion centers. In this study six thousands [6000] consecutive young healthy voluntary blood donors [age 16-50 years] comprising of 5476 males and 524 females, belonging to Multan region were included from Blood Transfusion Center Nishtar Hospital Multan and Fatmid Blood Transfusion Center Multan and were tested for HbsAg, Anti-HCV and HIV. Prevalence of Hepatitis B, C and HIV Infection was 3.37%, 0.27% and 0% respectively. The reported prevalence figures for HBsAg and Anti-HCV in other studies are quite variable, depending upon screening protocol, study groups selected and methodology of testing. If data from all the blood transfusion centers of Pakistan is collected and published, we can get representative prevalence values of HBV, HCV and HIV infection of the general population