Frequency of increased fibrinolysis after coronary artery bypass grafting

Objective: To determine the frequency of increased fibrinolysis after coronary artery bypass grafting [CABG]

Study Design: Descriptive study

Place and Duration of Study: One year duration conducted in the Department of Pathology, Army Medical College in collaboration with Armed Forces Institute of Cardiology [AFIC] from December 2013 to November 2014

Material and Methods: Sixty patients were selected who were admitted to AFIC for CABG surgery. Venous samples were drawn from the patients immediately after surgery when the patients were shifted to post operative ward. Patients were selected by non probability purposive sampling technique. D-dimers were analysed by rapid agglutination assay

Results: Out of 60 patients included in the study, 50 [83.3%] were males and 10 [16.7%] were females. D-dimers level more than 200ng/ml were considered to show increased fibrinolysis. Raised D-dimers were present in 40 [66.6%] patients while they were normal in 20 [33.3%] patients.Twenty [33.3%] patients had D-dimers<200ng/ml, 27 [45%] patients had D-dimers between 200-400ng/ml, 7 [11.7%] patients had D-dimers between 400-800ng/ml and 6 [10%] had D-dimers between 800-1600ng/ml

Conclusion: Increased fibrinolysis was present in 40 [66.7%] patients. It is more common in older age than younger ones

Thrombocytosis: analysis of 329 patients

To find out the nuquency of different clinical conditions causing thrombocytosis in hospitalized patient population. Cross sectional, descriptive study. Combined Military Hospital Attock, 1st Sept 2003 to 1[st] March 2004. All patients referred to haematology department for complete blood counts who had platelet count exceeding 400 x10[9] /L. Out of nine thousand patients, 329 [3.65%] revealed thrombocytosis. The Male to female ratio was 1.4:1, [48%] were adults, ana 52% were children. Platelet count ranged between 403 X10[9]/L and 1365 X10[9]/L In adults, iron deficiency [36%], infections [30%], infections concomitant with iron deficiency [13%], chronic inflammatory disorder [7%], clonal thrombocytosis [5%], haemorrhages [3%]; and in children infections concomitant with iron deficiency [36%], infections [26%], iron deficiency [18%], and acute gastro enteritis [6.5%] were the leading causes of thrombocytosis. Iron deficiency anaemia and infections are leading causes of thrombocytosis in our set up. Clonal thrombocytosis is seen in 5% of adult patients. Relative frequency of different conditions causing thrombocytosis varies with patient age

frequency of glucose-6- phosphate dehydrogenase deficiency in Pnjabis and Pathans

To find the frequency of Glucose-6-Phosphate Dehydrogenase [G6PD] deficiency in healthy young adult male population of various ethnic groups and sub-groups of Punjabis and Pathans. This Cross-sectional comparative study in Armed Forces Institute of Pathology, Rawalpindi, from Jan-Dec 2000. Eight hundreds apparently healthy unrelated adult males [Punjabis: 400 and Pathans: 400] were screened for G6PD deficiency by a commercial qualitative screening test kit. Out of 800 subjects, 47 [5.9%] were G6PD deficient [95% CI: 4.2-7.5%]. The frequency in Pathans [8.3%] was significantly higher than in Punjabis [3.5%] [p=0.006]. There were also differences in the frequency of G6PD deficiency among the sub groups of Punjabis and Pathans. G6PD deficiency is a fairly common abnormality in Punjabis and Pathans. Such individuals are highly susceptible to develop acute haemolytic episodes by a variety of stimuli including some of the commonly used drugs

Clinical assistance of bone marrow examination in a secondary-care hospital

This study was performed to evaluate various clinical situations requiring bone marrow examination and to assess its advantages in a secondary care hospital. One hundred and five bone marrow examinations were performed from 1st April 2002 to 31st March 2003. The age ranged from 4 months to 70 years with a mean age of 32 years, 10 patients were children under the age of 15 years and 95 were adults. Male to female ratio was 3:1. Progressive pallor [26%], visceromegaly [25%], abdominal disturbances [19%], fever of unknown origin [8.5%], bleeding manifestations [8.5%], lymphadenopathy [8.5%] bone pains [5%], and suspected hematological malignancy [8.5%] were the common clinical situations where bone marrow examination was asked. Nutritional deficiency anemia constituted 61% of the bone marrow examination results. Other conditions were anemia of chronic disorder [13.5%], acute leukemia [5%], chronic leukemia [3%], multiple myeloma [2%], myelodysplastic syndrome[2%], congenital sideroblastic anemia[1%], storage disorder[1%] and metastatic bone disease[1%]. Bone marrow examination at secondary care hospitals carries many advantages. About 80% cases can be treated in these centers and do not require referral. The disease is usually at its early stage, marrow is unaffected by any therapy and has better diagnostic value

Thrombocytopenia: analysis of 415 patients

To find out the relative frequency of conditions associated with thrombocytopaenia. Descriptive study Combined Military Hospital Attock in collaboration with Armed Forces Institute of Pathology Rawalpindi, from March 2003 to March 2004. Materials and All patients referred for blood counts. Patients with platelet count below 150x10[9]/L, were registered. Investigations including peripheral blood counts and smear examination, blood/smear for bacterial culture, IgM for Dengue virus, Hepatitis B surface antigen and anti-hepatitis C Antibodies, ultrasound abdomen and bone marrow examination were performed. Out of 18,000 patients, 415[2.3%] revealed thrombocytopaenia [341 adults and 74 children]. In adults, viral anti-body was found in 27.7%, malaria in 17%, bacterial infections in 12.4%, megaloblastic anaemia in 8.2%, bone marrow infiltrates in 7.9%, drug induced thrombocytopaenia in 4.4%, chronic liver disease in 3.5%, hypersplenism in 2.9%, DIC in 2.9%, pregnancy associated thrombocytopenia in 2%, aplastic anaemia in 1.5%, ITP in 1.2% and upper respiratory viral infection in 8%. In paediatric age group malaria was detected in 27%, megaloblastic anaemia in 23%, bacterial infections in 13.5%, leukaemia in 13.5%, neonatal thrombocytopenia in 9.5%, ITP in 2.7%, DIC in 1.4%, aplastic anaemia in 1.4% and upper respiratory viral infections in 8%. Malaria, viral and bacterial infections and megaloblastic anaemia are the most common causes of thrombocytopenia in our setup