Frequency and causes of anemia in Lymphoma patients

Objective: Purpose of this study was to find out frequency of anemia and its causes in newly diagnosed treatment naive lymphoma patients

Methods: We retrospectively studied all lymphoma patients [> 18 years age] diagnosed and treated at Shaukat Khanum Memorial Cancer Hospital and Research Centre, from January 2016 till January 2017. The data was collected from electronic Hospital Information System. Descriptive statistics were done by using summary measures for categorical variables as well as continuous variables

Results: Out of a total 408 patients, 272 were males and 136 females. Median age of patients was 33 years [18-76]. Hodgkin lymphoma [HL] and diffuse large B cell lymphoma [DLBCL] were the diagnosis in 201 and 134 patients respectively; rest of the patients had low grade lymphomas. Anemia was present in 184 [45%] patients. Anemia of chronic disease was the commonest cause of anemia and was present in 61 [33.1%] patients. Remaining patients had anemia secondary to marrow involvement 50[27.17%]; iron deficiency anemia, Vitamin B-12 deficiency anemia and hemolytic anemia were the causes in 7.6, 1.6%, % and 0.54% respectively

Conclusion: Anemia is a common feature in newly diagnosed lymphoma patients with anemia of chronic disease as the commonest cause. It is more frequent in patients with higher stages of lymphoma especially when bone marrow is involved by lymphoma. Since anemia is an important adverse prognostic factor for the outcome of lymphoma patients, work up for anemia prior to initiation of chemotherapy should be done in every lymphoma patient in order to help improve the management of these patients

Fetomaternal outcome with hepatitis E in pregnancy

To assess the maternal morbidity and mortality and fetal outcome with hepatitis E [HEV] in pregnancy. Cross-sectional study. Liaquat National Hospital, Karachi, from May 2008 to April 2010. Thirty patients admitted at Gynae Ward with serologically proven HEV in pregnancy were included in the study. All these patients were followed during their hospital stay with liver function tests and coagulation profile. Maternal morbidity and mortality and fetal outcome were recorded. Maximum maternal morbidities were noted in patients who presented in 3rd trimester, both clinically and derangement of haematological and biochemical tests. out of 30 patients, 08 patients expired with maternal mortality rate of 29.3% and rest were discharged safely. Perinatal mortality rate was 30.3 per 1000 live births. Hepatitis E runs a fulminant course during pregnancy with very high mortality rate especially during third trimester and postpartum period

Silent uterine rupture of scarred uterus - an unusual presentation as amniocele

Obstetricians should be aware of the possibility of silent rupture of scarred uterus. Ultrasound has an important role in the diagnosis of silent uterine rupture. A case of silent uterine rupture with foetal demise, that remained undiagnosed for many weeks, is described