prevalence and antenatal screening of beta thalassaemia trait in pregnancy by naked eye single tube red cell osmotic fragility test

To evaluate the prevalence of Beta Thalassaemia Trait [BTT] detected by Naked Eye Single Tube Red cell Osmotic Fragility Test [NESTROFT]. We also highlight the validity and importance of this test for antenatal screening of BTT to prevent incidence of Beta Thalassaemia major in our community as well as differentiating the BTT, BTT with coexisting iron deficiency anemia and only iron deficiency anemia in pregnancy. Experimental and observational study. This study was conducted at Pathology and Gynae-Obs Out Patient departments of Peoples University of Medical and Health Sciences for Women [PUMHSW] Hospital, Shaheed Benazirabad from February 2013 to February 2014. Total 461 pregnant women with their age ranged between 18 - 42 years including multigravida and primigravida as well as first trimester to second trimester of pregnancy were selected. The family history of thalassaemia and history of cousin marriages were noted. 4ml of anti-coagulated whole blood and 2ml of clotted blood samples were collected from each pregnant women and sent to the pathology department for NESTROFT testing, and later tested for Complete Blood Count [CBC] along with peripheral blood smear stained with Leishman's stained on the 2 to 3 slides as enhanced tool for BTT case finding while estimation of serum Ferritin were done from the clotted blood sample. Screening for BTT was done on Naked Eye Single Tube Red cell Osmotic Fragility Test [NESTROFT] with 0.36% freshly prepared saline. The diagnosis of BTT was confirmed on automated Hemoglobin Electrophoresis at cellulose acetate alkaline pH from the 2ml of clotted blood in NESTROFT positive cases. Out of total 461 pregnant women with their mean age 30 +/- 12, 30 were diagnose with BTT, out of 18 [54.5%] women were married with their cousins, neither the family history of Beta thalassaemia major was present nor husband of any women was carrier of thalassaemia. NESTROFT showed sensitivity, specificity, positive and negative predictive values and efficiency of 84%, 98.6%, 82%, 99% and 93% respectively. The laboratory parameters such as The mean values of hemoglobin g/dl, RBC count millions/cmm, PCV%, MCV fl, MCH pg, MCHC g/dl among these subjects were 11.9 g/dl, 4.5 millions/cmm, 82 fl, 38.7%, 26.9 pg, 33.2 g/dl respectively were showed in cases of BTT and co-existent iron deficiency anemia in pregnancy. Coexistent iron deficiency anemia did not preclude diagnosis of beta thalassaemia major. The prevalence of BTT in pregnant women is 6.5% and NESTROFT is a valuable, cost effective screening test for beta thalassaemia trait in pregnancy with cousin marriage ratio of 54.6%. The significant difference of hematological parameters in BTT alone, BTT coexistence iron deficiency anemia and iron deficiency anemia alone were founded in our study

Evaluation of nacked eye single tube red cell osmotic fragility test for screening of beta thalassaemia trait

The study aimed to evaluate the validity and significance of Nacked Eye Single Tube Red cell Osmotic Fragility Test [NESTROFT] for screening of beta thalassaemia trait [BTT] to reduce the incidence of birth of thalassaemic child in community. Cross sectional study. This study was conducted at Diagnostic and Research Lab in Pathology Department of Peoples University of Medical Health Sciences [PUMHSW] at Shaheed Benazirabad from January 2013 to December, 2013. Total 504 subjects comprising 303 [60.3%] females and 201[39.7%] males with age ranging between 5 and 48 years and male to female ratio 1:1.5 were selected for this study. The family history of thalassaemia and history of cousin marriages were noted. EDTA anti-coagulated whole blood samples were collected for on-site NESTROFT testing, and later tested for Complete Blood Count [CBC] and serum Ferritin concentration at Diagnostic and Research Laboratory of Pathology Deptt. PUMHS. Screening for BTT was done on Naked Eye Single Tube Red cell Osmotic Fragility Test [NESTROFT] with 0.36% freshly prepared saline. The diagnosis of BTT was confirmed on automated Hemoglobin Electrophoresis at cellulose acetate alkaline pH. Red cell indices [automated Hematology cell counter cell-tac alpha] were assessed along with peripheral smear morphology [Leishman's stained slides] as enhanced tool for BTT case finding. Out of total 504 subjects 201 married women and 101 married men with their mean age [26.5 +/- 21.5] years were selected. In this study, female to male ratio was 1.5:1 and among the total 302 married subjects, ratio of cousin marriages [60.4%] was noted. Neither any women were pregnant nor there was history of thalassaemia in their families. The laboratory parameters such as the mean values of hemoglobin g/dl. RBC count millions/cmm, PCV%, MCV fl, MCH pg, MCHC g/dI among these subjects respectively were 11.9 g/dl, 4.5 millions/cram, 82 fi, 38.7%, 26.9 pg, 33.2 g/dl. Out of 504 samples, NESTROFT was positive in 21[4.1%] and negative in 483 [95.9%]. Out of all NESTROFT positive cases 15 [71.4%] were true positive confirmed on the hemoglobin electrophoresis with increased hemoglobin A2 level above 3.5 and remaining 6[28.6%] were false positive. Only 4 [1%] cases were false negative, then sensitivity, specificity, positive and negative predictive values and efficiency of NESTROFT were calculated 87%, 86%, 71%, 99% and 99.9 respectively. The NESTROFT is a valuable, cost effective screening test for beta thalassaemia trait

Prevalence and proportion of anemia in pregnant women suffering from malaria

To find out the prevalence and proportion of anemia in pregnant women suffering from malaria. The aims and objectives of our study were to evaluate prevalence and proportion of anemia in pregnant women with malaria among the patients visiting the tertiary hospital PUMHS Hospital, Nawabshah, Shaheed Benazirabad so as to give awareness of these complications to doctors to ensure early diagnosis, prevention and prompt treatment of such cases. Descriptive observational study. This study was conducted at Outpatient Department of MMCH Hospital and Department of Pathology from April 2012 to February 2013. Study includes total 120 cases of malaria, diagnosed on the basis of clinical and laboratory findings. The hematological complications like anemia, leukocytosis and thrombocytopenia were studied in these patients. Out of 120, 64 patients were anemic. We divided pregnant women into 5 groups, 40 patients were in 16 - 20 years age group and amongst them 55% patients were anemic, 34 patients were in 21 - 25 years age group and amongst them 50% were suffering from anemia, 22 patients were in age group 26-30 and amongst them 22 % anemic, 15 cases were in age group 31 - 35 and out of them 46% were anemic and in age group 36-40 years 46 percent were anemic. Overall there were 53% anemic patients in total of 120. According to the occupation status majority were daily wages laborers and farmers and other were housewives. Out of 120 patients most of them were Multigravida. Most of the patients were suffering from anemia, 76% patients had Leucocytosis with Neutrophillia, 74 percent patients had complication of Lymphocytosis, 80 percent of patients had decreased level of monocytes and 60 percent had decreased level of platelets. All the patients were suffering from fever and associated symptoms of chills, sweating, feeling of hotness and coldness, 63 percent had back pain, 45 percent had headache and 23 percent had complication of Spleenomegaly. The diagnosis of malaria was made on clinical grounds and confirmed by laboratory findings. The problems of hematological complications as anemia, leukocytosis and thrombocytopenia were detected among the patient of malaria by determining hemoglobin concentration, complete blood picture and urine examination report. P.vivax malaria is most prevalent variety. Anemia, leukocytosis and thrombocytopenia are the most common hematological complications in these patients. It is suggested to ensure i. Effective malaria control program in country, specially interior Sindh. ii. Effective measures for prevention, diagnosis and treatment of patients. iii. effective health education through electronic and print media

Socio-demographic profile of female victims of vitriolage in interior sindh Pakistan

Vitriolage is a reprehensible crime. It is an easy mean of taking revenge in our society. The most common victims of this criminal act are women. This study highlights the sociodemographic profile of such cases. Retrospective / observational study. This study was conducted in the medico-legal section of Deptt. of Forensic Medicine and Toxicology, PUMHS for Women, District Shaheed Benazirabad during the period from 1[st] January 2013 to 31[st] December 2013. Sixteen cases of vitriolage were studied with reference to age, literacy, socioeconomic background, marital status, occupation, relationship with offender, time of incidence, time between occurrence and medical examination, place of incidence. All the cases were females, majority in age group 20-30, unmarried, uneducated, from middle class, had first degree burns and disfigurement of face. The offenders were known to victims in all the cases. The problem needs to be acknowledged by public at large. Individuals social issues should be resolved timely and wisely to guard against such happenings. Emotionally unstable people must be provided counseling by psychologists. The initiative taken by Peshawar High Court in the form of restriction on the sale of acid is a great attempt to minimize the risk and should be appreciated

Breast diseases, Pattern at LUMHS, 10 years experience of consecutive referrals to public sector medical university at Hyderabad /Jamshoro

Breast lump is the common complaint of women in clinics, which includes the second leading cause of cancer deaths in women. The study was conducted to know the pattern of female breast diseases in our setup at Hyderabad / Jamshoro. A descriptive Study. Liaquat University of Medical and Health Sciences, Jamshoro. Descriptive study. It was conducted in the department of pathology, Liaquat University of Medical and Health Sciences, Jamshoro. Ten years from January 2001 to December 2010. Total of 2693 breast biopsies and mastectomies specimen included in this study, of which 278[10.32%] fibrocystic changes, 507[18.83%] inflammatory, 983[36.5%] benign and 889[33.01%] malignant. Benign Breast disease; fibroadenoma was the most common lesion. Infiltrating ductal carcinomas were next frequent, which reached hospital at late stage of disease

prevalence and proportion of haemato-logical complications of Malaria in distric Shaheed Benazirabad

To find out the prevalence of malaria in district Shaheed Benazirabad [SBA]. To Study the proportion of haematological complications among the patients who present with malaria. This is descriptive and experimental study. This study was conducted at Medical Out Patients Department [OPD] and Pathology Department of PUMHSW Peoples Medical College and Hospital at district [SBA] from April 2008 to September 2010. A total 1200 cases of malaria diagnosed on basis of clinical and laboratory findings were recorded. The proportion of haemotological complication including anaemia, leucocytosis and thrombocytopenia among these patients were also studied. Out of 1200 patients, 700 [58.33%] were children and remaining 500 [41.77] were adults. Ages of these patients including children and adults ranged between 5 to 65 years with a mean of 35 +/- 30 years. Male to female ratio in these patients were 1.1:1. The diagnosis of malaria was made by clinical as well as by laboratory findings. The problem of haematological complications as anaemia, leucocytosis and thrombocytopenia were detected among the patient with malaria by determination of Haemoglobin Concentration and Complete Blood Count [CBC]. Malaria is more prevalent in district SBA, and many of these patient are children and women. Anaemia, leucocytosis and thrombocytopenia are common haematological complications in them

Comparative study of hypochromic microcytic anaemia in primigravida and multigravida in interior Sindh

To evaluate the frequency of hypochromic microcytic anemia commonly due to iron deficiency in female primgravida and multigravida patients. This also entails comparing both groups in the context of hemoglobin, MCV and RDW as study tools. Cross sectional analytical study. This study was conducted at the Obstetrics Department, Peoples Medical College Nawabshah from July 2008 to Oct 2008. This cross sectional study was carried out on 200 women [100 primigravida and 100 multigravida] with anaemia in their third trimester of pregnancy attending the Obstetrics Department, Peoples Medical College Nawabshah from July 2008 to Oct 2008. Hemoglobin, MCV and RDW levels were assessed in all cases. Data was analyzed using SPSS and students t test was used for evaluation of significance. Mean Haemoglobin +/- SD in Primigravida [Group A, n=100] and Multigravida [Group B, n=100] were 7.85 +/- 1.33 and 6.26 +/- 1.65 with ranges 3.1-10.9 and 3.2-10.4 gm/dl respectively. Mean MCV +/- SD in Group A and B were 63.95 +/- 4.71 and 62.08 +/- 4.97 with ranges 54.4-73.7 and 48.2 -73.7 fl respectively. Mean Red Cell Distribution Width [RDW, SD] +/- SD in Group A and B of anaemic patients were 19.83 +/- 3.05 and 21.31 +/- 3.32 with ranges 14.0-27.4 and 14.0-29.2 x 10[3] /micro l respectively. The results were significant in both groups. In Interior Sindh both primigravida and multigravida females are at high risk of developing iron deficiency anaemia and more so in multigravida. Aggressive health measures need to be taken to control this major health problem in Interior Sindh in particular and in the country as a whole especially in remote areas by promotion of regular consumption of food rich in iron and folates. The identification and treatment of severely anaemic patients with provision of iron supplement, improving personal hygiene, pure water supply and early antenatal diagnosis and follow up can decrease the prevalence of anaemia in pregnant women nationally and internationally. Need of the days remains the preparation and implementation of national nutrition plan with a special emphasis of controlling iron deficiency anemia during pregnancy