Seroprevalence of HDV among non-hospitalized HBsAg positive patients from KPK-region of Pakistan

Objective To study the seroprevalence of hepatitis B virus (HBV) and hepatitis delta virus (HDV) infections in patients visiting outpatient department of a major tertiary care hospital in Khyber Pakhtunkhwa region of Pakistan. Methods Blood samples were collected from non-hospitalized patients. Serological analysis was done by ELISA and viral DNA was amplified by PCR. The amplified DNA was analyzed by agarose gel electrophoresis. Results Altogether, 946 blood samples were screened, overall percentage of HBsAg-positive patients remained 22.41% (prevalence: 224.10/1 000; CI: 0.197 5 ± 0.250 7) with the highest incidence rates among relatively younger age groups (20–29 years). The prevalence of HBV–HDV co-infection was found to be 46.75/1 000; CI: 0.031 8 ± 0.061 7. In HBsAg-positive patients, anti-HBc-total was detected in 86.79% while 25.00% were positive for anti-HBc-immunoglobulin M. Similarly, among these patients, HBV DNA was detected in 64.13% and 10.85% were co-infected with HDV. Different symptoms were associated with the prevailing infection, including malaise (62%), anorexia (66%) and fatigue (73%). The most commonly associated symptom was abdominal discomfort. Among these patients, certain risk factors, including surgery, visit to dentist and intravenus infusions were frequently associated with the infection (χ

Iron deficiency anemia; red cell distribution width [RDW] and red cell indices in the prediction of among healthy women in third trimester of pregnancy

To determine the importance of the RDW and other red cell indices [MCV, HBG] in the prediction of iron deficiency anemia in third trimester of pregnancy in a tertiary care hospital of Peshawar. Cross sectional study. OPD Department of Gynecology and Obstetrics Postgraduate Medical Institute, Lady reading Hospital [PGMI-LRH] Peshawar. Period 1[st] August 2012- 10[th] Dec 2012. A Total of 152 women attending the centre were included. Necessary information's were recorded on the questionnaire prepared in accordance with the objectives of the study. A total of 152 women in their third trimester presenting to Gynecology and obstetrics department of Lady reading hospital Peshawar. The age range of the patient was from 20 years to 55 years with mean age of 33 +/- 3.4 years. Out of total 27[18%] were primagravida. Majority of the cases 118[77.6%] were from Peshawar, 9% from charsadda, 8% nowshera etc. We also received 2 patients 1.2% from Afghanistan. Regarding financial status 57%[87] females were in upper Class [i.e. income >20000/month] on recall. Of total 81[53%] of the females were having hemoglobin less than 11g/dl and 22% of the women had HCT<32% which as per criteria of the WHO were anemic at the time of presentation. While 29[19%] patients had low value of MCV [microcytic]. Fifty five patients [36.2%] had RDW CV[%] more than 15% which points more towards the microcytic nature of anemia and more anisocytosis. Fifty five patients [36.2%] had RDW CV[%] more than 15% which points more towards the microcytic nature of anemia. While 29[19%] patients had low value of MCV [microcytic]. Increased RDW is best indicator for the detection of iron deficiency anemia than MCV. Increased RDW even in the presence of normal MCV can be an early signal for iron deficiency anemia in pregnancy. Hence RDW is more reliable indicator for iron deficiency especially in pregnancy. Changes in RDW in last trimester is more significant that MCV

Beta-Thalassaemia trait: haematological parameters

Beta-Thalassaemia syndromes are a group of hereditary disorders characterised by a genetic deficiency in the synthesis of beta-globin chains due to a defect in beta-globin genes. The objective of this study was to determine the haematological features of beta-thalassaemia trait [BTT], and to determine the sensitivity of Mean Corpuscular Volume [MCV], Mean Corpuscular Haemoglobin [MCH] and Mentzer Index [MI] as a screening tool for beta-thalassaemia trait. A descriptive study was conducted in Hayatabad Medical Complex, Peshawar from May 2009 to May 2010 with 203 subjects having BTT. Blood samples were collected in EDTA anti-coagulated tubes. RBC indices were taken as part of complete blood count [CBC] by haematology analyser, and Haemoglobin [Hb] electrophoresis was done to determine the HbA2 percentage. The data was collected and analyzed on statistical software for demographic details, RBC indices and HBA2 levels. Out of 203 patients, 92 [45%] were males and 111 [55%] were females. Most patients tested were in the 15-45 year age group. One-hundred-sixty [79%] patients had anaemia. MCV was lower than 76 fl in all the cases. Mean MCV was 59.1 fl. MCH was low, the mean MCH being 19.3 g/dl. MCH <26 gave sensitivity of 99% in detecting BTT. We calculated MI for these cases and found out that it was <12 in 75% of cases and <15 in 197 [97%]. beta-thalassaemia traits present with a microcytic hypochromic blood picture, detected on simple haematology analysers as low MCV and MCH and MI which provide a useful screening tool for beta- thalassaemia trait

HIV infection and AIDS in NWFP Pakistan

A total of 4148 individuals were screened for HIV at HIV screening centre Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from August 1989 till the end of 1990. Among them 3860 were blood donors. All of them were HIV negative. None of the suspected immunodeficient patients were HIV reactive. Those who were coming from aboard, 10 out of 21 individuals were HIV positive. Among the HIV positive, one was Canadian, the rest were Pakistanis with only one female

G6PD deficiency and beta-thalassaemia in the same patient

A report of 8 months old female child with a rare combination is presented who had inherited G6PD deficiency from father and Beta-Thalassaemia from mother