Chromosomal study for prognostic grouping in chronic lymphocytic leukemia

To determine the frequency of various cytogenetic aberrations in newly diagnosed chronic lymphocytic leukemia [CLL] patients, and their detection rate by cytogenetic and fluorescent In situ hybridization [FISH] technique separately. A case series. Clinical and Molecular Cytogenetics Laboratories, University of California, Los Angeles, USA, from November 2007 to July 2008. Analysis was made on 100 diagnosed chronic lymphocytic leukemia patients. Cytogenetics and FISH technique were performed on blood or bone marrow samples. Nineteen out of 100 cases [19%] showed karyotype abnormalities; whereas 55 showed abnormalities using the CLL - specific FISH probes. The most frequent abnormality detected by standard Cytogenetics was trisomy 12. The most common abnormality detected by FISH was a deletion of 13q14 [40 out of 55 cases; 72% of the abnormal]. For prognostic grouping of CLL patients, FISH must always be requested which may even replace standard karyotyping. These chromosomal markers help in choosing the therapeutic options

Efficacy and safety of total dose infusion of low molecular weight iron dextran in the treatment of iron deficiency anemia during pregnancy

To determine the efficacy and safety of Total Dose Infusion [TDI] of low molecular weight iron dextran for the treatment of iron deficiency anemia compared to oral iron replacement during pregnancy through improvement in hemoglobin [Hb] after intervention. Non-randomized control trial. Section of Gynaecology and Obstetrics, Shifa International Hospital and Shifa Community Health Centre, Islamabad during January 2005 to January 2006. A group of 100 pregnant women with gestational age greater than 12 weeks with confirmed diagnosis of iron deficiency anemia attending the antenatal clinics were enrolled in this study. Total dose iron infusion of low molecular iron dextran was given to these patients after calculating iron deficit, in a monitored in-patient setting. Control comprised of a second group of 50 pregnant females matched for age, parity and baseline hemoglobin, tolerant to oral iron supplementation [ferrous sulphate 200 mg three times a day] attending the antenatal clinics during the same period. Post-treatment hemoglobin levels of study group as well as the oral control group were determined between 3 to 4 weeks. In the intervention group, mean pre-infusion hemoglobin level was 8.57 +/- 0.9 gm/dl [range 5-10.5gm/dl] and mean post-infusion Hb was 11.0 +/- 1.1 [range 8.4-14. 3 gm/dl]. In control group, mean pre-oral intake Hb level was 9.5 +/- 0.9 gm/dl [range 7-1 0.5 gm/dl] and mean post-oral intake Hb was 10.2 +/- 1.2 gm/dl [range 6.4-1 2.8 gm/dl]. Mean increase of Hb in intervention group was 2.43 gm/dl [95% Cl 2.4 - 3.8] and for controls it was 0.7 gm/dl [95% Cl 0.6-2.3]. Flushing and palpitations were observed in 4% of interventional group patients and none in the control group. No significant adverse reactions were observed in either group. We conclude that the total parenteral iron replacement with low molecular weight iron dextran is an effective and safe method for the treatment of iron deficiency anemia in a selected group of pregnant women

Effect of unadjusted dose of erythropoietin on hemoglobin in chronic renal failure patients

To assess the response of unadjusted dose of erythropoietin with respect to weight in patients on dialysis. Fifty-five patients who previously had three dialysis sittings, had received erythropoietin for at least one month and were coming on regular follow up dialysis in dialysis clinic of Shifa International Hospital, Islamabad were included in this study. Erythropoietin was given subcutaneously twice a week adding to a dose of 4000 units per week. Hemoglobin level was determined at the end of study period. The over all increase in hemoglobin after the administration of erythropoietin was 1.18 +/- 0.06 g/dl. 87.3% patients responded to erythropoietin and showed a rise in their hemoglobin, while 12.7% did not respond. Unadjusted dose of erythropoietin showed increase in hemoglobin but in most of the cases failed to achieve the target hemoglobin. In order to achieve the target hemoglobin, administration of adjusted doses of rHuEPO is required

Treatable disease causing untreatable harm: anemia in school going childern

Prevalence of anemia in Pakistan is high. Magnitude of anemia is well studied in pregnant woman and infants in Pakistan, but we do not have enough data on school age children. The aim of this study was to find the frequency of anemia in apparently healthy primary school age population in Islamabad and its suburban area. All children between the ages of 5 and 14 years attending participating non-formulary schools in Islamabad and its suburbs were enrolled in the study. Children attending these schools belong to low to lower middle socioeconomic status. Hemoglobin level was determined in all subjects and a level <11.5 gm/dl was considered as anemia. A total of 319 children were enrolled. Eighty-seven [27%] children were found to be anemic. Mean hemoglobin concentration was 12.1 gm/dl. There was no significant difference between mean hemoglobin concentrations of males vs. female children. Anemia is a significant problem in our apparently health school going children of low to lower middle class. We suggest that primary school age children must be screened for anemia and treated

Prevalence of antenatal care use of food supplements during pregnancy and lactation and factors responsible for not taking them in Tarlai urban slum of Islamabad

The objective of this study was to ascertain the prevalence of antenatal care, use of food supplements during pregnancy and lactation and factors responsible for not taking them in Tarlai, an urban slum of Islamabad. A Cross-sectional survey of 100 married women in the age range 15-45 years women utilizing and not utilizing antenatal care facilities during their previous pregnancy was carried out in April 2004. Data was collected through a structured questionnaire and processed and analyzed by using SPPS 10.0. Use of supplements was found high in women attending antenatal care. Realization of the importance of taking a healthy diet during pregnancy was significantly higher among women utilizing antenatal care. In most of the women's the diet remain unchanged. 56% women attended the antenatal care clinics. Those not taking food supplements, 39% were non affording, 21%had no concept of their benefits, 36% did not like to take and 4% felt nausea and vomiting. Just over 50% women received antenatal care. Utilization of antenatal care showed a positive impact on awareness of taking food supplements during pregnancy and lactation

Identification of seronegative pregnant women eligible for immunization against rubella

To estimate the frequency of Rubella seropositivity among pregnant women and thereby getting an estimate of seronegative women who should eventually be immunized against Rubella. A blood sample of 100 consecutive pregnant women coming for their first antenatal check-up at Shifa International Hospital, Islamabad, was collected in the year 2002. Enzyme-Linked immunosorbent assay [ELISA] technique was used to detect IgG antibodies against Rubella. Out of 100 pregnant women 61[61%] were positive for rubella [IgG antibodies] in the first trimester of pregnancy. Mean age of the study participants was 27 ' 3.27 years. Twenty-five [25%] women were primigravida, while 75 [75%] were multigravida. Majority of the women were housewives belonging to middle and lower middle socioeconomic class. We found 61% women had positive Rubella antibodies during first antenatal visit. Nearly 40% who were negative should be immunized against rubella, preferably before conception

Knowledge of type 2 diabetic patients about their illness: pilot project

To evaluate the baseline level of knowledge and awareness of diabetic patients about their disease and it's complications. It was a Cross Sectional Survey conducted at Foundation Clinic, Shifa College of Medicine, Islamabad, in April 2004. A structured questionnaire was used. Forty diabetic patients were interviewed to know their knowledge attitude and practices about diabetes. All data was entered into SPSS version 10.0. The data was re-validated and analyzed. Mean age of study participants was 45.35 +/- 13.05 years, 11[27.5%] were male and 29 [72.5%] were female. The mean BMI of the study participants was 27.06 +/- 6.29 kg/m2. Majority of the patients 27 [67.5%] had type 2 diabetes. The mean fasting blood sugar was 159 +/- 73.89 mg/dl and random blood sugar was 200 +/- 91.2 mg/dl, 50% of the patients were using antidiabetic drugs regularly and only 15% of the patients were regularly monitoring their blood glucose at home using a glucometer. Awareness level of the study participants was low. The awareness about the disease in majority of diabetic patients was not adequate in this study. Routine individual teaching and counseling represents an effective educational model [JPMA 55:221;2005]

Temperature regulation and standardization practices of clinical laboratories in Karachi

To examine the temperature regulation and standardization practices of clinical laboratories in Karachi. Forty five clinical laboratories in Karachi were examined for observing the standard protocols for running a lab with particular reference to temperature regulation. A questionnaire to the effect was filled. Among the 45 labs included, the mean complete blood count performed per day was 52 +/- 47. Only 5 [11%] labs had a temperature reader. Thirty [66.7%] labs had an air-conditioner installed, of which only 24 were found in working condition. Maintenance of instruments was carried out every 67.5 +/- .30.6 days. The mean number of haemolyzed samples was 2.3 +/- 1.7. Control was available in 24[53.3%] labs, which was used daily in only 10 labs. Quantity of blood was the same in all the tubes in only 33[73.3%] labs. Commercial laboratories should be properly registered and their quality standardized

Comparative study of knowledge, attitude and practices among antenatal care facitities utilizing and non - utilizing women

To compare the knowledge, attitude and practices among antenatal care facilities utilizing and non-utilizing women, aged 15-49 years. A Cross-sectional survey was conducted between October 2003 and April 2004, including 200 married women in the age range 15-49 years. Knowledge, attitude and practices of women utilizing and not utilizing antenatal care facilities during their previous pregnancy were compared by calculating odds ratios and 95% confidence intervals. P values were obtained by doing chi-square test. Pallor was significantly lower among women utilizing antenatal care [57%] as compared to those who were not [77.6%]. [O.R 0.38 95% CI[0.18-0.81] p value 0.02]. Tetanus toxoid coverage was higher among women utilizing antenatal care [92%] compared to those who were not [59.2%] [O.R 10.8 95% CI[4.5-26.2]. Knowledge about danger signals in pregnancy and realization of the importance of eating a healthy diet during pregnancy was significantly higher among women utilizing antenatal care. Lesser prevalence of Anaemia and better tetanus toxoid coverage was seen among women attending antenatal care facilities.Identification of danger signals in pregnancy and recognition of nutritional demands of pregnancy are better understood by women utilizing antenatal care facilities