Clinico-pathological presentation and therapeutic options for hairy cell leukemia

To look at clinical and hematological presentation as well as treatment outcome of patients with diagnosis of Hairy Cell Leukemia [HCL] in our population. All patients diagnosed with HCL by morphological and immunohistochemical methods presenting to Medical Oncology Ward at Hayatabad Medical Complex, Peshawar since August 2008 were included in the study. Out of 7 patients diagnosed with HCL, 6 were male and 1 was female [M:F ratio 6:1]. Median age at diagnosis was 44 years. Fever, pallor, palpitations and fatigue were the commonest presenting complaints. Spleenomegaly was noted in all patients [100%]. Pancytopenia was noted in all patients at presentation. Five patients were treated with Interferon while 2 were treated with Cladribine. At 18 months of follow-up, one out five patients treated with IFN had relapse while both the patients treated with Cladribine were in complete remission. Our study showed that HCL patients present at a younger age in our region but further studies with larger sample size are required to confirm this. All patients showed a complete response to Interferon and Cladribine with all patients alive at 18 months of follow-up.

Hospital waste management in the teaching hospitals of Karachi

To evaluate the current practices of segregation approaches, storage arrangements, collection and disposal systems in the teaching hospitals of Karachi. A cross-sectional survey was conducted in eight teaching hospitals of Karachi, using convenient sampling technique. The instrument of research was a self administered questionnaire, with four sections, relating to the general information of the institution, administrative information, information regarding Health Waste Management personnel and a check-list of Hospital Waste Management activities. Out of eight hospitals visited 2 [25%] were segregating sharps, pathological waste, chemical, infectious, pharmaceutical and pressurized containers at source. For handling potentially dangerous waste, two [25%] hospitals provided essential protective gears to its waste handlers. Only one [12.5%] hospital arranged training sessions for its waste handling staff regularly. Five [62.5%] hospitals had storage areas but mostly it was not protected from access of scavengers. Five [62.5%] hospitals disposed off their hazardous waste by burning in incinerators, two [25%] disposed off by municipal landfills and one [12.5%] was burning waste in open air without any specific treatment. No record of waste was generally maintained. Only two [25%] hospitals had well documented guidelines for waste management and a proper waste management team. There should be proper training and management regarding awareness and practices of waste disposal. Research must be undertaken to seal existing gaps in the knowledge about hospital waste management. The hospital waste management guidelines enacted on 7th June 2004 should be followed and regulated by law enforcement agencies rigorously [JPMA 55:192;2005].