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.

Frequency of seizures and epilepsy after ischaemic stroke

To evaluate the frequency and risk factors of seizures and epilepsy after ischemic stroke. This prospective observational study was conducted on patients with Ischemic Stroke in the Department of Neurology; Postgraduate Medical Institute, Lady Reading Hospital, Peshawar. These stroke patients were followed up for a total period of 2 years. Initially 210 patients were enlisted in the study. Out of these, 10 patients died or lost to follow up so they were excluded from the final analysis leaving a figure of 200. The main outcome measures were the occurrence of single or recurrent seizures as well as the occurrence of both early [within 2 weeks] and late [after 2 weeks] seizures were recorded. Patients who already had history of seizures, those with intra-cerebral bleed and sub-arachnoid hemorrhage were excluded from the study. Out of 200 patients [130 males and 70 female], 6 [3%] patients had early seizures while 10 [5%] patients presented for the first time with late onset seizures. So a total of 16 [8%] patients had post stroke seizures. Early seizures were mostly generalized tonic clonic seizures, while late seizures were mostly partial with or without secondary generalization. Epilepsy characterized by recurrent seizures occured in 3 patient's [1.5%]. Stroke patients have overall 8% risk of seizures and 1.5% risk of epilepsy in the first 2 years after an ischemic stroke. Majority of these seizures occurred after 2 weeks of onset of stroke