RESUMO
Infections due Hepatitis B and C with co-infection tuberculosis are important health issues all over the world. In TB patients, viral hepatitis infection increases risk of drug related hepatotoxicity up to three to five times more than TB patients which do not have viral infection. The study was designed to determine the frequency of Hepatitis B and C among the tuberculous patients admitted at Sheikh Zayed Hospital, Rahim Yar Khan. This is descriptive and cross sectional study which was conducted at Sheikh Zayed Hospital Rahim Yar Khan from September 2011 to April 2012.Blood samples were collected from TB patients aseptically from Pulmonology Department Sheikh Zayed Hospital Rahim Yar Khan. HBsAg and anti HCV antibodies were detected using ICT and ELISA techniques according to SOP of the kit manual. Among the 110 TB positive patients,5.5% were positive for HBsAg and 9.1% were positive for anti HCV antibodies using ELISA technique. Whereas, 5.5% HBsAg and 10% anti HCV antibodies were positive using ICT. The transmission of HBV and HCV was expected to have occurred were mostly found in barber shop and during ear nose piercing [30%], blood transfusion [20%], visit to quack [10%] as indicated from the history. Detection rate of HCV using ELISA is greater than ICT method. Male to female ratio 1:1 and age mean was 42 with standard deviation 18.2. We found a relatively increased frequency of HBV and HCV among TB patient. Therefore TB patients should also be screened for HBV and HCV for better management of the conditions
RESUMO
Patients with end - stage renal disease [ESRD] develop increased bleeding tendency, which is characterized by defective interaction of platelets with damaged sub endothelium due to impaired platelet functions. This study was earned out to demonstrate the aggregation defects in uraemic patients by using different platelet agonists. A total of 57 subjects were included in the study. These were divided into two groups; 37 patients of ESRD on maintenance haemodialysis and 20 healthy adults as control. Complete blood count [CBC], urea and creatinine were carried out on all the samples. Aggregation studies were performed using chronology 490 - 2D Platelet Aggregometer. Adenosine diphosphate [ADP], collagen, ristocetin and arachidonic acid were used as agonists to perform aggregation studies and correlation of these parameters with Haemoglobin [Hb], Haematocrit [Hct], urea and creatinine were determined. All the subjects included in this study were evaluated for platelet aggregation in vitro. Percentages of maximal aggregation of platelets with ADP, collagen, ristocetin and arachidonic acid were significantly low in uraemic patients as compared to the control group. Aggregation with ristocetin was particularly reduced in uraemic patients [Mean 57.54 +/- 23.85%] in comparison with controls [Mean 84 +/- 6.01%]. Inverse correlation of urea was found with ADP response [p value 0.028] and creatinine with arachidonic acid [p value 0.036] which was statistically significant. No correlation was found between haemoglobin, haematocrit and percentage of maximal aggregation after stimulation with collagen, ADP, ristocetin and arachidonic acid. Aggregation responses were reduced with almost all the agonists, especially ristocetin as compared to control samples. This shows that defective platelet - vessel wall interactions play an important role in uraemic bleeding tendency