RESUMO
BACKGROUND AND OBJECTIVES: Riyadh and central province falls in a moderate prevalent zone of hemoglobinopathies in Saudi Arabia. However, it has been observed that the physicians working in Saudi Arabia invariably advise all cases of anemia for hemoglobin electrophoresis (HE). The present work was carried out to study the yield of the HE in Riyadh and the investigative practices of the physicians advising HE. SETTINGS AND DESIGN: The study was carried out in the hospitals of King Saud University from 2009 to 2011 in order to assess the yield of HE in referred cases of clinical anemia. MATERIALS AND METHODS: A total of 1073 cases divided in two groups of males and females had undergone complete blood count and red blood cell morphology. Cellulose acetate HE was performed and all the positive results were reconfirmed on the high performance liquid chromatography (HPLC). The results were analyzed for the type of hemoglobinopathies. For statistical analysis Statistical Package for Social Sciences 15 version (SPSS Inc., Chicago, IL, USA) was used. RESULTS: A total of 405 males and 668 females blood samples were included in the present study. 116 (28.5%) males and 167 (25%) females showed an abnormal pattern on HE. The incidence of beta thalassemia trait was higher in females while sickle cell trait was predominantly seen in males. Red cell indices were reduced considerably in thalassemias, but were unaffected in sickle cell disorders, except those which had concurrent alpha trait. The total yield of HE was 26.6% which was much less than expected. CONCLUSION: The physicians are advised to rule out iron deficiency and other common causes of anemia before investigating the cases for hemoglobinopathies, which employs time consuming and expensive tests of HE and HPLC.
RESUMO
BACKGROUND AND AIMS: Saudi Arabia falls in the high prevalent zone of αα and ß thalassemias. Early screening for the type of thalassemia is essential for further investigations and management. The study was carried out to differentiate the type of thalassemia based on red cell indices and other hematological parameters. MATERIALS AND METHODS: The study was carried out on 991 clinically suspected cases of thalassemias in Riyadh, Saudi Arabia. The hematological parameters were studied on Coulter STKS. Cellulose acetate hemoglobin electrophoresis and high-performance liquid chromatography (HPLC) were performed on all the blood samples. Gene deletion studies were carried out by restriction fragment length polymorphism (RFLP) technique using the restriction endonucleases Bam HI. STATISTICAL ANALYSIS: Statistical analysis was performed on SPSS 11.5 version. RESULTS: The hemoglobin electrophoresis and gene studies revealed that there were 406 (40.96%) and 59 (5.95 %) cases of ß thalassemia trait and ß thalassemia major respectively including adults and children. 426 cases of various deletion forms of α thalassemias were seen. Microcytosis was a common feature in ß thalassemias trait and (-α/-α) and (--/αα) types of α thalassemias. MCH was a more significant distinguishing feature among thalassemias. ß thalassemia major and α thalassemia (-α/αα) had almost normal hematological parameters. CONCLUSION: MCV and RBC counts are not statistically significant features for discriminating between α and ß thalassemias. There is need for development of a discrimination index to differentiate between α and ß thalassemias traits on the lines of discriminatory Indices available for distinguishing ß thalassemias trait from iron deficiency anemia.
RESUMO
The relation between Helicobacter pylori (H. pylori) and pathological changes in gastric mucosa ranging from active superficial gastritis to chronic active deep gastritis accompanied with intestinal metaplasia and dysplastic changes to gastric carcinoma of different grades. Two hundred and sixty six (266) gastric biopsies were examined from Saudi patients. At the same time a total of (10) patients with antral gastritis were used as control. The age of the patients ranged from 16 - 58 years old. There was no difference of changes in between. The transition between these changes may be multifactorial processes in which H. pylori may play a part. The findings suggested that gastric cancer may be induced in the disease associated with H. pylori in spite that the etiology of gastric carcinoma has not been clearly identified. Results showed that H. pylori associated chronic gastritis was the associated disease in (8%) of patients with gastric cancer. The remaining (92%) seems to have normal stomach to severe corpus atrophy.