Haemolytic anaemia: a consequence of COVID-19.

A man in his early 50s presented with jaundice, mild shortness of breath on exertion and dark urine. He had had coryzal symptoms 2 weeks prior to admission. Medical history included obstructive sleep apnoea and hypertension. His initial blood tests showed a mild hyperbilirubinaemia and acute kidney injury stage 1. Chest X-ray and CT pulmonary angiogram were negative for features suggestive of COVID-19. He later developed a drop in haemoglobin and repeat bloods showed markedly raised lactate dehydrogenase and positive direct antiglobulin test. These results were felt to be consistent with a haemolytic anaemia. A nasopharyngeal swab came back positive for COVID-19. We suspect the cause of his symptoms was an autoimmune haemolytic anaemia secondary to COVID-19 which has recently been described in European cohorts.

Impact of tobacco health warnings on smokers in Pakistan.

OBJECTIVE: To see the impact of health warnings cigarette packets on the smoking habits of smokers. METHODS: The cross-sectional study was conducted in Karachi from July to October 2014, and comprised adult male cigarettes smokers. A self-administered questionnaire was presented to the participants who were selected through non-probability convenience sampling irrespective of their educational background. Data was analyzed using SPSS 17. RESULTS: Out of the 1500 subjects, 1330(88.7%) noticed warning on cigarette packets; 730(54.8%) considered the picture to have significant impact; 630(47.3%) tried to decrease smoking; and 430(32.4%) actually attempted to quit. Of the 430 who tried to quit, 300(69.7%) considered the picture as having had an impact. CONCLUSIONS: The current health warnings on cigarette packets sold in Pakistan do not carry a significant deterrent impact.