Clinico-Epidemiological Profile of Patients with Polycythaemia Rubra Vera - a Five Year Experience from a Tertiary Care Center.

BACKGROUND: Polycythaemia rubra vera (PV) is a Philadelphia chromosome negative myeloproliferative neoplasm characterized by increased red cell production, independent of the mechanisms that regulate normal erythropoiesis. The aim of this study was to analyze the clinico-epidemiological profile of Pakistani patients with PV. MATERIALS AND METHODS: In this retrospective cross sectional study, 26 patients with PV were enrolled from January 2010 to December 2014. They were diagnosed based on WHO criteria. RESULTS: The mean age was 53.4±9.31 years (range 36-72) and the male to female ratio was 2:1. Overall 30.7% of patients were asymptomatic. In symptomatic patients, major complaints were headache (30.8%), abdominal discomfort (23.1%), blurred vision (15.3%), pruritus (11.5%) and vascular incidents (11.5%). Physical examination revealed plethoric face and splenomegaly as predominant findings, detected in 34.6% and 30.7%, respectively, with the mean splenic span of 15.9±2.04cm. The mean hemoglobin was 18.1±1.9 g/dl with the mean hematocrit of 55.6±8.3%. The mean total leukocyte count was 12.8±7.1x109/l and the platelet count 511±341.9x109/l. Mean erythrocyte sedimentation rate was 3.5±1.22mm/hr. Serum lactate dehydrogenase, serum creatinine and uric acid were 552.7±309.2, 0.8±0.17 and 6.60±1.89 respectively. CONCLUSIONS: PV in Pakistani patients, unlike in the West, is seen in a moderately young population. The disease is frequently seen in male gender and primarily patients present with symptoms related to hyperviscosity.

Trends of Venereal Infections among Healthy Blood Donors at Karachi.

BACKGROUND: To determine the prevalence and trends of venereal infections, including the Human Immunodeficiency Virus (HIV) and treponema pallidum in healthy blood donors over a decade. MATERIALS AND METHODS: This cross-sectional descriptive study conducted at the Blood Bank of Liaquat National Hospital, extended from January 2005 to December 2014, in which 148268 healthy donors were enrolled. Screening for HIV was done by Microparticle Enzyme Immunoassay and Chemiluminescent immunoassay techniques. Syphilis screening was done by Treponema pallidum particle agglutination and Chemiluminescent Immunoassay methods. RESULTS: Out of the 148268 total donors, 147684 (99.6%) were replacement donors and remaining 584 (0.4%) were voluntary donors with a mean age of 29.09 ± 7.04 years. Overall, there were 147939 (99.8%) males and 329 (0.2%) females. A total of 1536 (1.03%) donors were reactive. Among the replacement donors, 1535 (1.03%) were found to be reactive for HIV and treponema pallidum. Of these, 172 (0.11%) donors were positive for HIV, while 1363 (0.91%) were positive for treponema pallidum. All reactive donors were male (99.94%), except for one female (0.06%). The prevalence of HIV and syphilis were higher in the younger age group (18 - 30 years). Out of 584 voluntary donors, only one (0.1%) donor was positive for HIV, while all donors were negative for treponema pallidum. The positive rates among replacement and voluntary donors were 1.03% and 0.1%, respectively. Co-infectivity was observed in two (0.001%) donors. CONCLUSION: The prevalence of venereal infection was higher in replacement donors as compared with voluntary donors. The prevalence of syphilis in our series was high compared with earlier studies. It emerges that syphilis positivity rate appears to escalate; however, HIV infection remains static over a decade. Higher prevalence in younger donors is alarming and adversely affects the prospective blood donation pool. Stringent donor selection, emphasis on voluntary donation, and vigilant donors screening are highly recommended to ensure the maximum safety of blood recipient.