Chronic myeloid leukaemia presenting as priapism: A case report from Khyber Pakhtunkhwa.

Priapism is known as a very rare complication of leukaemia. We report a 16-years boy who presented with the persistent painful erection of the penis for eleven days. He had aspiration without achieving sustained detumescence. The patient underwent an emergency irrigation and decompression of priapism by a consultant urologist. During the hospital stay blood morphology, bone marrow aspiration and BCR-ABL were done to confirm the diagnosis of chronic myeloid leukaemia. Our report thus explains the relevance of all physicians in the diagnosis and management of patients with priapism.

Clinical manifestations of patients with Systemic Lupus Erythematosus (SLE) in Khyber Pakhtunkhwa.

OBJECTIVE: To determine major symptoms and signs in patients of systemic lupus erythematosus. METHODS: This cross-sectional study was conducted at the Lady Reading Hospital, Khyber Teaching Hospital and Hayatabad Medical Complex, Peshawar, Pakistan, from January 15, 2014, to August 15, 2016, and comprised patients of systemic lupus erythematosus. Data was collected through an interview-based questionnaire containing questions about different symptoms. SPSS 20 was used for data analysis. RESULTS: Of the 663 patients, 606(91.4%) were females and 57(8.6%) males. The overall mean age of patients was 33.09 ± 12.40 years and the mean age of diagnosis was 31.85 ± 12.40 years. The most common general symptom in our study was fatigue which was present in 524(79.03%) patients. Other constitutional symptoms were fever 334(50.04%), body aches 443(66.08%) and weakness 411(62%). The most common clinical manifestation in our study was arthritis 518(78.1%). Malar rash was found in 487(73.5%) patients. Dry eye was in 227(34.2%) patients, followed by conjunctivitis 156(23.5%). Anaemia was present in 444(66.96%) patients, followed by leukopenia 166(25.03%) and thrombocytopenia 42(6.33%). CONCLUSIONS: Significant regional differences existed in the clinical manifestations of systemic lupus erythematosus in Khyber Pakhtunkhwa compared to other regions.

Serum Uric Acid level in the severity of Congestive Heart Failure (CHF).

BACKGROUND AND OBJECTIVE: It has been observed that in a clinical condition like hypoxemia there is an increase in the serum Uric acid level. The objective of our study was to find out the relationship between serum uric acid levels in the severity of Heart failure. METHODS: We analyze 285 patients with a diagnosis of Congestive heart failure admitted in Lady Reading Hospital Peshawar from March 1st to August 2016. Age group of patients was 17- 67 years. New York Health Association (NYHA) scoring were used to access the severity of Congestive Heart Failure. Serum UA level >7.0 mg/dl was considered high. RESULTS: Total 285 patients with CHF were analyzed with a mean age of 54±2.8 years in which males were 65.96% and 34.03% were female. 40% were in class II of New York Health Association (NYHA), 32.63% in class III and 25.61% in class IV and 1.75% were in class I. Out of 285, 59.29% met the definition of hyperuricemia. In which 83.43% were male and 16.57% were female. Most of the Hyperuricemic patients 62.13% were in age group of 51- 60 years, with a mean age of 57±4.5 years. We found a significant correlation between uric acid level and BNP (p= <0.001), and use of diuretics (p=<0.001). 34.93% of the Hyperuricemic CHF patients were in NYHA III and NYHA IV whose SUA was above 8 mg/dl as compared to 31.57% Hyperuricemic CHF patients whose SUA was below 8 mg/dl. CONCLUSION: High serum Uric acid was observed in 59.29% of patients with CHF. The observed significant correlation between UA level and some established prognostic markers in these patients may indicate that serum UA could provide additional prognostic information in this population. SUA as a marker can be measured anywhere at a low cost to help identify high-risk patients with CHF. Lowing uric acid is expected to be a new approach for prevention and therapy of HF.