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Objective: To test the sensitivity of localy available strips for the detection of Plasmodium Vivax and Plasmodium Falciparum species at a tertiary care hospital. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Transfusion, Rawalpindi Pakistan, done over one week during Nov 2021. Methodology: Four different commercialy available brands of Malaria Rapid Diagnostic Tests were taken. They were tested against venous blood sample taken from only one patient who had lab detected Malaria. Light microscopy showed trophozoites of both Plasmodium Vivax and Falciparum. Nine serial dilutions of different strengths were made from blood sample. These dilutions were tested against commercialy available four different Rapid Diagnostic Tests strips. Results: Malaria Rapid Diagnostic Tests kits from al the four brands which were commercialy available showed positive results for Plasmodium vivax up to 1:512 dilutions. However, only one brand Rapid Diagnostic Tests kits showed positive results with Plasmodium falciparum in 1:2 dilutions, in addition to Plasmodium vivax. Conclusion: The commercialy available Rapid Diagnostic Tests Immunochromatographic Technique have high sensitivity in diagnosing Malaria, but are not resolute when it comes to speciation, particularly for Plasmodium falciparum. [ABSTRACT FROM AUTHOR]

Objective: To assess the frequency of molecular markers along with serological markers of Hepatitis B virus, Hepatitis C virus and Human Immunodeficiency Virus among multi-transfused beta-thalassemia patients. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Transfusion, Rawalpindi Pakistan, from Apr to Jul 2020. Methodology: A total of 105 beta-thalassemia patients were included in this study. Demographic information and frequency of transfusion was noted. Serological markers were detected using chemiluminescence microparticle immunoassay while molecular markers were identified using real-time polymerase chain reaction. Results: Among 105 beta-thalassemia patients, 61(58.1%) were males and 44(41.9%) were females. The age range was from 2-34 years with a mean age of 11.8±6.4 years. Seropositivity and Nucleic Acid Testing reactivity was observed in 29(27.6%) and 16(15.2%) patients respectively. The frequency of hepatitis C Virus (HCV) antibodies and Ribonucleic Acid (RNA) was highest among infected patients while none of the patient was found to be reactive for anti-HIV and HIV-RNA. Viremia was detected in 12(11.4%) out of 29 seropositive patients and in 4(3.8%) out of 76 seronegative patients. Conclusion: Hepatitis C Virus was the most prevalent in beta-thalassemia patients folowed by Hepatitis B Virus and Human Immunodeficiency Virus. The serology should be augmented with NAT to detect viremia in seronegative cases as wel as seropositive cases. The NAT wil also help in early identification and treatment of infected patients and improve quality of life of these patients. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequencies of different cytogenetic abnormalities in patients of Acute Myeloid Leukemia and Acute Lymphoblastic Leukemia in Northern Pakistan. Methods: It was descriptive cross-sectional study conducted in Hematology Department of a Tertiary care referral institute from June 2015 to July 2017. All newly diagnosed cases of Acute Leukemia were analyzed. Cytogenetic analysis was performed on bone marrow aspirate samples using Giemsa-trypsin banding technique. Karyotypes were identified and interpreted according to ISCN criteria. Results: A total of 355 newly diagnosed patients of Acute Leukemia were analyzed. Out of these, 180 patients had AML and 175 had ALL. In Acute Myeloid Leukemia chromosomal abnormalities were detected in 28.2 % cases. Of these the common ones included t(8;21),t(15;17),+8, Inversion 16 and Monosomy 7. Other abnormalities included Complex karyotype, Down’s syndrome related AML, Hyperdiploidy, del 16q,-8,+Y and t(3p;17q)del 10. In Acute Lymphoblastic Leukemia chromosomal abnormalities were detected in 40% cases. Common ones included Hyperdiploidy, Tetraploidy and t(9;22). Other abnormalities included t(1;19) and t(2;8)t(8;14). Conclusion: Cytogenetically favorable abnormalities are commonest occurring chromosomal defects in both Acute Myeloid Leukemia and Acute Lymphoblastic Leukemia in Northern Pakistan, i.e., t(8;21) in AML and Hyperdiploidy in ALL. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of Del 13q14 in Chronic lymphocytic leukaemia, to compare its association with clinicpathologic features and to define the contribution of this abnormality to the prognosis. Study Design: Cross-sectional study. Place and Duration of Study: Department of Haematology, Armed Forces Institute of Pathology, Armed Forces Bone Marrow Transplant Centre and Oncology department, Combined Military Hospital Rawalpindi, from Apr 2017 to Jul 2018. Methodology: A total of 56 newly diagnosed cases of CLL were included in the study. Patients were diagnosed on the basis of National Cancer Institute Working Group guidelines for diagnosis of CLL. After detailed history and thorough clinical examination; complete blood counts, biochemical profile, bone marrow examination, immunophenotyping on bone marrow or peripheral blood samples were done and Interphase FISH studies on blood or bone marrow specimens for detection of Del 13q14 were performed. Clinico-pathological features of CLL patients with Del 13q14 were compared with other cytogenetic abnormalities. Results: The frequency of Trisomy 12 was found to be 37.5%. Most of CLL patients with Del 13q14 were aymptomatic and were diagnosed on routine workup. The WBC count and Absolute lymphocyte count was slightly lower in patients with Del13 q14 lower when compared with the CLL patients without 13q14 Deletion. Most of the patients with this aberration presented in early stage (Binet stage A) and this association of Del 13q14 with Binet stage was statistically significant (p<0.05). However, no association was found between 13q14 deletion and ZAP70 as all of our patients were negative for this marker. Many patients with Del 13q14 did not require chemotherapy at diagnosis and during follow up as compared to patients without del13q14, and this association was statistically significant (p<0.05). The study also showed that disease progression in patients with deletion 13q14 become significantly less as compared to patient without Del 13q14. Conclusions: The deletion of 13q14 influence clinical outcome of patients with CLL and was found to be associated with favourable prognosis. A determination of Del 13q14 should therefore be included in the investigations of the prognostic factors of B-cell chronic lymphocytic leukemia. This can prevent unwanted chemotherapy in these patients. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to determine and quantify those factors that anesthetist's use when deciding to transfuse blood in operating room. Setting: CMH abbottabad Period: Nov to Dec 2008 Design: Survey report. Patients and Methods: Prospective cross-sectional descriptive from operation theatre of Combined Military Hospital Abbottabad a tertiary care hospital. With consent from the local ethics committee, an audit was carried out using a questionnaire designed to examine some of the factors that could be important in the decision-making process surrounding blood transfusion during intermediate and major surgery. Anesthetists were asked to fill in the audit forms and to indicate whether they were going to give blood or not. Fifty two audit forms, completed during intermediate or major surgery, were analyzed to determine the strengths of certain factors in the decision-making process related to transfusion. Result: Fifty one forms had a satisfactorily complete data set with hemoglobin concentrations Hb between 6.6 and 15.0 g/dL. This study demonstrates that, of the physiological factors, the hemoglobin concentration was the most important factor used for red cell transfusion, and the presence of ongoing bleeding an important contextual factor. Peer pressure to transfuse became apparent at a [Hb] of about 8.5 g/dL. Conclusion: The patients were transfused at the average Hb value of 10.8 g/dL. This average Hb of transfused patients is much higher than current Hb trigger thresholds of 7.0-8.0 g/dL. [ABSTRACT FROM AUTHOR]

The article discusses detection of JAK2 gene mutation in Pakistani women with triple‐negative breast cancer. Topics include the percentage of samples correctly identified as positive and negative for the JAK2 V617F exon 14 mutation in both groups was calculated; TNBC comprises 17.28 percent of the breast cancers in Pakistani women according to one estimate; and all newly diagnosed untreated TNBC patients must have their JAK2 exon 14 statuses checked prior to therapy in Pakistan.