Frequency of ABO Blood Group Discrepancies and its Classification into Groups in Tertiary Care Hospital Karachi

Background: The aim of this study was to document the frequency of ABO discrepancies through ABO blood group test performed by the tube technique method. It was conducted on residents of Karachi in Ziauddin hospital, which were then categorized into four groups. Methods: Descriptive, cross-sectional type of study was conducted at the Blood Bank of Dr. Ziauddin Hospital, North Nazimabad and Clifton campuses in Karachi Pakistan. A total of 1522 samples were included with the exclusion criteria of neonates and infants of up to the age of 6 months. The time frame was from September 2016 to March 2017. Blood samples were collected from a superficial vein by trained phlebotomists and submitted to the blood bank department in 2 tubes, purple top vacutainer tube containing Di-potassium Ethylene Diamine Tetra Acetic Acid (K2 EDTA) anticoagulant and red top vacutainer tube containing clotted blood. Blood group testing was done by tube technique by a researcher and then redone by the senior technologist of blood bank to control bias. Results: 1557 hospitalized patients (854 males and 703 females) from various clinical specialties in Ziauddin Hospital, Karachi and other hospitals were included for ABO blood grouping. The male to female ratio was 1.2:1 with the age range from 9 months to 92 years. ABO discrepancies were positive in 18 out of 1557 Patients (1.1%). Male to female ratio among positive ABO discrepancies were 1:5 (11 males and 7 females out of 18 patients). Four groups of ABO discrepancies were formed. The most common one being group I discrepancies which had 12 out of 18 Patients (66.7%). Group II discrepancies had 2 out of 18 Patients (11.1%). Group III discrepancies had 1 out of 18 Patients (5.5%) and Group IV discrepancies consisted of 3 out of 18 Patients (16.7%). Conclusion: Forward and reverse groupings are essential to blood group testing for assigning the correct ABO blood group to the individual. Those ABO discrepancies in which forward and reverse grouping are not matched to each other can cause severe transfusion reactions resulting fatal for life. Therefore, it is necessary to ensure that the correct ABO blood product is transfused to save a life. Thus, reverse grouping should be strictly adopted in every blood bank and transfusion services as a routine practice

ABO AND RHESUS BLOOD GROUP DISTRIBUTION IN RESIDENTS OF KARACHI.

BACKGROUND: Blood transfusion till recently was a life threatening procedure until the discovery of ABO blood groups. Today committee of League of Nations has recommended A, B, AB & O classification for general use. This study was aimed to determine the frequency of ABO and Rh blood groups in residents of Karachi, so that necessary measures should be taken to maintain the blood product inventory. METHODS: A study was conducted at Dr. Ziauddin Hospital Clifton laboratory Karachi, Pakistan over a period of 07 months from 1st June- 31st Dec 2016. Healthy blood donors and patients requiring blood products of different age groups were included. After an informed consent, blood grouping was performed by taking blood samples under aseptic measures in EDTA and Gel separating serum tubes for ABO & Rh blood grouping by tube method. RESULTS: A total of 1583 individuals presented during the study period with 868 (54.8%) males and 715(45.2%) females. Blood group O+ve was found to be more common (31.9%) followed by B+ve (31.2%). In Rh system, Rh+ve (97.2%) were more common than Rh negative (2.8%) blood groups. CONCLUSION: This study was carried out to maintain the blood product inventory concerning the management of blood bank and transfusion services for the patient

FREQUENCY OF NEONATAL THYROID DISORDERS IN A TERTIARY CARE HOSPITAL IN KARACHI

Background: Thyroid hormone is necessary for metabolism, growth and brain development. Thyroid-stimulating hormone (TSH) secreted by anterior pituitary gland acts on thyroid to release thyroid hormones T3 and T4. Insufficient production of thyroid hormone at birth is known as congenital hypothyroidism (CH). CH leads to intellectual impairment, if not identified. Neonatal hyperthyroidism is relatively uncommon The objective of this study is to determine the frequency of thyroid disorders in neonates born in a tertiary care hospital. Methods: This is retrospective cross-sectional, observational study carried out at the tertiary care hospital Karachi, from October 2017 to May 2018. Screening for thyroid disorders is mandatory for newborns born in our hospital. Only data of neonates with thyroid stimulating hormone (TSH) performed was included for this study. TSH levels of these patients were determined by immunoassay on Vitros Enhanced Chemiluminescence technique. Results: In this study, 383 neonates were included, who were born in Ziauddin Hospital Clifton and /or were presented in Ziauddin hospital laboratory for TSH testing. The average age of neonates was 4.11+/-4.14 days and average TSH levels were 4.58+/-4.32 µIU/ ml. They were divided into two groups: Group# I from birth to 4days of life, 305 neonates were included in which 278(91.1%) were euthyroid and 27(8.9%) were hyperthyroid. None of neonates found hypothyroid in this age group. Group# II from 5 days to 1 month of life, only 78 neonates were included, 55(70.5%) were euthyroid, 18(23.1%) were hypothyroid and 5(6.4%) were hyperthyroid. Conclusion: Neonatal screening for thyroid disorders is very beneficial for patients as well as their families and also gives information regarding these disorder’s epidemiology, pathophysiology, diagnosis and treatment in infantile period

CLINICAL PROFILE OF PATIENTS WITH SEPTICEMIA

OBJECTIVE: To evaluate the clinical profile of patients with septicemia. PATIENTS AND METHODS: This cross sectional case series study of six months was conducted at tertiary care teaching hospital Hyderabad. The admitted patients of age ≥18 years, either gender diagnosed as sepsis were recruited. The diagnosis of sepsis was made by the detail clinical history and examination and relevant investigations. The clinical parameters include fever, hypothermia or hyperthermia, tachycardia, tachypnea, leucocytosis or leucopenia, acute altered mental status, thrombocytopenia, hypotension. The etiological diagnosis requires isolation of pathogen from the blood or local site of infection. The Gram staining and culture of the specimen from the site of infection for microbial study was taken. Other relevant laboratory investigations depending upon the requirement were advised accordingly. RESULTS: During six months study period total fifty individuals with sepsis were recruited and studied for detecting the focus of infection. The mean age ±SD for whole population was 55.83±8.95 with male gender predominance 37 (74%). The male gender was predominant 37 (74%), Common co-morbidities observed were diabetes 7(14%), hypertension 5(10%) and chronic liver disease 3(6%). The common source of infection detected were respiratory infection 10(20%), urinary tract infection 8(16%) and wound infection 06(12%). Forty two (84%) patients were recovered while eight (16%) were expired. CONCLUSION: Respiratory and urinary tract infection and wound infections were the most common source of sepsis. KEYWORDS: Septicemia, Infections, Sepsi

Knowledge, perceptions and myths regarding infertility among selected adult population in Pakistan: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>The reported prevalence of infertility in Pakistan is approximately 22% with 4% primary and 18% secondary infertility. Infertility is not only a medical but also a social problem in our society as cultural customs and perceived religious dictums may equate infertility with failure on a personal, interpersonal, or social level. It is imperative that people have adequate knowledge about infertility so couples can seek timely medical care and misconceptions can be rectified.</p> <p>We aim to assess the knowledge, perception and myths regarding infertility and suggest ways to improve it.</p> <p>Methods</p> <p>A cross-sectional survey was carried out by interviewing a sample of 447 adults who were accompanying the patients at two tertiary care hospitals in Karachi, Pakistan. They were interviewed one-on-one with the help of a pretested questionnaire drafted by the team after a thorough literature review and in consultation with infertility specialists.</p> <p>Results</p> <p>The correct knowledge of infertility was found to be limited amongst the participants. Only 25% correctly identified when infertility is pathological and only 46% knew about the fertile period in women's cycle. People are misinformed that use of IUCD (53%) and OCPs (61%) may cause infertility. Beliefs in evil forces and supernatural powers as a cause of infertility are still prevalent especially amongst people with lower level of education. Seeking alternative treatment for infertility remains a popular option for 28% of the participant as a primary preference and 75% as a secondary preference. IVF remains an unfamiliar (78%) and an unacceptable option (55%).</p> <p>Conclusions</p> <p>Knowledge about infertility is limited in the population and a lot of misconceptions and myths are prevalent in the society. Alternative medicine is a popular option for seeking infertility treatment. The cultural and religious perspective about assisted reproductive technologies is unclear, which has resulted in its reduced acceptability.</p

Standardised practices in the networked management of congenital hyperinsulinism: a UK national collaborative consensus

Congenital hyperinsulinism (CHI) is a condition characterised by severe and recurrent hypoglycaemia in infants and young children caused by inappropriate insulin over-secretion. CHI is of heterogeneous aetiology with a significant genetic component and is often unresponsive to standard medical therapy options. The treatment of CHI can be multifaceted and complex, requiring multidisciplinary input. It is important to manage hypoglycaemia in CHI promptly as the risk of long-term neurodisability arising from neuroglycopaenia is high. The UK CHI consensus on the practice and management of CHI was developed to optimise and harmonise clinical management of patients in centres specialising in CHI as well as in non-specialist centres engaged in collaborative, networked models of care. Using current best practice and a consensus approach, it provides guidance and practical advice in the domains of diagnosis, clinical assessment and treatment to mitigate hypoglycaemia risk and improve long term outcomes for health and well-being

Monocyte Distribution Width, a Novel Biomarker for Early Sepsis Screening and Comparison with Procalcitonin and C-Reactive Protein

Objectives Monocyte distribution width (MDW) can be used for the early recognition of sepsis. The study compared the diagnostic accuracy of the MDW with two well-known sepsis biomarkers, procalcitonin (PCT) and C-reactive protein (CRP). Materials and Methods A study was conducted from July 2021 to October 2021, on 111 patients admitted to the Indus Hospital and Health Network. Patients from the ages of 1 to 90 years were enrolled if hospitalized for more than 24 hours for suspected sepsis to avoid inclusion of patients who had short-term stay in the emergency department. According to the Sequential Organ Failure Assessment score, the clinical team did the characterization of cases as with sepsis or without sepsis. SPSS version 24 was used, and the diagnostic accuracy of MDW was assessed and compared using the area under the curves (AUCs) acquired from receiver operating characteristic curves. Pearson's chi-square/Fisher's exact test (as per need) was applied to determine the association. A p-value of less than 0.05 was considered significant. Results Among 111 patients, 81 (73%) patients were labeled with sepsis and 30 (27%) were without sepsis. We have reported significantly higher MDW, PCT, and CRP levels in septic patients (p < 0.001). The AUC of MDW was comparable with PCT (0.794). Significant cutoff value for the MDW was greater than 20.24 U with 86% sensitivity and 73% specificity. Conclusion MDW may have a predictive ability similar to PCT and CRP in terms of sepsis and, thus, can be used as a standard parameter for the timely diagnosis of sepsis

Adenocarcinoma of Lung Presenting as Lambert-Eaton Myasthenic Syndrome

Lambert-Eaton myasthenic syndrome (LEMS) is a paraneoplastic neuromuscular junction disorder. LEMS presents with muscular weakness and fatigability, mainly involving the proximal lower limbs. There are 2 types of LEMS depending on the etiology: paraneoplastic and idiopathic. The paraneoplastic form, which constitutes more than a half of the cases, is mostly associated with intrathoracic neoplasms. Most cases are seen in patients with small cell lung cancer; other subtypes of lung cancer are extremely rare. In this article, we report a case of LEMS as a rare association with adenocarcinoma of the lung