National Journal of Health Sciences
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Aberrant Expression of a T-Cell and a Monocytic Antigen in a Newly Diagnosed Precursor B-Cell Acute Lymphoblastic Leukaemia
No full textAbstract: Background: Aberrant expression of antigens/or loss of some antigens on leukemic cells is sometimes seen. Such expressions may or not affect prognosis of leukaemia. Aberrant co-expression of CD5 and CD64 on precursor B-cell ALL leukemic cells is found first time. Objective: To report a novel case of precursor B-cell ALL which co-expressed a T-cell lineage (CD5) and a monocytic lineage (CD64) antigens. Methods: Bone marrow immunophenotyping was performed using FACSCalibur (a four-color flowcytometer) and acute leukaemia panel of antibodies. Case Presentation: A 4-year old boy with circulating small sized blasts. Immunophenotyping data revealed expression of CD45, CD19, CD79a, TdT, CD34, CD10, CD5 and CD64 while absence of CD3, MPO, CD13, CD33, CD4, CD7 and CD8 antigens. Conclusion: A diagnosis of precursor B-cell ALL with aberrant CD5 and CD64 expression was made
Response to a Case Report titled: De Novo Deletion 17p (del17p) in an Adult T-Cell Prolymphocytic Leukemia as a Rare Presentation
No full textI read the case report titled De Novo Deletion 17p (del17p) in an Adult T-Cell Prolymphocytic Leukemia as a Rare Presentation, by Zara-tul-Ain Bashir et al. which published in the latest issue Volume 4, Issue 1, 2019 of your journal. As stated by the authors, T cell prolymphocytic leukemia is an exceptional condition that characterized with accumulation of lymphocytes not only in blood stream and bone marrow but also in lymph nodes and spleen. In fact, since malignant lymphoyctes originated from post-thymic T cell, nomenclature as “prolymphocyte” is a misused term
Anaemia in Children: Apathy in Healthcare Priorities
No full textA nutritional deficiency in younger age group includes both micro and macronutrient deficiencies leading to protein calorie malnutrition, failure to thrive, compromised immune function and nutritional anemia. Deficiencies of iron, vitamin B12, folic acid, and pyridoxine, compromise red cell production. Iron deficiency is the most common cause of nutritional anemia’s worldwide [1]
An Overview on Severe Combined Immunodeficiency Disorders
No full textSevere Combined Immunodeficiency Disorders (SCID) are rare life-threatening inherited conditions. They are characterised by the absence or non-functional immune system [1, 2]. As a result, affected children are unable to fight infections. Living in normal environment usually proves fatal for affected children. They get very sick with recurrent attacks of bacterial, viral and fungal infections and do not survive beyond first year of life. There are many genetic mutations responsible for different types of SCID. T-lymphocytes, B-lymphocytes and natural killer cells (NK-cells) can all be affected; two common types are the X-linked and theAdenosine Deaminase Deficiency (ADA deficiency). Affected kids develop symptoms usually within the first few months of life. Commonly affected body systems are; lungs, meninges, blood stream, skin, gut and liver. In the absence of efficient immune system, causative organisms do not easily respond to anti-microbial agents. Recurrent episodes of serious and life-threatening infections like pneumonia, meningitis, septicaemia, chronic skin infections, diarrhoea, and hepatitis result in death within first year of life [1]
Central Pleomorphic Adenoma of Mandible – Report of the First Case in a Pediatric Patient
No full textAbstract: Pleomorphic adenomas (PA) are the commonest salivary gland tumors of parotid gland. Central pleomorphic adenomas are extremely rare and so far only 7 cases have been reported in the literature; 2 in maxilla and 5 in mandible. The mean age of occurrence of central PA is 58.8, none of the case of central PA in children has been reported in the literature; hence this is the first report of central PA in a child. An 11 year old Indian boy presented with the jaw swelling from 1 year. Radiographic examination revealed a multilocular osteolytic lesion of mandible. A complete surgical removal of the lesion was performed and the defect was restored with reconsctruction plates. Histopathological features were consistent with central PA. Till now this is the first description of central PA in a child
An Insight into the Symptomatology of ß-Thalassaemia Major: Molecular Genetic Basis of the Disease – III
No full textThalassaemia syndrome is a group of inherited disorders resulting in low oxygen carrying capacity; severe anaemia due to haemolysis, ineffective erythropoiesis and bone marrow expansion in the bones, liver and spleen being the causes. Globally, there are approx. 394 ß Thalassaemia mutations (excluding alpha and other variants genetic mutations) responsible for this disorder [1]. Each ethnic group has 5-6 common mutations causing ß-thalassaemia; these mutations may not be shared in other ethnic groups [2]. Some mutations result in ß+phenotype (producing some functional Hb-A while others have more severe ß0phenotype (no functional Hb-A is formed). Rare cases are caused by deletion in ß globin gene (deletion of 619 base pairs in exon-1 of ß-globin gene); found in Gujrati, Sindhi, and Memon ethnicities
Prevention of Medication Errors in a Pakistani Hospital Because of Concurrent Evaluations and Interventions by Pharmacists
No full textAbstract: Objective: The aim of this study is to document different pharmaceutical interventions that took place during dispensing through Computerized Physician Order Entry (CPOE) to prevent medication errors at a multidisciplinary tertiary care hospital in Karachi, Pakistan. Method: Study Design: Systematic retrospective review of e-prescriptions received in inpatient pharmacy for dispensing in a multidisciplinary tertiary care hospital. Dispensing Setting: In order to decrease medication administration error, the hospital works on Unit Dose Dispensing System, all the orders are segregated by Health Management Information Software and appeared on inpatient pharmacist window for dispensing, the inpatient pharmacist then check all the medication order, if the pharmacist find any medication error or better alternative, the pharmacist contact the concerned physician and discuss about the error and suggest alternatives, if the physician find the suggestion beneficial for the patient then the order is intervened. Data Collection: These interventions were recorded by in-patient pharmacists from June 2014 till May 2015, which were then filled in aperforma and categorized for potential of harm if not intervened. Result: A total of 1336 interventions are accepted during the study period. About 83.2% of the interventions were found to be minor or moderately harmful. Most significant intervention was related to dose correction (26.9%), followed by drug alternatives (therapeutic or brand alternative) (26.6%), wrong frequency of drug (20.7%), excessive duration (9.2%), drug duplication (6.2%), culture and sensitivity based drugs (2.3%), wrong choice of drug (1.9%), wrong route (0.7%), wrong dosage form (0.7%), Addition of drug (0.2%) and drug-drug interactions (0.1%). Conclusion: This study shows that concurrent evaluation of prescription by pharmacist decreases preventable medication errors whichprobably decrease health care cost and decrease patient hospital stay
Hydatid Cyst in the Anterior Abdominal Wall; A Case Presentation
No full textAbstract: Objective: A 30 years old male presented with swelling in right abdomen. Initially it was small but with the passage of time it gradually increased in size. The surgical exploration revealed mass present in anterior abdominal wall without involvement of intra-abdominal structure. CT scan of abdomen was suggestive of intra-abdominal, but surprisingly hydatid cyst was found in anterior abdominal wall without intra abdominal involvement
Hemovigilence - Application in Tertiary Care Hospitals
No full textThe therapeutic uses of blood and its components are very well established as a lifesaving tool but at the same time one should not forget about the adverse effects related to it. The desired safe blood transfusions can be done only if there are enough healthy donors in the society making it a precious therapy. In order to cover these aspects, the term Hemovigilance was added to define blood safety. It is a surveillance mechanism covering the entire blood transfusion, donor vein to recipient vein chain, starting from the collection of blood and its components to the follow up of the recipients. WHO defines it as a process of monitoring, reporting, investigation and analysis of adverse or undesirable events related to the transfusion of blood and its components and taking actions to prevent their occurrence or recurrence [1]. The final results play an essential role in ensuring patient safety by learning from failures and then placing corrective changes in the system to prevent such events in future. Theawareness can be generated only after knowing the trends of transfusion hazards at a particular set up [1, 2]
Therapy Related Acute Lymphoblastic Leukemia (t-ALL): Case Report and Literature Review
No full textAbstract: Therapy related Acute Lymphoblastic Leukemia (t-ALL) is a rare secondary malignancy. It occurs in patients who are exposed to chemotherapy and/or radiotherapy for primary malignancy. We are reporting here a case of a thirty five years old female patient who was referred to us for fever, malaise and bleeding from gums. She had a history of ovarian carcinoma for which she took carboplatin and other chemotherapeutic agents. Extensive workup was done which was consistent with the diagnosis of Precursor-B cell Acute Lymphoblastic Leukemia. In the context of previous history of exposure to carboplatin, she was diagnosed as a case of therapy related Acute Lymphoblastic Leukemia secondary to carboplatin