13 research outputs found
The COVID-19: Yet another Viral Spill-Over of Unexpected Consequences
No full textThe human coronaviruses (CoV) are the causative agent of respiratory illness in human especially during winter and fall. They were first identified in 1960’s. The four corona strains i.e. NL63, 229E, HKU1 and OC63 accounts for about 30% of the annual common cold incidences ranging from mild to moderate illness in human worldwide. These are the largest RNA viruses from the sub-family Orthocoronavirinae of family Coronaviridae. Interestingly, the crown like spikes on their surface make them unique. So far four different groups of coronaviruses have been identified namely: alpha-, beta-, delta-, gamma- coronaviruses [1]. Beside the reported human-only beta coronaviruses HKU1 and OC63; lethal outbreaks of three other beta corona viruses i.e. Severe AcuteRespiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) and SARS-CoV2 - viruses were documented. The later three viral strains were confirmed as evolved viruses from animal origin. The genetic diversity of these viruses is sought to be facilitated by recombination and mutational events within the intermediate host predominantly a mammal
Diagnosis and Treatment of Polycythemia Vera in Pakistan; Barriers and Possible Solutions
No full textThis review aims to highlight the challenges encountered in managing Polycythemia Vera in resource-limited settings and to suggest a cost-effective strategy for timely diagnosis and treatment. Presentation to healthcare facilities at an advanced stage due to lack of awareness and limited access to medical care, delay in the diagnosis due to inadequate healthcare infrastructure, unavailability of molecular testing in the majority of centers, and suboptimal disease management, primarily due to lack of physician awareness and expertise in handling this condition are the key factors contributing to the higher rates of complications, including thrombotic events and disease progression, ultimately leading to poorer patient prognoses in Pakistani population. This review describes and evaluates a cost-effective diagnostic and treatment approach to Polycythemia Vera to reduce the morbidity and mortality of the disorder in Pakistan. A tailored investigation plan comprising of JAK2 mutation and serum erythropoietin levels and minimal cytoreductive therapy combined with phlebotomy and anti-platelet agent can be implemented to achieve optimal management of the disease in a resource-constrained country
Hemostatic defects in Dengue infection at a tertiary care hospital in Karachi
No full textThis study was aimed to investigate haemostatic defects in dengue infection. A cross sectional study was conducted from 2013-2014 at National Institute of Blood Diseases & Bone Marrow Transplantation, Karachi. Total 127 dengue patients of either sex were included. After clinical examination, serology was performed to confirm dengue. The complete blood picture (CBC), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, D-Dimer, liver function tests were performed. Out of 127 cases about 95.8% patients presented with myalgia and 88 had headaches. No splenomegaly or hepatomegaly was observed. Serologic antibodies were found in all patients. Average platelet count and white blood cell count were 47.2x103 /ul and 5.3x103/ul respectively. Eighty-three patients had prolonged PT while 92 patients had prolonged APTT value. Raised total bilirubin, alkaline phosphatase and SGPT were found in 7, 91 and 87 patients respectively. Highly elevated D-Dimer values were recorded in 96% cases while only 12% patients had higher fibrinogen levels. Marked hematological abnormalities were observed among all the patients diagnosed with DF regardless of age, sex and clinical presentation. Clinically significant haemostatic abnormalities were also recorded in DF patients suggestive of abnormalities in coagulation and fibrinolytic pathways
Klinička važnost dodatnih trombocitnih pokazatelja u dijagnostici imune trombocitopenije
No full textImmune thrombocytopenia (ITP) is an autoimmune disorder. Besides platelet
count, immature platelet fraction (IPF) can be used as a tool to predict megakaryocytic activity in ITP
patients. The aim of the study was to evaluate the utility of extended platelet indices in ITP diagnosis
and their association with disease persistence and severity. This case-control study (1:1), conducted from
January 2015 to December 2017, included 111 ITP patients and 111 healthy controls. ITP patients
were grouped as newly diagnosed ITP, persistent ITP, chronic ITP, and refractory ITP patients. Peripheral
blood was collected and complete blood profile parameters were recorded using Sysmex XN 1000.
Significant (p≤0.05) difference between the groups of ITP patients and healthy control subjects was
determined by Fisher exact test, while Pearson correlation was used to evaluate platelet count correlation
with IPF using SPSS ver. 23. Low hemoglobin and platelet counts with high total leukocyte count
and IPF were detected in ITP patients as compared to healthy subjects (p≤0.001). Among all groups of
ITP patients, very low platelet count (6.9±6.02.x109/L) with highest mean IPF (27.1±19.2%) was observed
in newly diagnosed ITP group. Other platelet parameters including mean platelet volume
(MPV), plateletcrit, platelet large cell ratio (P-LCR) and platelet distribution width values were also
altered in patient groups. Pearson correlation revealed negative relationship between platelet count and
IPF in all patient groups. With the advent of new, sophisticated hematologic analyzers, the IPF and
other platelet parameters provide simple, reliable and easier tools for predicting platelet disorders such
as ITP, and to some extent the disease severity. Besides IPF, the MPV and P-LCR seemed to predict
disease severity, treatment responsiveness, and duration of the disease to some extent.Imuna trombocitopenija (ITP) je autoimuna bolest. Uz broj trombocita, frakcija nezrelih trombocita (immature platelet
fraction, IPF) može se rabiti za predviđanje megakariocitne aktivnosti kod bolesnika s ITP-om. Cilj ovoga istraživanja bio je
procijeniti primjenu dodatnih trombocitnih indeksa u dijagnostici ITP-a te njihovu povezanost s ustrajnošću i težinom
bolesti.
Ovo ispitivanje slučajeva s kontrolnom skupinom (1:1) provedeno je od siječnja 2015. do prosinca 2017. godine, a
uključilo je 111 bolesnika s ITP-om i 111 zdravih kontrolnih ispitanika. Bolesnici s ITP-om podijeljeni su u skupine s novo
dijagnosticiranim, ustrajnim, kroničnim i refraktornim ITP-om. Prikupljeni su uzorci periferne krvi i parametri kompletnog
krvnog profila zabilježeni na uređaju Sysmex XN 1000. Značajne razlike (p≤0,05) između skupina bolesnika s ITP-om i
zdravih kontrolnih osoba utvrđene su Fisherovim egzaktnim testom, dok je Pearsonovom korelacijom procijenjena korelacija
broja trombocita s IPF pomoću SPSS ver. 23. Nizak hemoglobin i nizak broj trombocita uz visok ukupan broj leukocita i
visok IPF zabilježeni su u bolesnika s ITP-om u usporedbi sa zdravim osobama (p≤0,001). Među svim skupinama bolesnika
s ITP-om, vrlo nizak broj trombocita (6,9±6,02x109/L) uz najviši srednji IPF (27,1±19,2%) utvrđen je u skupini bolesnika s
novo dijagnosticiranim ITP-om. Ostali trombocitni parametri uključujući srednji volumen trombocita (mean platelet volume,
MPV), trombokrit, omjer velikih trombocita (platelet-large cell ratio, P-LCR) i širina distribucije volumena trombocita bili su
također promijenjeni u skupinama bolesnika s ITP-om. Pearsonova korelacija pokazala je negativan odnos između broja
trombocita i IPF u svim skupinama bolesnika. Uz nove, naprednije hematološke analizatore trombocitni parametri poput
IPF i drugi nude jednostavan, pouzdan i lakši način za predviđanje trombocitnih bolesti kao što je ITP, a do neke mjere i
težine bolesti. Uz IPF, čini se da MPV i P-LCR imaju utjecaj na težinu bolesti, odgovor na terapiju i trajanje bolesti
Expression of aberrant antigens in hematological malignancies: A single center experience
No full textT-cell Imbalance or Decreased Th:Tc Ratio in Immune Thrombocytopenia: Is it Clinically Significant?
No full textBackground: Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by low platelet count and various contributing factors. The imbalance in T cells may also cause ITP. Therefore, the present study was planned to assess the role of T-cells in the pathogenesis of ITP and to evaluate any possible link of Th: Tc imbalance to disease severity.Methods: The present study was conducted with 111 patients of ITP and similar number of controls as case-control study with a 1:1 ratio of from January 2017 to July 2019. The patients were grouped according to the guidelines of ASH as newly diagnosed/persistent ITP(ND-ITP/P-ITP) and chronic/refractory ITP(C-ITP/R-ITP). The blood samples were obtained, and CBC parameters were observed using advanced hematology analyzer XN-1000. The T cell subset analysis was evaluated by BD FACSCalibur flow cytometer. The Fisher’s exact test was done to evaluate the difference among the groups with (p < 0.05) by using SPSS version 19.Results: Significantly reduced levels of hemoglobin and platelet counts, with elevated IPF were observed in ND-ITP/P-ITP and C-ITP/R-ITP patients (p=<0.001).The significantly low Th:Tc ratio (p=<0.001) predicts imbalance of T cells in ND-ITP/P-ITP (0.86±0.47) as compared to control group (1.73±0.46).The mean of 0.84±0.34 Th:Tc ratio was observed in C-ITP/R-ITP children ≤16 years. No significant difference (P = 0.89) was found among children with non-severe chronic (0.84±0.42), severe chronic (0.82±0.49), and refractory ITP (0.85±0.51).Conclusion: In ITP patients’ low levels of Th:Tc ratio was observed suggesting dysregulation of immune system. The chronicity of the disease may be linked to elevated production of Tc in children (≤16 years) with C-ITP/R-ITP.Keywords: Immune thrombocytopenia; Platelets counts; Helper T-cells (Th); Cytotoxic T-cells (Tc)Editorial Note: You are viewing latest version of this article having language corrections
Possible correlation of electrochemiluminescence based numerical cut off index value with concentration of anti-SARS-CoV-2 antibody: Is it worth reporting?
No full textBackground: Many laboratories are reporting a numerical cutoff index value (COI) value for most anti-SARS-CoV-2 qualitative tests. These numerical values in patients’ report ultimately created great confusion in the public and physicians, therefore this study was designed to evaluate the correlation of electrochemiluminescence (ECLIA) based numerical COI values with quantitative ELISA of anti-SARS-CoV-2 antibody.
Design and Methods: Two hundred and twenty-eight (228) recovered COVID-19 patients were included; their serum samples were analyzed by quantitative ELISA and ECLIA for anti-SARS-COV-2 antibodies.
Results: One hundred and seventy-three (75.8%) patients tested positive by ECLIA and ELISA assay and thirty-seven (6.2%) were tested negative by both methods. A weak positive correlation (r=0.37) was found between numerical COI value of ECLIA with ELISA concentration, which was statistically significant with p<0.001. All values were dispersed on scatter plot and there was no significant linear relationship between ECLIA and ELISA assay.
Conclusions: As both testing techniques are base upon the same immunological phenomena of detecting antibodies against nucleocapsid protein. We suggest that COI values are not meant to describe the immunity level of the individuals thus the physicians should not consider it as a quantitative value for antibody levels in COVID-19 patients
Laboratory Diagnosis of Malaria: Comparison of Manual and Automated Diagnostic Tests
No full textMalaria is the second most prevalent disease in Pakistan resulting in ~30,000 annual deaths. In endemic countries like Pakistan precise and timely diagnosis of malaria is imperative to overcome the associated risks of fatal outcomes. Malarial parasite was screened in 128 malaria suspected patients and 150 healthy controls, by species-specific PCR, microscopy of blood smears, hemoanalyzer Sysmex XE-2100, and rapid test devices (First Response Malaria® and ICT Malaria Combo®). The microscopy detected MP in 126 samples (parasite load/µl 386–53712/µl); 71.094% were infected with Plasmodium vivax and 14.844% with P. falciparum while 14.062% had mixed P. vivax and P. falciparum infection. The mean parasite load for P. vivax and P. falciparum was 14496/µl and 24410/µl, respectively. The abnormal scattergrams of DIFF, WBC/ Baso, IMI channel, and RET-EXT on Sysmex XE-2100 supported 99.2% parasite detection, whereas only 93% of confirmed malaria cases were detected by both rapid tests. About 127 samples were positive by PCR. Since Sysmex XE-2100 automatically detected the presence of malarial parasite with high sensitivity, it can be a good option for presumptive diagnosis in endemic areas. Microscopy remains the gold standard to confirm MP in suspected patients. Rapid diagnostic tests have acceptable sensitivity and specificity
Additional file 1 of Influence of cytochrome P450 and glutathione S transferase polymorphisms on response to nilotinib therapy among chronic myeloidleukemia patients from Pakistan
No full textAdditional file 1: Supplementary Table 1. Impact of combination of multiple polymorphic defects in different DME genes on occurrence of CML
