Objectives: Acute leukaemia is the most common and highly curable childhood malignancy; subtyping and identification of antigens via immunophenotyping helps in treatment plan as well as minimal residual disease monitoring. Methods: This retrospective study was conducted at the Haematology section of the clinical laboratories of Ziauddin University Hospital and The Indus Hospital, Karachi conducted at January 1st, 2012 to December 31st, 2017. The study included 1379 cases of de novo acute leukemia from 2012 to 2017. Among these, 80% were diagnosed by using four color flowcytometry (FACS Calibur), 9% and 11% via immunohistochemistry on bone marrow trephine biopsy samples and morphological examination respectively. Results: The mean age of patients was 7.4 ± 4.3 years while male to female ratio was 1.75:1. Lymphoblastic leukaemia accounted for 77.2% and myeloid leukaemia 21.2%. Amongst lymphoblastic lineage, B-ALL was 80.4% while T-ALL was 19.6%. Among the phenotypic expression of B-ALL, CD79a (99.8%) had the highest positivity. In B-ALL, CD13 (29.8%) was the most common aberrant myeloid marker. Aberrant expression of CD79a observed in 11.1% of T-ALL cases. In non APL AML, aberrant expression of CD79a and CD19 was observed in 6.6% and 5.5% of cases respectively. Conclusion: Overall immunophenotypic profile, expression of aberrant phenotypes and subtype distribution in our patients was similar to international literature except for a relatively high frequency of T-ALL which was discordant from the western data. doi: https://doi.org/10.12669/pjms.37.3.3552 How to cite this:Jamal S, Meraj F, Mansoor N, Parveen S, Shaikh A, Jabbar N. Distribution of subtypes and immunophenotypic characterization of 1379 cases of paediatric acute leukaemia. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3552 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background & Objective: Determination of hemoglobinopathies is significant for epidemiological studies. There is a need to identify burden of hemoglobinopathies at national level to lay down the foundation of appropriate screening and prevention programs. The present study aimed to evaluate the spectrum of hemoglobinopathies along with hematological and biochemical parameters in a tertiary care hospital. Methods: This retrospective study included results of high performance liquid chromatography (HPLC) test from July 2015 - May 2020 in the department of Hematology, Indus Hospital and Health Network, Karachi, Pakistan. Data of all patients collected for red blood cell (RBC) indices, serum iron profile, and vitamin B12 and red cell folate levels. Diagnosis of hemoglobinopathies was done by an automatic analyzer ADAMS A1C Model No. HA-8180T Arkray/Japan. Results: Among 2422 participants, hemoglobinopathy observed in 14.5% (n=352). Beta thalassemia trait is observed as the most common hemoglobinopathy (6.4%). Severe anemia (Hb=5.1-5.5 g/dl) found in beta thalassemia major (BTM) and HbE disease. Red cell parameters showed significant association with different types of hemoglobinopathies. Mean ferritin level was high in E-beta thalassemia (687.8±591.9) followed by sickle cell disease (615.7±543.5). Conclusion: Apparently, overall frequency is static however, results of this study are not applicable to general population due to sample bias. Moreover, true figures are difficult to identify due to high incidence of iron deficiency anemia that masks the diagnosis by conventional techniques. Molecular characterization by DNA analysis is the most reliable tool of diagnosis. However, this method is not widely available in our country due to lack of expertise and cost issues. doi: https://doi.org/10.12669/pjms.38.8.5935 How to cite this:Mansoor N, Meraj F, Shaikh A, Jabbar N. Spectrum of hemoglobinopathies with hematological and biochemical profile: A five year experience from a tertiary care hospital. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.5935 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
We assessed the Association of Mental Health and different education systems among high school students. A total of 174 students (107 females and 67 males) from age 16-19 years studying in 11th and 12th grades or equivalent to A levels in Karachi, Pakistan were surveyed in this cross-sectional study. Data collection involved using a specially designed structured questionnaire through literature review as well as the patient Health Questionnaire, a validated tool for assessing depression. Our study found that majority of students suffered from mild depression (29.3%). This was followed by 27.5% of students with severe depression, 23.0% with moderate depression and 20.1 with no depression. It was also found that more females suffered from depression as compared to males. However, no significant correlation was found between the association of different education system on the mental health of adolescents.
Chronic lymphocytic leukemia (CLL) in pediatric age is rare in the literature. It is a common disease of older adults, characterized by clonal proliferation and progressive accumulation of monoclonal B-cell lymphocytes. The diagnosis is established by immunophenotyping and prognosis is defined by staging system (Rai and Binet), as well as by several biological and genetic markers. We report a case of CLL diagnosed in an adolescent girl presented at 16 years of age. The case is being reported to improve awareness regarding this rare entity in children. Case Presentation: A 16 year old female presented with fever, weight loss and cervical lymphadenopathy. After baseline workup, lymph node biopsy, bone marrow biopsy along with immunohistochemistry and flowcytometry on peripheral blood was performed to establish the diagnosis. The clinico-pathologic features including extensive immunophenotyping were consistent with CLL. Discussion: Management guidelines for older adults are very well established but no standardized protocol exists for pediatric age group. We offered her Fludarabine and Cyclophosphamide as first line regimen and she responded well and achieved remission after four cycles. Unfortunately disease relapsed within two years. At this time, determination of optimum therapeutic protocol was a unique challenge as hematopoietic stem cell transplant (HSCT) was not available at our institute. Conclusion: CLL is an extremely rare malignancy in childhood and adolescence. Therefore age specific treatment protocols are not established. Reporting this case will help in eliciting the high index of suspicion among pathologists and oncologists for this exceptionally unusual and life threatening disease so that delays can be avoided.
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