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Objectives:To study the prevalence of HBsAg, Anti-HCV, HIV, Syphilis and Malaria in blood donors.Methods:This is a cross sectional descriptive study, conducted at Blood bank and Transfusion center at Liaquat University of Medical & Health Sciences (LUMHS) Hyderabad, during the period from January, 2014 to June, 2015. A total of 4683 blood donors were screened for HBsAg, Anti-HCV and HIV on Architect 20001 (manufactured by Abbott), employing chemiluminescent microparticle immunoassay (CMIA). For Syphilis, VDRL ICT kits were used and Malaria parasite was screen through MP slides. Blood grouping was performed by both forward and reverse methods.Results:This study showed a high frequency of HBsAg, VDRL and malaria positivity among the O-ve blood group donors, i.e. 3.70%, 9.25% and 0.61% respectively. Blood group B-ve individuals were commonly infected with HCV (12.5%) as compared with all other blood group donors. HIV is more commonly reported in A+ve blood group individuals. Blood group O+ve is more prevalent (37.41 %).Conclusion:High frequency of HCV infection in blood donors advocates implementation of strict screening policy for donors and public awareness campaigns about preventive measures to reduce the spread of this infection as well as other transfusion transmissible infections.

… Background: Upper GI endoscopy is an established procedure for investigating a wide range of upper GI conditions especially inflammatory and malignant diseases of stomach and esophagus. A good correlation in diagnosis can be achieved by complementing endoscopic findings with histology of biopsy specimens. Aims and objectives: 1) To evaluate morphological patterns of upper GI conditions. 2) To correlate endoscopic characterization of upper GI lesions with histopathological assessment of biopsy specimens. Study design: A retrospective descriptive study. Period: Four year period from January 2010 to December 2013. Setting: Department of Pathology, LUMHS and were histologically assessed. Material and methods: A total of 433 upper GI endoscopic biopsies were received. Patient's age, gender and presenting complaints were noted. Results: Stomach was the most frequent site of endoscopic biopsy (51.3%) followed by esophagus (39%) and duodenum (9.7%). Majority of patients (51%) presented with dysphagia and abdominal pain. Mean age of presentation was 40 years; age range, 9-90 years and male: female ratio is 1:1.6. Esophageal malignancy was the commonest neoplastic lesion with squamous cell carcinoma being the dominant histological type. Interestingly, inflammatory conditions were more common in the stomach. In the duodenum, celiac disease was clinically suspected and histopathological grading confirmed the diagnosis with majority of the cases showing grade-II pathology. Conclusion: This large retrospective institutional based study showed a good correlation between endoscopic and histological diagnosis. It further shows that esophagus is the predominant site of upper GI malignancy with strong female predominance. Further studies are needed to identify the underlying risk factors. Article Citation: Memon F, Baloch K, Memon AA. Upper gastrointestinal endoscopic biopsy; morphological spectrum of lesions. Professional Med J 2015;22(12):1574-1579.

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Since recent research indicates that other modalities are at a minimum non-inferior to the NICE-recommended hormonal agent prostaglandin E (PGE), a retrospective cohort study was conducted on 1971 consecutively induced singleton pregnancies. Multinominal regression analysis showed that the odds ratio (OR) for vaginal delivery with balloon-mediated labour induction (84% vaginal deliveries; OR 1.6; 95% CI 0.7-3.5) is similar to the PGE agents propess (81%; OR 1.2; 95% CI 0.68-1.98) and prostin (79%; OR 0.99; 95% CI 0.55-1.79) when using a triple multi-agent induction as a reference. On the other hand, combining the propess and prostin (60% vaginal deliveries; OR 0.45; 95% CI 0.21-0.96) and attempting quadruple combinations of the induction modalities (56%; OR 0.37; 95% CI 0.16-0.85) yields significantly poorer outcomes. However, compared to the known factors associated with increased caesarean section rates, such as an increased maternal age, nulliparous pregnancies and a history of caesarean section, the differential impact of different induction modalities appear less pronounced. Impact statement What is already known on this subject? Recent published data from controlled clinical trials have shown that other labour-inducing agents, including balloon catheters, are as effective as prostaglandin E (PGE) in achieving a vaginal delivery. What do the results of this study add? The data from this pragmatic retrospective cohort study supports the findings of others that the use of a balloon is as effective as PGE. It also demonstrates that regular clinical practice can differ from an experimental environment, with patients receiving multiple induction modalities in a daily practice. Both the combination of different PGE medications and a quadruple labour induction approach are associated with poorer results, as measured by the vaginal delivery rate. The data presented here also confirms that a nulliparous status, a maternal age and a history of caesarean section are associated with reduced odds of achieving a vaginal delivery. What are the implications of these findings for clinical practice and/or further research? The body of evidence showing favourable results with a balloon induction is growing. Furthermore, there are limits to the effectiveness of combining the different induction modalities. Maternal and perinatal factors associated with a risk of caesarean section further complicate labour induction management.

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In this retrospective cohort study involving 393 singleton pregnancies, we evaluated the maternal and prenatal factors influencing the use of and the outcome of prostaglandin E(2) (PGE(2)) induced labours. Only a nulliparous pregnancy was shown to be a significant predictor of the use of more than one dose of PGE(2) (odds ratio, OR 2.73, 95% confidence interval, CI 1.61-4.63). When the type of delivery was assessed, nulliparous status was significantly associated with a decreased chance of vaginal delivery (OR 0.12, 95% CI 0.045-0.32). Other variables that positively influence the chance of vaginal delivery include a mother's age being under 30 years (OR 2.63, 95% CI 1.51-4.58) and a single dose of PGE(2) (OR 2.86, 95% CI 1.21-6.79). Gestational age, fetal weight and maternal BMI have much less impact on PGE(2) use and chance of successful vaginal delivery than parity.