Autoimmune hemolytic anemia (AIHA)-an immunological disease resulting from red cell hemolysis caused by circulating autoantibodies against antigens on red cell membrane. Positive direct antiglobulin test (DAT) always exist in association with AIHA and form basis for its serologic diagnosis. The objective of our study was to determine clinical presentation and etiological pattern in autoimmune hemolytic anemia at a tertiary care hospital. Study Design: Descriptive, cross-sectional study. Setting: Medical unit I of Liaquat University Hospital Jamshoro / Hyderabad. Period: 1 st January 2010 to 30 th June 2010. Patients and Methods: We enrolled 125 patients of either sex and ages from 13 to 81 years for evaluation of possible AIHA. We screened patients by performing direct and indirect antiglobulin tests (DAT and IAT) and cold agglutinin titre (CAT) levels. Pregnant women or those with history of blood transfusion in previous three months, DAT positive patients due to Rh and ABO incompatibilities in neonates and IAT positives cases in Rh-negative pregnant women were excluded. Results: We evaluated 125 patients who were DAT positive autoimmune hemolytic anemia. About 93(74.4%) were females and 32(25.6%) males with female to male ratio of 2.9:1. The mean age of our patients was SD ± 36.73 ± 9.32 years. Our patients commonly presented, generalized weakness in 33(26.4%), pallor of face and extremities in 22(17.6%) and breathlessness in 20(16%) respectively. On clinical examination, moderate to severe anemia was noted in 100(80%), splenomegaly in 40(32%), hepatosplenomegaly in 28 (22.4%) and no visceromegaly in 30(24%) of our cases. We found 35(28%) with primary and 90(72%) patients due to secondary causes of AIHA. The connective tissue disorders, renal failure and hematological disorders were common causes of secondary AIHA in this study. Conclusion: Our study showed females in their thirties presented with generalized weakness, pallor of face and extremities and breathlessness. Majority had secondary AIHA due to consecutive tissue disorders, renal failure and hematological disorders as underlying causes. Doctors must be cautious regarding whole blood transfusion as means for treating mild to moderate anemia.

Background objective: Hyponatremia is not uncommon complication of liver cirrhosis and may affect hospital mortality. This study was aimed to determine frequency and outcome of hyponatremia in liver cirrhosis patients. Patients and Methods: The cirrhotic subjects were assessed for hyponatremia while outcome measured in relation to hyponatremia and its severity. Data was analyzed in SPSS 16.0 and frequencies as well as percentages calculated for hyponatremia. Results: Out of one hundred liver cirrhosis patients, 65% were males and 35% females. Mean age ±SD of overall cirrhotic subjects was 40.79±7.83. Hyponatremia was identified in 72% (51% males and 21% females) patients. The mean ± SD for sodium level in overall population was 129.73±8.35 while 119.92±3.61 in hyponatremic cirrhotic patients. Conclusion: Dilutional hyponatremia is a frequent finding in liver cirrhosis patients.

Background: Metabolic Syndrome (MetS) comprises of an array of clinical, physiological, metabolic and biochemical disturbances; associated with a systemic inflammatory response. The debilitating condition entails high morbidity and mortality and thus it is important to identify and resolve it timely; a goal which may be achieved with the help of biomarkers. Fibrinogen and hsCRP; highly sensitive C-reactive protein, are found to be increased in acute inflammations. The raised quantity is indicative of underlying inflammatory states and thus may be relevant to MetS. Objectives: To determine the association of inflammatory markers with metabolic syndrome among pre & post-menopausal women. Materials and Methods: This cross-sectional analysis was carried out on a sample of 278 women (aged at or above 25 years) presenting to the Outpatient Department of General Medicine and the Obstetrics – Gynecology at Liaquat University Hospital (Hyderabad) from 01-02-2020 to 01-10-2020. Data was collected using a structured interview-based proforma which include information about biodata and sociodemographic details of research participants and biochemical analysis (CRP, DLC and fibrinogen and insulin measurement). Results: In this study a cumulative MetS prevalence was found out to be around 60% (63.7% as per IDF criteria and (57.6% as per ATP-III classifications). Women with MetS had higher levels of CRP and fibrinogen. Women with high fibrinogen levels and CRP suffered with more type of metabolic abnormalities. Conclusion: The findings of this studies showed that with total body fat and fat percentage, body mass-index, have a positive association with the studied inflammatory markers (CRP and fibrinogen).

Objectives: Autoimmune hemolytic anemia (AIHA)- an immunological diseaseresulting from red cell hemolysis caused by circulating autoantibodies against antigens on redcell membrane. Positive direct antiglobulin test (DAT) always exist in association with AIHAand form basis for its serologic diagnosis. The objective of our study was to determine clinicalpresentation and etiological pattern in autoimmune hemolytic anemia at a tertiary care hospital.Study Design: Descriptive, cross-sectional study. Setting: Medical unit I of Liaquat UniversityHospital Jamshoro / Hyderabad. Period: 1st January 2010 to 30th June 2010. Patients andMethods: We enrolled 125 patients of either sex and ages from 13 to 81 years for evaluationof possible AIHA. We screened patients by performing direct and indirect antiglobulin tests(DAT and IAT) and cold agglutinin titre (CAT) levels. Pregnant women or those with historyof blood transfusion in previous three months, DAT positive patients due to Rh and ABOincompatibilities in neonates and IAT positives cases in Rh-negative pregnant women wereexcluded. Results: We evaluated 125 patients who were DAT positive autoimmune hemolyticanemia. About 93(74.4%) were females and 32(25.6%) males with female to male ratio of2.9:1. The mean age of our patients was SD ± 36.73 ± 9.32 years. Our patients commonlypresented, generalized weakness in 33(26.4%), pallor of face and extremities in 22(17.6%)and breathlessness in 20(16%) respectively. On clinical examination, moderate to severeanemia was noted in 100(80%), splenomegaly in 40(32%), hepatosplenomegaly in 28 (22.4%)and no visceromegaly in 30(24%) of our cases. We found 35(28%) with primary and 90(72%)patients due to secondary causes of AIHA. The connective tissue disorders, renal failure andhematological disorders were common causes of secondary AIHA in this study. Conclusion:Our study showed females in their thirties presented with generalized weakness, pallor of faceand extremities and breathlessness. Majority had secondary AIHA due to consecutive tissuedisorders, renal failure and hematological disorders as underlying causes. Doctors must becautious regarding whole blood transfusion as means for treating mild to moderate anemia.

Objectives: Chronic obstructive pulmonary disease (COPD) leads to partialreversible obstruction of airways. The objective of our study is to determine frequency ofelevated C-reactive protein (CRP) level in patients of COPD at Liaquat University HospitalJamshoro/Hyderabad. Study Design: Cross-sectional study. Setting: Medical Unit-I of LiaquatUniversity Hospital Jamshoro/Hyderabad. Period: 1st March 2013 to 31st August 2013. Patientsand Methods: Patients of either sex and ages from 40-80 years old and having COPD for atleast two years duration were included. Patients below 40 years of age, having malignanciesor autoimmune disorders were excluded from this study. Results: We enrolled 186 patientswith COPD and their mean age was ± SD 57.63±8.45 years. Majority 182 (97.8%) had habitof smoking while 4(2.2%) were non-smokers. Mean CRP level in COPD patients was ± SD1.26±0.79 (range 0.1- 3.0 mg/d1). Out of 186 COPD patients, 94(50.6%) have raised CRP level(higher than 1.0 mg/dl). Median value of CRP level during this study was 1.10 mg/dl. About92(49.4%) patients have normal level of CRP (less than 1.0 mg/dl). Conclusion: On conclusion,frequency of raised C-reactive protein in our study was much higher (50.6%).