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.
In Pakistan, over 10,000 deaths have been reported due to COVID-19 while the exact course of illness and significant causes of mortality has not been found out. Objective: To enumerate the causes of death in hospitalized SARS CoV2 PCR positive patients and also to assess the relationship between COVID mortality and comorbidities. Methods: The cross-sectional study was conducted at Liaquat University Hospital after taken permission from the ethical review committee. Study included SARS CoV2 PCR positive patients, admitted at Liaquat university hospital and expired during hospitalization, aged greater than 15 year and belonged from either gender. Operated and RTA patients were excluded from study. Results: Patient’s age ranged from 18 to 90 year. Mean age was 59.6-year, Male were 79% and female were 21%. Triad of fever, cough and SOB present in 48% of patients. Respiratory failure (54%) and respiratory failure with sepsis (38%) were the leading cause of fatality. Anova Test showed statistically significant correlation between causes of death and comorbidities with p-value 0.015. Both Diabetes and Hypertension were present in 25% of patients. Conclusions: The study concluded that male gender was the dominant sufferer of COVID-19 and in contrast to normal perception, younger age is not an exception for mortality due to COVID-19. Fever, cough and SOB were the most frequent complain. Respiratory failure alone and with sepsis, was found to be the leading reason for mortality. Causes of death were strongly linked with presence of comorbidities in covid 19 patients.
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