Samra Waheed - Academia.edu (original) (raw)

Papers by Samra Waheed

HemaSphere

Background: ABO and Rh systems are the most important blood group systems of human body. More tha... more Background: ABO and Rh systems are the most important blood group systems of human body. More than 400 blood group systems have been reported, however majority of them are not clinically significant. The ABO group system comprises of antigens represented by forward blood grouping and antibodies represented by reverse blood grouping. Reverse blood grouping is usually done to verify the results of forward blood grouping. ABO discrepancy is defined as a difference of result between forward and reverse group and has been reported to be around 0.15-0.19%. ABO discrepancies are divided into 4 types. Type 1 discrepancy include those having missing antibodies in reverse grouping and are most common. Type 2 discrepancy include missing antigens in forward grouping. Type 3 are those because of abnormalities in plasma or proteins and type 4 is represented as miscellaneous. Aims and Objectives: The aim of this study was to calculate the frequency of ABO discrepancies in healthy blood donors, its classification into different types and identification of different subgroups in order to provide safe blood to the patients. Material and Methods: Descriptive, cross sectional study was conducted at Regional blood centre Karachi from January 2020 to August 2023.78,623 donors were enrolled in the study. Blood samples were collected in di-potassium ethylene diamine tetra acetic acid (K2 EDTA) and yellow gel top vacutainers. Blood grouping was performed by a technician/ technologist by tube method and was reconfirmed by a senior technologist. Results: 78623 samples were included in the study, with majority of the males. The mean age of blood donors was 28.5 years. ABO discrepancy was found in 108 cases (0.13%). 4 groups of ABO discrepancies were made according to AABB. Most common ABO discrepancy was type 4 (46.3%) followed by type 1 (37.0%). Type 2 and type 3 were 11.1% and 5.6% respectively. Most common blood group associated with ABO discrepancies was O positive, followed by A positive (p value 0.001). Most subgroups were associated with a followed by B. Conclusion: ABO blood grouping remains the most important testing in the blood donors. The significance of determining the actual blood group lies in the fact that safe blood transfusion should be the utmost priority. Complete blood grouping along with resolution of discrepancies will continue to be a significant feature in providing safe blood to the patients and preventing them from fatal transfusion reactions.

Journal of Ayub Medical College Abbottabad, Oct 11, 2022

Background: This study was carried out to determine the frequency of CD34 positivity in acute lym... more Background: This study was carried out to determine the frequency of CD34 positivity in acute lymphoblastic leukaemia (B-ALL) in our population and to report its association with the clinicopathological profile at the time of diagnosis. Methods: The cross-sectional study was conducted at National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan, from March 2020 till December 2020.Newly diagnosed patients were selected, from both genders and all age groups. Relevant history and findings of physical examination were recorded. Immunohistochemistry was done on trephine biopsy and molecular studies were carried on bone marrow aspirates or peripheral blood samples. Results: Out of 105 patients enrolled, 67 (63.8%) were males, with a male to female ratio (M: F) 1.8:1. Of the total patients, 62 (59.04%) were above 15 years of age. CD34 was expressed in 73 (69.5%) cases. Lymphadenopathy, splenomegaly, and hepatomegaly were separately noted in context to CD 34 expression in 22 (66.6%), 24 (64.8%), and 14 (58.3%) patients, respectively. CNS disease was seen in a total of 3(2.75%) subjects, in which 2 (66.6%) of the patients had CD34 expression. Total 81 patients in our study fall into the high-risk group out of which CD 34 expression was seen in 58(71.6%) subjects. Cytogenetic analysis, BCR-ABL p190, and MLL gene rearrangement were investigated in all participants. Cytogenetic analysis revealed an abnormality in 20 (19%) cases out of which 13 (17.8%) cases were from CD34 positive group. Conclusion: Our study reported CD34 expression in more than two-thirds of cases. High-risk disease was significantly associated with CD34 expression.

EMJ Hematology

BACKGROUND AND AIMS Patient blood management encompasses all aspects of the transfusion decision-... more BACKGROUND AND AIMS Patient blood management encompasses all aspects of the transfusion decision-making process, beginning with the initial patient evaluation and continuing through clinical management.1 It involves the timely, multidisciplinary application of evidence-based medical and surgical concepts, aimed at diagnosing and appropriately treating anaemia, along with minimising surgical and iatrogenic blood losses and managing coagulopathic bleeding, as well as supporting the patient while appropriate treatment is initiated.1 Haemovigilance is the set of surveillance procedures covering the entire blood transfusion chain, from the donation and processing of blood and its components, through to their provision and transfusion to patients, including their follow-up.2 The restrictive transfusion threshold uses a lower haemoglobin concentration as a threshold for transfusion (most commonly 7–8 g/dL), and the liberal transfusion threshold uses a higher haemoglobin concentration as a ...

Journal of Ayub Medical College Abbottabad, Oct 11, 2022

Background: This study was carried out to determine the frequency of CD34 positivity in acute lym... more Background: This study was carried out to determine the frequency of CD34 positivity in acute lymphoblastic leukaemia (B-ALL) in our population and to report its association with the clinicopathological profile at the time of diagnosis. Methods: The cross-sectional study was conducted at National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan, from March 2020 till December 2020.Newly diagnosed patients were selected, from both genders and all age groups. Relevant history and findings of physical examination were recorded. Immunohistochemistry was done on trephine biopsy and molecular studies were carried on bone marrow aspirates or peripheral blood samples. Results: Out of 105 patients enrolled, 67 (63.8%) were males, with a male to female ratio (M: F) 1.8:1. Of the total patients, 62 (59.04%) were above 15 years of age. CD34 was expressed in 73 (69.5%) cases. Lymphadenopathy, splenomegaly, and hepatomegaly were separately noted in context to CD 34 expression in 22 (66.6%), 24 (64.8%), and 14 (58.3%) patients, respectively. CNS disease was seen in a total of 3(2.75%) subjects, in which 2 (66.6%) of the patients had CD34 expression. Total 81 patients in our study fall into the high-risk group out of which CD 34 expression was seen in 58(71.6%) subjects. Cytogenetic analysis, BCR-ABL p190, and MLL gene rearrangement were investigated in all participants. Cytogenetic analysis revealed an abnormality in 20 (19%) cases out of which 13 (17.8%) cases were from CD34 positive group. Conclusion: Our study reported CD34 expression in more than two-thirds of cases. High-risk disease was significantly associated with CD34 expression.

National Journal of Health Sciences, 2020

The World Health Organization (WHO) has categorized acute undifferentiated leukemia (AUL) as a ra... more The World Health Organization (WHO) has categorized acute undifferentiated leukemia (AUL) as a rare subtype of acute leukemia of ambiguous lineage (ALAL). The prognosis of AUL is considered poor and it expresses no known lineage-specific markers. In majority of the cases, AUL has been associated with karyotypic abnormalities, most commonly deletion 5q and complex karyotype. Deletion 17p correlation with acute myeloid leukemia and myelodysplastic syndome has been previously established and is associated with poorer outcomes. Herein we are reporting a case of forty years old male who was referred to National institute of blood diseases and bone marrow transplantation with complains of fever, multiple neck swellings, and early satiety and was diagnosed as Acute Undifferentiated Leukemia along with deletion 17p. This is a rare entity and can aid in further diagnostic and therapeutic approaches.

Saudi Journal of Pathology and Microbiology

Cureus, 2022

Background An adequate supply of quality blood products is the backbone of any hospital. To maint... more Background An adequate supply of quality blood products is the backbone of any hospital. To maintain it, the utilization and wastage of the products should be closely monitored. Objective To determine the crossmatch to transfusion (C/T) ratio, transfusion probability (%T), and transfusion index (Ti) of packed red blood cells and to review the use of platelets. Materials and methods A total of 6,326 hematological patients receiving packed red blood cells were included in the study. The random donor platelets that were prepared during this period were also included to know the actual utilization of platelets. Results A total of 26,146 crossmatches were requested for these 6,326 patients in three years. Out of these, 26,024 units were issued and transfused to the patients. The CT ratio of our data was calculated to be 1.00, the transfusion probability was found to be 98.1%, and the transfusion index was computed to be 0.99. For random donor platelets, 37,162 were prepared from whole blood during this period, while 30,971 platelets were transfused to the patients. Conclusion The overall results of our analysis showed proper utilization of blood products at our institution. The wastage was considered to be minimal.

National Journal of Health Sciences, 2021

: Objective: Thrombocytopenia is a frequent finding in Dengue fever. Immune Thrombocytopenia (ITP... more : Objective: Thrombocytopenia is a frequent finding in Dengue fever. Immune Thrombocytopenia (ITP) is a diagnosis of exclusion and is not associated with febrile illness. Ignoring fever, low platelet count and clinical signs may be similar in both conditions. Peripheral film finding in Dengue fever shows many reactive lymphocytes. Enumeration of these reactive lymphocytes as high fluorescence lymphocyte count (HFLC) and computing immature fraction of platelets (IPF) may be useful in differentiating these two disorders as soon as the blood sample is analyzed on XN-1000 hematology analyzer. Materials and Methods: A cross-sectional study was conducted at National Institute of Blood Disease and Bone Marrow transplantation from January to July 2019 during (Dengue season); blood samples from emergency room were analyzed on XN-1000 hematology analyzer for complete blood count and IPF. Samples with thrombocytopenia were checked for IPF count and HFLC from the extended research parameter data of the analyzer. Patients presenting with fever, had Dengue NS-1 tested. Detailed history & examination was recorded from the patients. Results: Out of the 124 patients, 62 (50%) patients of Dengue and ITP respectively. Male to female ratio was 2:1. Mean age in Dengue was 25.52±10.46 years while 34.44 + 20.82 years in ITP group. Mean platelet count was significantly higher in dengue than ITP patients (120.59 ± 80.28 x109/L versus 41.84 ±38.62 x109/L) (p<0.001). HFLC was 11.71± 7.17% in Dengue fever while 0.198±0.25% in ITP patients whereas IPF in ITP group was 21.91 ± 16.09% while 8.79± 4.39%in Dengue patients were found to be significant i.e. (p<0.001). Conclusion: Excluding fever, thrombocytopenia, presence of increased number of HFLC and low or normal IPF can reliably a predictor of a diagnosis in Dengue season. Keywords: High fluorescence lymphocyte counts, Immature platelet functions, Dengue, Immune thrombocytopenia, Resource constraint Laboratories, Research parameters.

SSRN Electronic Journal, 2020

Background: There is a sharp decline in newSARS-CoV-2 cases in Karachi from July onwards; most of... more Background: There is a sharp decline in newSARS-CoV-2 cases in Karachi from July onwards; most of them were asymptomatic. Seroconversion rates vary markedly in different countries. Herd immunity for this virus is considered to be at 60-70%. Previously, 36% of seropositivity was reported in the adult population of Karachi in July this year. The current study was conducted to report if seroprevalence has reached the threshold of herd immunity. Methods: This was a prospective cross-sectional study conducted in the first and second weeks of September 2020 at the National Institute of Blood disease and Bone Marrow Transplantation Hospital (NIBD), Karachi, Pakistan. Blood samples were collected from different segments of the population of Karachi workforce/community. An anti-SARS-CoV-2 test was performed using ECLIA from Roche Diagnostics International. Results: A total of 2404 subjects’ blood samples were received from healthcare workers, the industrial workforce, and healthy blood donors. Seroprevalence in industrial workers was highest (70%) as compared to healthcare workers (40%). Overall seropositivity in males (39%) was higher than females (16%). Blood donors (all males) showed a seropositivity of 37.8%. The co-morbid state was not significantly associated with seropositivity (p-value >0.05). Total cases of antibody-positive were 1322 of 2100 (55 %). Conclusion: Our results confirmed the current seroprevalence of 55% in the adult population in Karachi. There was a sharp rise from 36% reported previously in July. This rise coincided with a sharp decline in new reported COVID cases. We can conclude that we are approaching the target of herd immunity in Karachi.

National Journal of Health Sciences, 2019

Journal of oncology, 2018

Most of the hematological disorders are heterogenous with regard to morphology, immunophenotype, ... more Most of the hematological disorders are heterogenous with regard to morphology, immunophenotype, and genetic rearrangements. Multiple recurrent chromosomal aberrations have been identified by conventional cytogenetic analysis, which is now widely recognized as one of the most important diagnostic and prognostic determinants in these patients. Though rarer, complex karyotype has been associated with worst prognosis. A total of 1185 bone marrow or peripheral blood cytogenetics samples were taken with different hematological diseases. They included both benign and malignant disease entities. In each case, cells were cultured and conventional cytogenetic analysis was performed. Among 1185 subjects, 41 (3.4%) patients possessed complex cytogenetic abnormalities. Out of these 41, 33 (80%) were males. The mean age was 37 years (median age 39 years). Myelodysplastic syndromes had the most numbers of complex karyotypes (8%), followed by acute myeloid leukemia (7%) and acute lymphoblastic leu...

Journal of oncology, 2018

Most of the hematological disorders are heterogenous with regard to morphology, immunophenotype, ... more Most of the hematological disorders are heterogenous with regard to morphology, immunophenotype, and genetic rearrangements. Multiple recurrent chromosomal aberrations have been identified by conventional cytogenetic analysis, which is now widely recognized as one of the most important diagnostic and prognostic determinants in these patients. Though rarer, complex karyotype has been associated with worst prognosis. A total of 1185 bone marrow or peripheral blood cytogenetics samples were taken with different hematological diseases. They included both benign and malignant disease entities. In each case, cells were cultured and conventional cytogenetic analysis was performed. Among 1185 subjects, 41 (3.4%) patients possessed complex cytogenetic abnormalities. Out of these 41, 33 (80%) were males. The mean age was 37 years (median age 39 years). Myelodysplastic syndromes had the most numbers of complex karyotypes (8%), followed by acute myeloid leukemia (7%) and acute lymphoblastic leu...

Journal of Public Health

Background The recent pandemic by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is... more Background The recent pandemic by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global emergency. There is large number of asymptomatic cases of SARS-CoV-2 that are not reported. Hence, serological evidence of SARS-CoV2 antibodies is warranted for a better estimation of the actual number of infected patients to limit the disease spread and to get an idea of herd immunity. Methods This is a cross-sectional study conducted from May 2020 to July 2020 at National Institute of Blood Diseases at Pakistan. The study includes healthcare workers (HCWs), community and industrial workers. The anti-SARS-CoV-2 test was performed by electrochemiluminescence immunoassay analyzer. Results A total of 1675 samples have been received from three groups of population. The percentage positivity for industrial employees is high (50.3%) for HCW (13.2%) and community population (34%).Total percentage for positive antibodies result is ~36%. Conclusion Our seroprevalence is 36%, which stil...

Case Report, Dec 1, 2019

Extensive fibrosis in myelodysplastic syndromes (MDS) is relatively infrequent and associated wit... more Extensive fibrosis in myelodysplastic syndromes (MDS) is relatively infrequent and associated with worst prognosis. It hasbeen classified as a specific entity by WHO. Moreover, the incidence and prevalence of Myelodyplastic Syndromes in children and adolescents is very low. Herein, we report a case of a 17 years old boy diagnosed as myelodysplastic syndrome with fibrosis along with ofmonosomy 7. Data pertaining relationship between myelodysplastic syndrome with fibrosis and karyotype abnormalities is relatively sparse. This case report will assist in considering better risk adapted therapies.

Transfusion and Apheresis Science

National Journal of Health Sciences

Recurrent cytogenetic abnormalities are manifested in approximately fifty percent cases of Myelod... more Recurrent cytogenetic abnormalities are manifested in approximately fifty percent cases of Myelodysplastic Syndromes (MDS) found as result of genomic instability verifying the presence of oncogenic genetic mutations. Over the years the molecular diagnosis of MDS, has emphasized the relevance of the molecular pathogenesis of this entity by utilizing the refined technology of next generation sequencing. We herein report a case of Myelodysplastic Syndrome with Excessive Blast 2(MDS EB 2) with isolated deletion 5q and the presence of oncogenic somatic driver mutation ASXL-1 elucidated through next generation sequencing. The reports pertaining the association of MDS with deletion 5q and ASXL 1 are relatively exiguous. This case report points towards the diagnostic and prognostic significance of somatic driver mutations, even in patients exhibiting good risk cytogenetics. This will assist in offering better risk adapted therapies in Myelodysplastic syndrome patients.

Background. Most of the hematological disorders are heterogenous with regard to morphology, immun... more Background. Most of the hematological disorders are heterogenous with regard to morphology, immunophenotype, and genetic rearrangements. Multiple recurrent chromosomal aberrations have been identified by conventional cytogenetic analysis, which is now widely recognized as one of the most important diagnostic and prognostic determinants in these patients. Though rarer, complex karyotype has been associated with worst prognosis. Materials and Methods. A total of 1185 bone marrow or peripheral blood cytogenetics samples were taken with different hematological diseases. They included both benign and malignant disease entities. In each case, cells were cultured and conventional cytogenetic analysis was performed. Results. Among 1185 subjects, 41 (3.4%) patients possessed complex cytogenetic abnormalities. Out of these 41, 33 (80%) were males. The mean age was 37 years (median age 39 years). Myelodysplastic syndromes had the most numbers of complex karyotypes (8%), followed by acute myeloid leukemia (7%) and acute lymphoblastic leukemia (4%). Also we found few patients with acute promyelocytic leukemia, aplastic anemia , chronic myeloid leukemia, and diffuse large B cell Lymphoma possessing complex karyotype. Frequencies of different cytogenetic abnormalities were assessed with respect to disease as well as independently. Trisomy 21 was the most common chromosomal abnormality found in 28% of patients. Conclusion. Complex karyotype was most frequently associated with myelodysplastic syndromes and acute myeloid leukemia. Trisomy 21 and deletion 5q were the commonest cytogenetic abnormalities found. We also assessed complex karyotype in benign diseases and detected one patient of aplastic anemia with complex karyotype. This is the first study highlighting the presence of complex karyotypes in hematological disorders in our region.

HemaSphere

Background: ABO and Rh systems are the most important blood group systems of human body. More tha... more Background: ABO and Rh systems are the most important blood group systems of human body. More than 400 blood group systems have been reported, however majority of them are not clinically significant. The ABO group system comprises of antigens represented by forward blood grouping and antibodies represented by reverse blood grouping. Reverse blood grouping is usually done to verify the results of forward blood grouping. ABO discrepancy is defined as a difference of result between forward and reverse group and has been reported to be around 0.15-0.19%. ABO discrepancies are divided into 4 types. Type 1 discrepancy include those having missing antibodies in reverse grouping and are most common. Type 2 discrepancy include missing antigens in forward grouping. Type 3 are those because of abnormalities in plasma or proteins and type 4 is represented as miscellaneous. Aims and Objectives: The aim of this study was to calculate the frequency of ABO discrepancies in healthy blood donors, its classification into different types and identification of different subgroups in order to provide safe blood to the patients. Material and Methods: Descriptive, cross sectional study was conducted at Regional blood centre Karachi from January 2020 to August 2023.78,623 donors were enrolled in the study. Blood samples were collected in di-potassium ethylene diamine tetra acetic acid (K2 EDTA) and yellow gel top vacutainers. Blood grouping was performed by a technician/ technologist by tube method and was reconfirmed by a senior technologist. Results: 78623 samples were included in the study, with majority of the males. The mean age of blood donors was 28.5 years. ABO discrepancy was found in 108 cases (0.13%). 4 groups of ABO discrepancies were made according to AABB. Most common ABO discrepancy was type 4 (46.3%) followed by type 1 (37.0%). Type 2 and type 3 were 11.1% and 5.6% respectively. Most common blood group associated with ABO discrepancies was O positive, followed by A positive (p value 0.001). Most subgroups were associated with a followed by B. Conclusion: ABO blood grouping remains the most important testing in the blood donors. The significance of determining the actual blood group lies in the fact that safe blood transfusion should be the utmost priority. Complete blood grouping along with resolution of discrepancies will continue to be a significant feature in providing safe blood to the patients and preventing them from fatal transfusion reactions.

Journal of Ayub Medical College Abbottabad, Oct 11, 2022

Background: This study was carried out to determine the frequency of CD34 positivity in acute lym... more Background: This study was carried out to determine the frequency of CD34 positivity in acute lymphoblastic leukaemia (B-ALL) in our population and to report its association with the clinicopathological profile at the time of diagnosis. Methods: The cross-sectional study was conducted at National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan, from March 2020 till December 2020.Newly diagnosed patients were selected, from both genders and all age groups. Relevant history and findings of physical examination were recorded. Immunohistochemistry was done on trephine biopsy and molecular studies were carried on bone marrow aspirates or peripheral blood samples. Results: Out of 105 patients enrolled, 67 (63.8%) were males, with a male to female ratio (M: F) 1.8:1. Of the total patients, 62 (59.04%) were above 15 years of age. CD34 was expressed in 73 (69.5%) cases. Lymphadenopathy, splenomegaly, and hepatomegaly were separately noted in context to CD 34 expression in 22 (66.6%), 24 (64.8%), and 14 (58.3%) patients, respectively. CNS disease was seen in a total of 3(2.75%) subjects, in which 2 (66.6%) of the patients had CD34 expression. Total 81 patients in our study fall into the high-risk group out of which CD 34 expression was seen in 58(71.6%) subjects. Cytogenetic analysis, BCR-ABL p190, and MLL gene rearrangement were investigated in all participants. Cytogenetic analysis revealed an abnormality in 20 (19%) cases out of which 13 (17.8%) cases were from CD34 positive group. Conclusion: Our study reported CD34 expression in more than two-thirds of cases. High-risk disease was significantly associated with CD34 expression.

EMJ Hematology

BACKGROUND AND AIMS Patient blood management encompasses all aspects of the transfusion decision-... more BACKGROUND AND AIMS Patient blood management encompasses all aspects of the transfusion decision-making process, beginning with the initial patient evaluation and continuing through clinical management.1 It involves the timely, multidisciplinary application of evidence-based medical and surgical concepts, aimed at diagnosing and appropriately treating anaemia, along with minimising surgical and iatrogenic blood losses and managing coagulopathic bleeding, as well as supporting the patient while appropriate treatment is initiated.1 Haemovigilance is the set of surveillance procedures covering the entire blood transfusion chain, from the donation and processing of blood and its components, through to their provision and transfusion to patients, including their follow-up.2 The restrictive transfusion threshold uses a lower haemoglobin concentration as a threshold for transfusion (most commonly 7–8 g/dL), and the liberal transfusion threshold uses a higher haemoglobin concentration as a ...

Journal of Ayub Medical College Abbottabad, Oct 11, 2022

Background: This study was carried out to determine the frequency of CD34 positivity in acute lym... more Background: This study was carried out to determine the frequency of CD34 positivity in acute lymphoblastic leukaemia (B-ALL) in our population and to report its association with the clinicopathological profile at the time of diagnosis. Methods: The cross-sectional study was conducted at National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan, from March 2020 till December 2020.Newly diagnosed patients were selected, from both genders and all age groups. Relevant history and findings of physical examination were recorded. Immunohistochemistry was done on trephine biopsy and molecular studies were carried on bone marrow aspirates or peripheral blood samples. Results: Out of 105 patients enrolled, 67 (63.8%) were males, with a male to female ratio (M: F) 1.8:1. Of the total patients, 62 (59.04%) were above 15 years of age. CD34 was expressed in 73 (69.5%) cases. Lymphadenopathy, splenomegaly, and hepatomegaly were separately noted in context to CD 34 expression in 22 (66.6%), 24 (64.8%), and 14 (58.3%) patients, respectively. CNS disease was seen in a total of 3(2.75%) subjects, in which 2 (66.6%) of the patients had CD34 expression. Total 81 patients in our study fall into the high-risk group out of which CD 34 expression was seen in 58(71.6%) subjects. Cytogenetic analysis, BCR-ABL p190, and MLL gene rearrangement were investigated in all participants. Cytogenetic analysis revealed an abnormality in 20 (19%) cases out of which 13 (17.8%) cases were from CD34 positive group. Conclusion: Our study reported CD34 expression in more than two-thirds of cases. High-risk disease was significantly associated with CD34 expression.

National Journal of Health Sciences, 2020

The World Health Organization (WHO) has categorized acute undifferentiated leukemia (AUL) as a ra... more The World Health Organization (WHO) has categorized acute undifferentiated leukemia (AUL) as a rare subtype of acute leukemia of ambiguous lineage (ALAL). The prognosis of AUL is considered poor and it expresses no known lineage-specific markers. In majority of the cases, AUL has been associated with karyotypic abnormalities, most commonly deletion 5q and complex karyotype. Deletion 17p correlation with acute myeloid leukemia and myelodysplastic syndome has been previously established and is associated with poorer outcomes. Herein we are reporting a case of forty years old male who was referred to National institute of blood diseases and bone marrow transplantation with complains of fever, multiple neck swellings, and early satiety and was diagnosed as Acute Undifferentiated Leukemia along with deletion 17p. This is a rare entity and can aid in further diagnostic and therapeutic approaches.

Saudi Journal of Pathology and Microbiology

Cureus, 2022

Background An adequate supply of quality blood products is the backbone of any hospital. To maint... more Background An adequate supply of quality blood products is the backbone of any hospital. To maintain it, the utilization and wastage of the products should be closely monitored. Objective To determine the crossmatch to transfusion (C/T) ratio, transfusion probability (%T), and transfusion index (Ti) of packed red blood cells and to review the use of platelets. Materials and methods A total of 6,326 hematological patients receiving packed red blood cells were included in the study. The random donor platelets that were prepared during this period were also included to know the actual utilization of platelets. Results A total of 26,146 crossmatches were requested for these 6,326 patients in three years. Out of these, 26,024 units were issued and transfused to the patients. The CT ratio of our data was calculated to be 1.00, the transfusion probability was found to be 98.1%, and the transfusion index was computed to be 0.99. For random donor platelets, 37,162 were prepared from whole blood during this period, while 30,971 platelets were transfused to the patients. Conclusion The overall results of our analysis showed proper utilization of blood products at our institution. The wastage was considered to be minimal.

National Journal of Health Sciences, 2021

: Objective: Thrombocytopenia is a frequent finding in Dengue fever. Immune Thrombocytopenia (ITP... more : Objective: Thrombocytopenia is a frequent finding in Dengue fever. Immune Thrombocytopenia (ITP) is a diagnosis of exclusion and is not associated with febrile illness. Ignoring fever, low platelet count and clinical signs may be similar in both conditions. Peripheral film finding in Dengue fever shows many reactive lymphocytes. Enumeration of these reactive lymphocytes as high fluorescence lymphocyte count (HFLC) and computing immature fraction of platelets (IPF) may be useful in differentiating these two disorders as soon as the blood sample is analyzed on XN-1000 hematology analyzer. Materials and Methods: A cross-sectional study was conducted at National Institute of Blood Disease and Bone Marrow transplantation from January to July 2019 during (Dengue season); blood samples from emergency room were analyzed on XN-1000 hematology analyzer for complete blood count and IPF. Samples with thrombocytopenia were checked for IPF count and HFLC from the extended research parameter data of the analyzer. Patients presenting with fever, had Dengue NS-1 tested. Detailed history & examination was recorded from the patients. Results: Out of the 124 patients, 62 (50%) patients of Dengue and ITP respectively. Male to female ratio was 2:1. Mean age in Dengue was 25.52±10.46 years while 34.44 + 20.82 years in ITP group. Mean platelet count was significantly higher in dengue than ITP patients (120.59 ± 80.28 x109/L versus 41.84 ±38.62 x109/L) (p<0.001). HFLC was 11.71± 7.17% in Dengue fever while 0.198±0.25% in ITP patients whereas IPF in ITP group was 21.91 ± 16.09% while 8.79± 4.39%in Dengue patients were found to be significant i.e. (p<0.001). Conclusion: Excluding fever, thrombocytopenia, presence of increased number of HFLC and low or normal IPF can reliably a predictor of a diagnosis in Dengue season. Keywords: High fluorescence lymphocyte counts, Immature platelet functions, Dengue, Immune thrombocytopenia, Resource constraint Laboratories, Research parameters.

SSRN Electronic Journal, 2020

Background: There is a sharp decline in newSARS-CoV-2 cases in Karachi from July onwards; most of... more Background: There is a sharp decline in newSARS-CoV-2 cases in Karachi from July onwards; most of them were asymptomatic. Seroconversion rates vary markedly in different countries. Herd immunity for this virus is considered to be at 60-70%. Previously, 36% of seropositivity was reported in the adult population of Karachi in July this year. The current study was conducted to report if seroprevalence has reached the threshold of herd immunity. Methods: This was a prospective cross-sectional study conducted in the first and second weeks of September 2020 at the National Institute of Blood disease and Bone Marrow Transplantation Hospital (NIBD), Karachi, Pakistan. Blood samples were collected from different segments of the population of Karachi workforce/community. An anti-SARS-CoV-2 test was performed using ECLIA from Roche Diagnostics International. Results: A total of 2404 subjects’ blood samples were received from healthcare workers, the industrial workforce, and healthy blood donors. Seroprevalence in industrial workers was highest (70%) as compared to healthcare workers (40%). Overall seropositivity in males (39%) was higher than females (16%). Blood donors (all males) showed a seropositivity of 37.8%. The co-morbid state was not significantly associated with seropositivity (p-value >0.05). Total cases of antibody-positive were 1322 of 2100 (55 %). Conclusion: Our results confirmed the current seroprevalence of 55% in the adult population in Karachi. There was a sharp rise from 36% reported previously in July. This rise coincided with a sharp decline in new reported COVID cases. We can conclude that we are approaching the target of herd immunity in Karachi.

National Journal of Health Sciences, 2019

Journal of oncology, 2018

Most of the hematological disorders are heterogenous with regard to morphology, immunophenotype, ... more Most of the hematological disorders are heterogenous with regard to morphology, immunophenotype, and genetic rearrangements. Multiple recurrent chromosomal aberrations have been identified by conventional cytogenetic analysis, which is now widely recognized as one of the most important diagnostic and prognostic determinants in these patients. Though rarer, complex karyotype has been associated with worst prognosis. A total of 1185 bone marrow or peripheral blood cytogenetics samples were taken with different hematological diseases. They included both benign and malignant disease entities. In each case, cells were cultured and conventional cytogenetic analysis was performed. Among 1185 subjects, 41 (3.4%) patients possessed complex cytogenetic abnormalities. Out of these 41, 33 (80%) were males. The mean age was 37 years (median age 39 years). Myelodysplastic syndromes had the most numbers of complex karyotypes (8%), followed by acute myeloid leukemia (7%) and acute lymphoblastic leu...

Journal of oncology, 2018

Most of the hematological disorders are heterogenous with regard to morphology, immunophenotype, ... more Most of the hematological disorders are heterogenous with regard to morphology, immunophenotype, and genetic rearrangements. Multiple recurrent chromosomal aberrations have been identified by conventional cytogenetic analysis, which is now widely recognized as one of the most important diagnostic and prognostic determinants in these patients. Though rarer, complex karyotype has been associated with worst prognosis. A total of 1185 bone marrow or peripheral blood cytogenetics samples were taken with different hematological diseases. They included both benign and malignant disease entities. In each case, cells were cultured and conventional cytogenetic analysis was performed. Among 1185 subjects, 41 (3.4%) patients possessed complex cytogenetic abnormalities. Out of these 41, 33 (80%) were males. The mean age was 37 years (median age 39 years). Myelodysplastic syndromes had the most numbers of complex karyotypes (8%), followed by acute myeloid leukemia (7%) and acute lymphoblastic leu...

Journal of Public Health

Background The recent pandemic by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is... more Background The recent pandemic by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global emergency. There is large number of asymptomatic cases of SARS-CoV-2 that are not reported. Hence, serological evidence of SARS-CoV2 antibodies is warranted for a better estimation of the actual number of infected patients to limit the disease spread and to get an idea of herd immunity. Methods This is a cross-sectional study conducted from May 2020 to July 2020 at National Institute of Blood Diseases at Pakistan. The study includes healthcare workers (HCWs), community and industrial workers. The anti-SARS-CoV-2 test was performed by electrochemiluminescence immunoassay analyzer. Results A total of 1675 samples have been received from three groups of population. The percentage positivity for industrial employees is high (50.3%) for HCW (13.2%) and community population (34%).Total percentage for positive antibodies result is ~36%. Conclusion Our seroprevalence is 36%, which stil...

Case Report, Dec 1, 2019

Extensive fibrosis in myelodysplastic syndromes (MDS) is relatively infrequent and associated wit... more Extensive fibrosis in myelodysplastic syndromes (MDS) is relatively infrequent and associated with worst prognosis. It hasbeen classified as a specific entity by WHO. Moreover, the incidence and prevalence of Myelodyplastic Syndromes in children and adolescents is very low. Herein, we report a case of a 17 years old boy diagnosed as myelodysplastic syndrome with fibrosis along with ofmonosomy 7. Data pertaining relationship between myelodysplastic syndrome with fibrosis and karyotype abnormalities is relatively sparse. This case report will assist in considering better risk adapted therapies.

Transfusion and Apheresis Science

National Journal of Health Sciences

Recurrent cytogenetic abnormalities are manifested in approximately fifty percent cases of Myelod... more Recurrent cytogenetic abnormalities are manifested in approximately fifty percent cases of Myelodysplastic Syndromes (MDS) found as result of genomic instability verifying the presence of oncogenic genetic mutations. Over the years the molecular diagnosis of MDS, has emphasized the relevance of the molecular pathogenesis of this entity by utilizing the refined technology of next generation sequencing. We herein report a case of Myelodysplastic Syndrome with Excessive Blast 2(MDS EB 2) with isolated deletion 5q and the presence of oncogenic somatic driver mutation ASXL-1 elucidated through next generation sequencing. The reports pertaining the association of MDS with deletion 5q and ASXL 1 are relatively exiguous. This case report points towards the diagnostic and prognostic significance of somatic driver mutations, even in patients exhibiting good risk cytogenetics. This will assist in offering better risk adapted therapies in Myelodysplastic syndrome patients.

Background. Most of the hematological disorders are heterogenous with regard to morphology, immun... more Background. Most of the hematological disorders are heterogenous with regard to morphology, immunophenotype, and genetic rearrangements. Multiple recurrent chromosomal aberrations have been identified by conventional cytogenetic analysis, which is now widely recognized as one of the most important diagnostic and prognostic determinants in these patients. Though rarer, complex karyotype has been associated with worst prognosis. Materials and Methods. A total of 1185 bone marrow or peripheral blood cytogenetics samples were taken with different hematological diseases. They included both benign and malignant disease entities. In each case, cells were cultured and conventional cytogenetic analysis was performed. Results. Among 1185 subjects, 41 (3.4%) patients possessed complex cytogenetic abnormalities. Out of these 41, 33 (80%) were males. The mean age was 37 years (median age 39 years). Myelodysplastic syndromes had the most numbers of complex karyotypes (8%), followed by acute myeloid leukemia (7%) and acute lymphoblastic leukemia (4%). Also we found few patients with acute promyelocytic leukemia, aplastic anemia , chronic myeloid leukemia, and diffuse large B cell Lymphoma possessing complex karyotype. Frequencies of different cytogenetic abnormalities were assessed with respect to disease as well as independently. Trisomy 21 was the most common chromosomal abnormality found in 28% of patients. Conclusion. Complex karyotype was most frequently associated with myelodysplastic syndromes and acute myeloid leukemia. Trisomy 21 and deletion 5q were the commonest cytogenetic abnormalities found. We also assessed complex karyotype in benign diseases and detected one patient of aplastic anemia with complex karyotype. This is the first study highlighting the presence of complex karyotypes in hematological disorders in our region.