Pakistan Journal of Pathology Pakistan Association of Pathologists en-US Pakistan Journal of Pathology 1024-6193 <p>The Pakistan Journal Pathology follows "CC BY NC" creative commons licensing. <a href=""><strong></strong></a>.</p> BRIGADIER (RETD) DR CHIRAGH HASSAN BREATHES HIS LAST <p>An eminent senior Pathologist, Brigadier Chiragh Hassan died in Lahore on 20<sup>th</sup> October 2022. He was born in Hoshiarpur District and migrated to Lyallpur in 1947.</p> <p>He graduated from King Edward Medical College, Lahore in 1981; has a span of Govt services first as House Physician in Mayo Hospital and later as Registrar till September 1965. He volunteered for Armed Services in 1965 war, where he continued to serve till his retirement as brigadier from CMH Lahore. He did his FCPS in 1978 and proceeded to on-the-job training in tumor pathology in a specialist unit in London for about a year. He spent a considerable part of his services in Pakistan Naval Hospital, Shifa, and an excellent job in upgrading its laboratory.</p> <p>Dr Chiragh was a keen tennis player. He was very hospitable and was loved by his friends and patients alike. After retirement he was an honorary consultant in a laboratory run by an NGO in Lahore Cantt.</p> <p>&nbsp;</p> <p>The profession will be a loser with a departure of Brigadier Dr Chiragh. May Allah bless his soul.</p> Muhammad Muzaffar Copyright (c) 2022 Pakistan Journal of Pathology 2022-12-30 2022-12-30 33 4 FREQUENCY OF THE APPROPRIATE USE OF PLATELET CONCENTRATES IN A TERTIARY CARE HOSPITAL <p><strong>Objective:</strong> The objective of the study was to determine frequency of the appropriate use of platelet concentrates in a tertiary care hospital.</p> <p><strong>Material and Methods:</strong> It was a descriptive cross-sectional study that was conducted in Department of Pathology, Pakistan Atomic Energy Commission (PAEC) General Hospital, Islamabad for a period of six months from 1<sup>st</sup> January to 30<sup>th</sup> June 2021. Patients of both genders, above five years of age receiving platelets transfusions during the study period were included in this study. An informed consent was obtained from the patients. The data was collected on a predesigned form that included patient demographic and clinical details. All patients were categorized whether the platelet transfusion was appropriate or inappropriate according to the mentioned definitions. To control confounding effects of various factors and to avoid bias in the study, the exclusion criteria were strictly followed. t test was applied to find statistical difference between appropriate and inappropriate transfusions.</p> <p><strong>Results:</strong> Out of total 331 patients, 169 (51%) were females while 162 (49%) were males, male: female ratio being 1: 1.04. Mean age was 41.75 <u>+</u> 23.1 years with a range of 6-92 years. Maximum patients were in 31-40 years age group. Single donor platelet units were transfused to 55(16.6%) patients while rest 276 (83.4%) patients received random donor platelets. 301 (90.9%) had appropriate transfusion while 30 (9.1%) patients received blood transfusion due to inappropriate indications. (p &lt;0.0001).</p> <p><strong>Conclusion: </strong> From this study it was concluded that a significant number of patients in hospital setting receive inappropriate platelet transfusions.</p> <p><strong>Key Words:</strong> Appropriate, Platelet concentrates, Transfusion.</p> Naheed Khattak Sara Jamal Sundas Ali Huma Abdul Shakoor Sana Syed Samina Tufail Amanat Copyright (c) 2022 Pakistan Journal of Pathology 2022-12-30 2022-12-30 33 4 114 118 10.55629/pakjpathol.v33i4.734 COMPARING THE EFFECT OF CHRONIC HYPERGLYCEMIA ON INTRA OCULAR PRESSURE IN DIABETIC PATIENTS <p><strong>Objective: </strong>To compare the effect of chronic hyperglycemia on intra ocular pressure (IOP) in diabetic patients.</p> <p><strong>Material and Methods: </strong>This cross-sectional study was conducted at Pathology &amp; Ophthalmology Departments of PNS Shifa Hospital, Karachi from February to May 2022. A total of 215 patients of Diabetes Mellitus having age between 40 to 70 years were included. HbA1c was used to categorize patients into two groups. Good glycemic control group (HbA1c &lt;7%) and Poor glycemic control group (HbA1c &gt;7%). IOP (mmHg) of both eyes was measured in both groups by applanation tonometer. Median comparison of IOP in both groups was done by Mann-Whitney U-test. To determine correlation between HbA1c levels and IOP, Pearson correlation was applied.</p> <p><strong>Results: </strong>Out of 210 patients 110(51.2%) patients had HbA1c &lt; 7% while 105(48.8%) had HbA1c &gt; 7%. Good glycemic control group had lower median IOP in both right (14.5 mmHg IQR 14-16) &amp; left eye (15mmHg IQR 14-16) as compared to poor glycemic control group having median IOP in right eye (20mmHg IQR 19-22) &amp; left eye (21 mmHg IQR 18-23). The difference was found to be statistically significant (p value &lt;0.001). Pearson correlation showed a significant positive linear correlation between HbA1c and right eye IOP (r = 0.898, p value &lt;0.01) and left eye IOP (r = 0.883, p value &lt;0.01).</p> <p><strong>Conclusion: </strong>Patients with poor glycemic control had higher IOP as compared to good glycemic control. Chronic hyperglycemia is associated with raised IOP in diabetics.</p> <p><strong>Key Words:</strong> Diabetes mellitus, Intra ocular pressure, HbA1c.</p> Uzma Ansari Muhammad Kashif Hanif Athar Iqbal Paracha Qurratulain Amina Tariq Sanam Haneef Copyright (c) 2022 Pakistan Journal of Pathology 2022-12-30 2022-12-30 33 4 119 123 10.55629/pakjpathol.v33i4.721 SPECTRUM OF CYTOGENETIC ABNORMALITIES IN PEDIATRIC PATIENTS WITH ACUTE MYELOID LEUKEMIA <p><strong>Objective: </strong>To determine the frequency and types of cytogenetic abnormalities in pediatric Acute Myeloid Leukemia.</p> <p><strong>Material and Methods</strong><strong>: </strong>This cross-sectional study was conducted from January 2021 to October 2021 in Hematology department of the CHUGHTAI Institute of Pathology in Lahore Pakistan. Total 60 patients who were newly diagnosed with Acute myeloid leukemia in CHUGHTAI Institute of Pathology and were also referred from Children Hospital Lahore were included. Patients under the age of 16 years and from both gender were included. Informed consent was taken from patient’s guardian/parents. Patients had their bone marrow aspirates processed for standard G-banding and their karyotypes were examined using a cyto-vision system, where the number of chromosomes was counted and examined for any changes, such as damaged, missing, rearranged, or additional copies of chromosomes. Morphology, immunophenotyping of aspirate, and trephine biopsy are used to make the diagnosis of AML. Data was entered in SPSS version 23.0.</p> <p><strong>Result: </strong>There were total 60 patients included in the study. The mean age was 10.2<u>+ </u>3.2 years. There were n=32(53.3%) males and n=28(46.6%) female. Normal karyotype was observed in n=36(60%) patients, abnormal were seen in n=14(23.3%) and unsuccessful was shown in n=10(16.6%) patients. Favorable cytogenetic results were seen in n=6 (10%), intermediate in n=41 (68.3%), and unfavorable in n=4 (6.6%) cases. t(8;21) (q22:q22) and t(15;17)(q24;q21) were found in 8.3% and 1.6% of our study population respectively which have favorable prognosis . One of our patients had complex cytogenetic abnormalities, including [del5p, del7q, del11q-17+] which shows poor prognosis.</p> <p><strong>Conclusion: </strong>The study discovered that 14 (23.3%) of the total pediatric patients with acute myeloid leukemia showed aberrant cytogenetic abnormalities. Chromosomal abnormalities should be identified as early as possible since they can be used for AML risk stratification and prediction of prognosis<strong>.</strong></p> <p><strong>Key Words: </strong>Acute myeloid leukemia, Complex cytogenetic, Cyto-vision, Karyotype, Morphology, Pediatric.</p> Shereen Umer Shazia Riaz Muhammad Jamil Awan Hassan Raza Tayyab Noor Ayisha Imran Copyright (c) 2022 Pakistan Journal of Pathology 2022-12-30 2022-12-30 33 4 124 128 10.55629/pakjpathol.v33i4.720 COMPARISON OF FOURTH WAVE VARIANT OF SARS-COV-2 AND ANCESTRAL WAVES, AN EXPERIENCE FROM A TERTIARY CARE HOSPITAL, KARACHI <p><strong>Objective: </strong>The study aims to identify the key differences between ancestral strains and the fourth wave variant of SARS-CoV-2 by comparing the epidemiological and clinical profile of patients admitted since the commencement of CoVID-19 disease.</p> <p><strong>Material and Methods: </strong>The data of all those patients who were SARS-CoV-2 positive from March 2020 to February 2022 was collected. Records of 99 patients admitted during the fourth were compared to admitted patients during three previous waves over a period of the past 23 months.</p> <p><strong>Results: </strong>From Jan till 2nd February 2022, 30.6% PCR turned out to be positive which was remarkably raised from our previous records where the positivity record was 9.11%. After October 2021 there was a remarkable reduction in SARS- CoV-2 infection, afterwards, we appreciated a sudden surge in positive cases during the first week of January 2022 (137/557 (24%)). This trend then led to a rise and fall pattern to 290/720(40%), 180/530 (33%) and 68/398 (17%) during the second, third and fourth week of January respectively. The majority of symptomatic patients developed mild disease 335/454(78%) and only 99/454(22%) developed moderate to a severe disease requiring hospitalization which was lower than the previous waves 410/1457(28%). The total mortality rate during the last three waves was 9% which was much higher than the recent strain during which mortality was only 1%.</p> <p><strong>Conclusion: </strong>Major epidemiological and clinical differences were observed between ancestral strains and fourth-wave variants of SARS-CoV-2 with decreased severity, fewer deaths, and a shorter hospital stay.</p> <p><strong>Keywords: </strong>SARS -CoV-2, Omicron variants, Outbreak, Vaccination</p> Abeera Ahmed Muhammad Imran Fatima Sana Hafiz Waheed Khan Syed Rehan Asghar Naqvi Aisha Siddiqi Copyright (c) 2022 Pakistan Journal of Pathology 2022-12-30 2022-12-30 33 4 129 133 10.55629/pakjpathol.v33i4.735 DISTURBANCES IN SERUM CALCIUM AND PHOSPHATE LEVELS IN PRE-DIABETES AND TYPE 2 DIABETES MELLITUS <p><strong>Objective:</strong> To evaluate serum calcium and phosphate levels in Pre-diabetic, Diabetic &amp; non-diabetic subjects.</p> <p><strong>Material and Methods:</strong> This comparative cross-sectional study was conducted at the Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, from July to December 2021. The study used a non-probability consecutive sample to include 300 people. Those people have been divided into three groups; diabetics, pre-diabetics and non-diabetics with a hundred people in every group. Blood specimens had been taken for the estimation of calcium, phosphate, HbA1c, plasma glucose and insulin in fasting in their respective tubes. SPSS version 24 was used to inspect the data. All descriptive variables had their means and standard deviations calculated. To examine descriptive characteristics within and between all groups, one way ANOVA and post hoc LSD were performed, and p-values 0. 05 were considered significant.</p> <p><strong>Results:</strong> Calcium and Phosphorus levels were lower in Diabetic group (Ca= 1.97±0.16mmol/l, PO<sub>4</sub> = 0.76±0.07 mmol/l) as compared to pre-diabetic group (Ca= 2.15±0.18 mmol/l, PO<sub>4</sub> = 0.93±0.06 mmol/l) and higher in non-diabetic group (Ca= 2.33±0.10mmol/l, PO<sub>4</sub> = 1.19±0.20 mmol/l) than both other groups. A one-way ANOVA and Post Hoc LSD revealed that the difference between and within groups was statistically significant with a p value of 0.01.</p> <p><strong>Conclusion:</strong> Our research has shown that as glycemic control slowly deteriorates, blood calcium and phosphate levels fall.</p> <p><strong>Key Words:</strong>Calcium, Phosphorus, Pre-diabetes, Type 2 diabetes mellitus.</p> Tehreem Fatima Awan Muhammad Anwar Zujaja Hina Haroon Afshan Bibi Muhammad Younas Sobia Irum Kirmani Copyright (c) 2022 Pakistan Journal of Pathology 2022-12-30 2022-12-30 33 4 134 138 10.55629/pakjpathol.v33i4.728 FREQUENCY OF UTERINE LEIOMYOMA WITH ITS RELATED RISK FACTORS OBSERVED AT A TERTIARY CARE CENTRE IN KARACHI <p><strong>Objective: </strong> To study the frequency of uterine leiomyoma with its risk factors.</p> <p><strong>Material and Methods: </strong>A cross-sectional study was carried out between January 2020 to June 2020 including women who were diagnosed with uterine leiomyomas in the Department of Gynecology, Jinnah Postgraduate Medical Center (JPMC), Karachi. All the major risk factors including demographic details, family history, marital status, parity, use of oral contraceptives and co-morbids were studied in 300 females using a questionnaire. The data was analyzed with the statistical program Statistical Package for the Social Sciences (SPSS) version 21.0.</p> <p><strong>Results: </strong>A total number of 300 patients having uterine leiomyomas were included in the study. The mean and standard deviation of the patients’ age was 42.52±7.98 and patients’ weight was 59.8±9.12. The mean and standard deviation of the patients’ BMI was 23.4±3.85 and patients’ height was 63.01±2.23. The demographic and clinical characteristics of the patients are presented in Table-I and II. Leiomyomas were reported mostly in women between the ages of 36-40 years (28%), followed by 46-50 years (20%) and 51-55 years (14.3%). 10% of the women reported hypertension as a co-morbid. 3.8% were both hypertensive and diabetic. 76.9% females presented with abnormal uterine bleeding and 69.8% had anemia. Most of the women with leiomyomas were para 3+ (36.9%) and para 3 (20.9%). 22.2% women were nulliparous. 72.2% women had a single fibroid and 21.6% had two or more fibroids. 5.7% women had a family history of fibroids. 5.4% women were using some form of hormonal contraception.</p> <p><strong>Conclusion: </strong>Risk factors for uterine leiomyomas were identified and a prevalence of these risk factors in patients with leiomyomas was observed.</p> <p><strong>Key Words: </strong>Leiomyoma, Risk factors, Uterine fibroid.</p> Talat Zehra Khadija Bano Syeda Sakeena Raza Mahin Shams Tajwar Fatima Amna Qadri Copyright (c) 2022 Pakistan Journal of Pathology 2022-12-30 2022-12-30 33 4 139 142 10.55629/pakjpathol.v33i4.732