BackgroundBlood donated by healthy people is extremely important as it is integral in emergent situations. The authors aimed to address and highlight the main causes of the wastage of donated blood and its components. MethodologyA cross-sectional study was conducted at a blood bank of a tertiary care center between January 2019 and March 2020. All the information regarding blood donated and blood components during the study period was documented on a predefined proforma. The blood bags which were seropositive, reached their shelf-life expiry, expired due to non-utilization, or quantity was non-sufficient were discarded. Blood showing any changes of either hemolysis or turbidity was also discarded. Other reasons for discarding blood units included leakage (damage to or fault in the blood bag), hemolytic reasons, or miscellaneous reasons. ResultsA total of 9308 blood donations were received as donations during the study period. Out of the total donations, 7,988 (85.8%) were subjected for component formation including red cell component (RCC), fresh frozen plasma (FFP), and platelets. A total of 23,964 components were prepared using the donated blood. Out of these 2128 (8.87%) units were discarded. Upon stratifying the discarded blood according to the type of component, it was found that platelets made up 1148 (53.9%) units, red cell component composed 324 (15.2%) units, and fresh frozen plasma composed 313 (14.7%) units of discarded blood. Seropositive was reported to be 32.3%. Of this, the red cell component made up 276 (85.2%) units. ConclusionThe present study reported a discard rate of 8.87%. Of these, the majority was composed of platelets due to the shortest shelf life. Leakage of blood bags remained a predominant cause for the discard of blood components. Seropositivity for hepatitis B, C, and human immunodeficiency virus (HIV) was reported in almost 30% units of donated blood. Further large-scale studies should be conducted to reassess how wastage of donated blood can be minimized.

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Introduction: Bone marrow is the site of involvement of various neoplasms. The objective of this study was to determine the incidence of various malignancies (Haematological and non-Haematological) in adults diagnosed on morphological examination of bone marrow. Materials and Methods: It was a single-centre, retrospective study conducted at the Department of Pathology, Fauji Foundation Hospital, Rawalpindi from January 2012 to December 2018. All patients above 15 years of age diagnosed as having Haematological or Non-Haematological malignancy involving bone marrow were included in the study. Data was analyzed using SPSS version 17. Results: A total of 275 adult patients had malignancies involving bone marrow; 233 (84.7%) were females and 42 (15.3%) were males.  Out of 275 patients, 50 (18.1%) patients had Acute Myeloid Leukaemia, 45 (16.3 %) had Chronic Myeloid Leukaemia (CML), 41 (14.9 %) having Non-Hodgkin lymphoma (NHL), 32 (11.6 %) having Acute Lymphoblastic Leukaemia (ALL), 31 (11.2 %) having Chronic Lymphocytic Leukaemia (CLL) and 27 (9.8 %) having Plasma cell Myeloma. Metastatic infiltrates were seen in 16 (5.8 %) patients. Myeloproliferative neoplasms (MPN) in 6 (2.1%), Essential Thrombocythaemia in 5 (1.8 %), Polycythaemia vera in 4 (1.4%), Primary myelofibrosis in 2 (0.7 %), Hodgkins Lymphoma in 2 (0.7 %), and Plasma Cell Leukaemia in 1 (0.3 %) patient were seen. Thirteen (4.7%) patients of Acute leukaemia and 6 (2.1%) patients of MPN required further testing by Immunophenotyping/Cytogenetics for a conclusive diagnosis. Conclusion: Leukaemias were the most common malignancies involving bone marrow, followed by Non-Hodgkin Lymphomas, Plasma cell myeloma and Metastatic infiltrates. Morphology by light microscopy remains the single most useful tool for the diagnosis of malignancies, especially in under-resourced centres.

Background & Objective: Undiagnosed malarial infectionis associated with significant mortality and morbidity. Laboratory investigations leading to rapid, accurate and timely diagnosis of malaria is still a challenge. This study was done to assess the utility of abnormal White blood cell differential fluorescence (WDF) scattergram for diagnosis of malaria. Our aim was to study the utility of WDF scattergram for early detection of malarial parasite. Methods: All EDTA anti-coagulated blood samples received in laboratory during a period from Dec 2019 to May 2020 were analyzed on anautomated hematology analyzer, Sysmex XN 1000. All abnormal WDF scattergrams pertaining to plasmodium specie were critically evaluated and recorded. Review of Leishman-stained peripheral smears as well as immune-chromatographic assay by rapid test devices (RTD) was done. Accordingly, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detection of malaria by abnormal scattergram were calculated. Results: Out of total 1, 26,000of samples analyzed, abnormal WDF scattergrams were detected in 96 cases. Amongst these, 95.8% (92) were positive for MP on Leishman-stained peripheral smear as well as on ICT with a p-value of 0.05. WDF scattergram abnormalities typical of malaria showed a sensitivity of 80% and specificity of 93.26%. Positive predictive value of 95.8% whereas negative predictive value of 99.9% was detected. Significant findings of hemolysis, platelet clumps, nucleated RBCS (NRBCs) and RBC agglutination were noted in cases (n=4) with abnormal WDF scattergram negative for malaria on peripheral smear. Conclusion: Interpretation of abnormal WDF scattergram not only increases the early detection rate for malarial parasite but isa strong indicator for presence of hemolysis, RBC agglutination, platelet clumps and leucoerythroblastic blood picture as well. doi: https://doi.org/10.12669/pjms.38.3.4702 How to cite this:Rehan M, Khalid A, Nasreen F. White blood cell differential fluorescence abnormal scattergram: A useful indicator for early detection of malarial parasite. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4702 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: The aim of this study was to determine frequency of secondary modifiers in non-transfusion dependent thalassemia. Methods: This descriptive cross sectional study was done at Fauji Foundation Hospital Islamabad. Seventy diagnosed patients of thalassemia intermedia were included. Deoxyribonucleic acid (DNA) was extracted using Chelex method. The Xmn-1 and BCL11A polymorphisms were analyzed by Amplification Refractory Mutation System (ARMS) and Restriction Fragment Length Polymorphism (RFLP) PCR. The PCR amplified products were run on Polyacrylamide Gel Electrophoresis (PAGE). Results: The Xmn-l polymorphism was seen in 26/70 (37.1%) and BCL11A polymorphism was seem in 50/70 (71.4%) of the patients. Conclusion: BCL11A and Xmn-l polymorphisms are important secondary modifiers in patients with thalassaemia intermedia in Northern Punjab. doi: https://doi.org/10.12669/pjms.39.5.7376 How to cite this: Nasreen F, Khalid A, Zafar L, Ahmad S, Shaikh A. Frequency of secondary modifiers in Beta Thalassemia intermedia in patients from Northern Punjab. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7376 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.