Objective: To determine the association of thrombocytopenia (mild, moderate & severe) with pregnancy-related disorders. Study Design: Cross-sectional study. Place and Duration of Study: Department of Haematology of Pakistan Railway Hospital, Rawalpindi Pakistan, in collaboration with the Departments of Obstetrics and Gynecology of Pak Emirates Military Hospital and Fuji Foundation Hospital, Rawalpindi Pakistan, from Oct 2018 to Oct 2019. Methodology: Seventy-five pregnant females with platelet count <150x109/l were included. Blood samples were taken and analyzed for complete blood count, peripheral blood smear, manual count by Neubauer chamber, uric acid, urinary proteins, liver function tests (bilirubin & aspartate aminotransferase), lactate dehydrogenase, coagulation profile and viral serology (Hepatitis B & C). Results: Out of a total of 75 thrombocytopenic pregnant females, gestational thrombocytopenia was most common (74.7%), followed by preeclampsia (17.3%), HELLP syndrome (4%), immune thrombocytopenic purpura (4%) respectively. Mild thrombocytopenia was frequently observed in patients of G.T. (62.5%), while moderate thrombocytopenia (84.6%) was generally detected in preeclampsia patients. Severe thrombocytopenia was mostly identified in patients with HELLP syndrome (66.7%) and immune thrombocytopenic purpura (66.7%). Conclusion: Mild thrombocytopenia is mostly presented in gestational thrombocytopenia. Moderate thrombocytopenia was frequent in patients with preeclampsia, and severe thrombocytopenia was usually diagnosed in patients with HELLP syndrome and immune thrombocytopenic purpura, which require apposite and judicious management for the safety of mother and fetus.

The COVID-19 pandemic has witnessed the rapid development of vaccines produced simultaneously form various countries. However, these vaccines were shrouded by a set of myths ranging from serious effects to change of human DNA. Pakistan was one of the countries to start vaccination early and the front-line workers were first to be vaccinated. We undertook to study the vaccinated health care workers for the post effects of vaccines they received. The methodology adopted was through a structured questionnaire comprising 12 questions covering almost all the possible post effects. This was circulated among health care workers of Pak-Emirates Military hospital and Army Medical College/ National University of Medical Sciences, Rawalpindi, Pakistan. Fever was the most frequently encountered post effect, followed closely by pain at site of injection, headache and fatigue. There was a strong association between age and post effects of vaccination. No life threatening or serious side effects were experienced by health are workers indicating that benefits of vaccine outweigh its adverse effects especially with emergence of new variants. No participant required hospitalization following immunization. Therefore, vaccination against SARS-CoV-2 should be carried out on priority basis in order to avoid severe COVID-19 infection.<br /><br />

Objective: To analyze SARS-CoV2 patients who presented to Military Hospital Rawalpindi having normal hemoglobin levels and those with low hemoglobin. Study Design: Cross Sectional study. Setting: Pathology Laboratory, Military Hospital Rawalpindi, Pakistan. Period: March 2020 to July 2020. Material & Methods: Patients of both genders and all age groups with positive PCR for Corona virus were included. Patients of both the genders and all age groups with negative PCR for corona virus. 2ml blood sample was taken in EDTA tubes from the patients in wards and Intensive care unit and Hemoglobin level was checked using the Sysmex KX21 analyzer. Results: 400 COVID positive patients were studied with Hemoglobin ranging from 7.0g/dl to 17g/dl. It was seen that patients with low Hemoglobin levels were increasingly shifted to ventilators as compared to those with normal Hemoglobin whereas, the Ferritin level was raised in patients who expired. Conclusion: Most patients who expired due to COVID-19 virus infection had low hemoglobin level and high Ferritin level.

Objective: To study the association of hypertension with raised serum homocysteine levels. Study Design: Comparative cross-sectional study. Place and Duration of Study: Army Medical College Rawalpindi in collaboration with Armed Forces Institute of Pathology and Military Hospital Rawalpindi, from Mar to May 2021. Methodology: Total study participants were four hundred in number. Two hundred patients with hypertension aged between 35-55 years were included in Group-1, whereas two hundred non-hypertensive patients with the closest possible age and sex matching were included in Group-2. Strict adherence to inclusion and exclusion criteria was ensured. Results: The mean age of patients with hypertension (Group 1) was 42.60 ± 9.95 years, and without hypertension, i.e., healthy participants (Group 2), was 42.26 ± 10.03 years. Systolic BP was 157.92 ± 8.07 mmHg among Group 1 (hypertensive subjects) and 114.60 ± 4.58 mmHg among Group 2 (healthy participants). Mean diastolic blood pressure in patients with hypertension (Group 1) was 104.95 ± 5.87 mmHg, whereas it was 74.20 ± 4.74 mmHg among non-hypertensive healthy participants (Group 2). Mean serum homocysteine level was significantly correlated with hypertension (p-value <0.001, r=0.804 for systolic and p-value <0.001, r=0.792 for diastolic blood pressure) and was higher in Group 1(20.64 ± 4.40 µmol/L) than that of healthy Group 2(9.48 ± 2.38 µmol/L). Conclusion: Our study concludes that serum homocysteine had a significant positive correlation with hypertension and can be used as an early marker for hypertension assessment in addition to regular blood pressure measurements.

Objective: To determine the in-vitro antimicrobial susceptibility pattern of Methicillin-resistant Staphylococcus aureus (MRSA) isolates using an automated VITEK-2 compact system. Study Design: Cross-sectional study. Place and Duration of Study: Pakistan Railway Hospital (PRH) Rawalpindi collaborates with the Armed Forces Institute of Pathology (AFIP) Rawalpindi, from Sep 2018 to Aug 2019. Methodology: 100 MRSA samples were isolated from tissue, pus, urine, blood, high vaginal swabs (HVS) and ear swabs using standard microbiological techniques. MRSA isolates' antimicrobial susceptibility pattern was made using an automated VITEK-2 compact system. Results: Among 100 MRSA isolates, 63% were obtained from pus and 17% from tissue, respectively. MRSA isolates showed 100% sensitivity to Vancomycin, Teicoplanin and Linezolid. Susceptibility to other drugs has shown wide variation, i.e., Tigecycline 97%, Rifampicin 95%, Clindamycin 86%, Tetracycline 79%, and Cotrimoxazole 78%. The minimum inhibitory concentration (MICs) of Vancomycin and Linezolid against MRSA isolates revealed that 41% had 0.5 µg/ml, 46% had one µg/ml, and 13% had two µg/ml for Vancomycin. Whereas for Linezolid, 38 isolates had MIC 1 µg/ml, then 62 isolates had MIC 2 µg/ml. Conclusion: All the isolates showed 100% sensitivity to Vancomycin, Teicoplanin and Linezolid. Moreover, being less costly, Clindamycin, Tetracycline and Cotrimoxazole are good oral choices for empirical therapy against minor MRSA infections.