Objectives: To evaluate various causes of autoimmune hemolytic anemia and its presenting signs and symptoms. Study Design: Cross sectional study. Setting: Fatima Jinnah Medical College Lahore. Period: November 2018 to April 2019. Material & Methods: In this study 90 cases were included having age range of 14-75 years with mean age of 46.5 year with the possibility of autoimmune hemolytic anemia (AIHA). Screening test used for evaluating AIHAin this study include Direct and Indirect Antiglobulin Tests and Cold Agglutinin Titer (CAT). All relevant data was documented properly. Results: Total 90 cases were included in the study comprising on 71% female and 29% male cases. 22.2% cases were having primary and 77.8% were having secondary autoimmune hemolytic anemia. Most common presenting complaint was generalized body weakness in 25(27.7%) cases and on examination most common finding was splenomegaly in 30(33.3%) cases. Hemoglobin was less than 8g/dl in 28(31%) cases. Direct Antiglobulin test was positive in 64(71%) cases, DAT and IATboth were found to be positive in 22(24.4%) cases and DAT and CAT both found positive in 4(4.4%) cases. Blood transfusion was done in 28% cases having severe anemia. Most common cause of autoimmune hemolytic anemia found among study group patients was connective tissue disorder in 25(27.8%) cases. P-value less than 0.05 were considered significant and more than 0.05 was non-significant. Conclusion: In our study autoimmune hemolytic anemia was mostly found in female population with most common presentation of generalized body weakness, pallor of hands, hepatosplenomegaly and severe anemia. Most common cause found of AIHA was connective tissue disorders.

Background: Controversy occurs in the relationship between serum ferritin levels, insulin resistance and risk of developing anemia in adolescents with family history of diabetes. Aims & Objectives: This study was designed to find out the association between serum ferritin levels with risk of developing anemia in non-diabetic adolescents with family history of type 2 diabetes mellitus (T2DM). Materials & Methods: A descriptive cross-sectional was conducted in a local medical institute of Lahore. Study included 50 non-diabetic, non-obese male / female adolescent with family history of type 2 diabetes mellitus and 50 healthy male/female non-obese adolescents without family history of T2DM considered as controls. Level of serum ferritin and serum insulin was estimated by Enzyme Linked Immunosorbent Assay. Blood glucose was estimated by auto-analyzer. Insulin resistance was calculated by HOMA-IR index and beta cell function was assessed by HOMA- beta index. Results: Levels of fasting blood sugar, insulin resistance were found to be increased with decreased level of serum ferritin and decrease beta cell function in both male as well as female cases as compared to controls. Negative correlation was found between serum ferritin and insulin resistance while a positive correlation was found between serum ferritin and beta cell function. Conclusions: Low level of serum ferritin is associated with reduced beta cell function and increased insulin resistance. This may increase the risk of developing iron deficiency anemia that can affect both immune system as well as increase susceptibility to infections.

Certain Rh positive blood groups showed a link between the ABO blood grouping and susceptibility to some infectious ailments. Study was carried out to find the association of ABO Blood Group System / Rh type with different viral infection. A retrospective observational study was carried in 7631 blood donors to find the association of ABO Blood Group System / Rh type with viral infection due to hepatitis B virus, hepatitis C virus, human immunodeficiency virus and Syphilis. Data of the study indicateF that the highest incidence of blood group in blood donor was B followed by O, A and AB. The incidence of HBsAg +ve, HCV Ab +ve and infection of Syphilis was also highest in donor with blood group B followed by O, A and AB. Blood group A were more susceptible to HIV Ab +ve followed by blood group B, O and AB. The group B donors had the greatest risk of viral infection with HBV, HCV, HIV, and Syphilis; followed by the groups O, A, and AB. Donors in group AB had the lowest incidence rate of all viral infection. The study revealed that blood group B is most prevalent among donors, followed by blood groups O, A, and AB. On the other side, the rate of HBV, HCV, HIV, and Syphilis infection was greatest among group B donors, followed by group O, group A, and group AB. Copyright(c) The Authors

TB is endemic in many low socio-economic countries including Pakistan and is the leading cause of death from a single infectious agent worldwide. Identification and early treatment of latent conditions will help in reducing the burden of TB. However, identification of those with latent infection is time taking and expensive.  A potential cheap and early biomarker for this purpose may be the “Monocyte to lymphocyte ratio” (MLR). The MLR may indicate an immune response to the presence of mycobacterium tuberculosis. Since household contacts of tuberculosis patients are at increased risk of LTBI, checking correlation of their MLR to the established diagnostic investigations might help establish this simple test as an extremely useful biomarker for LTBI. A cross sectional study was designed to find the efficacy of monocytes to lymphocytes ratio in identifying latent tuberculosis among household contacts of patients with active tuberculosis. About 40 patients recently diagnosed with active tuberculosis and 40 close contacts of these patients and 20 controls were included in the study Mean ratio of monocytes to lymphocytes was 0.165 in patients with active tuberculosis and 0.06 (range 0.03–0.08) in close contacts of patients and 0.04 (0.02–0.04) in controls. Ratio of monocytes to lymphocytes (> 06 %) were significant predictors for latent tuberculosis. It is an additional observation that patients with pulmonary tuberculosis with an age of greater than 50 years were seen to have higher ratio of monocytes to lymphocytes. Ratio of monocytes to lymphocytes (> 0.06) may help in diagnosing latent tuberculosis in close contacts of tuberculosis patients. Copyright(c) The Authors