Ishaq et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Background: Chronic hepatitis C is a common entity which is frequently associated with depression. Aim: To determine the frequency of depression in patients of chronic hepatitis C who had not yet received treatment. Settings: Department of Gastroenterology and Medicine at Fatima Memorial Hospital Lahore, Pakistan. Study design: Cross sectional Descriptive study Methods: Total 217 patients were enrolled. Each patient was interviewed and then marked down by the doctor himself. Patient Health Questionnaire (PHQ 9) (annexure 2 attached) was applied to determine the presence of depression. Depression was managed as per hospital protocol. The study was conducted from 10th April, 2018 to 9th October, 2018 Results: In this study mean age was 45 years with standard deviation ± 11.33. 62% patients were male, 38% patients were female. More over 57% patients had depression while 43% patients didn’t have depression. Conclusion: Our study concluded that there was a significant association between depression and chronic hepatitis C patients before they have started their treatment, in tertiary care hospital. Keywords: Depression, chronic, hepatitis C

Pakistan is an endemic area for malaria. Malaria is considered to be associated with thrombocytopenia. The frequency of thrombocytopenia varies in different studies. This study was done to determine the frequency of thrombocytopenia among patients with malaria. Objectives: To determine the frequency and severity of thrombocytopenia in patients of malaria. Study Design: Cross-sectional survey. Setting: Pathology Department, Nishtar Medical University, Multan. Period: Eight months; (04-03-2018 to 03-11-2018). Materials & Methods: One hundred and fifty patients with malaria were included in the study. Platelet count of all the patients was done on Sysmex KX-21. The patients were categorized according to the presence of thrombocytopenia (yes or no) and the severity of thrombocytopenia (mild, moderate or severe). The data was described as frequency distribution table. Results: The mean age of the patients was 31.81 + 15.31 years. There were 46 (30.7%) female patients and 104 (69.3%) male patients. Thrombocytopenia was present among 103 (68.7%) patients. Mild, moderate and severe thrombocytopenia was found in 60 (58.3%), 24 (23.3%) and 19 (18.4%) patients, respectively. Conclusion:This study concludes that frequency of thrombocytopenia is very high among patients with malaria. Severity of thrombocytopenia is mild to moderate, with few patients presenting with severe thrombocytopenia. This finding signifies that malaria is an important cause of thrombocytopenia. So the platelet count should be monitored closely in patients of malaria to avoid possible complications of thrombocytopenia. Moreover, it is suggested that malaria is an important differential diagnosis of thrombocytopenia with fever but needs confirmation by thick and thin smears for malarial parasite. In case of viral infections like dengue fever, smears will be negative for malarial parasite and patients will present with leucopenia and thrombocytopenia and majority of peripheral blood leucocytes will be reactive lymphocytes.

Objectives: Evaluation of coagulation profile in patients with Myeloproliferative Neoplasms. Study Design: Cross sectional survey. Setting: Department of Haematology, Shaikh Zayed Hospital, Lahore. Period: From 10-03-2015 to 09-03-2016. Materials & Methods: A total of 55 patients of myeloproliferative neoplasms (Chronic Myeloid leukaemia, Polycythemia vera, Essential thrombocytosis and Primary Myelofibrosis) were studied over 1 year period. Patients of >15 yrs and both the genders were included. Patients already on anticoagulation and liver disease were excluded. All patients underwent screening of PT, APTT and D-dimer. PT and APTT was measured by KC4 Amelung coagulometer and D-Dimer by Latex Kit 60X. Results: Twenty four of 55 cases (43.64%) of myeloproliferative neoplasms had elevated Prothrombin time. Activated partial thromboplastin time was elevated in 18 of 55 (32.73%) cases and D-Dimer was elevated in 11 of 55 (20%) cases. Conclusion: CML is statistically the most spreading form of MPN and ET is least common form in comparison with other MPNs. Thrombohaemorrhagic complications significantly affect the morbidity and mortality of MPN patients which can be assessed by coagulation studies. Timely diagnosis of these prothrombotic/haemorrhagic states can decrease the morbidity in these patients

Objective: To compare enzyme-linked immunosorbent assay and Chemiluminescence immunoassay for thyroid stimulating hormone analysis in human serum.   Methodology: This cross-sectional study conducted from 17th March till 13th June. In Punjab Rangers Teaching Hospital, Lahore after approval from Institutional Review Board.  Random samples from both genders, between 18-70 years of age were included. Haemolysed, lipemic or icteric specimens were excluded. The sera were assayed for thyroid stimulating hormone (TSH) by enzyme-linked immunosorbent assay (ELISA) and Chemiluminescence immunoassay (CLIA). Data was analyzed by SPSS 24. Results: A total of one hundred and ninety-eight serum samples were processed by ELISA and CLIA in all the samples, with more females as compared to males (1:1.3). ELISA technique identified 134 subjects as Euthyroid, 40 Hypothyroid and 24 Hyperthyroid, while 122 Euthyroid, 48 hypothyroid and 28 hyperthyroid subjects by CLIA. Thyroid stimulating hormone (TSH) levels reference range was taken 0.4-4.5mU/L according to American Thyroid Association. Mean ± SD of TSH was 1.45 ± 0.79; 12.27 ± 11.03 and 0.23 ± 0.17 mU/L respectively by ELISA whereas CLIA indicated Mean ± SD to be 1.93 ± 0.936, 16.04 ± 14.68 and 0.393 ± 0.375 mU/L respectively for Euthyroid, hypothyroid and hyperthyroid. Correlation of coefficient (R2 =0.89) was found significantly positive between both methods. There was a significant difference in hypothyroid and Euthyroid groups. Conclusion: TSH assay by CLIA has shown a wider range of functionality, throughout and borderline cases were identified better as compared to ELISA. Turn-around-time (TAT) decreased, physician satisfaction increased and indirectly benefitting patient treatment and prognosis.