As an island nation, Singapore has a small haemophilia population. Through a hybrid health care model which taps on state-funding, medical insurance, the national retirement savings fund and co-payment by patients, our haemophiliacs receive on-demand therapy as standard of care with opportunities for prophylactic treatment if indicated. Recently, we embarked on a comprehensive crosssectional review of our haemophilia A and B populations to determine their current demographic profile and clinical status in order to gauge the performance of our management model and permit forward planning.This study was conducted in 2013 at the three haemophilia treatment centres in Singapore: Singapore General Hospital (SGH), National University Hospital (NUH) and Kandang Kerbau Women's and Children's Hospital (KKH). SGH houses a Comprehensive Haemophilia Treatment Centre (CHTC) and maintains the National Haemophilia Registry. The Registry provided the baseline demographic information on our haemophiliacs while population and health care statistics on Singapore were obtained from the Department of Statistics, Singapore [1]. All haemophiliacs listed in the Registry were invited to participate in this study. Consenting participants answered a set of questionnaires that explores further details of their treatment, complications and socio-economic data. Participants above the age of 4 were also assessed by a site investigator for the status of their joints using the Haemophilia Joint Health Scores (HJHS) version 2.1 [2]. Joint assessments were only conducted in the absence of recent joint bleed or other acute joint symptoms. Data on factor concentrates usage in 2013 were obtained from units dispensing clotting factors at the respective hospitals.Singapore has 195 identified people living with haemophilia A and another 40 people with haemophilia B among a resident population of 3.85 million [2].The prevalence of haemophilia A and B is 10.31 per 100 000 males and 2.11 per 100 000 males respectively. Demographic and clinical characteristics of these individuals are shown in Table 1. Inhibitors developed in 17.9% of our haemophilia A population [8.2% persistent, 5.6% high responders]. Only one haemophilia B individual had inhibitors. Immune tolerance induction (ITI) therapy was successfully given to two haemophilia A adults with inhibitors using a dose regimen of 100 IU kg À1 day À1 without additional immunosuppressive therapy. One third (30.2%) of our haemophilia A and 20% of our haemophilia B population had no family history of haemophilia.Ninety-two individuals with haemophilia A and 16 with haemophilia B from the ages of 1-79 consented to contributing further socio-economic and clinical data. They represented 19.4%, 56.2% and 67.2% of the mild, moderate and severe haemophilia A population respectively and 40% of the haemophilia B population. The bleeding profile and bleeding-related complications of participating individuals as well as their current mode of treatment, type of product used and access to home treatment is shown in Table...

An IgG 1c immunoglobulin was present on the surface of the platelets in four of five patients with factor-VIII inhibitor. A similar antibody was found in the plasma of two out of three patients. Serum IgM was subnormal in two out of three patients with 'idiopathic' acquired factor-VIII inhibitor, while the two patients with haemophilia A (with inhibitors) had normal serum immunoglobulins.Recently, Call et a2 (1969) reported that the platelets in a patient with haemophilia A and Serum immunoglobulin levels were kindly measured by Dr J. R. Hobbs using a modified Mancini technique (Goldman & Hobbs, 1967). Direct Antiglobulin Consunrption TestAntiglobulin sera against whole human serum and anti-IgG sera were prepared as described

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Background AML can be diagnosed based on a sample of peripheral blood or bone marrow. In this article we will discuss the role of bone marrow assessment and peripheral blood monitoring in the diagnosis, management, and follow-up of patients with acute myelogenous leukemia (AML). For patients with circulating blast, it is reasonable to conduct the necessary studies for diagnosis and risk classification, including multifactorial flow cytometry, genetics Cellular, and molecular analysis on a peripheral blood sample. A 'pure day 14' assay is used to document cell deficiency in response to chemotherapy, but it is unclear whether this assessment is necessary as it often does not influence immediate management. Current recovery response assessments to assess remission and measure residual disease are based on bone marrow biopsy. Peripheral blood assessment may be sufficient to monitor relapse, but the sensitivity of the bone marrow test in some cases is higher. While bone marrow assessment can certainly be avoided in certain cases, this cumbersome and uncomfortable procedure currently remains the de facto standard for assessing response.Methods A retrospective study targeting 50 patients attending Al-Mujtahid Hospital in Damascus according to certain acceptance and exclusion criteria.Results Our study explored many aspects and factors related to leukemia, as it included two samples of 50 people, the largest proportion of them were males, and the largest proportion of the participants were between the ages of 65 − 20, and also the majority of the participants were non-smokers and non-alcoholic, moving to talk about antecedents, there was a percentage Few suffer from diabetes and arterial hypertension, while not all of the participants suffer from other tumors, as our knowledge has proven a relationship between age and remission, between smoking and AFP, and between insensitivity and complete inactivity.Conclusion We recommend conducting periodic analyzes and not neglecting any general symptom of lack of weight, appetite or heat, as it was the most common among patients. We also recommend the need to stay away from smoking and alcohol. For patients, we recommend the necessity of conducting periodic analyzes in order to monitor complete and partial complacency. We also note the need to monitor minimal residual disease. The remainder because of its importance in the recurrence of the disease

Background: Autologous serum skin test (ASST) is easy to perform, cost effective measure for initial identification of auto-antibody in patients suffering from chronic urticaria which may occur due to autoimmune trigger by spontaneously developed auto-antibodies against FcμRI receptor of skin mast cells.Objective: This review is designed to see the positivity of ASST in patients suffering from chronic urticaria.Materials & Methods: This a retrospective data analysis conducted from the records of patients suffered from at least two episodes of urticaria or more in a week for 6 weeks and who did ASST aged more than 10 years between July 2015 to June 2017. These subjects were not pregnant or lactating mother, did not had urticarial vasculitis, predominant co-existing physical urticaria and had negative Hepatitis B antigen and anti-nuclear antibody reports.Results: Total 53 were included in this study of them 33 were female. Mean age was 32 years with a standard deviation (SD) of 11 years. Among study patients 16 (30.2% of total) had a positive ASST result. No age or sex difference was observed in positive ASST cases. In positive cases significant (p-value:<0.001) mean induration difference of 2.75mm with a SD of 1.00 mm observed than induration produced by negative control.Conclusion: ASST is easy and effective tool for initial identification of auto-reactive urticaria.J MEDICINE JUL 2018; 19 (2) : 100-103