OBJECTIVES:  To analyze the impact of age and gender on iron stores in a population of the Nowshera region. METHODOLOGY: This cross sectional study was conducted in the Department of Pathology Qazi Hussain Ahmed Medical Complex Nowshera from 1st January 2019 to 31st March 2020. All patients were selected by convenience sampling in the Pathology department irrespective of age and gender.   Both descriptive and inferential statistics were applied to analyze data by the latest SPSS version 25.  RESULTS: Out of the total study population males were 70 (27.1%) and females 188 (77.9%) with median age 30 years.  The median ferritin level was 12.8 ng/ml. Out of total, 142 (55%) of cases were with serum ferritin less than 15ng/ml. A significant (p=0.03) gender based median ferritin level difference was observed with 1.5 times more probability of low iron stores in females as compared to males (OR=1.5). No statistically significant difference in body iron stores exists in different age groups. CONCLUSION:  A significant difference was noted in the iron stores in gender groups and the probability of depleted/low iron stores was higher in female gender as compared to male gender in all age groups in our population.

Objectives: To determine the role of deranged serum ferritin levels as independent pathogenic risk factor to predict the progression towards a worse clinical outcome in COVID-19. Study Design: Descriptive Cross Section Study. Setting: Hayatabad Medical Complex Peshawar. Period: 1 March to 10 July 2020. Material & Methods: A total of 267 patients were enrolled from COVID-19 isolation units, Hayatabad Medical Complex Peshawar Descriptive statistics were used for numerical variables. Binary logistic regression analysis was used to predict the worst outcome in patients with deranged levels of ferritin. Correlation statistic were used to quantify the correlation of ferritin with mortality and severity of the disease. Kaplan Meir test was used for survival analysis to compare the mortality rate in gender groups in COVID-19 patients with deranged ferritin levels. Results: The mean age of the patients was 53+14years. The median value of the Serum ferritin levels of Covid-19 patients was 978 ug/L the ferritin distribution in gender groups was not normally distributed (Shapiro Wilk test, p-value 0.001). 215/267(80.5%) cases reported >400 ug/Lof serum ferritin. There was a statistically significant uphill positive correlation of serum ferritin levels with an increase in age (rs-0.213, p-0.001) and with disease outcome in terms of mortality (rs-0.29, p-0.05). The probability case fatality in patients with deranged serum ferritin levels was 1.8 times more as compared to patients without hyperferritinemia (p-0.05, OR 1.8). The surviving capability in female gender with deranged ferritin levels in extreme of age was 65% as compared to 20% in male gender. Conclusion: More than 80% of the COVID-19 patients had abnormally higher readings of serum ferritin. The deranged ferritin levels had a statistically significant correlation with an increase in age of patient and with worst outcome in terms of death. Female gender more protective with higher chances of survival with deranged serum ferritin levels in all age groups compared to male gender.

Background: Iron deficiency and iron-deficiency anemia (IDA) affect around 2 billion individuals all over the globe. IDA is a problem for pregnant women in developing countries. Objective: To assess the association of low ferritin level of new born with iron Deficiency Anemia in Mothers Methodology: The current descriptive study was carried out at the Hematology Department, Hayatabad Medical Complex, Peshawar from January 2022 to July 2022. All the data including age, gender and lab parameters was documented in a proforma designed for this research. IBM SPSS version 23 was employed for analysis of data. Results: In the current research, totally 150 antenatal mothers having hemoglobin ≤10.5gm/dl were enrolled. The mean age of our study participants was 26 years with standard deviation of ±1.56. Among pregnant women with iron deficiency, the overall frequency of low ferritin level was 90 (60%). In distribution of women based on severity of low ferritin levels amongst 90 women, 41 (45.56%) women were observed with mild low ferritin levels, 43 (47.78%) women were observed with moderate low ferritin levels while 6 (6.66%) women were observed with severe low ferritin levels. Conclusion: In the present research, it was shown that there was a high frequency of low ferritin levels in newborns amongst women with iron deficiency anemia during pregnancy. Based on our findings we concludes that low ferritin level of newborns is strongly associated with the with iron Deficiency Anemia in Mothers. Keywords: Iron Deficiency Anemia; Ferritin levels; Pregnancy

Objectives: To assess the impact of lymphopenia on the COVID-19 disease outcome. Study Design: Retrospective study. Setting: ICU and Isolation Ward of Hayatabad Medical Complex, Peshawar. Period: July 2020 to Dec 2020. Material & Methods: Different parameters of CBC were performed using the five parts Sysmex differential hematology analyzer BS-1800. A total of 274 patients were included via non probability sampling. Relevant information’s were recorded on a pre-designed performa prepared in accordance with the objectives of the study. Results: The absolute lymphocyte count was lower in patients who were admitted in ICU as compared to those in isolation ward (p-value 0.07). Likewise patients with severe lymphocytopenia (lymphocyte count less than 0.5) had a greater rate of mortality (p value 0.01). No significant difference in term of TLC and ANC was noted in survivor’s vs non survivors groups in present study. Conclusion: Our study concludes that lymphopenia serves as a reliable and early prognostic factor in determining disease severity and mortality COVID-19.

Introduction Atypical chronic myeloid leukaemia (aCML) is a rare chronic myeloproliferative disorder with a poor prognosis. Case report This case report presents two cases of male geriatric patients, both referred from primary care in rural areas and received at an urban clinic in a tertiary care hospital on separate instances. The first patient complained of low-grade fever (on/off), generalized body aches, rapid weight loss and shortness of breath for the last 2 months. The second patient arrived pale looking with symptoms of generalized body aches, dizziness and anorexia. Both patients were diagnosed to have aCML according to the World Health organization criteria. Management & outcome Both the patients were from a low economic bracket and were treated with Hydroxyurea a relatively economic medicine successfully. The follow-up lasted for 12 months in both cases. No progression to acute myeloid leukaemia (AML) or relapse was observed. Discussion This case report shows the promising results of Hydroxyurea in treating aCML and can be a cost effective alternate to other expensive treatments (allogeneic hematopoietic stem cell transplantation) and expensive medicines in lower and middle-income countries especially for resource-limited patients. These two cases show promising evidence for further studies to evaluate and conduct pharmaco-economic evaluations as well as clinical trials to compare hydroxyurea with other available alternative treatments for an affordable therapeutic option towards prevention of relapse and disease free survival after aCML.