BackgroundBeta-thalassemia major, a genetic disorder, delineates a vast spectrum of hematological and endocrinological complications. Elevated serum ferritin levels in beta-thalassemia patients represent various transfusion-related complications including infection, hemochromatosis, and severe iron overload that might lead to endocrinopathies such as hypogonadism leading to sexual underdevelopment. Our study, thus, aims to explore the role of ferritin in determining sexual underdevelopment in such patients. MethodsThis multicentric cross-sectional study included a total of 120 beta-thalassemia patients. The sexual development of the patients was assessed using the Tanner staging system. Serum ferritin levels and other demographical parameters of the patients were collected. Independent-samples t-test, chi-square test, and receiver operating characteristic (ROC) curve were used to analyze the data. ResultsOut of 120 patients, 70 patients were males with a mean age of 18.95 ± 4.21 years. According to the Tanner staging system, 48 patients were sexually underdeveloped while 72 patients achieved sexual maturity. ROC curve analysis showed that ferritin levels at a cutoff value of 4900 mg/dL were 73.7% sensitive and 71.1% specific to predict sexual underdevelopment in beta-thalassemia patients. ConclusionsElevated serum ferritin levels were moderately sensitive and specific in predicting sexual underdevelopment in beta-thalassemia patients. This can serve as a low-cost parameter in determining sexual underdevelopment in such patients. More prospective cohort studies are needed to establish the association between elevated serum ferritin levels and sexual underdevelopment.

Background: Transmissible Infections (TTI’s) are a cause of significant burden on health care facilities by imposing a threat of infection transmission through disease reservoirs in asymptomatic donors. This eventually leads to a serious challenge in acquiring blood bags in a country like Pakistan where transfusion dependent disease are of high prevalence. The objective of this study is to determine the seroprevalence of TTI’s in blood donors in Rawalpindi District through a multi-center approach. Materials and Methods: This is an observational descriptive retrospective study based on 6 transfusion centers in the Rawalpindi District. The time frame of the study was from January 2015 to December 2018. A total of 223,242 donors were consecutively included and data on donor type, the purpose of transfusion, and seroprevalence (HBV, HCV, HIV, Syphilis, and Malaria) were collected through a structured questionnaire and laboratory investigation results. The collected data were entered in SPSS version 21.0 for analysis. Results: The seroprevalence of blood borne infections was 7,897 (3.537%) of which HBV, HCV, HIV, Syphilis and Malaria accounted for 2410 (1.080%), 3105(1.391%), 0(0.000%), 2017 (0.933%) and 365 (0.171%), respectively. Reactive samples reduced from 4.850% to 3.537% over 4 years, while there was a rise of 37.478% of blood donors from 2015 to 2018. The total number of voluntary donors and replacement donors was 22079 (9.890%) and 201156 (90.107%), with a rising incidence in voluntary donors from 2015 to 2018. A considerable number of donor bags were transfused to Thalassemia, Anemia, Leukemia and Hemophilia patients, 28156 (12.612%). This number also showed increasing rates from 11.654% to 14.017%. Conclusion: In conclusion, our study suggests that the risk of transmission through transfusion is still considerable. Targeting donors with a low-risk profile, a screening questionnaire, an ample supply of quality screening tests, and awareness campaigns for the diseases in question must be carried to further decrease the risk of transmission of TTIs in Pakistan. Keywords: Transfusion; Hepatitis; HIV; Syphilis; Malaria; Pakistan.

Background: The current COVID-19 pandemic has had devastating effects on the lives of people all over the globe. Thus, it is important to identify differences between the severity levels of the disease to understand pathophysiology better and therefore, come up with more efficient ways to diagnose and combat it. The objective of this study is to analyze the hematological profile of non-severe & severe patients at the time of presentation in tertiary health care set up and identify any differences between them.Materials and Methods: A comparative retrospective study was carried out among patients visiting the Infectious Diseases Department at Holy Family Hospital, Rawalpindi through systematic random sampling. The self-structured questionnaire consisted of 1) Sociodemographic details and 2) Hematological profile (samples taken at the time of admission). The hematological profile consisted of hemoglobin (Hb), white blood cell count (WBCs), platelets (PLT), neutrophils, prothrombin time (PT), and activated partial thromboplastin time (APTT). Continuous variables were compared by the Mann–Whitney U test and enumeration variables were compared by Pearson χ2 or Fisher exact test, where appropriate. Results: Out of 106 patients, fifty-eight (54.7%) were non-severe while 48(45.3%) were severe at the time of presentation. In our study, there was a lower level of platelets and consequently, more thrombocytopenia in severe patients comparatively. A significantly longer PT time was also observed in severe patients. Our results showed a marked difference in the levels of hemoglobin between the two groups, along with an increased incidence of neutrophilia in patients with severe outcomes.Conclusion: Thrombocytopenia, neutrophilia, and falling hemoglobin levels are the hematological factors that differ significantly between severe and non-severe forms of the disease.