September 1994, Volume 44, Issue 9

Review Articles

Abstracts from The Journals of The East

Fatema Jawad  ( 7/6, Rimpa Plaza, M. A. Jinnah Road, Karachi. )

Leukaemias in Children: A Study of 293 Cases. Iftikhar, S., Kazi, M.Y. Pak.J.Pathol., 1993;4:127-129.
A study was conducted in the Pathology Laboratory of the Paediatric Department of the Mayo Hospital, Lahore on 293 cases of Jeukaemia admitted from August 1984 to December 1992. The age range of the patients was from 1 month to 12 years with 220 males and 73 females. Provisional diagnosis was made by history, physical examination and blood count. Bone marrow aspiration and smears stained with Giemsa stain confirmed the case. Classification was based on the morphological appearance of blasts in the bone marrow and peripheral blood. The blood picture showed anaemia with haemoglobin ranging from 2 to 10G/dI. The total leucocyte count in acute leukaemia was 6- 3x109/L and 128x109/L in advanced cases. In chronic myeloid leukaemia the count ranged from 161-3 14x109/L. Thrombocytopenia with platelet count below 50x109/L wasfoundin62%ofALL and 59%ofAMLpatients. Nucleated red cells were found in 2% of ALL, 10% of AML and 21% of CML patients. The bone marrow aspirates in acute leukaemia were numerous, fleshy and hypercellular. Blast cells were promi­nent, erythropoetic cells reduced and megakaryocytes re­duced or absent. In CML immature white cells were present with myelocytes and metamyelocytes predominating. The morphological diagnosis was 209 cases of ALL, 65 of AML and 19 of CML. The results of the study compare well with others performed in developing countries. Preponder­ance of males could be attributed to the better care provided to the male child in our society.
Correlation of Haemoglobin level with Intestinal Para­sites in School Children of Peshawar University. Khan, M.ll., Azim, A., Banuri, F., Mabood, N., All, Z. J.
Ayub Med.Coll., Abbottabad, 1993;6: 10-13. A study was designed to detennine the pattern of intestinal parasites and their effect on haemoglobin level in school children of Peshawar University. Three schools were selected providing 230 children with ages between 5 and 12 years. There were 106 males and 124 females. Information was obtained regarding economic status, housing conditions, toilet facilities and source of drinking water. Fresh stool samples were collected and examined within an hour. Normal saline and ‘D’ Antion\\\'s iodine mounts were used. Negative results were confirmed by the concentration method. Haemoglobin was estimated by cyano-methemoglo­bin method. The results of the stool test revealed Ascaris lumbri­coides infecting 3 8.8% cases. Students drinking well water and belonging to large size families were more infected. Hymenolepis nana was second prevalent (26.8%) and Giardia Lamblia was found in 6 cases where hookworm infestation was detected in one case only. The mean haemoglobin in the infected subjects was 11.4 gm/dl which was statistically different from the value of healthy population(13.6 G/dl). Worm infestation is a common health problem in the world. Incidence varies from one country to the other. In Pakistan children are more prone to it as they are more exposed to soil borne infection. Other factors as lack of basic education, improper toilet facilities and sewerage disposal and unhygienic living conditions, all play an important role in promoting the problem. Malnutrition is the end result of worm infestation and leads to poor perform­ance of the child in school and susceptibility to other infectious diseases. ABO-Blood Group Frequencies in the Chittagong Re­gion (the South- East Zone) of Bangladesh. Abdullah, A.Z.M., Bangladesh J. Pathol., 1991;6:37-39. ABO blood group typing was performed on 23,890 individuals in the Blood Bank of Chittagong Medical College Hospital. The subjects analyzed were outdoor and indoor patients of Chittagong Medical College Hospital and other hospitals of the region. Blood groups were determinedby slide method and in children by the tube method at 4°C temperature. Both cell and serum typing were done by using standard anti-sera. The results revealed group ‘0’ to be prevalent in 36.83% subjects followed by group ‘B’ in 31.37%. Group ‘A’ was found in 24.23% individuals and group ‘AB’ in 7.57%. Comparing with other regions of Bangladesh it was observed that group ‘0’ was predominant in Chittagong whereas blood group ‘B’ was more prevalent in Dhaka region. Jessore area had an equal figure of ‘0’ and ‘B’ groups. The reason for the ‘0’ group being dominant in Chittagong could be attributed to the immigrants from Myanmar, Turkey, Germany, Spain, Peoples Republic of China, Arabia, UK, Portugal, France and Caucasian countries for centuries. The Chittagong port was used as a trading centre by these countries before the industrial revolution of Europe. The ABO blood group frequencies thus compare with those of the countries from where the ‘0’ dominant people migrated.
Nodular Goitre. Shaikh, S.A., Shaikh, S.M., Burdi, G.M., J.Coll.Phys. & Surg. Pak., 1992;2:93.
The clinical presentatiort diagnosis and management of 70 cases of nodular goitre, seen at surgical Unit II of Chandka Medical College Teaching Hospital, Larkana is presented. There were 11 males and 59 females with the maximum incidence being in the third and fourth decades. Dyspnoea was the main complaint of 10 cases. Dysphagia was Tound in 9 patients and 4 complained of a hoarsevoice. The remaining presented with a mass in the front of the neck. The thyroid function was found to be euthyroid in 62 patients and hypothyroid in 8 subjects. A thyroid scan with 1311 and Technetium-99m showed multiple nodules in 32 cases and solitary nodules in 34 cases whereas 4 had a diffuse enlargement with patchy uptake. Indirect laryngoscopy was done in55 patients of which 50 had normal vocal cords and 5 had paralysis of the cords. Surgery was conducted on 65 cases with 32 undergoing sub-total thyroidectomy and 29 lobectomy with Isthamec­tomy. Flistopathology revealed 5 specimens to have papillary carcinoma. The others were benign with one being Hashimo­tos thyroiditis. Ultrasonography and fine needle aspiration biopsy are important and helpful investigations for thyroid nodules. These could not be performed due to lack of facilities.

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