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OBJECTIVE: To determine the frequency of anemia in patients with newly diagnosed pulmonary Tuberculosis (PTB) presenting at Dr Ruth K M Pfau Civil Hospital Karachi (CHK). METHODOLOGY: This cross-sectional study was conducted at Dr Ruth KM Pfau CHK from July to August 2023. Newly diagnosed pulmonary tuberculosis cases of either gender, between 14-40 years, were included, while patients with a history of PTB, malnutrition, blood loss, HIV, pregnant females, autoimmune disorders, anemia before the diagnosis of PTB, chronic illness and malignancies were excluded. PTB patients were labeled anemic if the hemoglobin level was 38 years compared to 6.8% in the 18-30 age group (p

Treating hepatitis C has never been so convenient after the advent of Directly Acting Antivirals (DAA). Convenience is at both ends; for the doctors to prescribe and for patients to comply due to all oral therapy with few adverse effects. Many are already in market, these include, Sofosbuvir, Declastavir & Velpastavir while many others are in pipeline. The SVR success rates with these newer drugs is approaching 99% and they are also showing improvement in fibrosis1,2. Cost of innovative brands of DAAs is very high. According to one study Quality-Adjusted Life Years (QALY) with innovator sofosbuvir for short therapy resulted in expense of $24,000 as compared to no treatment3 . Pakistan being a poor country with low per capita income, health and innovator brand medicines are not in approach of average patient. With availability of generics there is up to 70% reduction in cost of treatment and they come into the affordability range of most of the patients4-7 .

Treating hepatitis C has never been so convenient after the advent of Directly Acting Antivirals (DAA). Convenience is at both ends; for the doctors to prescribe and for patients to comply due to all oral therapy with few adverse effects. Many are already in market, these include, Sofosbuvir, Declastavir & Velpastavir while many others are in pipeline. The SVR success rates with these newer drugs is approaching 99% and they are also showing improvement in fibrosis1,2. Cost of innovative brands of DAAs is very high. According to one study Quality-Adjusted Life Years (QALY) with innovator sofosbuvir for short therapy resulted in expense of $24,000 as compared to no treatment3 . Pakistan being a poor country with low per capita income, health and innovator brand medicines are not in approach of average patient. With availability of generics there is up to 70% reduction in cost of treatment and they come into the affordability range of most of the patients4-7 .

Treating hepatitis C has never been so convenient after the advent of Directly Acting Antivirals (DAA). Convenience is at both ends; for the doctors to prescribe and for patients to comply due to all oral therapy with few adverse effects. Many are already in market, these include, Sofosbuvir, Declastavir & Velpastavir while many others are in pipeline.

Objective: To determine frequency of depression in patients and their healthy attendants at medical OPD of Civil Hospital Karachi. Patients &Methods: Patients attending medical OPD were administered DSM-IV questionnaire comparative observational. Equal number of healthy attendants with the patients were selected as control. Diagnosis of depression was made if DSM-IV score of = 5 was present. Frequencies of depression were compared with control. Two groups were analyzed basis of gender, marital status, education and occupation. Results: During the study, 236 patients and equal number of controls were included. The mean DSM-IV score was significantly higher in patient group (3.8/Standard Deviation?) as compared with control group (1.6/ Standard Deviation?). The number of depressed subjects in control group was 19 (8.1%) and that in patient group was 99 (41.9%), the difference was statistically significant (x2 test; p value

Objective: To determine the correlation of ABRI with treatment intervention and outcome as discharged or expired in patients of acute variceal bleed. Design: Cross-sectional study Patients and Methods: Records of all die patients admitted in Medical IJnit-IV, Civil Hospital Karachi with acute variceal bleeding during January 2004 to October 2006 were retrieved. Use of vasoactive agents (Terlipressin Octreotide), endoscopic band ligation (EBL) and outcome (Discharged/Expired) were noted. ABRI was calculated by the following formula: Blood Units Transfused A B RI- ----------------------- ;-------- ;----------- [(Final Hematocrit - Initial Hematocrit) + 0.01 J Mean ABRI were compared by Student’s T test according to vasoactive therapy, EBL, and outcome. Correlation o f ABRJ with the same variables was also studied bv plotting Receiver Operative Curves (ROC). Results: Seventy' six patients fulfilling inclusion criteria were selected. No statistically significant difference was observed in the mean ABRJ scores when compared according to vasoactive drug administration, EBL and outcome. Significant correlation with mortality was seen on ROC plot with significantly larger area under the curv e. Conclusion: ABRI correlated significantly with mortality in this study. Larger prospective studies with appropriate power are required to evaluate its association with other variables.

Autoimmune hepatitis is an uncommon cause o f chronic hepatitis in Pakistan. One such case is describedoccurring in an adult female cirrhotic diagnosed on raised serum IgG and LKM-I.

Objective: To determine frequency of depression in patients and their healthy attendants at medical OPD of Civil Hospital Karachi. Patients &Methods: Patients attending medical OPD were administered DSM-IV questionnaire comparative observational. Equal number of healthy attendants with the patients were selected as control. Diagnosis of depression was made if DSM-IV score of = 5 was present. Frequencies of depression were compared with control. Two groups were analyzed basis of gender, marital status, education and occupation. Results: During the study, 236 patients and equal number of controls were included. The mean DSM-IV score was significantly higher in patient group (3.8/Standard Deviation?) as compared with control group (1.6/ Standard Deviation?). The number of depressed subjects in control group was 19 (8.1%) and that in patient group was 99 (41.9%), the difference was statistically significant (x2 test; p value

Objective: To determine frequency of depression in patients and their healthy attendants at medical OPD of Civil Hospital Karachi. Patients &Methods: Patients attending medical OPD were administered DSM-IV questionnaire comparative observational. Equal number of healthy attendants with the patients were selected as control. Diagnosis of depression was made if DSM-IV score of = 5 was present. Frequencies of depression were compared with control. Two groups were analyzed basis of gender, marital status, education and occupation. Results: During the study, 236 patients and equal number of controls were included. The mean DSM-IV score was significantly higher in patient group (3.8/Standard Deviation?) as compared with control group (1.6/ Standard Deviation?). The number of depressed subjects in control group was 19 (8.1%) and that in patient group was 99 (41.9%), the difference was statistically significant (x2 test; p value

Objective: To determine the correlation of ABRI with treatment intervention and outcome as discharged or expired in patients of acute variceal bleed. Design: Cross-sectional study Patients and Methods: Records of all die patients admitted in Medical IJnit-IV, Civil Hospital Karachi with acute variceal bleeding during January 2004 to October 2006 were retrieved. Use of vasoactive agents (Terlipressin Octreotide), endoscopic band ligation (EBL) and outcome (Discharged/Expired) were noted. ABRI was calculated by the following formula: Blood Units Transfused A B RI- ----------------------- ;-------- ;----------- [(Final Hematocrit - Initial Hematocrit) + 0.01 J Mean ABRI were compared by Student’s T test according to vasoactive therapy, EBL, and outcome. Correlation o f ABRJ with the same variables was also studied bv plotting Receiver Operative Curves (ROC). Results: Seventy' six patients fulfilling inclusion criteria were selected. No statistically significant difference was observed in the mean ABRJ scores when compared according to vasoactive drug administration, EBL and outcome. Significant correlation with mortality was seen on ROC plot with significantly larger area under the curv e. Conclusion: ABRI correlated significantly with mortality in this study. Larger prospective studies with appropriate power are required to evaluate its association with other variables.

Objective: To determine the correlation of ABRI with treatment intervention and outcome as discharged or expired in patients of acute variceal bleed. Design: Cross-sectional study Patients and Methods: Records of all die patients admitted in Medical IJnit-IV, Civil Hospital Karachi with acute variceal bleeding during January 2004 to October 2006 were retrieved. Use of vasoactive agents (Terlipressin Octreotide), endoscopic band ligation (EBL) and outcome (Discharged/Expired) were noted. ABRI was calculated by the following formula: Blood Units Transfused A B RI- ----------------------- ;-------- ;----------- [(Final Hematocrit - Initial Hematocrit) + 0.01 J Mean ABRI were compared by Student’s T test according to vasoactive therapy, EBL, and outcome. Correlation o f ABRJ with the same variables was also studied bv plotting Receiver Operative Curves (ROC). Results: Seventy' six patients fulfilling inclusion criteria were selected. No statistically significant difference was observed in the mean ABRJ scores when compared according to vasoactive drug administration, EBL and outcome. Significant correlation with mortality was seen on ROC plot with significantly larger area under the curv e. Conclusion: ABRI correlated significantly with mortality in this study. Larger prospective studies with appropriate power are required to evaluate its association with other variables.

Chronic hepatitis is common in Pakistan and most frequent causes are various viral hepatitis, while occasionally other causes like a alcohol, Wilson’s disease and, hepatitis (AIH) is an uncommon disease in Pakistan. It is characterized histologically by interface hepatitis, and serologically by the presence of non-organ and liver specific autoantibodies and increased levels of immunoglobulin G. Its onset is often ill-defined, frequently mimicking acute hepatitis. An interesting case of AIH with unusual presentation is being presented in this report.

Hemichorea - hem i ball ism is a rare neurologic disorder due to oxidative stress leading to neurodegeneration o f the dentate nuclei and striata. It is rarely observed in diabetes. One such case occuring in an adult female diabetic is described.

Hepatitis D has been show n to he reducing in frequency in the Western countries com m ensurate with HBV decline while recent reports from Pakistan are indicating a rising frequency. This review describes the m anagem ent and prevention o f this often overlooked cause o f hepatitis.

Chronic hepatitis is common in Pakistan and most frequent causes are various viral hepatitis, while occasionally other causes like a alcohol, Wilson’s disease and, hepatitis (AIH) is an uncommon disease in Pakistan. It is characterized histologically by interface hepatitis, and serologically by the presence of non-organ and liver specific autoantibodies and increased levels of immunoglobulin G. Its onset is often ill-defined, frequently mimicking acute hepatitis. An interesting case of AIH with unusual presentation is being presented in this report.

Hemichorea - hem i ball ism is a rare neurologic disorder due to oxidative stress leading to neurodegeneration o f the dentate nuclei and striata. It is rarely observed in diabetes. One such case occuring in an adult female diabetic is described.

Hepatitis D has been show n to he reducing in frequency in the Western countries com m ensurate with HBV decline while recent reports from Pakistan are indicating a rising frequency. This review describes the m anagem ent and prevention o f this often overlooked cause o f hepatitis.

Hemichorea - hem i ball ism is a rare neurologic disorder due to oxidative stress leading to neurodegenerationo f the dentate nuclei and striata. It is rarely observed in diabetes. One such case occuring in an adultfemale diabetic is described.