2021 VOL 6 , Issue 1

Editorial

Covid-19 Vaccination: A Bird’s Eye View

Tahir Sultan Shamsi and Mehjabeen Imam

Covid-19 pandemic plagued this world since the beginning of 2020 AD. It is caused by a new positive-strand RNA virus of coronaviridae family [1]. It causes Coronavirus disease 2019 (hence the name COVID-19). It is a contagious disease predominantly causes severe acute respiratory syndrome, hence the name SARS-CoV-2. It started from Wuhan, China, in December 2019. Since then, it has spread globally.
It is reported to be a new virus therefore it’s properties, pathogenesis, virulence, immunogenicity, variants, and how will host body will react to this virus was unknown. Despite of 22 months since this virus started to spread worldwide, researchers and clinicians continued to learn about it on daily basis. Newer information about it poured in daily in scientific journals as well as in print / electronic media. Mostly, newer information continued to negate earlier information. Social media disinformation continued to confuse the masses.

Received: October 07, 2021
Accepted: October 08, 2021

doi.org/10.21089/njhs.61.0001

Perspective

Non-Institutional Independent Tumor Boards Beneficial Impact on Post-Graduate Medical Training

Ahmed Nadeem Abbasi, Sohail Rasool and Muhammad Tahir Bashir

The doctors who are going through our postgraduate residency training programs are tomorrow’s specialists who will be playing pivotal roles as healthcare policy decision-makers. To establish site-specific multidisciplinary tumor boards, we have to rely on our present-day resident’s leadership skills.
We intend to provide meaningful specific patient-centered goals to our postgraduate students who are our future specialist healthcare providers. We are witnessing a slow positive change towards shared care and the implementation of multidisciplinary culture. This is high time to develop modules with a specific learning objective of providing high-quality leadership skills to all our postgraduate trainees. Effective and efficient team-building skills will enable them to initiate and maintain multidisciplinary professional processes complying with international standards [1].

Received: July 16, 2021
Revised: September 30, 2021
Accepted: October 21, 2021

doi.org/10.21089/njhs.61.0003

Research Articles

Hypothyroidism is Strongly Correlated with Mean Platelet Volume and Red Cell Distribution Width

Satilmis Bilgin, Burcin Meryem Atak Tel, Gizem Kahveci, Tuba Taslamacioglu Duman, Ozge Kurtkulagi, Semanur Yurum, Asli Erturk, Buse Balci and Gulali Aktas

Abstract: Objective: Hypothyroidism is characterized with insufficient production and release of thyroid hormones, and cause a variety symptoms including cold intolerance, constipation, deceleration in movement, and hair loss. It is associated with increased inflammatory burden. Therefore, we aimed to observe red cell distribution width (RDW) and mean platelet volume (MPV) levels, novel predictors of inflammation, in patients with hypothyroidism and to compare to those in healthy subjects.
Materials and Methods: The subjects with hypothyroidism that show up in internal medicine outpatient clinics of Abant Izzet Baysal University Hospital between January 2020 and January 2021 were enrolled to the retrospective study. Healthy volunteers were enrolled as control subjects. MPV and RDW of the study groups were compared.

Received: May 26, 2021
Revised: July 30, 2021
Accepted: August 10, 2021

doi.org/10.21089/njhs.61.0007

Knowledge and Attitude towards Infection Prevention at a Newly Established Hospital

Haya-Ul-Mujtaba, Nida Anwar, Naveena Fatima, Samina Mukry, Aisha Jamal, Qurat-Ul-Ain Rizvi and Tahir Sultan Shamsi

Abstract: Objective: Health care associated infections are those infections that patients acquire in hospitals during their treatment and health care workers are important source for it. The study was designed to evaluate the knowledge and attitude of Health care workers towards infection control.

Materials & Methods: A cross sectional study conducted from December 2019 to February 2020 at NIBD & BMT. Approval was taken from NIBD Research Committee. A pre-designed questionnaire was given to staff that had given informed consent. The questionnaire was composed of two parts. The first part comprised of sociodemographic information and the second part comprising 37 questions of knowledge and 11 question of attitude. Data was analyzed by SPSS version 23. Frequencies and percentages were calculated for categorical variables and mean for quantitative data. Chi-square test was used for association with level of significance as P-value <0.05.

Received: December 18, 2020
Revised: September 07, 2021
Accepted: September 08, 2021

doi.org/10.21089/njhs.61.0011

High Fluorescence Lymphocyte Count and Immature Platelet Fraction; “Can these Two Parameters Reliably Distinguish between Dengue and ITP?”

Jawad Hassan, Samra Waheed, Madiha Abid and Tahir Sultan Shamsi

Abstract: Objective: Thrombocytopenia is a frequent finding in Dengue fever. Immune Thrombocytopenia (ITP) is a diagnosis of exclusion and is not associated with febrile illness. Ignoring fever, low platelet count and clinical signs may be similar in both conditions. Peripheral film finding in Dengue fever shows many reactive lymphocytes. Enumeration of these reactive lymphocytes as high fluorescence lymphocyte count (HFLC) and computing immature fraction of platelets (IPF) may be useful in differentiating these two disorders as soon as the blood sample is analyzed on XN-1000 hematology analyzer.

Materials and Methods: A cross-sectional study was conducted at National Institute of Blood Disease and Bone Marrow transplantation from January to July 2019 during (Dengue season); blood samples from emergency room were analyzed on XN-1000 hematology analyzer for complete blood count and IPF. Samples with thrombocytopenia were checked for IPF count and HFLC from the extended research parameter data of the analyzer. Patients presenting with fever, had Dengue NS-1 tested. Detailed history & examination was recorded from the patients.

Received: July 30, 2021
Revised: October 08, 2021
Accepted: October 11, 2021

doi.org/10.21089/njhs.61.0017

Is The Theoretical Knowledge Reflected in Current Practice: Histopathological Helicobacter Pylori Research?

Mehmet Ali Kosekli

Abstract: Objective: Helicobacter pylori (H. pylori) is considered in the category of biological agent directly responsible for cancer. Guidelines recommend discontinuing suppressive conditions prior to histopathological helicobacter pylori testing, but there is little clinical trial data on how outcome is affected if this is not done. Optimal test recommendations in the guidelines are based on in vitro study results. In present study, we aimed to observe whether there was a difference in the prevalence of H. pylori histopathologically in patients who met the necessary prerequisites before Esophago-Gastro-Duodenoscopy (EGD) compared to the subjects group who did not meet the PPI discontinuation condition.

Materials & Methods: This retrospective study was conducted between October 2015 and August 2016 in a reference hospital with 1.5 million hinterlands. Patients who underwent EGD by meeting all the prerequisites recommended by the guidelines for the H. pylori test were included in the study group (n=213), and those who discontinued other suppressive drugs except PPI were included in the control group (n=193).

Received: August 09, 2021
Revised: September 20, 2021
Accepted: September 21, 2021

doi.org/10.21089/njhs.61.0022

Mini Review

Olanzapine in Chemotherapy Induced Nausea and Vomiting

Syed Saad Hussain, Fasiha Abdul Rahman and Sarmad Iqbal

Abstract: Objective: Patients diagnosed with cancer and undergoing chemotherapeutic regimen often anticipate many negative effects of the therapy. Chemotherapy induced nausea and vomiting is of their principal concerns which remains one of the most unpleasant, distressing and feared adverse effect. The management of chemotherapy induced nausea and vomiting has always been a challenge for high and moderate emetogenic chemotherapeutic agent. D₂-receptor antagonists were the first agents to produce antiemetic effect. Then 5-HT₃ receptor antagonist and NK₁ receptor antagonist were developed which proved to possess higher selective antiemetic effect compared to D₂ receptor antagonist. This review includes the clinical advancements of an atypical antipsychotic agent olanzapine and its role in chemotherapy induced nausea and vomiting. Olanzapine is traditionally used to treat schizophrenia and manic disorder. But recent clinical studies have illustrated its additional therapeutic effect as an antiemetic agent. This advancement may prove to have beneficial effect in managing chemotherapy induced nausea and vomiting and providing a better quality of life to patient being treated with different chemotherapeutic agents.

Received: May 18, 2021
Revised: August 24, 2021
Accepted: October 13, 2021

doi.org/10.21089/njhs.61.0026

Case Reports

Severe Pancytopenia and Stomatitis Case due to the Treatment with High Dose Methotrexate

Burcin Meryem Atak Tel, Satilmis Bilgin, Ozge Kurtkulagi, Gizem Kahveci, Recep Aktas, Kamile Kurt, Tuba Taslamacioglu Duman and Gulali Aktas

Abstract: Objective: Methotrexate is used to suppress inflammation in many rheumatologic conditions. Here we present an elderly patient who developed serious side effects due to methotrexate. A 78 year old male admitted to emergency department with oral mucosal bleeding, skin rash, decrease in oral nutrition intake and weakness. He had been using 5 milligrams of methotrexate as 2 tablets twice a day for 10 days, after he was diagnosed with psoriatic arthritis 15 days ago. A diagnosis of methotrexate intoxication established with history, physical examination and laboratory analysis, which revealed pancytopenia. His signs and symptoms, as well as pancytopenia were recovered on 6^th day of the hospitalization. He had been treated with folinic acid and filgrastim along with supportive care. Although methotrexate treatment and toxicity is well established it is still a clinical challenge that all clinicians must be aware of. In conclusion, methotrexate intoxication is a clinical entity that can lead to serious clinical consequences, and it is essential to diagnose and initiate appropriate treatment without delay to prevent morbidity and mortality.

Received: March 08, 2021
Revised: September 03, 2021
Accepted: September 08, 2021

doi.org/10.21089/njhs.61.0032

Acute Visual Loss in Young Boy

Muhammad Saeed, Memona Mohiuddin and Mohammad Hassan Al-Sumaili

Abstract: Objective: Multiple sclerosis is immune mediated disorder of central nervous system (CNS). Diagnosis of multiple sclerosis is based on clinical findings and investigations, like MRI of CNS. Herein, we presents a 13-year old boy who presented with sudden loss of vision in both eyes for two days duration. The concurrent phenomenon of optic neuritis and multiple sclerosis is less common in children and rarely reported.

Received: May 20, 2021
Revised: August 22, 2021
Accepted: August 27, 2021

doi.org/10.21089/njhs.61.0035

Guide lines

Interim-Guidelines for COVID-19 Vaccination in Hematological Malignancies and Hematopoietic Stem Cell Transplant Recipients

Raheel Iftikhar and Uzma Zaidi

Abstract: Objective: Hematologic malignancies such as Acute Leukemias, Myelodysplastic Syndromes (MDS), Myeloproliferative Neoplasms (MPNs), Lymphomas and Multiple Myeloma (MM) can be treated with chemotherapy, Hematopoietic Stem Cell Transplant (HSCT) or Chimeric Antigen Receptor T-cell (CAR-T) therapies with either a curative intent or to prolong survival. The hematologic malignancy itself or the anti-cancer therapies can result in long-term immunodeficiency; COVID-19 infection in this population is associated with a significantly higher risk of hospitalization and death [1]. Given lack of available data on COVID-19 vaccination from Pakistan, this guidance is based on the review of safety and efficacy of FDA and CDC approved vaccines for the prevention of COVID-19 disease and recommendations of European Society for Blood and Marrow Transplant (EBMT), American Society for Transplantation and Cellular Therapies (ASTCT) and British Society of Hematology (BSH) for the use of COVID vaccination in HSCT recipients and those with hematological malignancies. The American Society of Hematology (ASH), EBMT, ASTCT and BSH recommends the desired access to vaccines for this highly susceptible group along with care takers, family members, and domestic& everyday contacts when vaccine supply is available.

Received: July 11, 2021
Revised: August 15, 2021
Accepted: August 17, 2021

doi.org/10.21089/njhs.61.00 38