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Peripheral Blood Count Abnormalities and Skin Manifestations Among Patients with Hepatitis in Gestation

Introduction: Pakistan is the 6th most populist country in approximately 108 million. Prevalence of HCV infection reported in various studies by the Pakistani authors ranges from 2-14%. From the pathogenetic point of view in hepatitis, it is believed that disorders of primarily immunocomplex genesis generate skin vasculitis, Raynaud’s syndrome, nodular periarteritis, and mixed cryoglobulinemia. Pregnancy is a period in which more than 90% women have significant and complex skin changes that may have great impact on the woman's life. These changes are mainly due to a number of complexes endocrinological, immunological, metabolic, and vascular changes occurring in pregnancy that may influence the skin in various ways. Objective: To evaluate the burden of thrombocytopenia along with skin manifestations and hepatitis in gestation. Methods: This was cross sectional study conducted over a period of 2 years. Study was conducted at hepatitis OPD of tertiary care hospitals of Karachi. Pregnant women of age ranging between 29-35 years and gestational age between 28-38 weeks were selected. Linear regression analysis was performed to determine the independent relationship between the dependent variable of platelets, p value <0.05 was considered statistically significant. The study protocol was approved by ethical review committee. Results: Frequency of thrombocytopenia was 68.8%. Majority of patients (36.2%) were mild thrombocytopenic. The regression coefficient, b (Unstandardized Coefficients), of AST indicates if AST increases by 1 SD (standard deviation) platelets level will decrease by 105.88 SD units. The variable of ‘AST’ is the predictor of platelets level, with a Beta (Standardized Coefficients) of 0.65, a moderate effect size which was statistically significant. Conclusion: High frequency of association between thrombocytopenia and hepatitis-C. Disorders of primarily immunocomplex genesis generate skin vasculitis, and mixed cryoglobulinemia. Changes with pigmentation are among the most pronounced skin changes during pregnancy.

Author(s): Musleh Uddin Kalar, Afia Azam, Tooba Usman, Misbah Khan, Ayesha Jabbar, Aqsa hafeez, Shumaila Ali, Faiza Mukhtar, Nabila Kalar, Mariam Alzaabi, Farah Mansoor, Fizza Hassan, Narmeen Shahid

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