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Thalassaemia is the commonest single gene disorder 1,2 of globin chain synthesis all over the world . It is found as thalassaemia minor when the defect is inherited from one of the parents and as thalassaemia major when the defect is inherited from both of the parents. Studies of thalassaemia in Pakistan have shown that 5% of the population have 3 thalassaemia minor. Based on this figure it is estimated that each year in Pakistan approximately 5000 children with thalassaemia major are born and the total number of children with thalassaemia 4 major may be over 50,000. Thalassaemia major is a serious disorder in which the affected child is unable to synthesize its own haemoglobin. The child remains well for the initial three to four months but after this the signs and symptoms of anaemia start appearing. The child looks pale, becomes irritable, and fails to thrive. Diarrhoea and frequent respiratory tract infections are other frequent symptoms. Examination may show hepato-splenomegaly. The lab investigations show moderate to marked hypochromic microcytic anaemia, numerous nucleated red cells and 5 markedly raised Hb-F. An early diagnosis and blood transfusions may halt further deterioration. The child has to be put on lifelong blood transfusions. As a result of regular blood transfusions a large amount of extra iron starts accumulation in the body. This iron can be very harmful for many important organs like heart and endocrine glands. The extra iron must be removed from the body by using iron chelating medicines. Stem cell transplantation is a curative treatment of thalassaemia major. When done early in life over 80% disease free survival can be 6 achieved. The facilities for stem cell transplant are available at several places in Pakistan but the procedure is expensive and due to the limited capacity it can be offered to only a small number of 7 patients.

Suhaib Ahmed. (2018) Thalassaemia in Pakistan, Journal of Islamic International Medical College, Volume-13, Issue-2.
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