Study of etiological spectrum and clinical profile of patients admitted in tertiary care hospital of South Gujarat, India

Background: Pancytopenia is defined as reduction of all three formed elements of blood below normal reference range. The symptoms are fatigue, fever, dizziness and weight loss. Evaluation was done using complete hemogram and peripheral smear. The presenting marrow biopsy is most useful and accurate in evaluation of pancytopenia.Methods: Two ml of anticoagulated blood was collected for complete hemogram. The peripheral blood smear was stained with Leishman's stain and studied. Bone marrow biopsy and aspiration was done in all the patients to identify etiology.Results: Predominance was seen in the age group of 31-60 years. Most common cause of pancytopenia was megaloblastic anaemia in this study compared to other studies all over the world where most common cause was aplastic anaemia. This reflects higher prevalence of megaloblastic anaemia in the Indian subjects.Conclusions: A comprehensive clinical, haematological land bone marrow study of patients with pancytopenia usually helps in identification of the underlying cause.

Prediction and stratification of the future cardiovascular arrhythmic events: Signal averaged electrocardiography versus ejection fraction.

Cardiac arrhythmias as cause of sudden cardiac death remains an important public health problem. The availability of effective treatment in terms of the implantable defibrillator makes it critical to identify individuals at risk. An essential step in this process is the use of noninvasive techniques to screen patients and identify those at risk. The detection of ventricular late potential using the SAECG as a non-invasive technique is being explored for this purpose. The objective of the study was to stratify the future cardiovascular events including life threatening cardiac arrhythmias, in different cardiac diseases through positive and negative predictive values of SAECG and comparing with EF% another mechanical determinant. The study was conducted on 152 subjects selected from the OPD and admitted case of the New Civil Hospital and Govt. Medical College, Surat; between 25 to 75 years of age group, from August 2001 to June 2004. 80 healthy subjects free from any major acute/chronic illness were selected as a control using our own normative values for SAECG. The statistical analysis was performed using SPSS package. The results obtained were analyzed for significance by using Chi square and Independent ‘t’ test. When we compared the cardiac arrhythmic events on 6 month follow-up study, based on SAECG and EF% separately we found that negative predictive value of SAECG was more (99.1%) than negative predictive value of EF% (93.6%). However positive predictive values for cardiac arrhythmic events of SAECG were less (28.9%) compare to EF% (42.9%).When both the parameters SAECG and EF% are considered together the negative as well as positive predictive values of these tests were quite high (100% and 50% respectively). In this study conducted on 152 patients we found that SAECG and EF% together were an accurate predictor of the cardiac arrhythmic events in terms of positive and negative predictive value while SAECG or EF% alone were not. However SAECG has got a more negative predictive value compare to EF%. In this study SAECG compared favorably or even better than EF% for risk stratification. SAECG and EF% together (and not separately) may be considered as a better investigational tool to stratify future cardiovascular arrhythmic events.

Paget's disease of the bone: a report of three cases.

Paget's disease is uncommon in Asians. We present 3 patients with varying manifestations. A 50 years old lady was detected to have raised alkaline phosphatase at a routine health check-up. Isoenzyme studies confirmed its bony origin. Bone scan revealed polyostotic disease. A 65 years old male patient with known Paget's disease of 6 years duration presented with pelvic girdle pain, progressive increase in alkaline phosphatase levels and worsening bone scan. A 45 years old male was admitted with chest pain. Cardiac evaluation was normal. Bone scan picked up a cough fracture in the left 7th rib and an incidental Paget's disease of the skull. All three had elevated markers of bone metabolism in the serum and urine. With monthly intravenous pamidronate there was significant improvement in the bone markers and follow-up bone scans.

A young female with quadriparesis.

We report a case of a young female who presented with acute onset quadriparesis secondary to severe hypokalemia. She was normotensive and had no metabolic alkalosis or kaliuresis. Serum potassium was corrected over the next few days and the quadriparesis resolved completely. A detailed history later on revealed that she had been consuming alternative medication for infertility for a prolonged duration and had discontinued it a month prior. One of the ingredients of this medicine was Glycyrrhiza glabra.

Fine structure of olfactory epithelium in Schizothoraichthys progastus McClelland and Schizothorax richardsonii Gray (Cyprinidae: Teleostei) from Garhwal Himalaya (India).

The olfactory epithelium of two closely related species of snowtrout— Schizothoraichthys progastus McClelland and Schizothorax richardsonii Gray (Subfamily: Schizothoracinae. family-Cyprinidae, Teleostei), from a perennial glacier-fed river Mandakini of Garhwal hills was studied by employing transmission electron microscopic method The olfactory lamella comprises two epithelia—anterior and posterior, with a stroma sandwiched in between. Both are strartified. The anterior one is thicker than posterior. In Schizothoraichithys progastus, the sensory part of epithelium has two types of receptor cells—ciliated receptor cells and rod cells whilst in Schizothorax richardsonii, there arc three types of receptor cells—ciliated receptor cells, microvillous receptor cells and rod cells in addition to sustentacular cells, basal cells and mucous cells. While inhabiting similar hillstream habitat, the differential ecological niches, feeding habits etc., account for the presence of different receptor cell types in these species, It implies the possible diversification at cellular and physiological levels so as to minimize the competition by using varied olfactory cues.

Laboratory diagnosis of Malaria: overview

Malaria is recognized as a serious health problem in Africa; one that has far reaching medical; social and economic consequences. In order to minimise morbidity and mortality it is important to make prompt diagnosis so that appropriate treatment can be started early