ABSTRACT
Background: There has been little systematic study on the clinical spectrum of pancytopenia. This study was done to describe the etiology, presentation and outcome of patients with pancytopenia presenting in a general medical ward
Methods: Hundred patients with pancytopenia were included in the study from October 2001 to October 2002. Patients on cancer chemotherapy were excluded. Blood counts, bone marrow examinations and trephine biopsies were performed according to standard methods
Results: In all cases, megaloblastic anemia constituted the largest group [n=39], and also seen in conjunction with hemolytic anemia and septicemia. Hypersplenism secondary to portal hypertension [cirrhosis] was the second most common diagnosis [n=19]. Aplastic anemia, septicemia and myelodysplasia were other common causes. Two patients were the suspected cases of viral hemorrhagic fever. Thirteen [13%] patients expired. Absolute neutrophil count [ANC] less than 500 /microl was seen in 14 [14%] patients, among which 6 [15.3%] had megaloblastic anemia, 3 [37.5%] had aplastic anemia, and 2 [40%] had myelodysplasia. Eleven patients with platelet counts 100fL and > 110fL were more frequent in patients with megaloblastic anemia with most prominent anisopoikilocytosis, microcytosis and fragmented RBCs. Macrocytosis was noted in 35 [89.7%] patients with megaloblastic anemia and 12 [63.1%] with hypersplenism, 4 [50%] with aplastic anemia. Hypersegmented neutrophils were noted in the blood films of 36 [92.3%] patients with megaloblastic anemia
Conclusion: Megaloblastic anemia, hypersplenism and aplastic anemia are the common causes of pancytopenia in our study
ABSTRACT
To describe the frequency of indications, results and different parameters observed during the test. Design: A descriptive study. Place and Duration of Study: This study was carried out in coronary care unit of Holy Family Hospital, Rawalpindi from January, 2001 to January, 2002. Subjects and One hundred booked patients were selected by non-probability convenient sampling. Exercise stress test was done on Quintron Q710 Exercise and Resting ECG System. Patients having suspected coronary artery disease having typical or atypical angina pectoris, any rhythm disorders, and known coronary artery disease 6-8 weeks after myocardial infarction were included in the study. Out of 100 patients, 75 were males and 25 females. Twenty-seven% patients presented with typical chest pain [resting and exertional] and among them 18 had positive test. Among these, 9 [56.25%] male and 2 [33.3%] female patients developed significant ST-T changes in recovery period. Most common ST-T deviation lead was v4 [n=5] in males and lead III [n=2] in females. Out of 60 patients [60%] with atypical chest pain, only 3 [5%] males were found positive. Fifty-eight% patients [44 males, 14 females] were older than 40 years. Patients with inconclusive or borderline test included 10 [10%] males and 2 [2%] females. For primary care physicians, exercise stress testing is a cost-effective tool to evaluate patients presenting with symptoms of classical as well as atypical chest pain. It helps to stratify those with probable coronary artery disease into a high-risk group needing referral and a low-risk group that can be observed