ABSTRACT
Background: Purpose of current study was to study the ocular manifestations in beta-thalassemia major patients and assess the ocular side-effects of iron chelating agents. Methods: Cross sectional study included 45 β Thalassemia major patients from age group of 6months to 12 years were taken. Full medical history, thorough physical examinations were done to all patients groups, and ophthalmological examination to determine the prevalence of ocular manifestations for all patient groups and to correlate these manifestations or changes with iron chelating agents. Results: In 45 patients (22 males and 23 females) with age ranging between 2 years to 12 years, ocular involvement is seen in 35% in the form of decreased visual acuity 26%, tortuous blood vessels in 4.5%, disc hyperemia in 4.5%, heterochromia in 2.5%, retinal pigment epithelium mottling in2.5% and this involvement were more with older age group. Conclusion: Most of the ocular changes of beta thalassemia are attributed to the course and severity of the disease. Reduction in serum iron and serum Ferritin levels by iron- chelating agents and regular ocular examination to look for side-effects of such agents can aid in preventing or delaying ocular complications.
ABSTRACT
Background: Tuberculosis is the second most common cause of death from infectious disease at the global level, being second only to AIDS. Good data on the burden of all forms of TB amongst children in India is not available; most surveys conducted have focused on pulmonary TB. The present study was designed to study clinical profile of various forms of childhood EPTB. Objective of current study was to study clinico-epidemiological profile of various forms of childhood EPTB. Methods: Retrospective analysis of clinical profile of 100 patients of childhood EPTB in the age group of 6 months to 12 years. Results: Age distribution in our study showed that 62% cases falling in the age 0-5 years and 38% cases in 5-12 years (P = 0.041) with male to female ratio of 1.9:1. 96% (P = 0.016) of the patients belonged to the lower socio-economic class (P = 0.01). The distribution of EPTB was - TBME (46%), disseminated TB (21%), pleural effusion (12%), abdominal TB (10%), TB lymphadenitis (7%), Osteoarticular (4%). 28% of the patients had mild to moderate malnutrition (PEM Grade-I,II) and 46% (PEM Grade-III,IV) were severely malnourished. 66% of the patient were BCG vaccinated & history of Koch’s contact were present in 28% of the all cases. In CNS tuberculosis, fever was present in 97% followed by altered sensorium & convulsion in 80%, tonic posturing in 60% & abnormal movements in 4% and in most common sign was tonic posturing in 60%, crack pot sign positive in 41%. In abdominal tuberculosis - fever (100%), anorexia (90%), weight loss (80%) abdominal pain (50%) & hepatomegaly was common finding seen in 100% of abdominal tuberculosis. Conclusion: Childhood EPTB is commonly seen in children age more than 1 year, lower socioeconomic class & in severely malnourished. CNS tuberculosis commonly present with fever, altered sensorium, convulsion, abnormal movements while abdominal TB present with fever, anorexia, weight loss & abdominal pain.