ABSTRACT
Auto Immune Mixed Haemolytic Anaemia (AIHA) is defined as presence of both warm and cold antibodies against patient’s own red blood cells which is diagnosed by monospecific Direct anti-globulin test. Hereby we report a middle-aged women old women who was a known case of hypothyroidism on regular medication, presented with history of fatigability, exercise intolerance and exertional breathlessness of 1 month duration. The patient was subjected for preliminary investigations, which revealed severe anaemia with hemoglobin of 3.6 g% and an increased reticulocyte count of 12% with normal total leukocyte and platelet counts. Peripheral smear revealed anisopoikilocytosis, nucleated RBCs and schistocytes. Biochemical tests for haemolysis was evaluated which showed and elevated LDH levels (780U/L), and a reduced serum haptoglobulin levels. Liver Function test revealed a total bilirubin of 6.8mg/dl with indirect bilirubin of 5.4 mg/dl with normal liver enzymes. Baseline evaluation of Auto immune haemolytic anaemia with coombs test turned out to be positive. Patient was subjected for Mono specific DAT, Indirect Anti-globulin test (IAT) and antibody screening. Mono specific DAT showed both Anti IgG and anti C3 antibodies. IAT test was positive at 4⁰C and negative at 22⁰C and 39⁰C which confirmed that the AIHA was of mixed warm and cold type. On evaluation for connective tissue diseases, patient serum was reactive for ANA and ds-DNA and found to have Systemic Lupus Erythematosus which is a rarity and was responded to corticosteroids.
ABSTRACT
Trace metal levels in selected medicinal plant leaves from Western Ghats, Karnataka, India were studied A method for the determination of Zinc, Copper, Lead and Cadmium simultaneously in the pH of 4.5 in citrate buffer, and Cobalt and Nickel simultaneously in the pH 9.2 in ammonia buffer medium has been optimized. Electrochemical method, Differential Pulse Anodic Stripping Voltammetry (DPASV) has been used for quantification. The optimized procedure has been successfully applied for the determination of the above-mentioned metal ions in some medicinally important plant leaves from Western Ghats, Karnataka, India. The concentrations of trace metals in the medicinal plant samples were found to be in the ranges: 15.61-20.71 mg g(-1) for copper, 0.056-0.10 mg g(-1) for cadmium, 0.91-1.81 mg g(-1) for lead, 0.42-0.96 mg g(-1) for nickel, 1.21-1.97 mg g(-1) for cobalt and 23.29-32.52 mg g(-1) for zinc. The effect of pH, deposition time and potential has been studied and optimized. The study reveals that all the trace metals are well within the maximum permissible limits, therefore, medicinal plants of this region are very much suitable for medicinal use. The results are compared with the data obtained by atomic absorption spectroscopy.