ABSTRACT
Background: Pancytopenia is common clinical condition which we encounter in our daily clinical practice. Pancytopenia is characterized by decrease in all the three major components of blood like Red Blood Corpuscles, White blood Corpuscle, and platelets. This study was carried out to look for causes of pancytopenia and clinical presentations at tertiary care hospital in north India.Methods: The study was conducted at MLN Medical College, Allahabad in the Department of Medicine between June 2018 to July 2019. Total 125 patients who attended department of medicine were screened for study. After exclusion 94 patients were studied prospectively.Results: Out of 94 patients 59 were males, and 35 females in the study group. Male to female ratio was 1.6:1. Maximum patients were between 20 years to 35years of age group. Pallor and weakness were most common clinical feature in this study group. Out of various etiological causes vitamin B12 deficiency was the commonest in our study. 48(51%) patients had megaloblastic anemia due to vitamin B12 deficiency. Second most common etiological factor was hypo plastic/aplastic anemia. Other etiological abnormalities were hypersplenism, dengue, malaria, sepsis, myelodysplastic syndrome and multiple myeloma.Conclusions: Bone marrow examinations, aspiration cytology or biopsy are important tool for diagnosis of pancytopenia. Underlying cause and severity of disease determine the outcome of pancytopenia. The present study concluded that most of patients with pancytopenia have treatable cause so early diagnosis will be helpful for management of patients.
ABSTRACT
Efavirenz is the first line non-nucleoside reverse transcriptase inhibitor suggested by World Health Organization for newly diagnosed patients started on antiretroviral therapy. Dermatologic manifestations are the usual side effects associated with this drug. Authors hereby, present a case report of efavirenz induced drug hypersensitivity reported at a tertiary care hospital at Allahabad, Uttar Pradesh. The patient developed rashes and vomiting within a week of start of TLE regimen. Re-challenge test revealed confirmation of the adverse drug reaction by efavirenz. Change of the regimen was done for the patient following hospitalization for the event. This case report explains that strict pharmacovigilance is essential in the initial days of start of antiretroviral therapy. Further trials to improve the safety profile of the patients on ART are the need of the hour.
ABSTRACT
Introduction: For successful endodontic therapy it is vital to have thorough knowledge of morphology of the root canal system and its variations besides proficient aseptic intraoperative condition. Mandibular second premolars are usually single rooted tooth with single root canal system. The incidence of the number of roots and the number of canals varies greatly in the literature. Methods and Results: This case report describes an unusual case of mandibular second premolar with two roots and five root canals. This was confirmed by radiographs, dentascan and dental operating microscope (DOM), and was successfully treated using K files system, guttapercha and AH plus sealer in lateral condensation manner. Conclusion: The clinical significance of this case report is that the precise awareness about the aberrant morphologies of the root canal system can only be appreciated when advanced radiographic techniques, magnification and illumination are used to treat such type of cases.