ABSTRACT
Context: Z score defines the shift of an observed value from the mean. Aims: By determining the direction of this shift and its absolute value for mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC), one can quickly screen the hemogram for any spurious results in RBC parameters and also predict the type of anemia. This is because MCH and MCHC are derived parameters (from Hb, RBC, MCV) and thereby reflect the true as well as false changes in an erythrogram. Materials and Methods: A total of 975 hemograms were studied retrospectively. Basic statistical formulae using mean and standard deviation were applied to calculate z scores for MCH and MCHC. Results obtained were compared with the standard method and validated by an independent cohort of 100 random samples run on a different machine. Results and Statistical Analysis: Z score was found to be statistically significant (p <.001) in diagnosing iron deficiency anemias, megaloblastic anemias, hemolytic anemias, regenerative anemias, anemia of chronic disease and spurious findings. Z score was not significant (p = 0.9) in predicting beta thalassemia trait. The sensitivity was low for the differentials of microcytic hypochromic anemias. Conclusions: Despite this, Z score can be of immense help to the clinicians and pathologists in making quick interpretation of the underlying red cell abnormalities. Also, it can be used as a quality assessment tool in hematology laboratories taking pre analytical and analytical factors into account.
ABSTRACT
Background: Obesity in relation to physical fitness is of major concern nowadays, as the prevalence of obesity is increasing rapidly worldwide and India is no exception to it. Lack of fitness results in stress as well as increased burnout, which ultimately contributes to mortality from cardiovascular disease. Physicians who are having poor exercise habits are also less likely to counsel patients about exercise. Aim and Objectives: Hence, in this study, we aim to evaluate the body mass index (BMI) as well as cardiorespiratory fitness and self-reported sleep pattern among the resident doctors of MMIMSR, Mullana, Ambala, Haryana. Materials and Methods: Data were collected for the cross-sectional study. Sleep pattern was determined using a validated Pittsburgh sleep quality index questionnaire. Body weight and height were measured and BMI was calculated using Quetelet index. Queen’s College Step Test method was used to estimate cardiorespiratory fitness by calculating VO2max. VO2max is internationally accepted parameter and is the first choice in measuring a person’s cardiopulmonary status. Results: The result of our study showed highly positive significant (P < 0.01) association and correlation between obesity and sleep patterns and highly significant (P < 0.01) correlation between obesity and cardiorespiratory fitness among the resident doctors. Residents with relatively disturbed sleep pattern and with shorter sleep durations were either overweight or obese. Preliminary findings are consistent with the hypothesis that disturbance in sleep pattern may be one of the factors which influences BMI and also influences long-term cardiorespiratory health. Residents attributed time constraints due to training as a key barrier to physical activity. Conclusion: Proper awareness at early stage is extremely important to impress the consequences disturbed sleep pattern and in prevention of the development of obesity and improvement in the cardiorespiratory fitness.
ABSTRACT
Very few immunological studies in vernal catarrh have been conducted in India and abroad, but none in Himachal Pradesh in spite of its high incidence in the State. In the present study 25 patients of vernal catarrh residing at a height ranging between 1000 to 2500 meters above mean sea level have been evaluated. Their immunological status of serum and tears after detailed clinical assessment was studied by single radial immunodiffusion technique of Mancini et al. The values of serum IgA and IgM were significantly higher in patients than in controls. The serum IgE level had no significant difference. The IgG was significantly lower in patients with vernal catarrh. The values of tear IgM, IgE and IgA in these patients were significantly higher than in controls. However, in no case or control group C3C and C4 were detected in tears. The limbal type of vernal catarrh was found to be the most common in this part of the country. No mixed case was seen. Derangement of the immune system in the pathogenesis of vernal catarrh is suggested.