Clinical and hematological profile of pancytopenia in a tertiary care hospital of Southern Odisha, India

Background: Pancytopenia (anemia, thrombocytopenia and leukopenia) is a common haematological condition with various etiologies like ineffective haematopoiesis, bone marrow suppression, bone marrow infiltration and peripheral destruction of blood cells. The present study was done to see the clinical features and etiologies of pancytopenia in this geographical region.Methods: About 150 patients above 15 years of age after fulfilling the inclusion criteria were included in the study. They were evaluated with appropriate laboratory tests including bone marrow study, if indicated to find out the underlying etiology.Results: Common symptoms were generalized weakness (93.3%), fever (75.3%) and dyspnoea (54%). Common physical findings were pallor (100%), lymphadenopathy (43.6%) and hepatosplenomegaly (32%). Most common causes were aplastic anemia (28%), megaloblastic anemia (20%) followed by infections like malaria (13.3%), dengue (5.3%) and sepsis (1.3%). Bone marrow was hypocellular in 50 patients (41.7%), hypercellular in 45 patients (37.5%) and normocellular in 25 patients (20.8%).Conclusions: There are some reversible causes of pancytopenia like megaloblastic anemia, malaria, dengue and sepsis. Conditions like disseminated TB, collagen vascular diseases also can be treated with specific treatment if diagnosed early to avoid further complications.

Cognition Levels of Attendants of Patients with an acute relapse of Psychosis - Differences Immediately Prior to and Post Admission.

Background - Mental illness in a family member has an adverse impact on overall wellbeing of other caregivers. Aims - To study the cognition level of attendants of acutely relapsed psychotic patients. Methods - Two matched groups of 30 attendants each ,of acutely relapsed psychotic patients, who differed on admission status of their patients were administered MMSE and their cognition levels were compared. Results - Cognition level of attendants of acutely relapsed psychotic patients was found to be lower than that of the general population. 40% of attendants awaiting admission and 7% of attendants who had their wards admitted had at least mild cognitive deficit. Further, a likelihood of lower cognition level in attendants awaiting admission as compared to attendants who had had their wards admitted was found to be statistically significant. Conclusion - Attendants of acutely relapsed psychotic patients have a lower cognition level prior to admission and this fact may have implications on deciding the ideal time to obtain history from the attendants and to give them advice and instructions on patient care.