ABSTRACT
Background: Both SCD and Vit. D deficiency may cause joint pain. So, Vit. D may have a contributory role in severity of SCD presentation. This study was performed to assess burden of Vitamin D levels and association of vitamin D deficiency with severity of SCD in a tertiary care centre in India.Methods: This was a cross-sectional study, performed for one and half year. All SCD patients >18 years of age were included. Data was analysed to assess the burden of Vitamin D deficiency and to find out any correlation of S. vitamin D level with anemia, jaundice and number of episodes of hospital admissions in patients of SCD.Results: Total 50 patients were included. Multiple joint pain and easy fatigability were the most common symptoms. Most of them had history of jaundice and anaemia in the past, 84% had Vitamin D deficiency. There was significant difference in values of serum total bilirubin, blood urea, SGPT, SGOT, HbF, HbA2 and haemoglobin between the patients with Vitamin D3<30 and vitamin D3?30 (p<0.05). There was a significant positive correlation of vitamin D3 with haemoglobin (r = 0.889) and a negative correlation with Hb A2 (r= -0.123) and total bilirubin (r= -0.438).Conclusions: Vitamin D3 deficiency is associated with increased morbidity in SCD in terms of joint pain, anemia and jaundice. Routine testing and supplementation of Vitamin D levels in these patients may help to alleviate pain, improve functionality and reduce complications.
ABSTRACT
Diagnosis of pulmonary tuberculosis is challenging till today. Smear microscopy is the easiest, commonest and widely employed tool for confirmatory diagnosis of pulmonary tuberculosis, but it has low sensitivity and specificity. Sputum culture can increase the diagnostic yield by 20-40%, but it takes long duration of 2-8 weeks to give result. The role of newly introduced cartridge based nucleic acid amplification test (CBNAAT) in the revised national TB control program (RNTCP) is highly promising with a higher yield of bacteriological diagnosis in sputum negative pulmonary tuberculosis patients with detection of rifampicin resistance rapidly. However, it also has some limitations which may result in false negative results. Case of a 50- year-old-male was reported who was initially managed for community-acquired pneumonia in view of negative sputum and CBNAAT but was later confirmed to have TB but by then he had developed cavities in lung and had transmitted the infection to his son.
ABSTRACT
Background: Sepsis is a life-threatening medical condition triggered due to body's response to an infection. If empirical treatment for sepsis and bacteraemia is held up it will increase chances of mortality as well as duration of stay and cost. Hence, there is a need for risk stratification. So, we planned to study the clinicohematological profile of patients of sepsis admitted to this hospital in ICU.Methods: This was an observational study. A total of 50 patients of sepsis were included. All included participants were subject to CBC, RFT, LFT, RBS, Urine RM, ESR, chest X-ray, USG Abdomen. Laboratory evaluations were performed in the institutional pathology and biochemistry labs. Data was analysed to assess the clinicohematological profile of the patients of sepsis to identify common factors which if taken care of in time can reduce development to sepsis and the morbidity and mortality related to it.Results: Most common presenting complaint was fever (72%), followed by altered sensorium (58%), vomiting (30%), jaundice (30%) and breathlessness (20%). Most noticed signs were pallor (36%), icterus (36%), edema (6%), reduced air entry (34%) and crepitations (26%). Most common source of the infection were abdomen (28%), urinary tract infection (26%) and community acquired pneumonia (24%).Conclusions: Most common presenting complaints were fever, breathlessness, altered sensorium. Most common source of sepsis were urinary tract infection, lung, and abdomen which if adequately treated in time would aid in reducing the number of sepsis patients and thus will control the morbidity, mortality and cost associated with sepsis.
ABSTRACT
Background: Hypothyroidism is the most common of thyroid disorders in India. Anemia and hypothyroidism often occur simultaneously. Only few studies have assessed the role of vitamin B12 deficiency in this anemia. So, we planned this study to assess prevalence of anemia in hypothyroidism and to see if there is any association between vitamin B12 deficiency and anemia in these patients.Methods: It was an observational study. All hypothyroid patients attending the medicine OPD or admitted to medicine wards were enrolled for the study. Total 60 patients were included. Data was analyzed to assess the burden of anemia and B12 deficiency in hypothyroid and to find out any correlation between TSH level, anemia and vitamin B12 deficiency.).Results: About one third of hypothyroid had decreased vitamin B 12 levels. TSH level showed significant positive correlation with hemoglobin value. 28% of the hypothyroid patients had vitamin b12 deficiency, but TSH levels itself did not correlate with vitamin B12 level. However, it was seen that those who had combined thyroid and B12 deficiency had significantly higher chances of developing generalized swelling and breathlessness.Conclusions: Although there is no correlation between TSH level and B12 deficiency, it may be helpful to determine B12 level in hypothyroid patients who present with anemia, generalized swelling and/or breathlessness as B12 supplementation may give better symptomatic relief in them as compared to treating with thyroxine alone. More elaborative studies with larger sample size are required to explore this rather unattended relation of anemia in hypothyroidism with B12 deficiency.