ABSTRACT
Anaemia is a common clinical condition in elderly commonly associated with increased morbidity and mortality, increased hospitalization, decreased physical performance, loss of mobility and disability at higher rates than those people without anaemia. The present study was undertaken to assess the aetiological profile of anaemia in elderly. METHODSA cross sectional study was done among elderly patients with anaemia admitted in general medicine department and / or attending general medicine OPD, IGIMS, Patna, Bihar. 100 consecutive patients were selected as per inclusion and exclusion criteria. The patients were subjected to a thorough clinical examination and investigation, and data was analysed. RESULTSAnaemia is more common in males with a male to female ratio of 2.84:1. Maximum numbers of cases was in the age range of 61 to 70 comprising 70 % followed by 23 % in 71 to 80 years age group and 6 % in 81 to 90 years age group. Weakness was the most common presentation comprising 74 % cases. Comorbidities in patients along with anaemia were solid malignancy in 5 %, diabetes mellitus (DM) in 7 %, hypertension (HT) in 6 %, chronic kidney disease (CKD) in 5 %, cor pulmonale in 3 % and hypothyroidism in 1 %. 48 % patients were having moderate anaemia and 45 % patients were having severe anaemia. Morphologically most common variety of anaemia was normocytic normochromic contributing 57 % of the patients. Bone marrow examination done in 62 cases revealed hyper cellular marrow in 27, normocellular in 24, hypo cellular marrow in 6 and mildly hyper cellular to normocellular in 5 cases. Aetiological distribution showed 14 % of anaemia of chronic disease (ACD) and 14 % due to vitamin B12 deficiency. This was closely followed by iron deficiency anaemia (IDA) in 13 % cases. CONCLUSIONSAnaemia in elderly is a common clinical condition commonly presenting with nonspecific symptom. Normocytic normochromic anaemia is the most common morphological type of anaemia with various underlying treatable aetiologies.
ABSTRACT
Primary subcutaneous leiomyosarcoma (LMSs) are uncommon of all soft tissue malignancies. Its frequency is about 1% to 2%, with a predilection for middle age, and found more frequently in the lower extremity. They can be of two types according to its primary site of origin: deep subcutaneous and superficial cutaneous. The physical appearance of this tumour resembles more with benign condition and can easily be mistaken for nonmalignant condition. Hence, it is important to diagnose it correctly and it is important to differentiate it from other spindle cell neoplasm. A case of giant subcutaneous leiomyosarcoma is presented here which was found around knee in lower extremity. The diagnosis was suspected by histopathology and confirmed by immunohistochemistry.
ABSTRACT
Background & objectives: Successive outbreaks of acute watery diarrhoea occurred in Talikoti and Harnal, located in Bijapur District of the southern Indian sState of Karnataka, in July and August 2012, respectively. These outbreaks were investigated to identify the aetiology and epidemiology. Methods: Information was collected from the local population and health centres. Stool and water samples were collected from the admitted patients and their drinking water sources. Standard microbiological and PCR techniques were employed for isolation and characterization of the pathogen. Results: While 101 people (0.38%) were affected in Talikoti, 200 (20.94%) were affected in Harnal which is a small remote village. All age groups were affected but no death occurred. While the outbreak was smaller, longer and apparently spread by person to person contact in Talikoti, it occurred as a single source flash outbreak at Harnal. A single clone of toxigenic Vibrio cholerae O1 Ogawa biotype El Tor was isolated from the two stool samples obtained from Talikoti and subsequently from three of five stool samples obtained from Harnal indicating village to village spread of the aetiological agent. Striking similarity in antibiotic resistance profiles of these isolates with a particular strain isolated from the city of Belgaum, 250 km away, in 2010, prompted tracking the lineage of the V. cholerae isolates by DNA fingerprinting. Random amplified polymorphic DNA (RAPD) fingerprinting assay helped confirm the origin of the incriminating strain to Belgaum. Interpretation & conclusions: Our study reported the first twin outbreak of cholera in two remote areas of Bijapur district, Karnataka, south India. It also indicated the need for immediate preparedness to deal with such emergencies.
ABSTRACT
Background: Sickle cell anemia (SCA), which is an inherited blood disorder characterized primarily by chronic anemia and oxidative stress plays a major role in pathophysiology. Objective: This study aims to evaluate vitamin A (serum retinol) status and hematological parameters in children with homozygous and heterozygous sickle cell disorders and compared with age- and sex-matched healthy controls. Materials and Methods:A sample of 80 referred cases (37 sickle cell disorders and 43 normal cases) aged 2-40 years were included in the study. Hematological parameters were measured in cell counter and serum retinol by high-performance liquid chromatography. Results: The mean hemoglobin (Hb) and serum retinol were significantly lower among cases with sickle cell disease than in sickle cell trait and normal. Vitamin A deficiency (retinol < 20 μg/dl) reported to be higher in homozygous cases (46.2%) as compared to either heterozygous (29.2%) or control (23.2%) groups. Serum retinol was correlated directly with Hb, RBC count, and hematocrit levels, and inversely with percentage of sickling among sickle cell disorder cases. Conclusion: The results indicate that deprived vitamin A status with inductive oxidative stress is mainly due to sickling and hemolysis in SCA cases.