ABSTRACT
Background: β-Thalassemia major is considered to be one of the most common inherited hemolytic anemia. Enhanced years of survival of thalassemia have led to unmasking related complications related to alterations in certain trace elements like magnesium, calcium, phosphorus, copper, zinc etc. Objective:Present study was conducted to evaluate the effect of iron chelation therapy and blood transfusion on certain trace elements (Magnesium, Calcium, Phosphorus, Copper, Zinc) in β-thalassemic patients on chelation therapy more than one year. Materials and Methods:In the present cross sectional study, 100 β-thalassemic patients receiving chelation therapy for atleast 1year were recruited from Civil Hospital Ahmedabad, Gujarat during February, 2017 to December, 2018 and equal number (n=100) of healthy subjects were taken as a control group in the age range of 8 to 15 years of both sexes (male & female). The levels of serum magnesium, calcium, phosphorus, zinc, and copper in serum were analyzed and results were correlated with normal healthy subjects. Results:A significant increase in serum copper (P≤ 0.01) and phosphorus (P≤ 0.001) were observed levels while a significant (P≤ 0.05) fall in magnesium, calcium and zinc levels recorded in β-thalassemic patients in comparison to healthy control subjects. Conclusion:Aforementioned observations suggested that fluctuations in the trace elements levels in β-thalassemic children receiving blood transfusion and iron chelation therapy could leads to different complications like hemolyzed red cells, infections & hemochromatosis renal damage, hypoparathyroidism etc. if remains untreated. Hence routine assessment of these elements is recommended for better management.
ABSTRACT
Background: Epilepsy requires lifelong therapy with antiepileptic drugs (AEDs) and having medical and psychological consequence. So, the present study was conducted to evaluate the role of different AEDs on thyroid profile in epileptic patients.Methods: 50 epileptic patients receiving AEDs for minimum 1 year were recruited as study group and 50 healthy subjects considered as control group. These subjects were recruited from general (rural or urban) community of Punjab. Fasting blood samples were drawn from patients and healthy subjects for the evaluation of triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) levels.Results: Significant increase in TSH levels were recorded in epileptic patients while no significant change was found in T3 and T4 epileptic patients treated with different AEDs with respect to healthy controls. Maximum increase in TSH was seen in phenytoin, treated epileptic patients and maximum fall in TSH was recorded in levetiracetam treated epileptic patients. Maximum increase in T3 and T4 levels was found in phenytoin while a maximum decrease was recorded T3 and T4 levels in carbamazepine treated epileptic patients in comparison to other drugs treated patients.Conclusions: Aforementioned observations suggested that epileptic patients treated with phenytoin, valproic acid, carbamazepine and levetiracetam for long time could cause initiation of subclinical hypothyroidism further could leads to overt hypothyroidism which in turn responsible for pathophysiology of various coronary heart disease. Routine screening of thyroid profile during chronic use of AEDs is recommended.
ABSTRACT
Traumatic extrathoracic lung herniation is an exceptional complication of blunt trauma chest. We report a case of 44-year-old man who sustained severe blunt trauma chest with multiple rib fractures in a motor vehicle collision and the diagnosis was established through Computerised Tomographic scan chest. Patient was managed by standard posterolateral thoracotomy and a separate incision over the herniated part anteriorly to facilitate the reduction of herniated segment of the lung. Patient had an uneventful recovery.
ABSTRACT
Recovery of intrathoracic and intraperitoneal blood and reinfusion by autotransfusion has been demonstrated to be safe and practical in selected cases. This study has basically aimed at using a very simple method for collection and reinfusion of blood in haemothorax and haemoperitoneum. Autotransfusion was done in 50 cases admitted in Dayanand Medical College and Hospital, Ludhiana who were diagnosed to have haemothorax or haemoperitoneum which fulfilled the set criteria. There were increased haemoglobin levels in 26 patients and a decreased haemoglobin in 24 patients. The coagulation profile was deranged in 7 patients pre-operatively while it was deranged in only 2 patients postoperatively. There was no significant change in renal function tests and liver function tests preoperatively and postoperatively. This study had shown that intra-operative autotransfusion with this very simple, affordable and easily available technique is feasible and practical and its use should be encouraged.