ABSTRACT
Background: Dengue is the most rapidly spreading mosquito-borne viral fever especially in coastal regions due to heavy rainfalls. It is important to understand the hemato-pathological changes associated with dengue infections to avoid dreaded hematological complications. These hematological changes can be used as diagnostic aid in remote rural set-ups wherein rapid dengue diagnostic kits are not available. Objective: This retrospective study was carried out from 1st January 2018 to 31st August 2021 with an objective to analyze the hematological profile of serologically diagnosed dengue patients. Materials and Methods: A cross sectional, observational, retrospective study was carried out at a tertiary care center at Dervan, Konkan region of Maharashtra over a period of three years and eight months. Commercially available ‘Dengue Day 1 test kit’ was used to detect NS1 antigen and IgM and IgG antibodies. Patients with positive NS1 antigen and/or IgM or IgG antibody were included while patients with other febrile illnesses like typhoid, malaria were excluded from this study. Patient’s venous blood was collected in plain bulb for serology and in EDTA bulb for hematological profile (CBC/blood smear). This profile included hemoglobin, hematocrit (HCT), RBC indices like MCV, MCH And MCHC, total leucocyte count (TLC), Differential leucocyte count (DLC) and platelet count (PC). Results: A total of 330 patients were diagnosed as dengue cases based on rapid card test. Majority of the patients were positive for NS1 antigen (60%) followed by IgM antibody (27.87%). Male: female ratio was 1.8:1. Age of the patients were in the range of 10-65 years whereas majority of NS1 positivity was seen in the age group of 21-30 years. Hemoglobin levels among these patients ranged from 3.1-19.9 g/dl. 27.47% cases had hemoglobin level of more than 15 g/dl and 16.96% patients had hemoglobin level <10 g/dl. 225 out of 330 patients showed hematocrit (HCT) >35% above the average reference value. HCT ranging from 20-35% was seen in 72/330 (21.82%) patients. 143/330 (43.34%) cases showed TLC <4000/cumm (leukopenia). 51.07% patients showed relative lymphocytosis with 15.15% of these cases showing reactive lymphocytosis. Maximum cases showed thrombocytopenia (69.32%). 31.21% showed grade 1 thrombocytopenia that is, platelets between 75000-150000/cumm. This grade was followed sequentially by Grade III, II and IV thrombocytopenia cases. Conclusion: This study highlights important hematological parameters on different serological dengue diagnosis made on rapid card test. This study will help diagnose dengue disease in remote, rural set-ups wherein rapid diagnostic kits are not available.
ABSTRACT
Background: Malaria is a numero-uno infectious, killer disease in the developing world including India. This disease is caused by Plasmodium parasitic species with mosquitoes acting as vectors of transmission. Hematological tests include RBC, WBC and platelet parameters, peripheral blood examination which change based on parasitaemia need to be evaluated in various malaria affected regions to get prompt malarial diagnosis. Prompt diagnosis leads to prompt treatment avoiding troublesome malarial complications. Objectives: The present observational cross-sectional study was undertaken to estimate the Hematological profile in malaria cases diagnosed in a tertiary care hospital of Konkan region, Maharashtra. Methods: All the patients referred to Hematology section, Department of Pathology with malaria were evaluated with clinical details. The data was collected from 1st January 2017 to 31st December 2020 for three years’ duration. Total malarial cases studied were 50 cases. CBC/ PBS examination was done on EDTA blood sample. The RBC parameters, WBC parameters and platelet counts were studied with respect to malarial parasitaemia. Parasite index was found on smear and malarial diagnostic confirmation was also done using rapid kit test. All the findings were filled in MS-Xcel sheet 2010 and data was analyzed manually. Results: Malaria caused by P.vivax was predominant in present study. Patients in age range of 15-30 years were more affected in present study, that is, younger people were affected. Male predominance was seen. Fever was most common presenting symptoms followed by chills and rigor in present study. Hb, RBC count, PCV – showed that anemia was more common hematological change in present study, as these values were lower than normal level. Red cell indices like MCV, MCH, MCHC, RDW and peripheral blood smear revealed all the values in a normal range showing normocytic normochromic RBCs in the present study. Patients with malaria having normal TLC followed by leucopenia were more common in present study. Thrombocytopenia was most common hematological change seen in present study. Conclusion: Hematological parameters are measurable indices of blood that serve as a marker for malarial diagnosis.
ABSTRACT
Tuberculosis (TB), a disease caused by Mycobacterium tuberculosis is an infectious disease that continues to be a significant health problem in a developing country like India. The cause of peripheral neuropathy associated with tuberculosis is controversial. Possibilities include the toxic effects of antituberculous chemotherapy (especially, rifampicin, streptomycin & ethambutol), immune mediated neuropathy, direct invasion of nerves, vasculitic neuropathy, compressive neuropathy, and meningitic reaction. This report describes an unusual fi nding of tuberculous granulomas in the peripheral nerve (Greater auricular nerve) of a patient ,who presented with a painful neck swelling. Granulomas were present in Greater auricular nerve (C2,C3) biopsy specimen associated with tuberculous peri-neuritis, but with no more specifi c indications of the mechanism of the neuropathy.