Anemia in elderly patients ≥65 years of age: a hospital-based cross-sectional study

Introduction: Anemia in elderly patients of any degree contributes significantly to morbidity and mortality and has a significant effect on the quality of life. Despite of high prevalence, very few studies have examined the effect of anemia in elderly patients in India. Hence, this study is undertaken to know the prevalence and clinicopathological pattern of anemia in elderly patients. Objectives: 1. To estimate the prevalence of anemia in the elderly aged 65 years and above. 2. To determine the severity, clinicohematological patterns, and causes of anemia in the elderly aged 65 years and above. Materials and Methods: A hospital-based descriptive cross-sectional study was done. The study was conducted for 1 year; during this period, elderly patients aged 65 years and above admitted for other medical conditions were recruited in the study using consecutive sampling technique until the desired sample size of 236 was achieved and they were evaluated for anemia. Among them with hemoglobin cutoff value <13 g% for men, <12 g% for women were further evaluated to known the cause of anemia and its clinicohematological pattern. Ethical committee approval was obtained. Data were analyzed using SPSS Software version 23.0. Results: The mean age of the participants was 73.9 ± 7.4 (standard deviation [SD]) years. Majority, 53.8%, of the participants were males. Among the 236 elderly patients, recruited in the study 65.3% were anemic and among them 44.2 had mild anemia and 37% had moderate anemia. Mean hemoglobin value of the participants was 10.7 ± 2.83 SD and it ranged from 3 to 16.3 g/dl. There was no significant difference in the hematological parameters between male and female elderly patients in the study. The main cause of anemia was found to be due to chronic diseases followed by iron‑deficiency anemia. Conclusion: This study concludes that anemia was highly prevalent among elderly patients and most of them had identifiable and treatable etiology. Hence, all elderly patients with anemia should be evaluated properly for underlying etiology and treated accordingly to reduce the mortality and morbidity in elderly patients with multiple comorbidities.

Maternal and Perinatal Outcome in Twin Gestation in a Referral Hospital at Visakhapatnam

Background: Multiple births have been a subject of great interest to various Scientists such as endocrinologists and geneticists, a source of fascination to some people and a causes concern to obstetrician and pediatricians. Multiple pregnancies are associated with many problems for the obstetrician during ante-natal, intranatal and postnatal periods. For the mother the prognosis is worse than a singleton pregnancy and for the fetus the prognosis is very depressing and it is associated with very high fetal mortality. Aim: To study various factors leading to maternal and fetal morbidity and mortality in multiple fetal gestations. Material and methods: Prospective observational study was carried out on 100 antenatal women with twin gestations who attended Victoria Government Hospital, a referral hospital for women and child at Visakhapatnam from October 2015 to September 2017. Maternal and perinatal morbidity and mortality and their causes were analyzed. Results: In this study, 73 women (73%) were booked and 27 women (27%) were unbooked. Maternal and perinatal complications were more in unbooked cases. Incidence of preeclampsia was 22%, gestational hypertension cases 10% and eclampsia cases twice more than the singleton pregnancy. Incidence of poly-hydromnios 5%, Anemia was 40%, APH was 1%, pre-term labour – 30%. Gundu Vanaja, Polumuru Usha Devi, D Hemalatha Devi, Usha Prasad, P Durga Kumari, Y Madhuri. Maternal and Perinatal Outcome in Twin Gestation in a Referral Hospital at Visakhapatnam. IAIM, 2017; 4(12): 153-157. Page 154 Intrapatrum and postpartum complications like PROM – 20%, uterine inertia – 6%, cord prolapse – 2%, PPS – 13%, LSCS rate – 40%. Conclusion: Twin gestation is a high risk pregnancy associated with antenatal, intranatal and postnatal complications which cases increased morbidity and mortality of both mother and fetus. Early diagnosis, good antenatal care and treatment of antenatal complications, labor management in the tertiary center, liberal use of C-section also NICU will improve perinatal, maternal outcome.

Conjunctival Squamous Cell Carcinoma with Stromal Invasion

Limbal squamous cell carcinoma is uncommon worldwide. Its early stages of presentation may look like the commoner limbal mass, pterygium or actinic keratosis. We report a case of invasive squamous cell carcinoma of limbusin a 45-year female patient. A high index of suspicion is required to prevent delay in the diagnosis of an invasive condition that can destroy the eye completely[1]. A rare case of squamous cell carcinoma of the conjunctiva is presented here. This highlights the significance of aggressive management of such cases surgically and the use of adjuants per operatively to prevent recurrence.

Atypical Presentation of Mycobacterium Tuberculosis in an Infant.

Tuberculosis of the skeletal muscle is very rare which is often missed in the early stages. This leads to delay in treatment resulting in irreversible limb deformity and loss of function. The authors describe a case of healthy child with an intramuscular cystic swelling above the elbow joint. The pus showing acid fast bacilli morphologically resembling Mycobacterium tuberculosis was also isolated in culture. Following the diagnosis and confirmation, the child was treated successfully with anti tubercular drugs.

Effect of vitamin E supplementation on diabetes induced oxidative stress in experimental diabetes in rats.

Diabetes induced by streptozotocin (50 mg/kg body wt, i.p.) in the rats substantially increased the plasma glucose and malondialdehyde levels along with corresponding decrease in the antioxidants levels. Supplementation of vitamin E (200 mg/kg body wt., ip) for 5 weeks resulted in non-significant decrease in the blood glucose levels but plasma malondialdehyde levels were reduced to below normal levels. Plasma vitamin E, vitamin C, uric acid and red blood cell glutathione levels were also restored to near normal levels on vitamin E supplementation to diabetic rats as compared to control (diabetic) rats. The activities of antioxidant enzymes, catalase (EC 1.11.1.6), glutathione peroxidase (GSHPx EC 1.11.1.9), and glutathione reductase (GR EC 1.6.4.2) were also concomitantly restored to near normal levels by vitamin E supplementation to diabetic rats. The results clearly demonstrated that vitamin E supplementation augments the antioxidant defense mechanism in diabetes and provides evidence that vitamin E may have a therapeutic role in free radical mediated diseases.

Effect of alliums on total lipid in plasma and tissues of Japanese quails (Coturnix coturnix japonica) with respect to age and sex.

Dietary onion and garlic caused an increase in the level of liver and plasma total lipids in Coturnix coturnix japonica. This increase could be due to the effect of an increased feed intake, bile production, digestion and absorption that in turn caused an increased utilisation of dietary fat, increased transfer of dietary lipids to the liver and/or due to increased lipogenesis as such. However, there was no increase in the muscle lipid content. This effect in the muscle could be due to inhibitory effect of onion or garlic on lipoprotein lipase activity. Further, the changes in the tissue total lipid level in the control group due to change in age and sex were also observed.

Isolation of Mycobacterium chelonae from wound infection following laparoscopy: A Case Report.

M. chelonae is a rare cause of human infection and is difficult to diagnose unless suspected for the same. A 55 year old healthy gynaecologist, diagnosed to have right inguinal hernia, underwent laparoscopic hernioplasty, after which he showed signs of post-operative wound infection which was confirmed to be due to M. chelonae. Definitive identification of this species of mycobacterium was possible by growth characteristics and biochemical tests. The organism was sensitive to Kanamycin, Clarithromycin, Ciprofloxacin and Amikacin. However, complete recovery from infection was possible after prolonged treatment with antibiotics to which the organism was sensitive.

Injection site abscess due to Mycobacterium fortuitum: a case report.

Injection abscess is an iatrogenic infection occurring as an isolated case or as cluster outbreak. These infections occur due to contaminated injectables or lapse in sterilisation protocol. While pathogens such as Pseudomonas, Klebsiella, E. coli, and S. aureus are the usual causative agents, unusual organisms such as mycobacteria, particularly the rapidly growing non-tuberculous mycobacteria (NTM) may cause the abscess. The chances of overlooking these organisms is high unless an acid fast bacilli (AFB) smear and culture is done on all aspirated pus specimens. We report a case of a three year old child who presented with a gluteal abscess following an intramuscular infection with an unknown preparation.

Effect of onion (Allium cepa Linn.) and garlic (Allium sativum Linn.) on plasma triglyceride content in Japanese quail (Coturnix coturnix japonicum).

Dietary onion and garlic caused an increase in the level of plasma triglyceride which could be due to insulin like activity of dietary alliums and other factors that promote lipogenesisi in growing stages. Changes in the plasma triglyceride level in the control group due to change in age and sex were also noted. The triglyceride level was more in female birds when compared to males of similar age group. The plasma trigelyceride level increased with age in both sex except for the level being similar in the 6 and 9-week old females and 3 and 6-week old male birds. The results suggest that the effects of alliums in growing and adult stages may be different which needs further study.