Résumé
Introduction: The frequency of underlying pathology causing pancytopenia varies considerably depending upon various factors including geographic distribution and genetic disturbances. The severity of pancytopenia and the underlying pathology determine the management and prognosis of the patients with pancytopenia. The basic investigations in a suspected case of pancytopenia include Complete Blood Count with peripheral blood film and Reticulocyte count. Aim: To evaluate the clinical and etiological profile of patients presenting with pancytopenia. Materials and methods: A total of 65 patients were identified over a period of 12months were included in the study. Basic investigations were performed for each patient including Haemoglobin, Total leukocyte count, Platelet count, Reticulocyte count. Absolute values including packed cell volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were calculated for every patient. Results: 24.62% of patients had aplastic anemia. Of which 10 (62.5%) were male and 6 (37.5%) were female Mean age of patients with aplastic anemia is 33.43 yrs. Average Hb% of these patients are 4.78 gms%.56.25% of patients had thrombocytopenia < 100000 cells/chum Megaloblastic anaemia was more common in females (14) compared to males (11) in our study. While aplastic anemia is common in males (10) than females (6); both of which are statistically significant. Anisopoikilocytosis (92%) and hyper segmented neutrophils (92%) are the most common findings in peripheral smear of patients with megaloblastic anaemia. Hypersplenism, MDS, viral infections were P. S. Rani, K. Sureshkumar. To evaluate the clinical and etiological profile of patients presenting with pancytopenia in Government Dharmapuri Medical College Hospital, Dharmapuri. IAIM, 2017; 4(6): 125-131. Page 126 common in males; while acute leukaemia’s, myelofibrosis were common in females. Both of which is statistically insignificant. Conclusion: As much physicians should have a high index of suspicion for Vitamin B12 deficiency when dealing with patients presenting with symptoms of anemia such as pallor and weakness and/or diagnosed with pancytopenia on further workup. The finding of hyper segmented neutrophils in the peripheral smear will guide in the diagnosis of megaloblatic anemia.
Résumé
Introduction: Heart failure is the end stage of all diseases of the heart and is a major cause of morbidity and mortality. Since 1970s the treatment of CHF has been transformed, resulting in major benefit to patients. This advance has been the consequence of better understanding of the pathophysiology, investigations, the introduction of newer drugs and cardiac transplantation. Aim of the study: To find out the prevalence of congestive heart failure among the patients admitted in the hospital and to analyse their presenting features and precipitating factors. Materials and methods: A total of 196 cases that satisfied the inclusion and exclusion criteria stated above were taken up for subsequent study. Results: During the study period, 6072 patients were admitted in the medical wards. Out of them 196 satisfied the inclusion criteria. So the prevalence was 3.2 % (196/6072). Among the 196, 7 were expired, thus case fatality rate was 3.5% (7/196). Conclusion: The prevalence of congestive heart failure among hospitalized was 3.2 %Congestive heart failure was common among the age group of 45 – 65 years. Drug intake mainly Non-steroidal anti-inflammatory drugs, anaemia and infections were the most common precipitating factors
Résumé
Introduction: Cardiac disease is a major risk factor for stroke, ranking third after age and hypertension. Congestive Cardiac failure ranks second in cardiogenic stroke risk. The prevalence of cardiac failure increases substantially in prevalence as the population ages. Cardiac failure is also associated with high mortality, with a 15 year total mortality rate estimated at 39% for women and 72% for men. LVSD is common and treatable, accounting for 8%of people aged 25-75 years and 12% of 45-75 years. Of the 8%, 4% are asymptomatic6. The patients who appear to be at high risk of LVSD are those with ischaemic heart disease, hypertension or diabetes, and smokers. Aim of the study: Assessment of Left Ventricular Function in Ischaemic Stroke Patients. Materials and methods: LV function was assessed by Trans thoracic 2 - dimensional echo cardiography in patients admitted with ischaemic stroke under various medical units of our government hospital. Results: 142 Patients of the study group were divided into various sub groups. Ischaemic stroke was most commonly observed between 51-60 years of age followed by patients aged 61-70 years .The mean age of the patients was 58 years. All of these patients were men. Out of 94 men, 73 patients were chronic smokers (51%). The mean age of the smokers was 54 years. Associated history of chronic alcohol intake was seen in 33 male patients. Associated hypertension was seen in 11 patients who had statistical significance (P- value .00). Coexisting diabetes mellitus was observed in 8 patients. This correlation had a statistical significance (P- value .01) Prior history of coronary artery disease was obtained in 6 patients. This was not statistically significant. Hypercholesterolemia was noticed in 42 patients. Past history of stroke was present in 25 patients. History of shortness of breath of varying degree suggestive of left heart failure was observed in 20 patients. Conclusion: LVSD was observed in 30 patients of the present study (21.13%).Diastolic dysfunction was observed among 12 patients (3.4%).Association of LVSD with clinical severity and extent of the P. Sasikumar, P. S. Rani. Assessment of left ventricular function in ischemic stroke in GDMCH Dharmapuri. IAIM, 2017; 4(6): 64-70. Page 65 stroke had of positive correlation statistically .Association of LVSD with in hospital stay mortality was not significant. Hypercholesterolemia was observed as the most common risk factor among the ischaemic stroke patients. Coexisting coronary artery disease and diabetes mellitus had positive correlation with left ventricular systolic dysfunction.
Résumé
Introduction: The incidence of diabetes in India is 3.8%34. It is well known that diabetes is a systemic disease; it affects almost all organ systems. Non-alcoholic fatty liver disease (NAFLD) is being increasingly recognized today as a potentially serious complication of diabetes, especially type 2. The spectrum of NAFLD extends from simple steatosis or steatosis with mild inflammation to severe non-alcoholic steatohepatitis (NASH). Aim of the study: The Aim was to analyse the prevalence of Fatty Liver (Non Alcoholic Fatty Liver Disease) in Patients with Diabetes. Materials and methods: The study was to be conducted in Government Dharmapuri Medical College Hospital, Dharmapuri, and Tamil Nadu. It was an observational type of study. Interview technique was used to collect information on a predesigned proforma. All diabetes patients both type 1 and type 2. Both male and female patients were included in the study. Results: Among the 75 diabetics who were studied, fatty liver was found in 31patients (41.33%). No. of patients with fatty liver was 31. No. of patients without fatty liver was 44. The number of males with fatty liver were 2 (2.6%) and females 29 (38.6%). The number of patients with fatty liver who had central obesity (waist hip ratio >1) was 23 (74.19%). All the patients with fatty liver had central obesity (waist hip ratio >1 in males and >0.85 in females). Conclusion: The prevalence of non-alcoholic fatty liver disease was 41.3% and it was present mainly in patients with type 2 diabetes mellitus. It occurred more commonly in women (38.66%) than men.