Aetiological Profile of Anaemia in Elderly at a Tertiary Care Centre

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.

Study of Urinary Tract Infection in Patients with Diabetes Mellitus

Introduction: Urinary tract infection is one of the most common types of bacterial infection in patients with diabetes mellitus.Aim: The aim of the study was to assess the prevalence of urinary tract infection among hospitalized diabetic patients.Materials and Methods: A hospital-based prospective study was carried out from June 2018 to May 2019. A total of 100 patientsof diabetes mellitus with urinary tract infection were included in this study.Results: Of 100 patients, 54 were male and 46 were female, the most common age group was 46–55 years. Most patientshad a fever with rigor (48%) followed by dysuria (22%), suprapubic pain (20%), increased frequency of urine (18%), flank pain(10%), pyuria (6%), and hematuria (4%). Urine culture analysis revealed that Escherichia coli (29%) was the most commonorganism responsible of urinary tract infection. The majority of isolated organisms were sensitive to antimicrobial agents suchas amikacin, nitrofurantoin, and levofloxacin.Conclusion: Urinary tract infection is frequent in diabetic patient and the urine culture should be performed in all hospitalizedpatients with diabetes mellitus. Early diagnosis, knowledge of common predisposing factors, and appropriate clinical managementare important to improve prognosis.

Level of C-reactive Protein in Obese and Overweight Individuals at Indira Gandhi Institute of Medical Sciences: A Tertiary Care Center of Bihar

Introduction: Human adipose tissue releases interleukin-6 which is a pro-inflammatory cytokine that causes low-grade systemicinflammation. Acute-phase C-reactive protein (CRP) is a sensitive marker for systemic inflammation. Low-grade systemicinflammation in overweight and obese can be measured by serum CRP level.Objective: The objective of this study was to find out the prevalence of raised serum CRP level among the obese and overweightperson.Materials and Methods: Overweight and obese persons were screened for raised CRP (≥3.0 mg/L) after excluding comorbidity.Results: The prevalence of raised CRP among obese and overweight is 23%, the female has higher prevalence of 25.45% ascompared to male 20%. The prevalence among overweight and obese participants is 18.88% and 60%, respectively.Conclusions: The finding suggest a higher prevalence of low-grade systemic inflammation in obese as compared to anoverweight person.

Study of Clinical Profile of Acute Undifferentiated Fever in a Tertiary Care Hospital

Introduction: Major aetiology of acute undifferentiated fevershows wide variation, especially in developing countriesincluding India. Acute undifferentiated fever poses a diagnosticand therapeutic challenges to health care workers, particularlyin limited resources. It is one of the commonest presentingproblem in hospital. It is necessary to know the cause, whichwill be useful to give proper treatment to the patients. Thisstudy was aimed to find out the acute undifferentiated feveraetiologies and clinical pattern.Material and Methods: This study was conducted onhundred patients of acute undifferentiated fever, admittedin Indira Gandhi institute of Medical Science, Patna fromFebruary 2018 to January2019.Result: Acute undifferentiated fever affected all age groupbut most common in 26 to 35 years of age group (29%).One hundred patients were included, 78male and 22female.In this study, Typhoid (41%) was leading cause of acuteundifferentiated fever followed by Malaria (23%), DengueFever (20%), Leptospirosis (5%), Scrub Typhus (3%) andChikungunya (1%). Common symptom was fever (100%),Headache (64%), Vomiting (48%), Rigor and chills (42%)whereas common sign was hepatosplenomegaly (55%).Typhoid fever (41%) was the commonest cause of acuteundifferentiated fever followed by malaria (23%), denguefever (20%), urinary tract infection (5%), scrub typhus (3%)and chikungunya (1%).Conclusion: It is important to know the aetiology andclinical pattern of acute undifferentiated fever for theirproper management and it will help to prevent morbidity andmortality.

Study of spectrum of acute kidney injury in tertiary care center

Introduction: Acute Kidney Injury is a common medical problem. AKI is responsible for major mortality and morbidity of hospitalized patients because of serious nature of the underlying illness and incidences of complication. Materials and methods: A total number of 100cases of Acute Kidney Injury who fulfill the inclusion criteria were studied with a detail history, clinical examination and investigation according to need. Results: Out of 100 patients 78 were male and 22 were female. Maximum numbers of patients were in age group of 51 to 60 years. Vomiting (60%) and Oliguria (48%) were common presenting features. The study showed various etiological factor associated with Acute Kidney Injury like Septicemia (43%), Acute gastroenteritis (10%), Malaria (9%), Nephrotoxicity (8%), Cirrhosis of Liver and Obstetrical cause cause (7%), Glomerolonepritis (6%), CCF (5%), Snake bite (4%), and Leptospirosis (1%). In this study, Hypotension (40%) were common complication of acute kidney injury followed by Hyperkalemia (35%). Conclusion: We observed that early diagnosis and early investigation were probably responsible for good survival rate in acute kidney Injury