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Background: Macrocytosis can be seen in many hematological and non-hematological disorders and more than one cause may co-exist in an individual. Serum vitamin B12 and folic acid tests are routinely ordered but they are limited by their low sensitivity and specificity. This study is done to analyze the clinical, hematological and biochemical parameters in macrocytic anemia and to study the difference between megaloblastic and non-megaloblastic anemia in these parameters.Methods: There were 100 patients presenting with macrocytosis were taken in to study. A detailed clinical history and physical examination was done in all cases. CBC, biochemical investigations, peripheral blood examination, Vitamin B12, folate levels, bone marrow aspiration and reticulocyte count was done in all cases.Results: Primary bone marrow disorders were the most common cause of macrocytosis (45%). The other causes in decreasing order of frequency were megaloblastic anemia (36%), alcoholism and liver disease (15%), drug induced (2%) and idiopathic thrombocytopenic purpura (1%). There was a significant difference in the mean values of MCV and serum LDH between megaloblastic and non-megaloblastic macrocytosis. When serum LDH >1124.5IU/L or MCV>120.5fl (criterion values of ROC curve) with reticulocyte count <2% was taken as criteria, the sensitivity was 94.4% and specificity was 93% for diagnosing megaloblastic anemia.Conclusions: Systematic evaluation of macrocytosis will help us to distinguish megaloblastic and non-megaloblastic macrocytosis. The blood and biochemical parameters especially CBC, RC, and serum LDH along with supporting clinical features help us in diagnosing megaloblastic anemia in a setup where vitamin and metabolite levels are difficult to obtain.
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Background: Obesity is an increasingly prevalent disease worldwide and can be regarded as a health problem among individuals of different occupations, including policemen, who are responsible for public security. Working throughout the day in stressful atmosphere produces adverse physical and psychological effects. We conducted this study to find the prevalence of obesity among policemen, if any, and to identify the associated risk factors for obesity in this population.Methods: Cross sectional study was conducted among 410 police personnel of 4 talukas of Chitradurga District, Karnataka from July 2017 to January 2018. Semi-structured questionnaire was prepared to collect the data, which consist of socio-demographic data, clinical examination findings, anthropometric measurements and biochemical investigations. At the end whoever had high risk factors, were treated for the same along with advice on healthy life style. Data entered in Microsoft Excel 2007 and analysed using SPSS software, version 20. Frequency tables, ANOVA test and chi-square test were used for analysis and interpretation.Results: There were total 392 males and 18 females. Age group was ranging from 21 years to 59 years. 201(49%) of the police officers were overweight and 45(11%) were obese. Ideal weight police men were younger than obese policemen and weighed less than obese police. There was statistical difference in BMI between the three groups of policemen. The mean TG and TC levels among overweight and obese were higher than ideal weight policemen and this difference was statistically significant. 32.9% of participants had a high TC level (≥200 mg/100 ml). Moreover, 93.4% and 84.1% had a low level of HDL-C and high level of LDL-C, respectively (<40 mg/ 100 ml and >150 mg/100 ml, respectively). 49.5% of our study participants had TG levels >150mg/100 ml. 60.5% and 42.7% had high SBP and DBP, respectively (>130 mmHg and >90mmHg). The difference between TC and HDL between different BMI groups was statistically significant.Conclusions: Obesity and hypertension are high risk factors for development of cardiovascular diseases. Early detection of the same and effective implementation of a physical fitness program, a regular balanced diet, inoculation training for managing stress can improve the life of police personnel.
RESUMO
Background: Dengue is a global public health problem and thrombocytopenia associated with it is a serious complication for which there is no specific treatment available. This study was done to assess the effect of Carica papaya Leaf Extract (CPLE) on thrombocytopenia associated with Dengue and to study other clinical parameters of dengue.Methods: A longitudinal study conducted in Department of General Medicine, BMCH, Chitradurga, from September 2017 to March 2018. All the participants were randomized into two groups by simple randomization by lot method. Study group was given Carica papaya Leaf Extract (CPLE) and routine supportive treatment for other group. The patients were followed from the day of admission till their discharge from hospital. The platelet counts and other baseline hematological investigations, duration of hospital stay in both the groups were compared statistically by unpaired t-test.Results: There were total 127 males and 73 females. Age groups were comparable in both the groups. Most common presenting complaints were fever (100%) followed by headache (85%), myalgia (81.4%), fatigue (75%), arthralgia (65%). On admission baseline investigations were done and mean levels of both groups were compared. It was found that there was only significant difference of mean RBC levels (p=0.045). When followed up with daily platelet counts of both the groups, it was seen that there was increase in platelet counts in study group compared to placebo group and on third day there was significant difference between both (p=0.002). It was also found that discharge rate is earlier in study group than placebo group.Conclusions: Carica papaya leaf extract accelerates the increase in platelet count and reduces the hospital stay. So, it can be used as supplementary drug to reduce complications.