RESUMO
Background: Hemoglobinopathies are the major cause of anemia throughout the world complicating pregnancy outcome. Hence, detection of hemoglobinopathies in antenatal period is of critical importance as it not only predict the possibility of birth of a child with thalassemia but also reduces the complications associated with anemia in pregnancy. Hence, identification of a reliable cost-effective screening method for detection of hemoglobinopathies is of utmost importance. Aims and Objectives: The present study was conducted to evaluate the role of red blood cell (RBC) parameters including hemoglobin (Hb%), RBC count, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) in detection of thalassemia carriers among healthy antenatal mothers in a tertiary care hospital of Eastern India. Materials and Methods: Venous blood samples were collected from total 1458 antenatal mothers aged 18 years or above with <17 weeks of gestation and were analyzed for complete blood count, serum ferritin level, and high-performance liquid chromatography for identification of abnormal Hb. Patients with iron deficiency anemia as diagnosed by serum ferritin <15 ng/ml were excluded from this study. Results: The prevalence of hemoglobinopathy was found to be 12.55% with ß-thalassemia trait (BTT) being the most common type (7.9%). All the RBC parameters were significantly lower among the BTT group compared to individuals with normal or other hemoglobinopathies (P < 0.05). Conclusion: RBC parameters such as Hb, RBC, MCV, and MCH can be used as cost-effective yet very effective screening method to identify different hemoglobinopathies among antenatal mothers.
RESUMO
Background: Anterior mediastinal tumors comprise only 3% of all chest tumours. They are often of diagnostic challenge to both clinicians and histopathologists owing to their wide variety of clinical presentations and diversity in histomorphological appearance respectively. Hence, there is a need for elaborated studies to make the pathologists and clinicians aware of their diversity. Aim and Objectives: The present study was aimed to evaluate the diverse spectrum of clinical presentations and histomorphological appearances of anterior mediastinal lesions. In addition, cytological and radiological interpretations were correlated with histological diagnosis to assess their comparative role in diagnosis. Materials and Methods: It was a descriptive observational cross-sectional study. Patients diagnosed with anterior mediastinal mass on chest computed tomography (CT) scan were included in this study. Demographic details including clinical presentations and radiological interpretations were recorded. Patients underwent both CT guided Fine needle aspiration cytology (FNAC) and needle core/excisional biopsy. Histological diagnosis was correlated with radiological and cytological interpretations. Results: Of 659 patients presented with chest tumours, 19 were detected as having anterior mediastinal mass on chest CT scan indicating the prevalence of 2.88%. The most common presenting symptom was respiratory distress (73.68%), followed by chest pain (36.84%), superior vena cava syndrome (26.32%) and Myasthenic features (5.26%). About 50% of malignant tumours occurred at the 2nd decade of life. Thymic epithelial neoplasms comprise the major tumour type in this study (52.63%) followed by germ cell tumors (15.79%) and lymphomas (10.53%). Cytology was found to be more effective compared to radiology in diagnosis. Conclusion: Anterior mediastinal tumors are extremely heterogeneous in clinical presentation and histomorphological appearance. CT-guided FNAC can play an important role in their diagnosis along with radiology and histology.
RESUMO
Background: Although most of the COVID-19 patients presented with mild symptoms and recovered, a considerable number of cases became serious with poor prognosis in an unpredictable manner. They mostly presented with respiratory symptoms and coagulation abnormalities with thrombosis and multi-organ failure. Hence, timely prediction of these cases with the early intervention might decrease mortality. Aims and Objectives: The objectives of this were to determine whether values of fibrinogen, fibrin degradation products (FDP), and D-dimer level correlates with disease severity in COVID-19 patients. Materials and Methods: This observational cross-sectional study was done on total 400 hospitalized COVID-19 adult patients where patients were categorized into moderate and severe cases as per guideline of Government of India. Patients with pre-existing coagulation disorder or receiving anticoagulant drugs were excluded from the study. FDP, fibrinogen, and D-dimer values of these two groups were evaluated and compared statistically to determine their significance. Results: Overall mean and standard deviation of fibrinogen, FDP, and D-dimer were 607.48 ± 177.73, 34.93 ± 29.2, and 6.23 ± 6.48 for severe category, while for moderate category disease, they were 389.77 ± 110.16, 10.79 ± 10.47, and 1.96 ± 3.3, respectively. Unpaired t-test showed that the study parameters are significantly higher in severe COVID-19 patients compared to moderate ones. Conclusion: It was concluded that elevated level of D-dimer, fibrinogen, and FDP is indicator of disease progression in COVID-19. Thus, regular estimation of these simple coagulation parameters may predict disease severity and help in adequate management.
RESUMO
Background: Dyslipidemia is one of the common conditions associated with poor glycemic control in Type 2 diabetes mellitus (T2DM) patients. It is associated with an increased risk of cardiovascular disease which is the leading cause of death in these patients. Glycated Hemoglobin (HbA1c) is the gold standard test for monitoring glycemic control. Thus, the level of HbA1c could potentially be utilized as a possible biomarker for predicting the risk of dyslipidemia. However, there is a discrepancy in the data available till now regarding the relationship between HbA1c and the lipid profile. Hence, it requires further studies. Aim and Objectives: The present study was conducted to assess the role of glycemic control (as indicated by HbA1c level in blood) on lipid profile of patients with T2DM. Materials and Methods: This was an analytical cross-sectional study done over a period of 5 months. Total 165 participants were randomly selected from out patient department OPD of which 138 were diagnosed cases of T2DM and 27 were age and sex-matched non-diabetic healthy individuals. Patients of T2DM were sub grouped based on American Diabetic Association Criteria (2013) as having either controlled diabetes with HbA1c ?7% or uncontrolled diabetes with HbA1c >7%. Blood samples collected from all the participants were analyzed for HbA1c and lipid profile using standard methods. The collected data were analyzed with Statistical Package for the Social Sciences software using appropriate statistical method. Results: In the present study, we found a significant positive correlation between HbA1c and total cholesterol, Triglyceride, Low-density lipoproteins, and very low-density lipoproteins (P < 0.01) though high-density lipoprotein was not significantly correlated with HbA1c level. Conclusion: We concluded that apart from a reliable index of glycemic control, HbA1c can also be used as a predictor of dyslipidemia in T2DM patients, and thus regular monitoring of it can help us to reduce the mortality of these patients.
RESUMO
Background: Most of the patients of Coronavirus Disease-19 (COVID-19) presented with mild symptoms and recovered, but a considerable number of cases deteriorated and succumbed to death. They often present with hemostatic abnormalities mimicking disseminated intravascular coagulation with increased risk of thrombosis rather than bleeding. Hence, early prediction of disease severity by some easily available hematological parameters might be helpful to reduce mortality in COVID-19 cases. Aim and Objectives: The aim of the study was to determine whether values of Prothrombin Time (PT), International Normalized Ratio (INR), Activated Partial Thromboplastin Time (APTT) and D-Dimer (DD) correlate with disease severity in COVID-19 and also to find out cutoff value of these parameters to predict disease severity. Materials and Methods: This observational cross-sectional study was done on total 400 hospitalized COVID-19 adult patients where patients were categorized into moderate and severe cases as per guideline of Government of India. Patients with pre-existing coagulation disorder or receiving anticoagulant drugs were excluded from the study. PT, INR, APTT, and DD values of these two groups were evaluated and compared statistically to determine their significance and the cut-off value to predict severity. Results: Among the measured blood parameters means of PT (P < 0.001), INR (P < 0.001) and DD (P < 0.001) found to be significantly higher in the severe group of patients compared to moderate ones and DD value ?1.365 mg/L indicates severe disease. APTT showed no statistically significant association with severity. Conclusion: PT and INR can be used as severity marker in COVID-19 patients; however, DD is the most reliable marker correlating with disease severity.
RESUMO
Context: Acute viral hepatitis (AVH) is predominantly caused by hepatitis A virus (HAV) and hepatitis E virus (HEV), the prevalence of which varies in different geographical regions. Aims: This study aimed to determine the prevalence of HAV and HEV infections in patients with AVH, the rate of HAV-HEV co-infection and the prevalence of HEV infection among pregnant women with hepatitis. Settings and Design: It was a retrospective observational study conducted over 3 years from January 2015 to December 2017, after obtaining clearance from the institutional ethics committee. Subjects and Methods: A total of 675 serum samples were collected from patients with a clinical diagnosis of AVH, between January 2015 and December 2017. The study population included outdoor and hospitalised patients between 3 and 70 years of age who presented with signs and symptoms of hepatitis. The presence of IgM anti-HAV and IgM anti-HEV antibodies in serum were assessed by enzyme-linked immunosorbent assay. Statistical Analysis Used: Chi-square test. Results: The prevalence of HAV, HEV and HAV-HEV co-infection was found to be 6.96%, 9.63% and 2.07%, respectively. Among males, this was 7.3%, 8.8% and 2.6%, respectively and in females 6.7%, 10.2% and 1.7%, respectively. However, these differences in the prevalence rates were of no statistical significance. The prevalence of HEV infection in pregnant women with hepatitis was 9.4%. HAV and HEV infections showed a seasonal trend with predominance during summer and rainy seasons (May to September). Conclusions: A higher seroprevalence of HEV as compared to HAV together with a co-infection rate of 2.07% mandates screening for HEV in all suspected cases of acute hepatitis, particularly pregnant women in whom the outcomes of HEV infection are poor. Health and civic authorities should make necessary efforts to counter epidemic or outbreak situations, thus reducing morbidity, mortality and economic burden.