Pattern of Leukaemias in a Tertiary Care Hospital - A 5 Years Retrospective Study of 103 Cases.

Objective: To study the distribution of various types of leukaemia in the RIMS Hospital in terms of types, age, sex and among various ethnic groups. Material and Method: It’s a retrospective study carried out in the department of Pathology, Regional Institute of Medical Sciences (RIMS) Hospital over a five years period between November 2006 and October 2011. Diagnosis was based on peripheral blood count, peripheral blood smear and bone marrow examination for morphology along with cytochemistry study whenever required. FAB classification is followed in the study. SPSS software package, version 16, was used for statistical analysis. Result: Out of total 103 cases, 49cases (47.6%) were children and adolescents and 54 cases (52.4%) were adults. Age range was 9 months to 79 years with a mean age of 31.2 years. Among the children and adolescents, 30 cases were males and 18 cases were females (M: F ratio 1.7:1). In the adults 34 cases were males and 21 cases were females with M: F ratio 1.6:1. Overall male female ratios was 1.6:1. Out of 103 cases, 85.4% were of of acute leukaemia and rest were chronic leukaemia (14.6%). Acute leukaemia was the most common leukaemia in all age groups. Of all leukaemia cases reported, maximum cases were of acute myeloid leukaemia (AML). Acute lymphoblastic leukaemia (ALL) is the most common type of leukaemia in the children (60.7%) and adolescents (52.3%). AML (66.7%) is the most common acute leukaemia in adults. Among ALL, L2 is the most common variant (82.3%) and in AML, M3 is the most common (38.8%). Chronic leukaemia was more common in adult (80%) than children and adolescents. Out of total 12 cases of the chronic leukaemia reported in adults, 10 were of chronic myeloid leukaemia (CML), 2 were chronic lymphocytic leukaemia (CLL). The maximum cases of leukaemia were among Meitei community (64%) followed by tribal community (28%) and minimum in Muslims (8%). Conclusion: In this study, acute leukaemia was the most common leukaemia in all age groups. Of all leukaemia cases reported, maximum cases were of AML and minimum cases were of CLL. Chronic leukaemia was more common in adult. In children, majority of cases were ALL and chronic leukaemia was rare. Leukaemias were more common in males. Meitei community was affected the most.

Prevalence, Geographical Distribution, Social Problems and Treatment of Thalassemia Patients.

A total of 700 beta thalassemia patients were gathered at the outdoor of the Hematology department of Medical College, Kolkata, attending during the period from January 2010 to December 2010. The data is generated by the interaction between them and their family members in presence of the physicians. Actual ethnic identities, place of residence, parity and sibship together with social stigma, if any, faced by the patient or by the member of the family and details of their treatment including transfusion history were noted down and reconfirmed from past records. The prevalence of thalassemia was found 70% among Hindus of which the 62.26% was contributed by castes like Maishya, Namasudra, Barga Kshatriya and Panda Kshatriya. The relative prevalence of subtypes of b-thalassemia was found to be 65% E-b thalassemia, 30% Homozygous b-thalassemia and 5% S-b thalassemia. The aboard of the 85.28% patients were found to be localised along banks river Hooghly and Ganga delta region and we can thus consider tentatively that this belt is a thalassemia zone in West Bengal. The maximum number of cases showed parity to be 1 and there was considerable amount of reproductive wastage. Regarding social stigma, 82.71% responded with no stigma. Early diagnosis and early onset of transfusion with chelation therapy was found to provide benefit for the patient reducing the total amount of transfusion needed per year and also restoring the quality of their life.

Seropositivity of HIV and HBV Co-infection.

The rise of HIV as well as HBV infections in rural population is alarming. Different studies suggest, approximately one third of HIV infected individuals also harbour Hepatitis B virus simultaneously. Co-infection of HIV and HBV leads to complex immuno-pathological disease heralding poor prognosis. The present study was undertaken to ascertain sero-positivity of HIV and Hepatitis B virus co-infection in and around the rural area of Loni. The rate of sero-positivity for HIV infection was 2.61%; however, that of Hepatitis B was 1.26 %. The incidence of Hepatitis B in HIV infected individuals was found to be 2.5 %.

Sociodemographic Factors Associated with Deliberate Self Harm in Two Different Age Groups.

Objective: To study the different demographic and social factors predisposing to deliberate self harm in young (15 – 24 years) and elderly (45-74 years) people and compare. Method: Consecutive cases of Deliberate self harm attending Psychiatry OPD and admitted to Medical, Surgical and Psychiatric wards of R.G. Kar Medical College and Hospital were studied. Demographic history was taken both from patient and family members. For social factors two scales were used – Modified Kuppuswamy’s socioeconomic rating scale for urban people and Pareekh’s scale for rural people. Results: Demographic factors- In the present study some factors were found to be same but certain factors were found to be significantly different in these two age groups. In young age group females outnumbered males by a ratio of 3.8:1, whereas in elderly group number of females was less than males-ratio 1:2.1 In both groups Hindus were most common; most people came from urban area and studied up to secondary level. In young group most male people were self employed or students whereas elderly males were mostly in service or self employed workers, rest were retired. Most females in both groups were housewives. In young group 54.1% were single, rest were married. In elderly group all were married, but 12% were separated or divorced, widow or widower. In both groups most people came from small (member<5) nuclear family. Socioeconomic status: In both groups most people were from social class IV. Conclusion- Apart from age and sex composition there is not much difference in sociodemographic profile between young and elderly DSH patients. The difference found in marital status and occupation was probably due to their age difference.

Nutritional Anemia in the Medical Students.

Background: Nutritional anaemia is very much prevalent and largely undiagnosed among students in Professional Institutes. Various socio-demographic characteristics like age, sex, social class, dietary habits, and infections are the etiological factors for nutritional anaemia. Objectives: To study the nutritional anaemia and its correlates among the MBBS. Medical Students of Rohilkhand Medical College and Hospital, Bareilly in Western U.P. Materials and Methods: The study was done on 100 MBBS students. Haemoglobin estimation was performed by Sahli’s Haemoglobinometer and observations were interpreted as per the WHO criteria. The data was analyzed by SPSS Statistical software. Results: In the present study on 100 Medical students, 32.0% students were anaemic, out of which 44.0% were girls and 20.0% boys. 25.0% students had mild anaemia. Majority (81.8%) of anaemic students were undernourished as per their Body Mass Index. Conclusions: Haemoglobin estimation of students at the time of entrance to Medical Colleges should be done. Iron and folic acid tablets and deworming drugs in therapeutic doses should be provided to anaemic students. The students should be motivated and educated to take balanced diet, rich in green leafy vegetables and fruits as nutritional anaemia is totally preventable.

Incidence of Mood Disorders among Referred Indoor Patients.

Consultation-Liaison (C-L) Psychiatry is a growing area of research in psychiatry where a large number of patients having main complaints of psychiatric symptoms in the non-psychiatric wards. So diagnosis of these cases fully depends upon referrals. In spite of the high prevalence of Psychiatric morbidities in India, the overall referral rate was 1.48 %(4) .This study is aimed to find out the incidence of mood disorders among referred indoor patients from Medicine & allied departments of Medical College, Kolkata. The study was done using psychiatric referrals from General medicine and allied department. The study may sensitize all medical professionals and it will contribute towards improvements of mental health at all levels of health care institutions.