ABSTRACT
OBJECTIVE: Bone marrow examination (BME) is an important modality for investigation of case of pyrexia of unknown origin (PUO). However, its yield in the diagnosis of infections has not been extensively studied and its role has not been well established. The aim of the study was to investigate the usefulness of BME and to evaluate the etiological and clinico-hematological profile in cases of bone marrow infections. MATERIAL AND METHOD: This was a retrospective study where bone marrow cases were retrieved and a review of bone marrow findings with an infectious etiology from July 2014 to June 2018 was done. Detailed history, clinical examination and hematological parameters at presentation were recorded. Clinico-hematological correlation using descriptive statistics was performed. RESULTS: The study included 55 cases, on analysis of which the maximum number of infections were those of leishmaniasis accounting for 35%, followed by HIV (29%) and tuberculosis (15%). Other etiological agents included fungal infections (histoplasmosis and aspergillosis), Enteric fever, Scrub typhus, parvovirus, falciparum malaria and filariasis. The most common clinical presentation was fever (80%) and the most common clinical finding was splenomegaly (66%). CONCLUSION: Bone marrow examination is an important diagnostic tool to delineate etiological diagnosis in infectious conditions, particularly those presenting with PUO. Moreover, it is particularly important if urgent diagnosis is required or if alternate diagnostic modalities have not revealed a reason for PUO.
Subject(s)
Bone Marrow Examination , Bone Marrow/pathology , Communicable Diseases/pathology , Fever of Unknown Origin/etiology , Adolescent , Adult , Aged , Child , Child, Preschool , Communicable Diseases/complications , Female , Fever of Unknown Origin/diagnosis , Host-Pathogen Interactions , Humans , Infant , Male , Middle Aged , Predictive Value of Tests , Retrospective Studies , Tertiary Care Centers , Virus Diseases , Young AdultABSTRACT
The present study investigated the effects of heavy metals (Ni, Zn, Cd, Cu, and Pb) toxicity on the performance of 18 MLD activated sludge process-based sewage treatment plant (STP) during celebration of Holi (festival of colors in India). The composite sampling (n = 32) was carried out during the entire study period. The findings show a significant decrease in chemical oxygen demand removal efficiency (20%) of activated sludge system, after receiving the heavy metals laden wastewater. A significant reduction of 40% and 60% were observed in MLVSS/MLSS ratio and specific oxygen uptake rate, which eventually led to a substantial decrease in biomass growth yield (from 0.54 to 0.17). The toxic effect of metals ions was also observed on protozoan population. Out of the 12 mixed liquor species recorded, only two ciliates species of Vorticella and Epistylis exhibited the greater tolerance against heavy metals toxicity. Furthermore, activated sludge shows the highest metal adsorption affinity for Cu, followed by Zn, Pb, Ni, and Cd (Cu > Zn > Pb > Ni > Cd). Finally, this study proves the robustness of activated sludge system against the sudden increase in heavy metal toxicity since it recovered the earlier good quality performance within 5 days.
