Haematological profiles after Intensive phase of Anti Koch Treatment with special emphasis on bone marrow changes.

BACKGROUND: Tuberculosis remains a major public health problem in various parts of the world. It leads to various haematological changes. Study of these haematological changes will help better patient management. OBJECTIVE & METHODS: It is to evaluate haematological changes in tuberculosis patients and compare the result with special emphasis to bone marrow changes as active case search is sharply decreasing the miliary tuberculosis. It is also to evaluate the patients with before and after the Intensive Phase of Anti Koch Treatment. Sputum positive and sputum negative tuberculosis patients confirmed by other ancillary techniques were included into this study. It is conducted at a tertiary level hospital in rural area. RESULT: In this study bone marrow hypercellularity was of erythroid series with only 1.92% patients showed granuloma in bone marrow aspiration. In addition to bone marrow changes, significant changes were evident in haemoglobin level, Erythrocyte Sedimentation Rate (ESR) Total White Blood Cell count and RBC count. DISCUSSION: In majority cases this study showed Erythroid Hyperplasia. It is sharp contrast with other study where myeloid hyperplasia was evident. This study also differs from other study where high number of bone marrow granuloma was reported. In this study only 1.92% cases showed bone marrow granuloma. This study also documented higher number of anaemic cases mostly because of the institute serves poor and tribal population. CONCLUSION: In our study the cases showing granuloma and hyperplasia of myeloid series were limited. With introduction of Directly Observed Treatment and house to house active case search helped to sharply decrease bone marrow granuloma by limiting multi-organ spread. This study showed, ESR level may be considered as prognostic parameters of tuberculosis.

Diagnosis of erythema nodosum leprosum (type 2 reaction) by cytology.

OBJECTIVE: It was the aim of this study to evaluate the possible role of cytology in erythema nodosum leprosum (ENL) and its use for early treatment of the disease. STUDY DESIGN: We present a prospective study conducted with 15 clinically diagnosed ENL cases. Among them, 13 cases had previously been diagnosed with lepromatous leprosy (LL) and 2 patients were new LL cases with signs and symptoms of ENL lesions. Haematoxylin and eosin stain with modified Ziehl-Neelsen stain was performed on fine needle aspiration material. One case was sent for biopsy. RESULTS: Complete cytological diagnosis of ENL was done in all 15 cases. Histopathological study revealed classical ENL lesions which also showed ENL features in cytodiagnosis. CONCLUSION: In the past, the accurate mode of diagnosis of ENL lesions was histopathology. However, clinicians have to wait a long time for the report and generally they start treatment only on the basis of clinical signs and symptoms. Cytodiagnosis of ENL lesions is an early, effective method for accurate diagnosis and helps to initiate treatment for these painful lesions.

Microfilaria in breast aspiration--an uncommon finding.

Filariasis is a major public health problem in many tropics and subtropics of Africa, Western Pacific and parts of the Americas, affecting over 83 countries. It is also a public health problem in India. A large majority of the cases found in India are attributed to infection by Wuchereria bancrofti which mainly affects the lymph nodes and the lymphatic channels. Breast is an unusual site for filariasis. In the present case report the patient presented with a gradually increasing breast lump, clinically diagnosed as fibroadenoma.