A study of clinical and etiological profiles of patients presenting with Pancytopenia in NRI General Hospital

Introduction: Pancytopenia is characterized by a decrease in the red blood cells, white blood cells along with the platelet count below the normal levels. It can be due to a number of pathologic mechanisms, depending on the geographic location. Early diagnosis and treatment are crucial in the management of pancytopenia. There are very few studies regarding the clinic-pathological profile of such patients. Materials and methods: A cross-sectional study was undertaken at NRI General Hospital, Chinakakani. All eligible participants more than 13 years of age were included. Data collection was done from August 2016 to August 2018. A thorough history taking along with clinical examination and laboratory investigations were performed among the study population. Data was analyzed using SPSS version 13. Results: The most common finding suggestive of etiology was megaloblastic anemia at 38.4%, which was more common among females. Aplastic anemia was the second most common finding at 24.6%. Other diagnoses included hypersplenism, myelodysplastic syndrome and acute leukemia. Fever and pallor were the most common presenting symptoms. Blood examinations demonstrated anisopoikilocytosis, hypersegmented neutrophils, erythroblasts, macrocytes and reticulocytes, which were found in differing proportions in the various etiological diagnoses. Conclusion: It is noteworthy that megaloblastic anemia, a reversible condition, is common in India compared to the higher occurrence of aplastic anemia and myelodysplastic syndrome in developed Vijaya Kumar Vasa, Sadhna Sharma, Rakesh Nukasani, Srivani Gulleli, Phani Kumar Reddy. A study of clinical and etiological profiles of patients presenting with Pancytopenia in NRI General Hospital. IAIM, 2019; 6(2): 114-120. Page 115 nations. Clinical alertness and suspicion can assure early diagnoses and treatment can prevent complications and reduce the burden. The need for more standard management protocols is immediate.

Liver dysfunction in malaria – An observational study

Introduction: Malaria is associated with significant mortality and morbidity in India. Hepatic dysfunction in malaria is often under-diagnosed. Early identification of hepatic dysfunction is crucial for preventing complications. Materials and methods: A prospective observational study was conducted in NRI Medical College and General Hospital, Chinakakani, Guntur District in Andhra Pradesh. A total of 50 patients with malaria were studied. Liver function tests were performed to assess the type of jaundice. The collected data was analysed. Results: The incidence was P. Vivax and P. falciparum malaria were 64% and 34% respectively. The incidence of jaundice was 26%. All of them had predominantly conjugated hyperbilirubinemia. Around 14% had mixed jaundice, and 22% had hepatic jaundice. Only one case expired which had the highest level of serum bilirubin. Conclusion: Hepatic involvement is more common among those with malaria. The incidence in vivax and falciparum malaria is comparable. Conjugated bilirubinemia with elevated liver enzymes is the most common manifestation. Early screening and identification of hepatic involvement in malaria are crucial. Initiation of treatment on time will aid in reducing mortality and morbidity