Study of Hematological Parameters in Patients of Different Subtypes of Panduroga

Introduction: Diagnosis in Ayurveda depends on history and clinical examination of the patient. Application of technological advancements and diagnostics tin Ayurveda may increase its acceptability globally and add objectivity to it. This research is advancement in the same direction to observe and analyze the haematological profile in patients of Panduroga (anemia) after categorizing them into Pandu roga subtypes and report the findings.Material and Methods: A prospective non – interventional observational exploratory study was conducted for a period of 18 months on hundred newly diagnosed adult and pediatric cases of anemia presenting to department of pediatrics and general medicine. Patients were categorized into Panduroga subtypes after examining them in detail with history, physical examination, hematological and other relevant investigations and with their due written informed consent. The data was then put to statistical analysis.Results: Differences were observed in the values of hematological parameters for the different subtypes of Panduroga which were statistically significant for Hemoglobin, Total Red blood cell count (TRBC), Hematocrit (HCT), Mean corpuscular volume (MCV), Mean corpuscular hemoglobin (MCH), Mean corpuscular hemoglobin concentration (MCHC) and Red cell distribution width (RDW).Conclusion: The differences in the objective profile as uncovered in the study reveals that the subtypes of Panduroga correlate to some extent to the different stages and pathology of anemia. However, the application of this study to the management of different types of anemia will require further confirmatory study with larger sample size in each subgroup

Evaluation of clinical, biochemical and hematological parameters in macrocytic anemia

Background: Macrocytosis is a common finding encountered in automated coulters and evaluation of clinical, biochemical and haematological parameters in macrocytic anemias will provide a clue to diagnosis. This study was done to evaluate the clinical and laboratory parameters in macrocytic anemias and their utility in differentiating megaloblastic and non-megaloblastic anemia.Methods: 100 patients presenting with macrocytosis were taken in to study. A detailed clinical history and physical examination was done in all cases. CBC, biochemical investigations, peripheral blood examination and reticulocyte count was done in all cases and Vitamin B12 and folate levels, bone marrow aspiration and bone marrow biopsy in some cases. After evaluation, a provisional diagnosis was made and patients with megaloblastic anaemia was given vitamin B12 and folic acid treatment and followed up after 2 weeks and 1 month.Results: Primary bone marrow disorders were the most common cause of macrocytosis (46%). The other causes in decreasing order of frequency were megaloblastic anaemia (38%), hemolytic anemia (6%), drug induced (5%), alcoholism and liver disease (4%) and idiopathic thrombocytopenic purpura (1%). There was a significant difference in the mean values of MCV and serum LDH between megaloblastic and non – megaloblastic macrocytosis. When serum LDH >1345.2 IU/L or MCV>121fl (criterion values of ROC curve) with reticulocyte count <2% was taken as criteria, the sensitivity was 92.1% and specificity was 93.5% for diagnosing megaloblastic anemia.Conclusions: Systematic evaluation of macrocytosis will help us to distinguish megaloblastic and non – megaloblastic macrocytosis. The blood and biochemical parameters especially CBC, RC, and serum LDH along with supporting clinical features help us in diagnosing megaloblastic anemia in a setup where vitamin and metabolite levels are difficult to obtain.

2,3-Dibromo-3-(2-bromo­phen­yl)-1-(3-phenyl­sydnon-4-yl)propan-1-one

In the title compound [systematic name: 2,3-dibromo-3-(2-bromo­phen­yl)-1-(5-oxido-3-phenyl-1,2,3-oxadiazol-3-ium-4-yl)propan-1-one], C17H11Br3N2O3, the oxadiazole ring is essentially planar, with a maximum deviation of 0.003 (1) Å. The –CHBr–CHBr– chain and bromo­phenyl ring are disordered over two sets of sites with a refined occupany ratio of 0.756 (5):0.244 (5). The central oxadiazole ring makes dihedral angles of 54.07 (11) and 13.76 (18)° with the attached phenyl and the major component of the bromo-substituted benzene rings, respectively. The dihedral angle between the major and minor components of the bromo­phenyl rings is 13.4 (5)°. In the crystal structure, mol­ecules are connected by C—H⋯O hydrogen bonds, forming [010] ribbons

2,3-Dibromo-3-(4-bromo­phen­yl)-1-[3-(4-meth­oxy­phen­yl)sydnon-4-yl]propan-1-one

In the title compound {systematic name: 4-[2,3-dibromo-3-(4-bromo­phen­yl)propano­yl]-3-(4-meth­oxy­phen­yl)-1,2,3-oxa­dia­zol-3-ylium-5-olate}, C18H13Br3N2O4, the central oxadiazole ring, which is essentially planar with a maximum deviation of 0.016 (3) Å, makes dihedral angles of 29.98 (16) and 52.04 (16)°, respectively, with the terminal bromo-substituted and meth­oxy-substituted benzene rings. An intra­molecular C—H⋯O hydrogen bond generates an S(6) ring motif

Brain natriuretic peptide in differentiating cardiogenic and non- cardiogenic dyspnoea in patients with renal dysfunction: a single centre study

Background: Both BNP (Brain Natriuretic Peptide) and renal function are prognostic indicators of survival in patients with congestive heart failure. However, relationship between BNP, renal function and heart failure as an emergency diagnosis are unknown. The usefulness of BNP as a diagnostic tool in patients with renal dysfunction is thus explored in this study.Methods: The present study was prospectively designed diagnostic test evaluation study conducted in Banaras Hindu University, Varanasi. Out of 166 participants with renal dysfunction defined as creatinine >1.5mg/dl who presented with acute dyspnoea, clinical history, BNP, 2D Echo and baseline estimated glomerular filtration rate were assessed. Patients with severe anaemia, eGFR less than 15 ml/min/1.73 m2 and those on dialysis therapy were excluded from the study. The final diagnosis was adjudicated by cardiologist who was blinded to BNP values.Results: The final diagnosis of CHF was in 104 (62.7%). The correlation between BNP and eGFR values were r=-0.49 for those with CHF (p<0.001) and r=-0.279 (p<0.028) for those without CHF. Median BNP in patients with renal dysfunction with CHF was 1206 pg/ml and without CHF was 186 pg/ml. The area under the receiver operating characteristic curve and optimal cutpoints for EGFR categories 59-30 ml /min/1.73 m2 and EGFR less than 30 ml/min/1.73m2 were 0.992 and 491.5 pg/ml (sensitivity 97% and specificity 95%) and 1.000 and 512pg/ml (sensitivity 100% and specificity  95.5%) respectively.Conclusions: Renal function weakly correlates with BNP in patients without CHF (congestive heart failure). BNP is an important bed side tool for distinguishing cardiogenic and non-cardiogenic dyspnoea in patients with renal dysfunction requiring higher diagnostic cut points. Thus the present study emphasises BNP is the strong and independent predictor of CHF even after taking renal function into considerations.

The epidemiology of Leishmania donovani infection in high transmission foci in India.

OBJECTIVE: Visceral Leishmaniasis (VL) is highly prevalent in Bihar, India. India and its neighbours aim at eliminating VL, but several knowledge gaps in the epidemiology of VL may hamper that effort. The prevalence of asymptomatic infections with Leishmania donovani and their role in transmission dynamics are not well understood. We report data from a sero-survey in Bihar. METHODS: Demographic and immunological surveys were carried out in July and November 2006, respectively in 16 highly VL endemic foci in Muzaffarpur district in Bihar. Household and individual information was gathered and capillary blood samples were collected on filter papers. Direct agglutination test (DAT) was used to determine infected individuals (cut-off titre 1:1600). DAT results were tabulated against individual and household variables. A multivariate generalized estimating equation (GEE) model was used to study the prevalence of serologically positive individuals taking into account the clustering at household and cluster levels. RESULTS: Of study subjects 18% were DAT positive, and this proportion increased with age. Women had a significantly lower prevalence than men >14 years old. Owning domestic animals (cows, buffaloes or goats) was associated with a higher risk of being DAT positive [OR 1.16 (95% CI 1.01-1.32)], but socio-economic status was not. CONCLUSIONS: Prevalence of leishmanial antibodies was high in these communities, but variable. Demographic factors (i.e. marriage) may explain the lower DAT positivity in women >14 years of age. Within these homogeneously poor communities, socio-economic status was not linked to L. donovani infection risk at the individual level, but ownership of domestic animals was

Ethyl 2-[2-(2-meth­oxy­phen­yl)hydrazinyl­idene]-3-oxobutano­ate

In the title compound, C13H16N2O4, an intra­molecular N—H⋯O hydrogen bond generates an S(6) ring. The mol­ecule adopts an E configuration with respect to the central C=N double bond. In the crystal, symmetry-related mol­ecules are connected into chains along [010] via weak C—H⋯N hydrogen bonds. The crystal structure is further stabilized by weak C—H⋯π inter­actions

4-[2-(2-Benzyl­idene­hydrazin­ylidene)-3,6-dihydro-2H-1,3,4-thia­diazin-5-yl]-3-(4-meth­oxy­phen­yl)­sydnone

In the title compound, C19H16N6O3S, the 3,6-dihydro-1,3,4-thia­diazine ring adopts a twist-boat conformation. The dihedral angle between the meth­oxy-substituted benzene ring and the oxadiazole ring is 71.91 (7)°. In the crystal structure, centrosymmetrically related mol­ecules are linked into dimers via pairs of inter­molecular N—H⋯N hydrogen bonds, generating R 2 2(8) ring motifs. There is an intra­molecular C—H⋯O hydrogen bond which generates an S(6) ring motif