Pancytopenia: etiologies and manifestation in eastern India

Background: Pancytopenia is the simultaneous presence of anemia, leucopenia and thrombocytopenia. The aetiologies causing pancytopenia varies depending upon factors e.g. age, sex, occupation, and geographical distribution. Unfortunately, the major treatises of haematology give more emphasis to Aplastic anaemia; while Megaloblastic anaemia is more common in developing countries than western world. Therefore, this Observational study was carried out over a period of two years in the Department of Medicine of Institute of Medical Sciences (IMS), BHU with the aim to identify etiologies of pancytopenia and its manifestation in eastern India.Methods: All the patients with features of anemia, thrombocytopenia or leukopenia were screened for pancytopenia and a total 214 cases were selected. A detailed physical examination, hematological and biochemical investigation was done.Results: The most common cause of pancytopenia in our study was Aplastic anemic (36.9%) followed by Megaloblastic anaemia (18.7%), Kala-azar (11.7%) and Myelodysplastic syndrome (10.5%).Conclusions: Megaloblastic anemia should be considered as important cause of Pancytopenia, especially when serum LDH level of patient is raised.

Prevalence of different components of the metabolic syndrome in type 2 diabetics attending tertiary care hospital in Himalayan region

Background: There are enormous studies on various aspect of Diabetes and Metabolic syndrome, majority of studies are on urban population, few in rural area but very few for the population living in far flung hilly region of Himalaya. The aim was to find the prevalence of different components of metabolic syndrome in Type 2 diabetics living in the hills of Himalaya and to find correlation with obesity.Methods: All the Type 2 Diabetic patients age 35 years and above attending the inpatients and out patient’s department of V. C. S. G. G. M. C and RI Srinagar, Uttarakhand from October 2012 to March 2013 were enrolled and were evaluated for metabolic syndrome by IDF (International Diabetes Federation) criteria.Results: 128 diabetics were enrolled (76 males and 52 females), the prevalence of obesity in patients of type 2 diabetics was 45.3%. There was poor correlation between obesity and type 2 diabetes (correlation coefficient 0.08) The prevalence of metabolic syndrome was 40.6 % and high percentage (62%) had all five components of the syndrome.Conclusions: The prevalence of obesity and Metabolic syndrome is relatively lower in Type 2 Diabetics of Shivalik range of Himalaya (Uttarakhand)

Study of inflammatory markers in idiopathic osteoarthritis of knee

Background: The aim of the present study was to analyse inflammatory markers in idiopathic osteoarthritis of knee and to formulate reliable disease markers in the diagnosis and prognosis of the disease.Methods: This prospective study was conducted for 2 years in a tertiary care center in 60 patients with idiopathic osteoarthritis of knee and compared them with 60 controls that had no signs of osteoarthritis.Results: The hematological markers to study inflammatory basis of idiopathic osteoarthritis of knee suggested that ESR (erythrocyte sedimentation rate) was more than 20 mm/hour in 83.3%. Serum rheumatoid factor (RF) and CRP (C-reactive protein) was positive in 8.3% and 13.3% patients respectively. Antinuclear antibody (ANA) was positive in 2 (3.3%) patients and negative in 58 (96.7%) patients. Synovial fluid analysis was done in 44 patients with RF positivity in only 1 patient. The control group has ESR less than 30 mm/hour and CRP was (<3 µg/ml). In the control group RF and ANA were similar to the normal population.Conclusions: Synovial fluid analysis is of value to rule out crystal arthropathies and pyogenic arthritis. The study indicates that ESR, CRP and RF collectively can serve as surrogate markers in idiopathic osteoarthritis of knee. Further studies need to be done to formulate reliable disease markers in idiopathic osteoarthritis of knee.

To study the correlation of mean macular thickness using optical coherence tomography with distant and near visual acuity in patients of diabetic maculopathy

Background: to study the correlation of mean macular thickness using optical coherence tomography with distant and near visual acuity in patients of diabetic maculopathy.Methods: A prospective, single centre study was conducted on 50 eyes of diabetic patients, with Diabetic Retinopathy with CSME in which patients macular thickness was measured on Ocular Coherence Tomography using fast macular thickness scan. The unaided and best corrected visual acuity was measured in all patients using Snellens distant vision and Jaggers near vision charts.Results: A linear correlation between the OCT measured macular thickness and both the distance visual acuity and the near visual acuity. That means that for a given level of macular thickness, we can predict visual acuity for it. In our series correlation coefficient was 0.921 for distance visual acuity and 0.899 for near visual acuity. Although the correlation value is high in our study, we did find a range of visual acuities for a given range of macular thickness. For every 100 micron change in mean macular thickness, best corrected visual acuity (BCVA) changed 0.3 LogMAR units, for distance as well as for near.Conclusions: Macular thickness and visual acuities (distance as well as near) are strongly correlated but there can be variations. And a wide range of visual acuities is possible for a given degree of macular edema. Macular thickness though a strong predictor of visual acuity; other factors might also play a role in determining visual acuity for a particular patient

Preparation of Tamra Bhasma by classical method

Tamra Bhasma and Rasakalpas containing Tamra Bhasma are used in treatment of various diseases. In Rasagranthas especially in Tamra Bhasma Amritikarana Samskara is said to remove remaining Doshas of Tamra Bhasma. It is said to be Aim of this work is to prepare proper Tamra Bhasma by using classical method and to develop manufacturing procedure of Tamra Bhasma. For Samanya Shodhana Tamra was heated and after red hot it was quenched for 7 times in Tila Taila, Takra, Gomutra, Kanji and Kulattha Kwatha in order. During Shodhana color of Tamra became black. After Samanya Shodhana weight of Tamra was 390 gm. At the end of Samanya Shodhana there was 13.33% loss of weight in Tamra. Vishesha Shodhana was done by Swedana in Gomutra in ‘DolaYantra’. After Vishesha Shodhana 338 gm Tamra obtained. Tamra Bhasma is very harmful if it’s Shodhana and Marana is not done properly. At the end of Vishesha Shodhana total loss in weight of Tamra was 12 g (3.42%). pH of Gomutra was increased from 9 to 9.5. In this Tamra Bhasma was prepared by Kapota Puta. In this study after 9 Putas the Bhasma Lakshana’s were attained. Maximum temperature found during Tamra Bhasma preparation is 550°C. After 9th Puta 630 gm Tamra Bhasma was obtained. The average weight loss of Tamra after Marana was 13.59%. When Bhasma was properly formed it was black in color. In Amritikarana procedure the maximum temperature was 580°C. After Amritikarana weight of Tamra Bhasma was 608 gm. Total weight gain after Amritikarana was 1.33 %

Can p53 expression and staining intensity correlate with histopathological prognostic parameter and clinical staging in head and neck squamous cell carcinoma?

Background: In recent years, p53 has emerged as an important tool for not only diagnosis and predicting prognosis in head and neck squamous cell carcinoma. The aim of this study was to find the role of p53 staining intensity in determining prognosis. Materials and Methods: Fifty histopathologically proven cases of squamous cell carcinoma of head and neck were studied. The findings of the study were analyzed particularly in reference to p53 expression and their correlation with age, sex, anatomical site, tumor size, histological grading, vascular, peri-neural, muscle invasion, lymph node metastasis and staining intensity.Results: Immunopositivity rate of p53 was 64% with percentage positive cells varying from 5-76% with mild, moderate and strong staining intensity. A positive correlation of p53 independently was seen with oral cavity, grade, lymph node metastasis and pathological staging.Conclusion: p53 immunoexpression is an important independent variable of prognostication.</p

Electronic structure modification in two-dimensional pentagonal PdS2 by external strain

We investigated the electronic structure modifications in two-dimensional (2D) pentagonal PdS2 materials by external strains. In the absence of external strain the 2D pentagonal PdS2 materials are indirect band gap semiconductors. The band gap decreases with an increase in the number of stacking PdS2 monolayers. The external uniaxial and biaxial strains significantly modify the contributions of p-orbitals of S atoms and d-orbitals of Pd atoms to the conduction and valence band edges. It consequently modify the electronic structures of 2D pentagonal PdS2 materials. This strain tunability of electronic structures of 2D pentagonal PdS2 materials may be useful for their electro-mechanical applications.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Left Atrial Myxoma presenting as Stroke-Case Report & Review of Literature

Left Atrial Myxomas present as a wide variety of symptoms. We describe one such case which initially presented with hemiparesis and was diagnosed as cerebral infarction. On retrospective work up, the main cause was found to be a left atrial myxoma. The myxoma has embolised to give rise to cerebral infarction. The LA myxoma was then successfully operated under general anaesthesia and Cardiopulmonary bypass

Comparative colour doppler study of lower limb deep venous thrombosis in diabetic and non diabetic patients with review of current knowledge

Introduction: The present study compared the clinical characteristics of DVT patients with and without DM. The risk of venous thromboembolism appears to be elevated in type 1 and type 2 diabetic patients. Hyperinsulinemia, often present in type 2 diabetes, has also been shown to have a prothrombotic effect. Doppler ultrasonography is a reliable, non-invasive and rapid investigation to detect DVT. Therefore helping in the early detection of DVT in clinically suspected patients. On USG, findings in favour of DVT are non-compressible venous segment with loss of phasic flow on Valsalva, shows absent colour flow if completely occlusive, and lack of flow augmentation with calf squeeze and increased flow in superficial veins. Objectives: To assess and analyze the colour Doppler findings and evaluate the site, extent and stage of lower limb deep vein thrombosis in diabetic and non-diabetic patients. Methods: Present observational comparative study was conducted in the Department of Radio-diagnosis of tertiary level care. Results: A total of 36 patients were enrolled in this study 21 were diabetic, and 15 were non-diabetic. The incidence of DVT was found to be 21% among diabetics and 15% among non-diabetics. Conclusion: The incidence of deep vein thrombosis in diabetic and non-diabetic patients differs. However, it is not statistically significant. Anatomic localization of the thrombus revealed that common iliac, external iliac, common femoral, femoral and popliteal vein involvement was more common among diabetics as compared to non-diabetics