Background: In an infant or child thrombocytopenia can occur due to large spectrum of illness ranging from tropical infection to malignancy or bone marrow failure. Management is decided by the severity of thrombocytopenia, associated risk factors and underlying illness. Children with thrombocytopenia may be asymptomatic – detected by complete blood count for some other clinical issue or symptomatic-presenting with mucosal and/or cutaneous bleeding and rarely central nervous system bleed. Aim of this research is to study the distribution of patients with thrombocytopenia, their grading according to platelet counts and etiology with special focus to infective causes, other complications in these infections and recovery from thrombocytopenia.Methods: This is an observational analytical retrospective study. 100 randomly selected pediatric patients (6 months to 12 years) admitted in pediatric ward with documented thrombocytopenia (platelet count <150,000/ul) on admission or at any point of time during hospitalisation are enrolled and analyzed.Results: 91% patients have thrombocytopenia associated with infective causes, of which 44% have dengue. 7 patients in study have bleeding manifestations and 3 required platelet transfusion. 50% patients with dengue with thrombocytopenia have leucopenia and 2% have pancytopenia. 57.1% patients with enteric fever with thrombocytopenia show elevated alanine aminotransferase (ALT) levels. Mean platelet recovery time is 2 to 4 days for various infections.Conclusions: Majority of patients do not have bleeding manifestations, and they are mainly seen with severe thrombocytopenia associated with infections. Requirement of platelet transfusion is not common and is seen only in patients with severe thrombocytopenia with significant bleeding manifestation.
Background: Iron deficiency is a global public health problem with unique cultural, dietary and infectious hurdles that are difficult to overcome. Aims and objectives were to study clinical and biochemical profile of iron deficiency anemia, risk factors for iron deficiency anemia, presenting illnesses associated with iron deficiency anemia, association of other nutritional deficiency with iron deficiency anemia, treatment of iron deficiency anemia and recovery rate.Methods: This cross-sectional prospective study is conducted between June 2017 to May 2019in a tertiary care institute Gujarat state of India. All the children in the age group of 6 months to 5 years admitted in paediatric ward with anaemia were included in study. Data collection was done using a pretested questionnaire including socio-demographic factors. Data was analysed using statistical package for social sciences and excel and p<0.05 was considered as statistically significant.Results: The prevalence of anemia is 62.31% in patients admitted during study period. Mild to moderate anemia is observed in 75% patients. In present study, 62% patients are in age group of 6 months to 2 years and 38% patients are >2 years to 5 years. Patients with dimorphic anemia have initial mean serum B12 level 31.36 ng/ml, which improved after treatment to 312.98 ng/ml falling in the range of normalcy.Conclusion: Though anemia is common, most patients are stable and present with mild to moderate anemia. Only a fraction of patients presenting with congestive cardiac failure require packed red blood cells transfusion. Oral iron therapy for three months is the mainstay of treatment for iron deficiency anemia. Vitamin B12 therapy is also needed in patients with dimorphic anemia.
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