Background: Pancytopenia is one of the important hematological disorders seen in regular clinical practice, which is characterized by the decrease in all the three cellular elements of peripheral blood i.e. red blood corpuscles, white blood cells as well as platelets. The prevalence and risk factors are different in different geographical areas and hence this study was undertaken to identify the prevalence of pancytopenia in our area and analyse the risk factors. Methods: 42 patients with pancytopenia, of all age groups and both the sexes were included in the study. A detailed demographic and clinical history was taken from the patients. All of them were subjected to thorough physical examination; blood tests were collected for hematological study. Bone marrow aspirate was also taken form these patients. Results: Out of 42 patients, 54.8% patients were males and 45.3% were females, with most of them below 40 years of age. The most major cause of pancytopenia was megaloblastic anaemia comprising of 38.1% of the cases, followed by aplastic anaemia with 26.2%. The other minor contributors were leukaemia, malaria, malignancy, septicemia among others. Pallor, dyspnoea, fever were the most common symptoms observed. Conclusions: The study shows that there is a great incidence of pancytopenia in younger and middle age group rather than in the elderly. Detailed hematological examination including bone marrow aspiration should be done in these patients to understand and diagnose this disease early so that proper intervention and management of these patients can be done.

Background: Diagnosis of dengue hemorrhagic fever (DHF) in children is based on clinical suspicion and prompting laboratory criteria.Methods: This prospective study in children (6 months-14 years) presenting with features of DHF aimed to identify symptoms and signs, laboratory parameters for in early detection and assessed the association between clinical, laboratory, immunological parameters and outcome.Results: Of 50 children, 26 were females, mean±SD age was 8.3±3.02 years; age group 8-12 years were affected the most (38.0%) and infants the least (4.0%). Fever (100%), followed by skin rash (56.0%), myalgia (52.0%) and head ache (48.0%) were the symptoms. Fever of 4-5 days (52.0%), high grade fever (84.0%) and of sudden onset (76.0%) were common. Ascitis was seen in nine. Peteche and malena (48.0%) were predominant manifestation of bleeding tendency (100%). Positive tourniquet test (48.0%) did not correlate with bleeding tendency. Lower levels of Hemoglobin (<12gms%, 100%), hematocrit (<40%, 98.0%), platelet count (<100000/mm3, 100%), serum albumin (76.0%), and abnormal liver enzymes (64.0%) along with prolonged prothrombin time (44.0%) and aPTT (18.05%) were noted. Ultrasound abdomen confirmed Pleural effusion (52.0%), ascitis (22.0%), Hepatomegaly (68.0%). Mean detection time was 4 days. Positive dengue IgM and IgG (60.0%), IgM (16%), and IgG (24%) were observed with increase of IgM in early phase.Conclusions: lower platelet count, raising haematocrit, increased liver enzymes with low serum albumin levels are early indicators. Prolonged PT and APTT are associated with severe bleeding manifestations. Apart from clinical expertise, chest X-ray, abdominal ultrasonogram are useful diagnostic tools.

Background: Unrecognition or delayed diagnosis of severe congenital cardiac diseases (CCD) can lead to cardiac failure, cardiovascular collapse and death. Pulse oximetry can be used as a screening tool for detection of critical CCD (CCCD) in newborns. We conducted this study to correlate pulse oximetry findings in asymptomatic newborns to detect CCCD and coarctation of aorta.Methods: All babies delivered in our hospital were included; after clinical evaluation, pulse oximetry screening was done 12 hours after delivery, taken in three extremities (Right thumb, left thumb and left great toe). If the readings were <95% in any of the limbs, they were further evaluated to detect cardiac defects.Results: Of 800 babies, 54.4% were males and 66.1% were delivered by normal vaginal delivery. Antenatal scan of all were normal. Mean±SD birth weight was 2.92 kg ±.29 ranging 2.14 Kgs-3.80 kgs. Oxygen saturation was >95% in 799 babies, there was no significant clinical findings, and were negative for pulse oxymetry screening; one baby had positive pulse oximetry screening (<95%) with ‘ejection systolic murmur’ over left 2nd and 3rd intercostal space. There was no evidence of cyanosis, oedema or tachypnoea. Pulse oximetry reading was 88% in right thumb, 90% in left thumb and 92% in left great great toe. Echocardiography showed Atrial Septal Defect, Ventricular Septal Defect with Pulmonary Stenosis.Conclusions: Pulse oximetry is a non-invasive, reliable, and useful screening tool for an early detection of CCCD in newborns. The combination of pulse oximetry and clinical judgement is needed.