BACKGROUND Chronic Liver Disease (CLD) is a disease process causing progressive destruction and regeneration of liver parenchyma leading to fibrosis and cirrhosis. It is frequently associated with haematological abnormalities and causes complications including bleeding and infection which can increase morbidity and mortality rate. Dietary deficiencies, bleeding, alcoholism and abnormalities in hepatic synthesis or proteins used for blood formation or coagulation add to the problem of liver disease. Therefore, wide range of haematological abnormalities is seen in liver disease. This study studies the correlation between abnormalities in haematological parameters and severity of chronic liver disease. METHODS 100 chronic liver disease patients were studied retrospectively and prospectively for a period of one year from January 2018 to December 2018. In all cases, patients age, gender and relevant clinical history were obtained. RESULTS In chronic liver disease patients, all haematological parameters were decreased except MCV and MCH which were increased. However, it was not statistically significant. Prolonged PT and abnormal peripheral smears were also seen. A table of all haematological parameters studied by mean, interquartile range, median and standard deviation was prepared. Mann Whitney test was used to calculate p value. CONCLUSIONS Chronic liver disease patients are frequently associated with haematological and biochemical abnormalities showing anaemia, leucopenia and thrombocytopenia along with derangement in liver enzymes and decrease in renal function test. Prolonged prothrombin time and abnormal peripheral smear are also seen in these patients. It is associated with increased morbidity and mortality. In our study, haematological parameters (Hb, RBC, PCV MCHC, platelet, PT) all were decreased except MCV and MCH which were increased. However, MCH was statistically not increased. MCV was reduced significantly and biochemical parameters like deranged liver function test were all increased except total protein, albumin and renal function test. S. Urea and Creatinine were reduced. Thus, the complete blood count picture had shown the picture of anaemia, leucopenia and thrombocytopenia. Highly significant p values <0.001 were seen.
Atrial myxoma is the most common primary cardiac neoplasm. It is a tumor of adults, most often seen in women aged 20 to 60 years. Most commonly arise in isolated fashion (90%) but few (10%) can be associated with carney complex (myxoma syndrome) an autosomal dominant disease seen in younger age group. Left sided myxomas present signs of mitral stenosis or insufficiency and right sided tumors with dyspnea, syncope, distension of neck veins is seen. Two dimensional echocardiography, CT, MRI, gated radionuclide blood-pool scan, or cardiac catheterization can all visualize myxomas, but cannot differentiate between other pedunculated tumors or thrombi. It is important to rule out Carney complex because chances of recurrence are much higher than when compared to non syndromic myxomas. Hereby in this case report we discuss a large atrial myxoma in female who presented with breathlessness and chest pain.
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