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Henoch Schonlein Purpura (HSP) is a systemic small vessel vasculitis which most commonly affects children. HSP is characterized by non-thrombocytopenic palpable purpura, arthritis or arthalgia, gastrointestinal and renal involvement. Scalp edema is uncommon in children over 3 years. Early recognition, especially outside of the typical age group, with appropriate management can reduce morbidity and organ damage. We present a case of a young adult with HSP who

Introduction: Among patients with Hepatic Encephalopathy, prevalence of Minimal HE variesbetween 30-50%. Identifying patients with MHE has been shown to improve with medications anddelay development of Overt HE, however only limited clinicians screen for MHE in patients due totime consuming neuropsychological and neurophysiological tests. The Number Connection Test isan easy way to evaluate patients to diagnose MHE. The aim of this study is to find out the prevalenceof covert hepatic encephalopathy. Methods: The descriptive cross-sectional study was done to find out the prevalence of covert hepaticencephalopathy among patients with chronic liver disease. To diagnose Covert HE which includedMHE as well, NCT was used in Devanagari script. Results: The prevalence of covert hepatic encephalopathy is found to be 56 (58.3%) at 90% confidenceinterval (58.23-58.37%). A total of 96 patients (71.9% male) were diagnosed as HE, with mean age of49.6+11.8 years. The cause of CLD in 85 (88.5%) of these patients was alcohol, of which 76 (79.2%)consumed locally brewed alcohol. Of these 96 patients with HE, only 40 (41.7%) had overt HE.Among all these, maximum patients had MHE (37.5%). Conclusions: Our study showed that although the prevalence of minimal HE is quite high amongcirrhotics, they are usually missed in clinical practice due to absence of symptoms. Active screeningwith easy-to-administer tests, like Number Connection tests, can help identify patients with minimalHE and hence treat them early.

Introduction: Essential thrombocythemia, a myeloproliferative condition with an increased number of circulating platelets, is a rare hematological malignancy. The aim of the study is to find out the prevalence of essential thrombocythemia among patients with myeloproliferative neoplasms presenting in haematology unit of a tertiary care centre. Methods: This was a descriptive cross-sectional study at a tertiary care centre from September, 2020 to September, 2021 (Reference number: 48 (6-11) E2077/076). All the patients with a diagnosis of essential thrombocythemia and willing to give consent were included in the study while the patients with incomplete investigations were excluded. A sample size of 72 patients was taken and convenience sampling was done. Data were entered in Microsoft Excel 2010 and analysis was done by the Statistical Package for the Social Sciences Version 22.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data along with mean and standard deviation for continuous data. Results: Among 72 patients with myeloproliferative neoplasms, the prevalence of essential thrombocythemia was found to be 17 (23.61%) (13.80-33.42 at a 95% Confidence Interval). The mean age of patients was 55.41±11.20 years with a male to female ratio of 9:8. The mean hemoglobin level and platelet count in patients were found to be 11.20±2.1 g/dl and 677000±262067.70 cells/mm3. Twelve (70.58%) of total patients were under low risk of essential thrombocythemia while 3 (17.64%) of them were at high risk. Conclusions: The prevalence of essential thrombocythemia was similar to other studies done in similar settings.

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