Immune thrombocytopenia (ITP) is an auto-immune condition that results in isolated thrombocytopenia associated with possibly lethal haemorrhage. In its secondary form, ITP can be triggered by many infectious and non-infectious conditions. Secondary ITP associated with tuberculosis (TB) has rarely been described in the literature. We report on a 22-year-old patient presenting with hypermenorrhoea and petechiae due to ITP secondary to tuberculous lymphadenitis. Normalisation of thrombocytopenia was only achieved after initiation of anti-tuberculosis treatment following failure of thrombocyte substitution and immune-modulatory treatment. A search of the literature available on TB-associated ITP identified 50 cases published between 1964 and 2016. We reviewed all cases using suggested case definitions on the likelihood of association between ITP and TB. A broad spectrum of TB sites was reported to be associated with ITP, and anti-tuberculosis treatment was the most effective therapy for platelet count normalisation. Time from initiation of anti-tuberculosis treatment to platelet count recovery ranged from 2 days to 3 months. In endemic regions, TB should be considered as an underlying cause of ITP. Early diagnosis of TB and initiation of anti-tuberculosis treatment appears crucial for rapid platelet count recovery, and can reduce the risks associated with long-term immunosuppression, transfusions and the time at risk for haemorrhage.

Dengue is a vector-borne disease that is highly endemic in countries located in tropical regions. It can cause severe complications and can even lead to death in the case of delayed diagnosis. Detection of dengue is done by manually examining the platelets and lymphocytes in Leishman's stained peripheral blood smear (PBS) images. PBS examination is considered the gold standard for diagnosing various haematological disorders. However, manual analysis of the PBS is labour-intensive, tedious, and time-consuming, requiring a skilled and experienced haematologist. Today, soft computing methods and artificial intelligence have made their way into every science and technology branch. One such area which has adopted this approach is digital pathology, for automatically identifying and diagnosing various diseases. The main objective of this work was to design an intelligent algorithm to classify normal and dengue patients with the help of digital microscopic blood smear images. A total of 94 normal and dengue-infected PBSs were acquired at a magnification of 100Â. Grey-level segmentation based on Otsu's thresholding was used for the segmentation of the nucleus of lymphocytes. Distinct features from the nucleus that differentiated infected cells from normal were extracted using a pre-trained MobileNetV2 network and local binary pattern. Significant features were selected using the ReliefF algorithm. Subsequently, these features were fed to the support vector machine (SVM) classifier. Our proposed system gave an accuracy, sensitivity, and specificity of 95.74%, 98.14%, and 92.50%, respectively. Hence, the developed intelligent model with deep and hand-crafted features can be valuable for dengue diagnosis.

FCA not only helps in confirming morphologic diagnosis in acute leukemia but also helps in assigning specific lineage to the blasts, particularly in acute lymphoid leukemia. Immunophenotyping is of utmost importance in classifying acute leukemia as it greatly influences the treatment and the prognosis.

A B S T R A C TAim: To study the clinical spectrum of patients with Glanzmann's Thrombasthenia (GT) in a tertiary care hospital in South India and to correlate the clinical & laboratory parameters of GT. Materials and Methods: This study includes 15 patients who were diagnosed as GT by characteristic clinical features, basic lab parameters (prolonged bleeding time, abnormal clot retraction and absence of platelet clumps on direct smear) and platelet aggregometry. Results: 66.6% of our patients were below 10 years of age. The common forms of bleeding in our patients was epistaxis,gum bleeding and prolonged bleeding from trauma site which was seen in >50% of our patients.The significant findings on routine laboratory testing was a prolonged bleeding time (93.33%) and an abnormal clot retraction test (66.6%). Platelet aggregation studies showed decreased aggregation with ADP, Collagen and Epinephrine in 100% of our patients whereas 50% also showed decreased aggregation with Ristocetin. Hence most of the patients in this study presented with the classical symptoms and laboratory findings of GT however some had unusual findings. Conclusion: The prevelance of GT is higher in southern India due to increased incidence of consanguineous marriages in this area.Though basic hemostatic screening tests and platelet aggregometry are sufficient to establish the diagnosis in majority of the patients,however some may require more sophisticated tests like flowcytometry for glycoprotein (GP) IIb-IIIa.