Swati Patel

Abstract

Background: To evaluate the prevalence of microalbuminuria in patients with essential hypertension and its relationship to severity of hypertension, to renal function and its association with coronary artery disease and target organ damage, present study was conducted. Materials and Methods: Total 100 primary hypertensive, non diabetic patients and 25 healthy normotensive, non diabetic patients (controls) admitted in S.S.G.H (Sir Sayajirao General Hospital) from June 2009 to November 2011. Patient's complete history, routine investigation along with microalbuminuria was measured by ACR by immunoturbidimetric method. Results: In present study patient’s mean age was 52.7 years. Total 70% of patients selected for study were males and 30% were females. Total 50% to 75% of patients in the 61 -80 year age group were positive for microalbuminuria. Total 42.85% of males were positive for microalbuminuria as compared to 33.33% of females. Total 75% of patients having hypertension for more than 8 years had microalbuminuria. Total 67.5% of patients positive for microalbuminuria had associated target organ damage. Total 45% of patients positive for microalbuminuria had left ventricular hypertrophy and 40% of patients had hypertensive retinopathy. Conclusion: Microalbuminuria helps to identify incipient nephropathy and vascular changes. Its detection can thus help to prevent the development of complications by aggressive treatment to get down targeting blood pressure.   Keywords: Microalbuminuria, Hypertension, Hypertensive Retinopathy, Left Ventricular Hypertrophy.

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Abstract

Background: To evaluate the common etiologies and bleeding manifestations in patients of thrombocytopenia and its clinical presentation, methods of investigation, and impact of various modes of management. Materials and Methods:  Total 104 patients with platelet count less than l00,000 per cu.mm. with age, more than 12 years admitted to hospital between January 2010 to October 2011 were included in this study. Platelet count on automated cell counter less than 100,000 per cu.mm. and confirmed in peripheral smear were included in the study. All EDTA samples were processed in Abacus junior 5 hematology Analyser. Peripheral blood smear review was done for all cases. Clinical history and physical examination were collected from patients and medical record files. Results: The present study included 56 male patients and 48 female patients. The most common bleeding manifestation was petechial rash 8.6%, hemoptysis and traumatic bleeding account for 1.9 % each, whereas 74% of patients did not present with any bleeding issues. Total 66 patients presented with symptoms of fever, 73 had signs of pallor, 22 patients had splenomegaly, 16 patients had hepatomegaly. Total 37.5% of patients were diagnosed with malaria and 1 patient (0.96%) was diagnosed with plasma cell leukemia. Chronic liver disease, megaloblastic anaemia, ITP (Idiopathic thrombocytopenia) and chronic renal failure account for 9.6%, 13.4%, 5.7% and 3.8% respectively. Total 16 patients had platelet counts less than 20000/cu.mm. and 37 patients had platelet count between 60000-80000/cu.mm. Malaria (39 patients) was the major cause of thrombocytopenia. Out of 39 patients with malaria 10 patients had P. Falciparum, 27 had P. Vivax and 2 patients had both.  Conclusion: Patients with a platelet count less than 100,000/cu.mm have very high chances of bleeding manifestation. Cutaneous bleed is the most common manifestation. Malaria can be present with signs of thrombocytopenia. Timely and accurate diagnosis is the key to the management of thrombocytopenia.   Keywords: Thrombocytopenia, Malaria, Cutaneous Bleeding, Platelet Count.

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