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Jul21
HEMATOLOGICAL CHANGES IN CHRONIC ALCOHOLIC LIVER DISEASES
AIM:
To study the hematological changes in chronic alcoholic liver diseases.

MATERIALS AND METHODS:
Thirty chronic alcoholic patients were investigated after excluding the patients having pathological diseases of other organs those altering the haematological status. All selected cases had history of alcohol abuse for more than 5 years, all the haematological parameters were compared with the duration and amount of alcohol consumption and the observations were complied and discussed. The significance of mean in comparison to control was done by using student unpaired ‘t’ test. Association of parameters with amount and duration of alcohol consumption was made by calculating correlation coefficient.

RESULTS:
Chronic alcoholism was commonly observed in 4th and 5th decades with median age of 44 years.

The mean Hb% was 9.21.3 gm% , macrocytosis (MCV > 96fl) in 56.7% of cases and all cases were normochromic (MCH >27 pg and MCHC>30%). Raised ESR (86.6%), leucopenia (33.33%), thrombocytopenia (30%) were other observations.

CONCLUSION:
Correlation of duration of alcohol consumption with haematological changes revealed a significant decrease in Hb% and increase in ESR and increase in MCV with the duration of alcohol consumption 5 to 10 years and when it is more than 10 years of duration.

CRP IN AMI – A UNIQUE PROGNOSTIC INDICATOR
S. Bhakta, Sk Lath, SR Pattnaik, BK Barik, B Pradhan , S Tripathy, RC Sethy

Aim and Objective:
Plaque rupture, the commonest cause of acute myocardial infarction(AMI) is associated with raised level of acute phase reactants like C-reactive protein. CP is a marker of atherosclerotic inflammation and insult of myocardial necrosis. In this study serum CRP level in AMI pateitns at the time of hospital admission was correlated with their subsequent in hospital prognosis.

Materials and Methods:
In the present study, 61 AMI patients with varied types of presentation and risk factors were taken. Fifty healthy age and sex matched volunteers were taken as control. Non-cardiac causes, which can raise the CRP level, were excluded from both groups. Blood samples of AMI patients for CRP were sent at the time of their hospital admission. Other cardiac markers like CK-MB and troponin I also estimated for diagnostic purpose as well as to correlate with CRP as a prognostic indicator. Patients were followed up fro complications like LVF, repeat cardiac discomfort, arrhythmia, cardiogenic shock and death.
Observation:
Raised level of CRP (8.203.86 ms/1 SD) was noted in AMI patients compared with controls (31.195 mg/1 SD). Patients with >6 mg/1 of CRP developed more (82.85%) complications like arrythmia, CCF, pericarditis and repeat chest complications (P<0.001). 11 patients (18%) expired out of them 10 had > 6 mg/1 CRP (91%). More complications observed when CRP levels were raised within 6 hr duration of symptoms (70.83%). In contrast to it other cardiac markers (CK-MB and TROP – I) failed to predict the prognosis within 6 hr duration of symptoms. After 6 hours , prognostic value of CRP and other cardiac markers correlated well.

Conclusion:
The serum CRP level on hospital admission is an indicator short term of prognosis of AMI irrespective of the duration of symptoms.


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