Abstract              Present study was undertaken at general hospital, Solapur. To study various aetiological factors and clinical patterns of anaemia’s. The study included 100 consecutive patients (50 males, 50 females), with age ranging from 16 to 65 years. Patients having haemoglobin less than 9 gram % were studied. Each patient was subjected to detail history, physical examinations and following investigations; haemoglobin %, peripheral smear examination, ESR, urinalysis, bone marrow exam, serum iron, iron binding capacity, ECG and X-ray chest. Symptoms observed were tiredness in 100 patients, giddiness in 69 patients, swelling over legs and face in 43, breathlessness in 19, palpitation in 15 patients. Bone marrow aspiration showed predominantly megaloblastic in 24 patients, normal in 65 patients. In 5 patients bone marrow tissue was not seen. 100 patients of anaemia were evaluated clinically as well as by laboratory methods. Etiological factors leading to anaemia were analysed in these patients. Types of anaemia in patients were 1. Iron deficiency 44, dimorphic 20, megaloblastic 19, normocytic in 7 and aplastic anaemia in 4 cases. 2. Aetiological breakup was nutritional deficiency 33, chronic blood loss 29, worm infestation 20, chronic infection 14, other cause in 19 patients.

Key Words: anaemia, aetiological factors.

 

INTRODUCTION

Symptoms observed were tiredness in 100 patients, giddiness in 69 patients, swelling over legs and face in 43, breathlessness in 19, palpitation in 15 patients. Bone marrow aspiration showed predominantly megaloblastic in 24 patients, normal in 65 patients. In 5 patients bone marrow tissue was not seen.

Types of anaemia in patients were

1. Iron deficiency 44, dimorphic 20, megaloblastic 19, normocytic in 7 and aplastic anaemia in 4 cases.

Aetiological breakup was nutritional deficiency 33, chronic blood loss 29, worm infestation 20, chronic infection 14, other cause in 19 patients.

Since ages the problem of anaemia is existing in our country. If anaemia remains chronic and severe leads to complications such as cardiac failure, ischaemic heart disease and neuropathy etc. Causes of anaemia are multiple, the major one being deficiency states as well as chronic diseases. Present study was undertaken to know various etiological factors and clinical pattern of anaemia in a tertiary care centre.

 

MATERIAL AND METHODS

The study included 100 consecutive patients of anaemia with Hb less than 9 gm% admitted in medical wards of a tertiary care hospital, attached to Dr.V.M. Govt medical college, Solapur. 50 males and 50 females of age group 15 years to 65 years were studied. Detailed history was recorded and a through clinical exam was done and patients were subjected to following investigations-Hb%, peripheral blood smear, serum iron level, iron binding capacity, reticulocyte count, stool and urine exam, bone marrow exam, X-ray chest and ECG.

Other investigations were done as and when required and relevant to the case.

DISCUSSION

In our study we had highest incidence of iron deficiency anaemia i.e. 44% and 2^nd in the rank was dimorphic anaemia. Iron deficiency anaemia is more common in females than in males, 30% in females and 14 % males. The cause of this is menstrual blood loss, pregnancy and lactation. Cause of iron deficiency anaemia in males is chronic blood loss from haemorrhoids, or peptic ulcers or from other sites. After the reproductive age these causes also contribute to iron deficiency anaemia in females. The nutritional deficiency of iron is common cause in males and females. Megaloblastic anaemia was seen in 19% in our study. In study of John Fry hypochromic anaemia was seen two males and 16 females without underlying cause and 4 males and 14 females with underlying disease – total 35 cases. Hyperchromic anaemia was seen in 1 male and 3 female patients having pernicious anaemia and 1 male, 1 female patient having haemolytic anaemia – total 6 patients. In this study hypochromic anaemia was most common morphology with etiology of nutritional deficiency in 92% followed by underlying disease as etiology. Aundry Dawson reported study of patients of anaemia where 78 patients out of 133 had nutritional deficiency as cause of anaemia followed by chronic blood loss and malignancies. Hamid Al Mandhiry et al who studied patients of anaemia who reported almost all having breathlessness after exertion. In our study 19 patients presented with breathlessness 15 had palpitation and 2 patients got chest pain as a predominant symptom. Present study correlates well with both the above studies as we got hypochronic RBC morphology in 90% patients and dimorphic in 35% patients. Etiology of anaemia was found to be nutritional deficiency in 63% patients followed by chronic blood loss and underlying infections.

 

CONCLUSION

In present study of the 100 patients commonest aetiology of anaemia was found to be nutritional deficiencies-33%. The next common cause was chronic blood loss – 29%. There were 14 patients having underlying infections. 8 patients had underlying malignancies. Chronic blood loss and underlying infections are more in our study as compared to the previous studies. Because the patients were never investigated and treated in time which led to the anaemia and effects on health. Symptoms of the patients should be taken seriously at any age and paid attention. Blood loss and underlying infections must be treated at the earliest so that we can prevent the anaemia and its further complications. If physician detects anaemia with its cause earlier and gives treatment in time one can cure it completely and prevent future complications.

 

REFERENCES

1. Audrey A Dawson, O. Ogston. Evaluation of diagnostic significance of certain symptoms and physical signs in anaemic patients. British medical journal. vol 3.:1969
2. Hamid Al Mondhiry and Akram. Clinical observations in 100 patients of anaemia with very low Hb level. Arch.Intern Medicine vol 139. Sept 1979
3. John Fry Clinical patterns and course of anaemia in General practice. British Medical Journal Dec. 30. 1961
4. Kandyaswami S. and K. Padmanabhan. Heart in severe anaemia. Indian heart journal. Vol 29. 1977
5. Mehta B.C. Prevalence and problems of iron deficiency anaemia. JAPI 1990 vol 38
6. Mehta B.C. Panjwani D.D. Electrophysiologic abnormalities in iron deficiency anaemia. Effect of iron therapy IRCs medicine science 1983, 175:6
7. Mehta B.C., Shah S.J. Peripheral nerve function in iron deficiency anaemia. IRCs, Medical sciene 1984:12 : 119
8. Mehta B.C., Modi. A. Renal function in iron deficnency anaemia: effect of iron therapy Journal of associate physicians, India 1988:36:45
9. Mehta B.C. Iron deficiency disease. Journal of post graduate Medicine: 1988:vol. 34.
10. Sanghivi L.M. Electrocardiogram In chronic severe anaemia. American heart journal vol 56: 79:1958.
11. Krantz S.B. et al. pathogenesis and treatment of anemia of chronic disease Am. J of med science, 1994, 307(5)
12. K.G.Prakash et al, clinical profile of anaemia in elderly, a cross sectional study from tertiary care centre.  Scholars journal of applied medical sciences (SJAMS) 2015,3(3c) 1266-1270.
13. Beghe C, Wilson A., frshler WB, Prevalence and outcome of anaemia. A systematic review of literature. American journal of medicine 2004, 116 (Suppl 7A) 3S-10S.
14. Mann S. kumar A, singh S K, Katyal S. chopra G., varma SK;  Analytical evaluation of anaemia in geriatric putier a cross sectional study conducted at tertiary care hospital, national journal of community medicince, 2014 5(3). 316 to 320.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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