Background: Pancytopenia is an important clinicohaematological entity encountered in our day to day clinical practice. Pancytopenia refers to reduction in all the three major formed elements of blood, red blood cells, white blood cells and platelets. It’s not a disease entity but a triad of findings that may result from a number of disease processes primarily or secondarily involving the bone marrow. The severity of pancytopenia and the underlying pathology determines the management and prognosis of patient. Objective: To study the etiopathology of pancytopenia, spectrum of haematological changes in various causes of pancytopenia. Methods: Study carried out on the patients admitted in the Dept. of Medicine, VIMSAR, Burla who had HB<10mg/dl, TLC <4000/cmm and Platelets <1lac/cmm. Haematological and other investigations: CBC, Peripheral smear examination, Reticulocyte count, Urine routine & microscopy, Renal function test, Serological investigation, Blood culture, HIV, HBV, HCV, Abdominal USG, Serum electrophoresis was done. Bone marrow aspiration using standard method was done whenever indicated avoiding the cases where causes of pancytopenia was obvious. A written informed consent obtained from all the patients after fully explained the purpose and procedure. Results: The observations are based on 100 cases of pancytopenia reported on routine haematological investigation in the Department of Medicine of VIMSAR, Burla having male to female ratio 0.92:1. 62% of patients presented with fever, easy fatigue were the 2nd most common complain present in 57%. Primary or idiopathic aplastic anemia was the most common etiological factor followed by malaria and sepsis which was sharp contrast with most of other study conducted in our country. Conclusions: Pancytopenia is not an uncommon haemotoligical problem encountered in clinical practice and should be suspected on clinical ground when a patient presents with unexplained anemia, prolonged fever and tendency to bleed.

Background and objective: The Laryngeal Mask Airway-Supreme is a single-use supraglottic airway device that offers gastric access. The present study compares the safety and efficacy of LMA Supreme with Endotracheal tube (ETT) in adult patients undergoing laparoscopic procedures. Methods: In this prospective study eighty patients of either sex, ASA grade I & II, were randomly assigned to LMA-Supreme and ETT for airway management and intraoperative ventilation. After induction of general anesthesia, devices were inserted, correct placement was verified, airway leak was noted, and a gastric tube was inserted. Insertion success rates and time, ventilatory capability, efficacy of seal, risk of gastric distension and hemodynamic responses were investigated. Results: The insertion of LMA-S was comparatively easier and required lesser time for insertion than ETT.Ventilation parameters and airway pressure during peritoneal insufflations, for LMA-S and ETT were comparable.LMA-S and ETT show similar efficacy during laparoscopic surgery with controlled ventilation. No gastric distension or signs of regurgitation were detected in both groups. The hemodynamic responses to insertion and removal were greater for the ETT than LMA-S.Complications or pharyngo-laryngeal morbidity was less with LMA-S as compared to ETT. Conclusions: The LMA-S is a safe, efficacious and easy-to-use, supraglottic airway device during general anaesthesia for normal as well as laparoscopic procedure. It provides a functional airway seal with minimum adverse events.

The article discusses the effectiveness of inhalation of highly concentrated oxygen in patients with heart failure in large cities: quality of life, frequency of hospitalization and survival. Matherials and methods of investigation: In the study were included 100 people (age is from 50 to 74 years, mean age is 62.3±8.52 years, 50 male and 50 female including) with the heart failure of II-III functional classes (NYHA) on the basis of ischemic heart disease. Examination of the patients included a 6-minute walk test, an assessment of the quality of life using the SF-36 and MLHFQ questionnaires. Endpoint frequency analysis (annual mortality and hospitalization rate analisys) has used. The results of the study: It was found that a year after the start of controlled monitoring, the quality of life of patients who daily, in combination with the main treatment used inhalations of highly concentrated oxygen (group 2), probably improved (p<0.05) due to all its parts of the physical component of health (PF, RP, BP, GH). The improvement in quality of life was also due to the refining of the parts of the emotional component of health (VT, SF, RE and MH, p<0.05). In both observation groups, the quality of life was improved according to the MLHFQ questionnaire - the total number of points (p<0.05), the number of points in the physical (p<0.05) and emotional spheres (p<0.05). It was proved that during the oneyear of observation in both groups there were significant changes and improvement in the test results with a 6-minute walk with increasing distance traveled (in group 1 - from 335.8±34.6 to 378.2±25.4 meters, p<0.05, in the second group - from 324.2±22.8 to 412.7±35.1 meters, p<0.05). A more significant increase was observed in group 2, p<0.05. According to the Kaplan-Meyer survival analysis of the cumulative frequency of endpoints (survival and hospitalization) of patients there was a significant discrepancy between the observation groups. The effectiveness of combination therapy with the inclusion of inhalations of highly concentrated oxygen in patients with heart failure to reduce the frequency of clinically important cardiovascular events was 10%, p<0.05.

The 2019-CoV infected number more than 4,101,992 of people and killed 280,454 of people in many countries over 212 (May 10, 2020). Aim: Explore new lifestyle as a Preventive Measures to prevent covid 19 among people. Electronic tool quionnair sheet, include 2 parts Part I: Demographic data: this to assess demographic data as jop, qualification. Part II: to assess using healthy life style as protective measures among people to assess actual life style as eating, exercise, sleep, social distance, use protective measure as mask, gloves, use complementary therapy. Conclusion: healthy life style among studied groups. High percentage for them reported more than 90% take healthy diet. Make hand wash more than 90% were mask, keep recreation only medical occupation keep exercise.

Lassa fever (LF) is a viral haemorrhagic fever (VHF) endemic in West Africa including parts of Nigeria. Ribavirin has been shown to have therapeutic benefits especially if commenced within six days of the symptoms. After seven days, patient with LF tend to progress to clinical stage 3 characterized by multiple complications including bleeding with poor prognosis. We report a case of LF with clinical stage 3 symptoms, which made full recovery without ribavirin therapy. This is a case report of confirmed LF case managed at University of Nigeria Teaching Hospital Ituku/Ozalla. LF was confirmed using RT-PCR of venous blood sample. Other investigations performed include liver function test (LFT), serum electrolyte, urea and creatinine (SEUC), full blood count (FBC), urinalysis. A 24 year old male was referred from private hospital with two weeks history of fever associated with myalgia, anorexia and bleeding per rectum significant enough to require blood transfusion. A preliminary diagnosis of sepsis with bleeding diathesis was made. Although the FBC and SEUC findings were within normal limits, findings of elevated transaminases (AST > ALT), haematuria and proteinuria heightened the clinical suspicion of LF. He was managed conservatively with intravenous fluids, antipyretics, antibiotics, blood transfusion and nutritional support. Empirical ribavirin therapy was not possible due to unavailability of the drug. After eight days, his symptoms resolved and no new complications were observed. He was counseled and discharged home on request. Lassa virus RT-PCR result received after his discharged turned out positive. Contact tracing was carried out but none of his primary contacts developed symptoms of Lassa virus infection. He has remained stable. Individuals suffering from LF and its complications could potentially experience favourable prognosis following optimal conservative management if ribavirin is unavailable. This information is useful for management of LF in resource-limited settings.

In Indonesia, South Sulawesi Province ranks fourth in the number of stunting sufferers, and Enrekang District has the highest stunting sufferer in South Sulawesi Province. This research is to find out the political commitment of the District Government. Enrekang in overcoming the problem of stunting to reach the target SDG. This study uses qualitative research methods with the type of case study research. This research was conducted in Enrekang Regency in January - March 2020. Informants in this study were 11 people selected by purposive sampling technique. Data collection is done by in-depth interviews, document review and collection. Data validation uses the triangulation method. The results of this study indicate that the commitment of the Enrekang Regency government regarding policies and budgets in stunting management is quite good. Stunting prevalence indicator is the main performance indicator in the Enrekang Regency RPJMD with a target of 2023 of 19.5%. The activity budget will increase by 74% in 2020. The budget commitment and budget is quite good on budget commitments and cross-sectoral cooperation. It is hoped that the Enrekang district government will increase commitments related to budgeting and cross-sectoral cooperation.

Teratomas are an infrequent and account for only 7- 11% of extra gonadal teratomas, in Pediatrics. We report a case of 6 years old, with a mediastinal mass causing pleural effusion. Pleural cytology was neagative. Computed Tomography suggested a mediastinal mass. Child’s thoracotomy was done and mass was excised. Histopathology was suggestive of mature teratoma of thymus.