Journal of Advanced Research in Medicine (E-ISSN: 2349-7181 & P-ISSN: 2394-7047)

Haematological Abnormalities in Decompensated Chronic Liver Disease

PRALAYAKAVERI DWARAKA — 2025-06-28

Abstract

Introduction:
Decompensated chronic liver disease (DCLD) represents an advanced stage of hepatic dysfunction, often accompanied by significant hematological abnormalities. These include anemia, thrombocytopenia, and coagulation disorders, which not only reflect disease severity but also influence the risk of complications such as gastrointestinal (GI) bleeding. This study aimed to assess the prevalence, patterns, and clinical significance of hematological abnormalities in DCLD patients.

Materials and Methods:

This study was conducted in the Department of General Medicine. Fifty adult patients diagnosed with DCLD were enrolled based on predefined inclusion and exclusion criteria. Relevant clinical history, physical examination, and laboratory investigations including complete blood count, peripheral smear, liver function tests, serum iron profile, serum folate, prothrombin time (PT), and international normalized ratio (INR) were recorded and analyzed.

Results:
Among 50 DCLD patients, 42 (84%) were males. Alcoholic cirrhosis (66%) was the most common etiology. Anemia was observed in 94% of patients, with normocytic morphology being the most frequent (57.4%). Thrombocytopenia was present in 72% of cases, and prolonged PT and elevated INR were noted in 68% and 74% of patients, respectively. A statistically significant association was found between thrombocytopenia and GI bleeding (p = 0.047), and also between GI bleeding and elevated PT (p = 0.009) and INR (p = 0.012).

Conclusion:
Hematological abnormalities are highly prevalent in DCLD and show a strong association with bleeding complications. Early identification and appropriate management of these derangements are crucial to improving patient outcomes.

Nutritional Deficiencies and Haematological Profiles in Adult People Living with HIV: A Cross-Sectional Study

Sourav Kumar — 2025-08-04

Background: Nutrition and HIV are intricately linked, with malnutrition worsening immune impairment and accelerating HIV progression. Conversely, HIV-related immune dysfunction can exacerbate nutritional deficiencies. This interplay is particularly concerning in PLHIV, where optimal nutrition is crucial for immune responses and overall health. This study assessed haematological and biochemical profiles and the
prevalence of deficiencies in PLHIV attending an ART centre in Delhi. Methods: A cross-sectional study was conducted from January 2021 to June 2022, including 30 adult PLHIV consenting patients. Data on
demographics, BMI, and haematological/biochemical parameters were collected and analyzed using SPSS, with significance set at p<0.05. Results: High rates of nutritional deficiencies were found: anaemia
(66.66%), vitamin B12 deficiency (56.66%), low serum iron (63.33%), low ferritin (70%), insufficient vitamin D3 (80%), and low albumin (40%), significantly exceeding general population prevalence. Malnutrition was
prevalent, with 60% underweight and only 26.7% having a normal BMI. Low BMI was associated with albumin deficiency (p=0.033). Age correlated with lower haemoglobin and total protein. Trends suggested higher ferritin
deficiency in females (p=0.073) and lower phosphorus in males (p=0.061). Conclusion: Nutritional deficiencies are common in PLHIV and negatively impact their haematological and biochemical parameters.
Addressing these deficiencies is crucial for improving health outcomes. This research highlights the critical need for ongoing studies to explore effective nutritional interventions and their impact on the health of individuals living with HIV.

A Case Report: Forced Alkaline Diuresis in a Case of 2, 4 D Dimethyl-Amine Herbicide Poisoning

Sagar Gupta — 2025-05-19

To study the use of 2, 4 D is increasing because of resistance emerging
in Paraquat and Glycophosphate for weed control, hence accidental
or suicidal intoxication incidences are rising. Action of this is dose
dependent with detrimental effects on cell membrane of Acetyl - CoA
metabolism and oxidative phosphorylation.
It is fatal if not treated timely, having no specific antidote involving
CNS, CVS, RS, Hepatoblliary, muscle and endocrine systems. Usually,
it is very common with intoxication of organophospate compounds in
India, similar to alcohol, sedative drugs, aromatic compounds which is
suspected when patient comes to emergency room. So, Identification
of correct compound for timely management can be lifesaving.
Prolonged Coma, Metabolic complications, Skeletal muscle complication
are some of the complications of 2 4 D. Treatment with forced alkaline
diuresis is life saving measure in resource limited rural area where
hemodialysis is not available.

How to cite this article:
Gupta S, Deshmukh R, Deshpande S, Patki S,
Akotkar S, Suradkar P. A Case Report : Forced
Alkaline Diuresis in a Case of 2, 4 D Dimethyl
Amine Herbicide poisoning. J Adv Res Med 2025;
12(1): 1-3.

DOI: https://doi.org/10.24321/2349.7181.202501

An Uncommon Presentation of Scrub Typhus: A Case of Sixth Nerve Palsy

Brij Gandhi — 2025-08-08

Scrub typhus, caused by Orientia tsutsugamushi, is an acute febrile illness with rare neurological complications, including sixth cranial nerve palsy. A 30-year-old female from an endemic region presented with fever, abdominal pain, vomiting, and diplopia. Examination revealed isolated left-sided abducens nerve palsy without meningeal signs. Laboratory tests showed elevated liver enzymes, mild CSF pleocytosis, and positive scrub typhus IgM. Intravenous doxycycline (100 mg twice daily) led to fever resolution within 48 hours and complete recovery in two weeks. This case highlights scrub typhus as a potential cause of abducens nerve palsy. Early recognition and doxycycline treatment can ensure a favourable outcome.

How to cite this article:
Gandhi B, Chaudhary D, Yadav. An Uncommon
Presentation of Scrub Typhus: A Case of Sixth
Nerve Palsy. J Adv Res Med 2025; 12(1): 17-20.

DOI: https://doi.org/10.24321/2349.7181.202502