12 yr female pt presented with mild grade fever with anemia since 1 month...received blood transfusion for anemia...but she repeatedly presented with anemia...what will be line of investigation and management...?? cbc s/o of lymphocytic leukocytosis.....

21 yrs/M Engineering Student came with c/o Loss of appetite. general weakness weight losss no c/o pruritis, breathlessness.bipedal edema.cough. no c/o Pr bleed,Hematemesis. deny any addiction Past h/o Blood transfusion 2years back for low Hb,no details available right now,advised to bring all old papers. O/E Yellow discoloration of Skin,upper bulbar conjunctiva present. Pr 78bpm. bp120/50mmhg wide pulse pressure RS clear Spo2 99at RA PA Soft NT No Hepato,splenomegaly. urgent cbc lft done. cbc s/o Hb 4.0gm%,WBC 3500,Plt 413000. LFT= S/O raised conjugated bilirubin 1.64,Unconjugated 0.87mg/dl TB 2.51mg/dl Sgot/Pt 83.4/77.4 Alp 281. ?Hepatocellular Jaundice. plan for Supportive rx fr hepatitis,BGCM,Bld transfusion,Urine R &M,Usg Abdo,Viral markers hepatitis,RFT,SE,Complete LFT,Bt,Ct,PT/INR. please comment on Diagnosis further line of investigations and management.

12 yo female of 33 kg admitted with c/o periumbilical pain, intermittent fever,loss of appetite, yellowish discoloration of eyes, Sensorium wnl Icterus++ PALLOR + Clubbing absent LN non palpable stool Malena urine yellowish chest b/l not clear with costophrenic crepts P/A soft with +3cm liver, spleen non palpable RR 22pm PR 121 SPO2 80 % without O2 ,>95%on o2 Via nasal Our ddx acute liver failure with enteric fever vs acute viral hepatitis with Pulmonary Koch kindly add ddx Kindly comments on CXray what may be pathophysiology AC to you thanks

Beta Thalassemia Minor. *Chief Complaints* A 42 yr old Male attended Mopd with fatigue and Generalized weakness on and off since few months. No associated chest pain, sob, cough, fever, nausea or vomiting,pain abdomen,Hemoptysis,Hematamesis,Urine discolouration,polyuria,polydipsia ,Dysuria,palpitation,dizziness etc No H/O HTN,DM,Thyroid disorder or substance abuse. O/E Pallor + Rest General Examination normal. Systemic Examination normal. Routine blood Ix was advised. Next day pt attended Mopd with reports showing- Low Hb 8.9 SR FERRITIN 559 STOOL FOR OCCULT BLOOD NEG. PBS-MILD MICROCYTIC HYPOCHROMIC ANEMIA AND ANISOPOIKILOCYTOSIS ESR 13. MCV 66.3 MCH 20.5 MCHC 30.9 RETIC COUNT- 1 USG -W/A - SPLENOMEGALY ? ABSENT/ECTOPIC/SMALL LEFT KIDNEY. Reports are suggestive of Microcytic Hypochromic Anemia under Ix. HB Electrophoresis was done next showing Raised HbA2 of 4.90 suggestive of Beta Thalassemia Minor. Pt started on conservative management and counselled regarding his condition and tests for family members.

15 years male Thalassemia major patient with hepato spleenomegaly Liver and spleen biopsy for comments