Anaemia

 It is defined as the decrease in the circulating red cell mass.The criteria is Hb(hemoglobin) <12gms/dl in women and <14gms/dl in men.. In terms of hematocrit the criteria is <36% in women and <41% in men.
Classification:
        Based on the etiology
                                           1.Due to blood loss
                                                       - acute
                                                       - chronic
                                           2.Due to decreased RBC production
                                           3.Due to increased RBC destruction
Diagnosis:
       Symptoms&Signs:
                  -Fatigue is the most common presentation.
                  -Headache,tinnitus.exercise intolerance,oligomenorrheoa may be present
                  -On examination pallor,tachycardia,hypotension,edema,kilonychia,angular chelosis,glositis may be present.
      Laboratory investigation:
                     -Hb <12gms/dl in women and <14gms/dl in men
                     -Hct<36% in women and <41% in men
                     -Normal range of Mean corpuscular volume(MCV) 80-96 femtolitres(fl);<80fl indicates microcytosis;>96fl indicates macrocytosis
                     -Reticulocyte index(RI) is a measure of the response of the bone marrow.
                              RI=%reticulocyte X (estimated Hct/normal Hct)
nomal value is 1.0 to 2.0 ; <2.0 indicates decreased production; >2 indicates loss of blood or hemolysis.
                    -Peripheral smear for studying number and morphology of blood cells

                    -Bone marrow biopsy is indicated in cases where cause is not clear.

Hypoglycemia

It is a clinical entity that arises as a consequence of a dropping of blood sugar level below 40mg/dl( normal- 70-120mg/dl) . This causes a common symptom of giddiness,may cause even seizures.Everyone would have experienced its symptoms on a day when we starving from the morning.But because of the liver and pancreas the blood sugar level becomes near normal saving us from collapsing.
           Causes :
                       1.Drugs like insulin,sulfonylureas,ethanol
                       2.hepatic,renal and cardiac failure,sepsis
                       3.Hormone deficiencies like cortisol,growth hormone or both,glucagon and epinephrine(in insulin deficient diabetes)
                       4.Endogenous hyperinsulinism like insulinomas etc
                       5.Postgastrectomy
                       6.galactosemia
                       7.Idiopathic
           Treatment :
                    oral glucose 20grams; if the patient is not able to take orally the intravenous glucose 25mg. sometimes inj.glucogan can be given i.m or sc