Volume-4, Issue-8, August 2018

Abstract

Chronic lymphocytic leukemia (CLL) is considered the most common B-cell leukemia. Its clinical course is highly variable and depends on clinical, biological and genetic features of leukemic Bcells. Expression of ZAP-70, CD38 and mutated p53 was assessed by flow cytometry methods in 175 BCLL patients and estimated their impact on disease progression rate (DPR) and overall survival (OS). Fifty-one patients (29%) were ZAP-70(+), 81 (46%) were CD38(+), 24 (13.7%) were p53(+). OS was significantly shorter in CD38(+) patients (94.8 vs. 120 months, p<0.001). The similar tendency was found in ZAP-70(+) cases (88 vs.114 months, p<0.01) and in p53(+) patients (88.5 vs. 111.5 months, p=0.48). CD38, ZAP-70 and p53 positive patients have had 4-fold increased mortality rate then the patients with negative markers and this rate was significantly higher after the 6th year of the disease beginning. At multivariable analysis, combined CD38/ZAP-70/p53 status confirmed its independent prognostic role. Double positive CD38/ZAP-70, CD38/p53 and ZAP-70/p53 expressions showed over 19-fold increased DPR above the negative CLL cases (p<0.001). They were classified in a high risk CLL group. The single expressions of these markers were connected with lower DPR and were distributed in middle risk group. CD38, ZAP-70 and p53 negative patients were with the lowest DPR and were classified in the CLL group with good prognosis. ZAP-70 and CD38 expressions appeared to be more predictive than p53 expression and more relevant in defining the cases of B-CLL with higher disease progression rate.

Keywords: Chronic Lymphocytic Leukemia (CLL), CD38, ZAP-70, p53 expression, survival study.

References

Keywords: Chronic Lymphocytic Leukemia (CLL), CD38, ZAP-70, p53 expression, survival study.

Abstract

Ventilator associated Pneumonia (VAP) occurs in about 9-27% of intubated neonate patients and has a mortality rate of 27% to 43% depending on the causative agent. Such high mortality, increased morbidity, increased hospital stay and costs make the VAP crucial. This present study was conducted to determine the proportion of VAP among Neonatal Intensive Care Unit (NICU) with risk factors of acquiring VAP with the outcomes of these cases. This prospective observational study was conducted from October 2016 to October 2017 at a tertiary care center attached with a medical college. Total of 85 neonates of both sexes who have been intubated for >48 hours, were studied. Outcome of these patients was assessed in terms of onset of symptoms and the result of treatment given and survival of patient. In present study, 45.9% was the proportion of VAP among NICU neonates. Out of these 67% cultures were sterile while 33% showed growth. Most common causative organism being Pseudomonas (31%) followed by CONS (23%), Acinobacter, Klebsiella (15% each), E. Coli and S. Aureus (8% each). In terms of disease onset 23% subjects developed VAP within 5 days and regarding mortality 18% patients with VAP died & 72% were discharged.

Keywords: Ventilator associated Pneumonia (VAP), Neonatal Intensive Care Unit (NICU), Neonates.

References

Keywords: Ventilator associated Pneumonia (VAP), Neonatal Intensive Care Unit (NICU), Neonates.

Abstract

Bupivacaine is one of the local anesthetic used most frequently as it has a longer duration of anesthesia. Sometime other medicines are used to get better effect. So this study was conducted to compare the anesthetic effect of Bupivacaine alone and Bupivicaine along with Dexamethasone. For this purpose 30 upper limb surgery cases were given Bupivacaine alone and 30 upper limb surgery cases were given Bupivicaine along with Dexamethasone. The mean time of onset of sensory block in Bupivacaine group was 16.7 minutes and 10.3 minutes in Bupivacaine plus Dexamethasone group. The mean time of onset of motor block with Bupivacaine group was 8.6 (± 1.2) minutes and with Bupivacaine plus Dexamethasone group was 5.6 (± 0.7) minutes. The mean duration of sensory block in Bupivacaine group was 4 (± 6.3) hours and in Bupivacine plus Dexamethasone group was 5.9 (± 0.7) hours. The mean duration of motor block in Bupivacaine group was 1.9 (± 0.5) hours and in Bupivacaine plus Dexamethasone group was 4.3 (± 0.9) hours. It can be concluded from this study that time taken to onset of sensory block and motor block was significantly earlier in Bupivacaine plus Dexamethasone group than Bupivicaine only group. Although there was no significant difference in duration of sensory block in both the group but duration of motor block was significantly more in Bupivacaine plus Dexamethasone group than Bupivicaine only group. Number of rescue analgesic doses in 24 hours required were significantly more in Bupivacaine than Bupivacaine plus Dexamethasone groups.

Keywords: Bupivicaine, Dexamethasone, Anesthetic effect.

References

Keywords: Bupivicaine, Dexamethasone, Anesthetic effect.

Abstract

Keratoconus is a progressive asymmetrical, bilateral, non-inflammatory corneal ectasia casing refractive errors. Various techniques are used to manage these cases. Corneal collagen cross linking (accelerated method) is one of such technique. A hospital based follow up study was conducted on 30 Keratoconus patients to find out the effect of corneal collagen cross linking (accelerated method) on refractive variables of Keratoconus patients. After this procedure, there was improvement in Best Corrected Visual Acuity 0.382, decrease in Cylindrical Refractive Power at 0.73%, decrease in Spherical Refractive Power at 19.32%, decrease in Spherical Equivalent at -6.15%, decrease KMAX of 0.712%, decline Mean Irregularity of 9.09%, Corneal thickness (Thinnest Point) decreased by 3.48%, Anterior Best Fitted Sphere Values decreased by 1.49% and Posterior Best Fitted Sphere decreased by 1.16%. It can be concluded from this present study that there is a significant improvement in topographic corneal changes and refractive results in patients with corneal ectasia after C3R. These results can illustrate the efficacy and usage of CXL for keratoconus among Indian patients. However, more studies and clinical trials are required to establish definite conclusions on the efficacy of C3R.

Keywords: Keratoconus, Corneal Changes, Collagen Cross Linking.

References

Keywords: Keratoconus, Corneal Changes, Collagen Cross Linking.

Abstract

Under five mortality if found more in children having any of risk factor. So this community based cross sectional prevalence study was conducted on 400 under vive children to find out the prevalence of 'At Risk' under five children in field practice area of Rural Health Training Centre Nayla (Rajasthan) India. It was observed from this present study that 61.25% under five children were found 'At Risk' in study children of filed practice area of Rural Health Training Centre (RHTC) Nayla, district Jaipur (Rajasthan) India. Among total 'At Risk' under-five children, maximum number of 'At Risk' children were from Rahori village i.e. 22.86%, followed by from Papad (21.63%), Nayla village (19.59%), Dodya Dungar (18.76%) and Raniyawas (17.14%). It shows that there is not much area wise difference in proportion of 'At Risk' under five children.

Keywords: 'At Risk' under-five children, Prevalence.

References

Keywords: 'At Risk' under-five children, Prevalence.