Richardmunoz1615

43, p = 0.03, 95% CI 0.20-0.92). Grade 3 and 4 hematological and non-hematological toxicities were more common in DAEPOCH arm. There were 2 treatment related deaths, 1 in each arm (4.3% for DAEPOCH vs 2.9% for CHOP). HGBL, NOS is a heterogeneous group of aggressive lymphoma associated with early relapse in nearly half of the cases. Intensive regimens like DAEPOCH is associated with improved outcome in terms of PFS and OS. Though toxicities are more with DAEPOCH, they are manageable and treatment related mortality is low.To analyze the pathological findings in patients with marrow metastasis from solid tumors and to compare the accuracy of the bone marrow aspirate, trephine imprint and trephine biopsy in detecting metastasis. A total number of 174 cases diagnosed on bone marrow aspiration and/or bone marrow biopsy from January 2000 to December 2018 were included in the study. In addition to clinical and demographic data, we evaluated peripheral blood findings, and pattern as well as morphology of the tumor cells in bone marrow aspirate, imprint cytology and biopsy. The changes in the bony trabeculae were classified according to the classification of carcinomatous osteodysplasia. The most common laboratory findings included cytopenias and leucoerythroblastic blood picture. Trephine biopsy was found to be the most sensitive technique for detection of marrow metastases with a sensitivity of 99.4%. Trephine imprint cytology (89.9%) showed a significantly better detection rate than bone marrow aspiration (58.5%). Metastatic adenocarcinomas and undifferentiated carcinomas were more common than non-epithelial tumors. Metastatic carcinomas with known primary were mostly from breast, prostate and lung. Ewings/PNET and neuroblastoma were the commonest among metastatic non-epithelial tumors. Fibrosis (53.4%) was the most frequent stromal change and abnormalities in bony trabeculae were noted in 61.2% cases. Trephine biopsy has the highest sensitivity in detection of marrow metastasis followed by trephine imprint cytology. Immunohistochemistry on trephine section will help in confirming and or suggesting the primary tumor in unknown cases.Faecal carriage of Carbapenem-resistant Enterobacteriaceae (CRE) is being observed as an important risk factor for bacteremia among patients with hematological malignancies. A prospective surveillance study was conducted among these patients to determine the gut colonization of CRE. Rectal/perianal swabs were collected to isolate CRE. Carbapenem resistance was detected by disk diffusion, modified-Hodge, Carba-NP test, and PCR for bla NDM-1, bla KPC, bla OXA-48, bla VIM, bla IMP genes. A total of 209 CRE isolates were identified from 151 patients. E. coli was the most common (83.2%) CRE identified, followed by Klebsiella spp. (9.6%). The majority of CRE were observed resistant to ertapenem (86%). bla NDM-1 was the most common gene (57.3%), followed by bla OXA-48 (37.8%). 26.8% isolates found to carry both bla NDM-1 and bla OXA-48 genes. CRE is increasingly observed to cause bacteremia among hematological malignancy patients due to increased colonization. Screening for gut CRE colonization is necessary to guide empirical therapy and apply infection control measures among these patients.The current study aimed to estimate the seroprevalence of SARS-CoV-2 IgG (S-protein) antibodies along with neutralizing assay (RBD-domain) among the whole blood donors without any prior Covid-19 history or symptoms visiting Blood Centre at a Tertiary care institution, South India amidst the ongoing pandemic. During September 2020 to March 2021, 1034 whole blood donors were enrolled into the study and were screened for anti-SARS-CoV-2 IgG antibodies using Chemiluminescence assay followed by neutralizing antibodies using surrogate neutralization ELISA. The study reported seroprevalence of 49.4%, (95% CI 46.3-52.5) among whole blood donors, with test sensitivity and specificity adjusted prevalence of 54.9% (95% CI 51.5-58.3). Seroprevalence was similar across age groups, gender, voluntary/replacement donations, area of residence, ABO and Rh groups without any statistical significance. However higher IgG antibody responses were found to be elicited in the 30-45 years age group when compared with 18-29 years age group (p value 0.046). This study also analysed the mean neutralizing capacity of SARS-CoV-2 antibodies among 97 blood donors which was 71.9 (SD + 21.03, range 15.5 to 97.3). Donor samples with SARS-CoV-2 IgG S/Co > 9.5 had significantly higher neutralising capacity (> 68%) when compared with donor samples of S/Co  less then  9.5 (p value 0.000). Real-time seroprevalence studies will help to know the herd immunityamong the blood donors which will assist in knowing the Covid-19 transmission dynamics, distribution of immunity levels at a particular point in time, immunity gaps, development of novel therapeutics and prioritize the vaccination programmes to high risk individuals.Monoclonal gammopathies (MGs) reflect conditions in which abnormal amounts of immunoglobulins are produced by a clone that developed from a single pro-B germ cell. They range from asymptomatic, benign disorders such as monoclonal gammopathy of undetermined significance to malignant plasma cell and lymphoid disorders, including multiple myeloma and Waldenstorm macroglobulinemia. The identification of the particular subtype of immunoglobulin molecule is done by serum immunofixation by use of specific antisera directed against different subtypes of immunoglobulin classes. However depending upon the characteristic position taken up by migrating M band on protein electrophoresis due to its molecular weight and charge, serum protein electrophoresis can itself reveal the nature of the immunoglobulin without the need to do serum immunofixation. IgA mostly migrates to beta globulin region and may often be missed out for lack of a sharp, discrete M band in gamma globulin region. Systemic manifestations of MG can be attributed to the physicochemical properties of the monoclonal immunoglobulin, to its antibody activity or to other mechanisms. We describe a case of IgA MG with pseudohyperphosphatemia.Sialic acid is a terminal component of carbohydrate chains of glycoproteins and glycolipids. The present study estimated total sialic acid (TSA) and its ratio with total proteins (TP), in serum and saliva of preeclampsia. The study further investigated the association of these parameters with clinical variables of disease progression. 50 preeclampsia patients (32 mild preclampsia and 18 severe preeclampsia cases) and 50 pregnant controls were included in the study. Serum and salivary free sialic acid, protein bound sialic acid and TP were measured spectrophotometrically. Serum and salivary TSA and its ratio with TP were calculated. There was a significant increase in serum TSA and its ratio with TP in preeclampsia compared to the controls. The increase reflected with the severity of the disease. selleckchem Serum TSA and TSA/TP showed a significant positive correlation with blood pressure, proteinuria and a significant negative correlation with infant birth weight. In saliva, there was no statistical difference between TSA in preeclampsia and controls. Salivary TSA/TP increased significantly in preeclampsia. However the increase was not in accordance to the disease severity. Salivary TSA and TSA/TP were not significantly associated with any of the clinical parameters of disease progression. Significant increase in seum TSA reflects the disturbance in sialyation of serum proteins in preeclampsia, that could not be depicted in the saliva of these patients. Disturbance in serum protein sialyation is further exaggerated with the severity of the disease. Serum TSA and TSA/TP and not the respective salivary parameters, could serve as useful indicators in assessment of clinical progression of the disease.Epileptic patients have to continue anti-epileptic drugs (AED) over a long period of time which can have deleterious effects on the endocrine system including the thyroid hormones with rare check. Risk factors for the development of thyroid dysfunction are still unclear. Therefore the aim of study was to evaluate thyroid functions in epileptic patients receiving anti-epileptic drugs (AED) as monotherapy and polytherapy and to determine potential risk of low thyroid function in epileptic patients receiving treatment. This cross-sectional study included 100 epilepsy patients more than 12 years of age. Serum levels of free thyroxin (FT4), free triiodothyronine (FT3), and thyroid stimulating hormone (TSH) were evaluated in all subjects in addition to serum AED levels. TSH levels were found to be significantly higher in the polytherapy subgroup (p  less then  0.05) in comparison to the monotherapy group. 44% of the patients in the VPA monotherapy group had raised TSH levels and 41.2% of the patients on CBZ had low FT4. A significant negative correlation was observed between CBZ and FT4 (p  less then  0.05). Female sex and old age were additional risk factors detected for deranged thyroid function. Female patients with epilepsy, an older age and AED polytherapy were found to be associated with a higher risk of thyroid dysfunction. Thus, Thyroid function in these patients should be monitored closely. In conclusion, we observed significant changes in thyroid hormone levels in patients receiving antiepileptic treatment in both monotherapy and polytherapy. Elevated CBZ levels were significantly associated with decreased FT4 levels.Dyslipidemia is an important risk factor for atherosclerosis and coronary heart disease, leading to mortality and morbidity in subjects with T2DM. This risk is higher in subjects with diabetes who are on retinoid therapy for some other indication, where hypercholesterolemia, hypertriglyceridemia, and low serum high-density lipoprotein cholesterol (HDL-C), and sudden cardiovascular deaths have been reported. Our study aimed to find the correlation of serum retinol and atherogenic index (AI) in subjects with T2DM and compare them with healthy controls. We found there was a significant difference in systolic and diastolic blood pressure, body mass index, waist circumference, waist hip ratio, total cholesterol (TC), Triglycerides (TG), non-high density lipoprotein cholesterol (non-HDL-C), the atherogenic ratio of cholesterol (ARC), atherogenic index of plasma (AIP) and AI between the two groups. There was a significant positive correlation of serum retinol with TC, TG, LDL-C, Non-HDL-C, ARC, AIP, and AI. In our study we found an association of serum retinol with atherogenic index and dyslipidemia in subjects with T2DM. Serum retinol can be a novel predictor of cardiovascular risk in subjects with T2DM.Malnutrition is a significant comorbidity in nearly one-third of the 8 million deaths in children under five years of age worldwide. Children with severe acute malnutrition have severely disturbed physiology and metabolism. Considering the vital importance of amino acids and the likely changes with the therapeutic diet, we aimed at evaluating these changes in children with SAM at baseline and after rehabilitation with a therapeutic diet at 14 days. Severe acute malnutrition defined as per WHO, for children between 6 months and 5 years with weight for height/length  less then  -3SD of WHO charts, bilateral pitting edema, and mid-upper arm circumference (MUAC)  less then 1.5 cm. A total of 38 children were enrolled as cases, whereas the control group comprised of 37 children. Anthropometric measurement and estimation of amino acids in the blood were done at the baseline and after dietary rehabilitation. The individual levels of the essential and non-essential amino acids were significantly lower in the cases as compared to the controls, except for Aspartate and Threonine.