Hydroxyurea- a cost effective treatment in developing countries for Atypical Chronic Myeloid Leukemia (aCML): Case Report of Two Patients

2022 ◽  
pp. 107815522110735
Author(s):  
Zair Hassan ◽  
Ayesha Iqbal ◽  
Saiqa Zahoor ◽  
Iftikhar Ali ◽  
Muhammad Mamoon Iqbal ◽  
...  
Keyword(s):  
Case Report ◽  
Myeloid Leukaemia ◽  
Cost Effective ◽  
World Health ◽  
Economic Evaluations ◽  
Low Grade ◽  
Care Hospital ◽  
Rapid Weight Loss ◽  
Hematopoietic Stem ◽  
Cost Effective Treatment

Introduction Atypical chronic myeloid leukaemia (aCML) is a rare chronic myeloproliferative disorder with a poor prognosis. Case report This case report presents two cases of male geriatric patients, both referred from primary care in rural areas and received at an urban clinic in a tertiary care hospital on separate instances. The first patient complained of low-grade fever (on/off), generalized body aches, rapid weight loss and shortness of breath for the last 2 months. The second patient arrived pale looking with symptoms of generalized body aches, dizziness and anorexia. Both patients were diagnosed to have aCML according to the World Health organization criteria. Management & outcome Both the patients were from a low economic bracket and were treated with Hydroxyurea a relatively economic medicine successfully. The follow-up lasted for 12 months in both cases. No progression to acute myeloid leukaemia (AML) or relapse was observed. Discussion This case report shows the promising results of Hydroxyurea in treating aCML and can be a cost effective alternate to other expensive treatments (allogeneic hematopoietic stem cell transplantation) and expensive medicines in lower and middle-income countries especially for resource-limited patients. These two cases show promising evidence for further studies to evaluate and conduct pharmaco-economic evaluations as well as clinical trials to compare hydroxyurea with other available alternative treatments for an affordable therapeutic option towards prevention of relapse and disease free survival after aCML.

scholarly journals Tinea Corporis Resolution by Homoeopathy: A Case Report

2021 ◽  
Vol 11 (6) ◽  
pp. 135-139
Author(s):  
Zeba Waheed ◽  
Ram Krishna Ghosh ◽  
Aniruddha Banerjee
Keyword(s):  
Case Report ◽  
Alternative Therapy ◽  
Cost Effective ◽  
Tinea Corporis ◽  
Complementary And Alternative Therapy ◽  
Tinea Cruris ◽  
Clinical Presentations ◽  
Cost Effective Treatment ◽  
Causative Agents ◽  
Line Of Therapy

Dermatophytes, the most common causative agents, are assuming high significance in developing countries like India. These organisms metabolise keratin and cause a range of pathologic clinical presentations, including tinea pedis, tinea corporis, tinea cruris, etc. Although usually painless and superficial, these fungi can behave in an invasive manner, causing deeper and disseminated infection and should not be neglected. The lesions may become widespread and may have significant negative social, psychological, and occupational health effects, and can compromise the quality of life significantly. The recent prevalence of dermatophytosis in India ranges from 36.6-78.4%. Currently, dermatologists across India are inundated with cases of dermatophytosis presenting with unusual large lesions, ring within ring lesions, multiple site lesions (tinea cruris et corporis), and corticosteroid modified lesions, making diagnosis a difficult bet. 1 First line of therapy has always been a topical agent; while in resistance of the topical agents next preferred treatment are the oral therapies of antifungal agents (Ketoconazole, Terbinafine, Fluconazole and Itraconazole). However complementary and alternative therapy has also shown the significant results in control of growth of these dermatophytes. Homoeopathy has always been a safe and cost effective treatment in cases of dermatophyte infections.2 The present case report of a 31 years old Muslim female, Sepia officinalis 1M and Sulphur (30C and 200C) have shown marked improvement in the reduction of the lesion. Key words: Tinea corporis, homoeopathy, totality of symptoms, repertorisation.

scholarly journals Well-Differentiated Liposarcoma of The Larynx: A Case Report and Review of Literature

2016 ◽  
Vol 9 (1) ◽  
pp. 85-89
Author(s):  
Svetlana A. Mateva ◽  
Margarita R. Nikolova ◽  
Alexandar V. Valkov ◽  
Margarita R. Nikolova
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
World Health ◽  
Low Grade ◽  
Review Of Literature ◽  
Grade Malignancy ◽  
Well Differentiated ◽  
Health Organization ◽  
Histologic Types

Summary Liposarcoma is one of the most common soft tissue sarcomas in adults with a relative incidence amongst other sarcomas ranging from 9.8% to 16%. It usually locates in the limbs and retroperitoneum. Primary liposarcomas of the larynx and hypopharynx are rare, comprising less than 20% of all head and neck liposarcomas. According to World Health Organization, these tumors are divided into four histologic types, and well-differentiated liposarcoma is the most common one. It is a tumor of low-grade malignancy that may recur locally, but does not metastasize. We present a case of laryngopharyngeal well- differentiated liposarcoma in an old patient with two previous removals. We also discuss recently published cases with this unusual location of liposarcoma.

Management of dental fluorosis by amodified treatment strategy amidst a global pandemic

2020 ◽  
Vol 12 (2) ◽  
pp. 46-49
Author(s):  
Dr Nileena Mary Cherian ◽  
Dr K. C Ponnappa ◽  
Dr SalinNanjappa ◽  
Dr K. K Nanjamma
Keyword(s):  
Case Report ◽  
Treatment Strategy ◽  
Treatment Modality ◽  
Dental Treatment ◽  
Dental Fluorosis ◽  
Cost Effective ◽  
Treatment Scenario ◽  
Global Pandemic ◽  
Effective Treatment Modality ◽  
Cost Effective Treatment

In recent months, the dental treatment scenario has changed due to the outbreak of the Covid 19 pandemic. Most of the aerosol generating procedures have been avoided. This case report, describes a conservative, less aerosol generating and cost-effective treatment modality, for the immediate aesthetic management of moderate fluorosis using enamel microabrasion technique.

scholarly journals Gastric mixed adenoneuroendocrine carcinoma case report

2019 ◽  
Vol 7 ◽  
pp. 2050313X1982891
Author(s):  
Miguel Angel Moyón Constante ◽  
Fernando Xavier Moyón Constante ◽  
Jorge Fernando Tufiño ◽  
Andres Cárdenas Patiño ◽  
Gabriel Alejandro Molina ◽  
...  
Keyword(s):  
Case Report ◽  
World Health ◽  
Low Grade ◽  
Radical Gastrectomy ◽  
Upper Endoscopy ◽  
Mixed Adenoneuroendocrine Carcinoma ◽  
First Case ◽  
The World ◽  
Medical Teams ◽  
Health Organization

Mixed adenoneuroendocrine carcinomas are rare tumors that contain both an exocrine and an endocrine component. Since the latest classification by the World Health Organization and with the aid of immunostaining, more mixed adenoneuroendocrine carcinomas are now identified and diagnosed. Nonetheless, our knowledge of these tumors is still limited, notably concerning gastric variants, as the cases reported in the literature are very limited. The clinical and surgical treatment, including the chemotherapy schemes, the prognosis, and recurrence still represent challenges for the medical teams. We present the case of a 62-year-old woman. After an upper endoscopy revealed multiple polyps and a low-grade neuroendocrine tumor, a D2 radical gastrectomy was performed. A low output esophageal anastomotic leak was discovered in the postoperative period and successfully managed. Pathology revealed a gastric mixed adenoneuroendocrine carcinoma, the first case of this kind reported in Ecuador. Patient is doing well and under constant surveillance up until her 13th postoperative month.

scholarly journals Economic Evaluation of Five Tobacco Control Policies Across Seven European Countries

2019 ◽  
Vol 22 (7) ◽  
pp. 1202-1209
Author(s):  
Teresa Leão ◽  
Julian Perelman ◽  
Luke Clancy ◽  
Martin Mlinarić ◽  
Jaana M Kinnunen ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Tobacco Control ◽  
Large Scale ◽  
Cost Effective ◽  
World Health ◽  
Economic Evaluations ◽  
Short Term ◽  
Healthy Life ◽  
Control Policies ◽  
Tobacco Control Policies

Abstract Introduction Economic evaluations of tobacco control policies targeting adolescents are scarce. Few take into account real-world, large-scale implementation costs; few compare cost-effectiveness of different policies across different countries. We assessed the cost-effectiveness of five tobacco control policies (nonschool bans, including bans on sales to minors, bans on smoking in public places, bans on advertising at points-of-sale, school smoke-free bans, and school education programs), implemented in 2016 in Finland, Ireland, the Netherlands, Belgium, Germany, Italy, and Portugal. Methods Cost-effectiveness estimates were calculated per country and per policy, from the State perspective. Costs were collected by combining quantitative questionnaires with semi-structured interviews on how policies were implemented in each setting, in real practice. Short-term effectiveness was based on the literature, and long-term effectiveness was modeled using the DYNAMO-HIA tool. Discount rates of 3.5% were used for costs and effectiveness. Sensitivity analyses considered 1%–50% short-term effectiveness estimates, highest cost estimates, and undiscounted effectiveness. Findings Nonschool bans cost up to €253.23 per healthy life year, school smoking bans up to €91.87 per healthy life year, and school education programs up to €481.35 per healthy life year. Cost-effectiveness depended on the costs of implementation, short-term effectiveness, initial smoking rates, dimension of the target population, and weight of smoking in overall mortality and morbidity. Conclusions All five policies were highly cost-effective in all countries according to the World Health Organization thresholds for public health interventions. Cost-effectiveness was preserved even when using the highest costs and most conservative effectiveness estimates. Implications Economic evaluations using real-world data on tobacco control policies implemented at a large scale are scarce, especially considering nonschool bans targeting adolescents. We assessed the cost-effectiveness of five tobacco control policies implemented in 2016 in Finland, Ireland, the Netherlands, Belgium, Germany, Italy, and Portugal. This study shows that all five policies were highly cost-effective considering the World Health Organization threshold, even when considering the highest costs and most conservative effectiveness estimates.

scholarly journals Cost of Hemodialysis in a Tertiary Care Hospital in North India

JMS SKIMS ◽  
2012 ◽  
Vol 15 (1) ◽  
pp. 47-50
Author(s):  
Mushtaq Ahmad ◽  
Ajaz Mustafa ◽  
M Saleem Najar ◽  
Farooq Ahmad Jan ◽  
Anil Manhas ◽  
...  
Keyword(s):  
Average Cost ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Cost Effective ◽  
Chronic Hemodialysis ◽  
North India ◽  
Care Hospital ◽  
Effective Treatment Option ◽  
Cost Effective Treatment ◽  
Cost Efficient

BACKGROUND: Chronic kidney disease (CKD) is a worldwide public health problem with significant health consequences and involvement of high cost on treatment worldwide. Although renal transplant is a cost effective treatment option for ESRD, use of hemodialysis in patients with ESRD patients remains one of the most resource intensive and expensive therapeutic intervention. OBJECTIVE: To estimate cost of hemodialysis treatment for patients with ESRD that would help in making policy decisions and enable cost efficient utilization of ESRD programme and hemodialysis. METHODS: 58 patients with ESRD on chronic hemodialysis were incorporated in the present study at a tertiary care teaching hospital between January 2010 to December 2010. Patients who survived less than 3 months after commencement of treatment were excluded. RESULTS: Mean age of the study patients was 46.4±8 in yrs. Among the 54 patients studied 51 % were male. 86% of patients received three sessions of hemodialysis weekly, with duration per session varying between 2 - 4 hours. Average cost was Rs. 2001.84 per session. Estimated total annual burden was Rs. 209449.10 per patient. Average cost borne by hospital was Rs. 951.84 per session/patient (47.55 % of cost bone by the patient); cost born by hospital per patient per year was Rs. 123647.70. Principal expenses (% wise) were: staff salary cost 20.84 %, instrument cost (purchased locally from market) 32.50%, salary cost 20.84%, and rental cost 18.20 %. CONCLUSION: The costs estimated in this study comparable with national average cost of hemodialysis in India but lower as compared to that in other SARC countries; approaches to reduce cost further are needed. JMS 2012;15(1):47-50.

scholarly journals THE PHARMACOECONOMIC IMPACT OF GASTRO-PROTECTIVE AGENTS AT A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 92-96
Author(s):  
NIRUPAMA KULKARNI ◽  
MOPIDEVI RASI ◽  
NAZARIYA NIZAR ◽  
NISHOJA DAVID ◽  
PRASAD N BALI ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Cost Benefit Analysis ◽  
Tertiary Care ◽  
Medical Science ◽  
Cost Effective ◽  
Care Hospital ◽  
Statistical Tool ◽  
Protective Agents ◽  
Cost Effective Treatment ◽  
Study Results

Objectives: The study aimed to evaluate the pharmacoeconomic impact of gastro-protective agents (GPA) by carrying out cost-benefit analysis (CBA) and cost-effective analysis (CEA). Methods: This prospective observational study was carried out by simple randomization technique at Karnataka Institute of Medical Science, Hubballi. Data used were socio-economic details based on modified B. G Prasad scale. Current Index of Medical Specialists updated version March 2021 was used for CBA and CEA. Regression analysis was the statistical tool used in the study. Results: A total of 120 participants were included in the study. 57.5% were male and 42.5% were female. 3.33% were pediatrics, 32.5% were young adults, 37.5% were elder adults and 26.67% were geriatrics. Out of 120 samples, 94 participants were prescribed with pantoprazole, other drugs prescribed include domperidone and pantoprazole, rabeprazole, and ranitidine. The CBA revealed ratio of benefits over costs for pantoprazole was 3.86, ranitidine was 9.31, pantoprazole and domperidone was 0.84 and rabeprazole was 0.84. Additional cost of 138.30 Indian Rupee must be spent on pantoprazole over ranitidine to get cost-effective treatment without disease for one whole year. Conclusion: The CBA revealed that maximum patients received benefits for pantoprazole. CEA gives an idea on best effective treatment over two drugs of different class. Our study concludes that pantoprazole is deemed to be superior over other drugs of GPA prescribed among study participants.

An Early Loaded Implant-Supported Mandibular Complete Arch Fixed Prosthesis in a Young Completely Edentulous Patient: A Case Report

2013 ◽  
Vol 39 (4) ◽  
pp. 487-495
Author(s):  
Miriam Mathew ◽  
Bobby John ◽  
Arun George
Keyword(s):  
Case Report ◽  
Treatment Plan ◽  
Cost Effective ◽  
Bone Volume ◽  
Edentulous Patient ◽  
Mandibular Arch ◽  
Early Loading ◽  
Cost Effective Treatment ◽  
Fixed Prosthesis ◽  
Provisional Restoration

The restoration of the mandibular arch up to the first molars with 5 one-piece implants presents a viable and cost-effective treatment plan in patients with adequate bone volume and favorable ridge relationships. The early loading of the implants with a provisional restoration reduces the period of edentulousness and restores the patient's ability to eat, talk, and smile effectively. Implants in younger patients prevent resorption of the residual alveolar ridge. This article presents a case report of the restoration of an edentulous mandibular arch with an early loaded implant-supported fixed restoration in a young patient.

scholarly journals Donor Cell-Derived Acute Myeloid Leukaemia with 3q26.2 Involvement/MECOM Rearrangement ‐ A Case Report and Literature Review

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Jun Gu ◽  
Wei Wang ◽  
Guilin Tang ◽  
Gokce A. Toruner ◽  
Ming Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Genetic Information ◽  
Molecular Genetic ◽  
Donor Cell ◽  
Hematopoietic Stem ◽  
Acute Myeloid ◽  
Uncommon Complication

Donor cell-derived leukaemia (DCL) is an uncommon complication of allogeneic hematopoietic stem cell transplantation (HSCT). DCL might represent up to 5% of the post-HSCT disease relapses, but case numbers reported in the literature might underestimate the frequency. The leukemogenesis of DCL is not well understood due to the limited numbers of cases reported and lack of detailed molecular genetic information from recipients and donors. Although many theories have been proposed for leukemogenesis of DCL, the underlying molecular genetic mechanism are likely heterogeneous. Here we report a case of donor cell-derived acute myeloid leukaemia with 3q26.2 involvement/MECOM rearrangement and chromosome 20q deletion. We also reviewed the literature of previously described DCL cases, and we discussed the risk factors that might be important to the onset of DCL.

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