scholarly journals Disease staging according to international scoring system in newly diagnosed patients with multiple myeloma

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Saira Parveen Sheikh ◽  
Syed Muhammad Irfan ◽  
Sadia Sultan Sheikh
Keyword(s):  
Multiple Myeloma ◽  
Scoring System ◽  
Tertiary Care ◽  
Stage Iii ◽  
Outcome Variable ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Male Predominance ◽  
Disease Staging

Objective: To determine the frequency of disease staging according to international scoring system in patients who are newly diagnosed with Multiple Myeloma (MM) at a tertiary care hospital at Karachi. Methods: This single center, non probability consecutive, cross sectional study was conducted from Nov 11, 2015 to May 11, 2016. After taking informed written consent, detailed history was taken and serum β2 microglobulin and albumin levels were checked to assess the study outcome variable i.e. stage of MM. All the collected information was entered in the prescribed performa. Results: Eighty newly diagnosed patients with multiple myeloma as per inclusion criteria were included. Sixty seven (83.75%) were male and 13(16.25) were females, with mean age of 58.35+10.077 years. Twenty seven patients (33.75%) were found to have stage-I disease, in 23 (28.75%) stage-II and stage-III in 30 (37.5%). Conclusion: Multiple myeloma is relatively common in 5th decade, with male predominance. International Staging System have great potential for characterizing and stratifying multiple myeloma and revealed a predominance of advanced stage III disease in our setting. How to cite this:Shaikh SP, Irfan SM, Sheikh SS. Disease staging according to international scoring system in newly diagnosed patients with multiple myeloma. Pak J Med Sci. 2019;35(1):90-94. doi: https://doi.org/10.12669/pjms.35.1.173 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Efficacy of Bortezomib plus dexamethasone as a first line treatment in newly diagnosed cases of Multiple Myeloma: A Single Centre Study in a Tertiary Care Hospital

2020 ◽  
Vol 28 (1) ◽  
pp. 34-41
Author(s):  
Mahbuba Sharmin ◽  
Mohammad Manirul Islam ◽  
Abdul Aziz ◽  
Salauddin Shah ◽  
Md Jalilur Rahman ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Partial Response ◽  
Intracranial Haemorrhage ◽  
Response Rate ◽  
Malignant Tumors ◽  
Tertiary Care ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Overall Response ◽  
Highly Effective

Background: Multiple Myeloma (MM) accounts for 1% of malignant tumors and 10%–15% of hematopoietic neoplasms. Bortezomib, a first in class proteasome inhibitor, induces apoptosis and growth arrest and reverse chemoresistence in Myeloma cell and has demonstrated no irreversible adverse effect on haemopoietic stem cell. Dexamethasone increases the response rate. Thus, Bortezomib plus dexamethasone represent highly effective regimen for previously untreated Multiple Myeloma cases and significantly higher response rates approximately 70%– 90% have been observed.This combination thus may serve the basis of future strands of care in Multiple Myeloma patients. Objective: The aim of the study was to assess the efficacy , safety and tolerability of Bortezomib in newly diagnosed cases of Multiple Myeloma patients in Bangladesh. Materials & Methods: This prospective observational study was carried out in the Haematology department of BSMMU from June 2017 to December 2018. Patients received inj. Bortezomib (1.3mg/m2 ) 4 cycles as an intravenous bolus on days 1,4,8,11 in a three week cycle (twice weekly administration) in indoor and same patients as day care basis in outpatients department. Dexamethasone at 40 mg was given intravenously or orally on the day of and day after inj Bortezomib.A self administered questionnaire containing different set of questions regarding Multiple Myeloma were used for data collection. Results: Among the study population, 93% of patients had anaemia followed by bone pain (86%) and renal impairment (39%). Out of 25 patients,complete response achieved in 13 patients (52%), where 4 patients(16%) showed partial response,6 (24%) showed very good partial response and 2 (8%) patients showed no response. The overall response rate was 92% belonged to partial,very goofd partial and no respone respectively. Death occurred in 3 cases (12%). 5 patients (20%) developed Bortezomib induced peripheral neuropathy.Life threatening intracranial haemorrhage occurred in two patients (8%). Death occurred in 3 cases (12%),2 patients due to intracranial haemorrhage and another from cardiac arrest. In this study,S. creatinine, â2 microglobulin and bony lesion variables showed significant association with treatment response. Conclusion: Bortezomib plus dexamethasone is a highly effective and safe regimen for previously untreated multiple myeloma patients. This novel therapy in myeloma represent a new trearment paradigm targeting both tumor and microenvironment which has markedly improve overall response(OR), long progression free survival (PFS) and overall survival (OS)across in all risk groups. Moreover,it can be administered safely in the outpatient setting provided by clinicians. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 34-41

scholarly journals Clinicohormonal Parameters as a Primary Step to Differentiate Normosmic Idiopathic Hypogonadotropic Hypogonadism and Kallmann Syndrome in a Tertiary Care Hospital in Eastern India

2021 ◽  
Author(s):  
Ram Chandra Bhadra ◽  
Dona Saha ◽  
Arjun Baidya
Keyword(s):  
Genetic Disorder ◽  
Hormone Replacement ◽  
Hypogonadotropic Hypogonadism ◽  
Tertiary Care ◽  
Serum Testosterone ◽  
Kallmann Syndrome ◽  
Care Hospital ◽  
Cross Sectional ◽  
Idiopathic Hypogonadotropic Hypogonadism ◽  
Male Predominance

Introduction: Idiopathic hypogonadotropic hypogonadism is a rare gonadal dysgenesis in which puberty does not take place naturally. It occurs due to insufficient pulsatile secretion of Gonadotrophin-Releasing Hormone (GnRH) and the resulting Follicle-Stimulating Hormone (FSH) and Luteinising Hormone (LH) deficiency leads to absence of or delayed sexual maturation. Kallmann syndrome is an uncommon genetic disorder characterised by hypogonadotropic hypogonadism associated with anosmia or hyposmia. When anosmia is absent, the same is referred as normosmic Idiopathic Hypogonadotropic hypogonadism (nIHH). Aim: To find out the significant differences between Kallmann syndrome and nIHH based on clinical features and biochemical assessment as a primary measure to initiate the treatment early. Materials and Methods: This hospital based cross-sectional observational cohort study was conducted in Department of Endocrinology, Nilratan Sircar Medical College and Hospital, Kolkata, India. The study was done on 55 cases of IHH presenting to the department with delayed secondary sexual characteristics. Results: Out of these 55 cases, 45 (81.8%) were of nIHH and only 10 (18.2%) cases were of Kallmann Syndrome. It was found that both the conditions show male predominance. Smell abnormalities were present only in Kallmann group. The level of serum testosterone was significantly higher (p<0.05) in nIHH subjects (mean-35.59 ng/dL) than patients with Kallmann Syndrome (mean-14.90 ng/dL). Patients with Kallmann syndrome showed significantly reduced pubic and axillary hair development and absence of gonadal development. Conclusion: Absence of puberty with anosmia/hyposmia with low serum FSH and LH, drastically reduced serum testosterone, are factors that point towards the diagnosis of Kallmann syndrome even in absence of genetic study, which is helpful for initiation of hormone replacement therapy for treatment.

scholarly journals Epidemiological study on admission of infectious diseases in pediatrics department of a tertiary care hospital, Jharkhand, India

2020 ◽  
Vol 7 (9) ◽  
pp. 3493
Author(s):  
Nisha Murmu ◽  
Pushpa . ◽  
Anit Kujur ◽  
Vidya Sagar ◽  
Vivek Kashyap
Keyword(s):  
Hand Hygiene ◽  
Infectious Diseases ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Male Predominance ◽  
Prime Concern ◽  
The Family

Background: Infectious diseases have a major contribution in the mortality and morbidity among children in India. The aim of our study was to assess the infectious diseases and the sociodemographic characteristics along with the assessment of awareness on mode of transmission of these diseases among the family members.Methods: This was a cross-sectional study done in Department of Pediatrics, RIMS, Ranchi, for a period of 6 months by consecutive sampling. Pre-tested, semi structured questionnaire was used for data collection and analysed in SPSS version 20.Results: A total of 220 children were included in the study. Majority of patients (60%) comprised of under 5 age group with male predominance (55%), with 84.1% children fully immunized, among which 54.1% were institutional deliveries and approx. 85.9% children were breast fed for more than 6 months. Malaria, being an endemic disease of Jharkhand affected maximum children (38.2%). Sanitation, (toilet facilities) was about 27% and hand hygiene was only 5% in the family members of the patients admitted. Thus lack of awareness and poor hand hygiene was an important finding in our result.Conclusions: Health education among the community should be the prime concern for the reduction of the diseases.

scholarly journals Clinical Profile and Outcome of COVID Positive Hematology Patients during the COVID-19 Pandemic - an Analytical Cross Sectional Study from a Tertiary Care Centre in India

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4996-4996
Author(s):  
Faisal Kassim ◽  
Chirag Sunil Lalwani ◽  
Hamsini Movva ◽  
Sani Kodathumuriyil Sunny ◽  
Merlin Moni ◽  
...  
Keyword(s):  
Active Treatment ◽  
Conflicts Of Interest ◽  
Tertiary Care ◽  
Outcome Variable ◽  
Categorical Variables ◽  
Care Hospital ◽  
Cross Sectional ◽  
Hematological Diseases ◽  
Significant Difference ◽  
D Dimer

Abstract Introduction: The COVID-19 pandemic is a global public health challenge that has affected more than 30 million people and taken more than 4 lakh lives in India. The first and second COVID waves have greatly impacted the lives of a vast majority and vaccination of the masses remains a struggle. Although SARS -CoV-2 infections in patients with hematological diseases are expected to have an adverse outcomes, only limited reports are available from India. Hence, our study aims to identify the outcome in terms of severity and mortality in this group and the risk factors involved in developing severe COVID-19 and death. Methodology: This is a cross sectional analytical study done in a tertiary care hospital in Southern India for a period of 11 months. All hematological patients irrespective of age, who were infected with SARS-CoV-2 during the first wave (June -December 2020) and second wave (March - June 2021) were consecutively enrolled for the study after IRB approval. The patients were then categorized as neoplastic (acute and chronic leukemia, lymphoma, myeloma, MPN and MDS ) and non-neoplastic (ITP, aplastic anemia, hemolytic anemia, MGUS and TTP ) diseases. The clinical data was collected retrospectively from the electronic medical records and by direct telephonic contact. Patients were categorized as having mild (spO2 &gt; 94 % symptomatic /asymptomatic), moderate (spO2 90 - 94 %) and severe (spO2 &lt; 90 %) disease based on their severity of infection, each category of patients received appropriate clinical management. Treatment details, mortality and other outcomes were recorded for 30 days. The continuous variables were represented as mean (± SD)/median (IQR) and categorical variables as frequency and percentage. The association of the outcome variable with selected variables were calculated using Chi-square tests and kaplan meier survival analysis. The data sets were analyzed (SPSS version 21) and a p value of &lt; 0.05 was considered statistically significant. Results: The study was conducted with 70 patients (n=70). Demographic details of patients are summarized in Table 1.Seventeen (24.3%) out of 49 (70%) hospitalized patients required ICU care. There were 13 (18.6%)deaths. in the patients who survived, prolonged antigen positivity of COVID on testing after 21 days was seen in 9 patients (16.1%). In 35 patients (50%)hematological treatment was restarted with a mean delay of 9.2 +/- 10.72 days. Predictors of severity of the disease is summarized in Table 2. Age more than 50 years (P=0.002)(Figure 1a), severe COVID (P=&lt;0.001) and D dimer value of &gt;2 times normal (P=0.047) were associated with a 30-day mortality. Additionally, patients on active treatment for hematological disease were at greater risk of severe COVID (P=0.012). There was no significant difference in severity (P=0.197) or mortality (P=0.556)in patients with neoplastic vs. non-neoplastic disorders Conclusion: COVID-19 patients with malignant and non-malignant hematological diseases showed an increased mortality. Age &gt; 50 years and high D dimer values (&gt;2N) were identified as predictors of mortality. Active treatment for haematological disease predisposed to severe disease.The study needs to be validated further on a larger cohort of patients . Preventive strategies including vaccination is warranted in patients with hematological disorders. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals DIABETIC KETOACIDOSIS;

2018 ◽  
Vol 25 (08) ◽  
pp. 1235-1239
Author(s):  
Muhammad Imran Hassan Khan ◽  
Junaid Mushtaq ◽  
Ibtesaam Amjad ◽  
Israr ul Haque Toor ◽  
Ghias un Nabi Tayyab
Keyword(s):  
Type 1 Diabetes ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Male Predominance ◽  
Laboratory Investigations ◽  
New Diagnosis ◽  
Hospital Study

Objectives: To observe the frequency, precipitating factors and outcome ofdiabetic ketoacidosis (DKA) in adults with established and newly diagnosed type 1 diabetesat a tertiary care hospital. Study Design: Retrospective study. Setting: Lahore GeneralHospital, Lahore. Period: From January 2013 through December 2015. Methods: Patients whowere admitted with a diagnosis of DKA. The clinical presentations, laboratory investigations,management, time of recovery and outcome were compared. Data were collected viaretrospective chart review. Results: A total of 202 patients were included who fulfilled the criteriaof DKA, of which 160 (79.2%) were less than 26 years of age with a male predominance of 156(97.5%). Out of all cases 72 (35.6%) had established Type 1 diabetes and 130 (64.4%) werenewly diagnosed. The most common presenting complaints in both groups were sepsis 105(52%). The comparison of clinical improvement and laboratory investigations between the twogroups showed that newly diagnosed Type 1 diabetes patients had lower pH, low bicarbonateand high BSR at presentation as compared to those with established type 1 diabetes. Thepatients with established diabetes improved earlier, required lesser duration of intravenousfluids and IV insulin was changed to subcutaneous in less time. Hospital stay of more than 7days was observed in patients with new diagnosis. Conclusion: It can be concluded from theabove data that earlier diagnosis of type 1 diabetes mellitus, appropriate treatment, regularscreening for complications and infections will result in less hospital admissions and betteroutcome.

scholarly journals Assessment of infection in newly diagnosed multiple myeloma patients: risk factors and main characteristics

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chenyao Lin ◽  
Hui Shen ◽  
Shuimei Zhou ◽  
Minghui Liu ◽  
Anjie Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Cross Sectional Study ◽  
Severe Anaemia ◽  
Stage Iii ◽  
Strong Impact ◽  
Advanced Stage ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Independent Risk Factors

Abstract Background Infection is a leading cause of morbidity and death in patients with multiple myeloma (MM). The increased susceptibility to infection is complicated and multifactorial. However, no studies have explored the spectrum and risk factors of infections in newly diagnosed MM patients at the first admission. This cross-sectional study aimed to provide ideas for the assessment, prevention and treatment of infection in newly diagnosed MM patients when admitted for the first time. Methods Retrospectively, the data from electronic medical records for 161 patients newly diagnosed with MM from May 2013 to December 2018 were analysed. All the information was collected at the time of admission, and the patients had received no antineoplastic therapy previously. Independent risk factors of infection in multiple myeloma were determined by univariate and multivariate analysis. Results Newly diagnosed patients with MM were highly susceptible to viruses (43.9%), especially Epstein-Barr virus (EBV) (24.4%) and hepatitis B virus (HBV) (17.1%). Advanced stage (ISS stage III, P = 0.040), more severe anaemia (Hb < 90 g/L, P = 0.044) and elevated CRP (> 10 mg/L, P = 0.006) were independent risk factors for infection. Moreover, infections represented a major survival threat to patients with newly diagnosed MM (P = 0.033), and the existence of risk factors for infection was significantly correlated with poor prognosis (P = 0.011), especially ISS stage III (P = 0.008) and lower haemoglobin level (P = 0.039). Conclusions Newly diagnosed MM patients are highly susceptible to viruses. Advanced ISS stage, more severe anaemia and the elevation of CRP are independent risk factors of infection, which also have a strong impact on prognosis. Our results suggest that viral infection should be taken into account if antibacterial drugs are not effective, and the prevention of infection and improvement of prognosis should be paid more attention in newly diagnosed patents with advanced stage and more severe anaemia.

LABORATORY PROFILE OF INDOOR PATIENTS ADMITTED WITH ACUTE ENCEPHALITIC SYNDROME IN A TERTIARY CARE CENTRE OF NORTH-BENGAL

2021 ◽  
pp. 76-78
Author(s):  
Smarajit Banik ◽  
Debasis Chakrabarti ◽  
Sandip Saha ◽  
O P. Pandey ◽  
Dipanjan Bandyopadhyay
Keyword(s):  
Tertiary Care ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Study Region ◽  
Male Predominance ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
Wbc Count ◽  
North Bengal

Background: Acute encephalitis syndrome (AES) is dened as the acute-onset of fever and a change in mental status (including signs and symptoms such as confusion, disorientation, delirium or coma) and/or new-onset of seizures (excluding simple febrile seizures) in a person of any age at any time of the year. Most AES is considered to be due to a viral-encephalitis, virus like West Nile, Herpes simplex virus, Flaviviruse like JE and dengue are more prevalent in South East Asia. Methods: This observational Cross sectional Study was conducted in the indoor patients of Department of Medicine at Tertiary care Hospital in North Bengal from May 2013 to April 2014. All consecutive patients of AES admitted during this period were included in the study. The study region covers the various districts of North Bengal. Template was generated in MS excel sheet and analysis was done on SPSS 20.0 software. Results: Among 104 acute encephalitis syndrome patients, 68 (65.38%) were male and 36 (34.62%) were female. The majority of pts (54.81%) were >40yrs of age. The lowest wbc count was 3000/cumm and highest was 21,200/cumm with mean wbc count being 10462.56±3567.832/cumm. Asignicant number 56 (53.85%) of patients had serum potassium levels between 2.5-3.5meq/dl. The no. of JE Positive patients was 75 (72.12%) which may be due to the local endemicity of the disease Conclusions: Majority of cases were in the age-group of more than 40 years, with male predominance. The no. of JE Positive patients was 75 (72.12%) which may be due to the local endemicity of the disease.

scholarly journals Prevalence of Gastric Cancers among Patients Undergoing Upper Gastrointestinal Endoscopies in a Tertiary Care Hospital in Nepal: A Descriptive Cross-sectional Study

2020 ◽  
Vol 59 (233) ◽  
Author(s):  
Subash Bhattarai ◽  
Merina Gyawali ◽  
Sudeep Regmi
Keyword(s):  
Gastric Cancer ◽  
Gastric Carcinoma ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Male Predominance ◽  
Gastric Cancers ◽  
Upper Gastrointestinal

Introduction: Gastric cancer is a common malignancy of the upper gastrointestinal tract. Gastric cancer is a common cause of death worldwide. This research aimed to study the prevalence of gastric cancer among patients undergoing upper gastrointestinal endoscopies. Methods: A descriptive, cross-sectional study was conducted in the Department of Medicine at Manipal Teaching Hospital, Nepal, from January 2018 to June 2020. A total of 2640 subjects underwent upper gastrointestinal endoscopies over the study period. Ethical approval was taken from the institutional review committee of Manipal College of Medical Sciences (MEMG/ IRC/ 383/GA). Data were analyzed by SPSS version 20. Results: The prevalence of gastric cancer among patients undergoing UGI endoscopies was 2.4%. The mean age of subjects was 58 ± 12.35 years (range of 31 to 96 years) with male predominance (M:F=1.9:1). Antrum was the most common site for gastric carcinoma. The most common morphology was ulcerative growth (61.6%). Adenocarcinoma (98.4%) was the most common histology, and the majority was of intestinal subtype (56.3%). Conclusions: Gastric cancer is not an uncommon finding in patients undergoing UGI endoscopies. Gastric cancers were commonly seen above 50 years of age and predominant in males. Patients with gastric carcinoma usually present late with advanced disease stages and unfavorable histopathology.

scholarly journals Frequency of Patients with Coronary Artery Disease Achieving Optimal Glycemic Control at Tertiary Care Hospital, Karachi

2021 ◽  
Vol 15 (6) ◽  
pp. 1937-1940
Author(s):  
Sharafuddin . ◽  
Javed Khurshed S. ◽  
M. Hashim Kalwar ◽  
M. Hassan Butt ◽  
Sarfraz Hussain Sahito ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Diseases ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Tertiary Care ◽  
Outcome Variable ◽  
Care Hospital ◽  
Cross Sectional ◽  
Artery Disease

Objective: To determine frequency of glycemic control in patients with coronary artery disease (CAD) visiting to National Institute of Cardiovascular Diseases, Karachi. Study Design: Descriptive Cross-Sectional study Place and Duration: This study was conducted at Department of Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan for six months duration from 12th October 2019 to 11th April 2020. Methodology: One hundred and ten patients of both gender with coronary artery disease were enrolled in this study. Informed consent was taken after explaining the procedure, risks and benefits of the study. In our study, all the included patients were given the emergency treatment and their blood samples were sent to laboratory to assess the outcome variable i.e. glycemic control. All the data was analyzed by SPSS 24.0. Results: Mean ± SD of age was 62.5±8.4 years. Out of 110 patients, 65 (59.1%) were male while 45 (40.9%) were female. Obesity was found in 41 (37.3%) patients. Glycemic control was noted in 20 (18.2%) patients. Conclusion: It is to be concluded that less glycemic control was noted among coronary artery disease (CAD) patients with increasing prevalence of diabetes. Indicators of quality care (HbA1c & other complications) should be assessed regularly for better diabetes management. Keywords: Glycemic Control, Coronary Artery Disease, Type 2 Diabetes, Risk Factors

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