scholarly journals Clinicohematological study of spectrum of myeloproliferative neoplasms in a tertiary care hospital

2020 ◽  
Vol 11 (3) ◽  
pp. 3710-3718
Author(s):  
Sonal Gupta ◽  
Sujata R. Kanetkar
Keyword(s):  
Bone Marrow ◽  
High Risk ◽  
Tertiary Care Hospital ◽  
Risk Group ◽  
Myeloproliferative Neoplasms ◽  
Tertiary Care ◽  
Care Hospital ◽  
Trephine Biopsy ◽  
Maximum Serum ◽  
Hasford Score

Myeloproliferative neoplasms (MPNs) are a group of disorders of hematopoietic stem cells which were initially recognised by William Dameshek in 1951. Objectives of the study were to diagnose and classify cases of myeloproliferative neoplasms according to 2016 revision of WHO classification of myeloid neoplasms and acute leukaemias, to study various haematological parameters of cases of MPNs (Peripheral smear findings, bone marrow aspirate and trephine biopsy) and their clinical manifestations, to record the cytogenetic/molecular genetic abnormalities of the cases and to categorise CML patients according to Hasford Risk Score as a predictor of prognosis. This study was a prospective study carried out in the Department of Pathology of a tertiary care hospital over two years from June 2016 to September 2018. The study included a total of 41 cases of MPNs. The cases of CMLs were diagnosed on peripheral blood findings, Bone marrow aspiration, Trephine biopsy Serum LDH and uric acid. CML was the most common MPN encountered (37/41; 90.24%) in the present study. Maximum serum LDH elevation was observed in CML cases with a mean value of 1396.6 U/L. Of the 37 CML cases, as per Hasford score, 17 cases were categorised into a low-risk group, 17 cases into an intermediate-risk group and 3 cases into a high-risk group. In the present study of Hasford score in CML cases, it was found that it helps in making a better-informed decision about the adaption of alternative high-risk treatment, and was of value in oncology practice.

scholarly journals The Baseline Characteristics of Patients with COVID-19 and Impact of Various Risk Factors on the Outcome of Patients Admitted in Tertiary Care Hospital.

2021 ◽  
Author(s):  
Samiullah Shaikh ◽  
Faiza Deedar ◽  
Tara Chand Devrajani
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Tertiary Care Hospital ◽  
Risk Group ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Severity Of Illness ◽  
University Hospital ◽  
Categorical Variables ◽  
Care Hospital

Abstract Background: The outbreak caused by novel coronavirus was first reported in Wuhan, China in December 2019 when a new pathogen was discovered from the bronchoalveolar lavage fluid of the patient suffering from pneumonia. Globally over 81.47 million confirmed cases and 1.79 million deaths has been reported. The clinical spectrum ranges from mild influenza-like illness to severe life threatening respiratory disease requiring ventilatory support to death. The purpose of this study was to evaluate the baseline carecteristic of the patients and impact of various risk factors on the outcome of patients admitted in tertiary care hospital. MATERIALS AND METHODSStudy Area and Period: This study was conducted at Liaquat University Hospital from April 2020 to September 2020. Study Design: Cross-Sectional Descriptive.Inclusion Criteria: The patients were included on the basis of diagnosis of COVID-19 confirmed on reverse transcription Polymerase Chain reaction (RT-PCR) test. Categorical variables such as age, sex, Gram-Covid risk category ,diabetes mellitus, hypertension, renal, pulmonary disease, obesity, outcome of patient were presented as frequency and percentage RESULTS: This study included 235 consecutive patients admitted at Liaquat University Hospital from April 2020 to September 2020. There were 187(79.6%) male and 48(20.4 %) female. The age < 65 years were present in 80 ( 34%) and ≥ 65 155(66%) patients. The most prevalent symptoms were fever ,breathlessness, cough, anorexia, fatigue in all 235(100% ) patients. Severity of illness according to Gram-Covid Score 18 (7.7%) patients were in low-risk group, 93(39.6%) in moderate risk group and 124 (52.8%) in High risk group.There were no risk factors in 121(51.5%) , one risk factor in 49(20.9%), two risk factors in32(13.6%) , three risk factors in 18( 7.7%) and four risk factors in 15(6.4%) patients.The outcome of patients showed 57(24.3%) deaths, 107 (45.5%) patients had prolong stay and 71(30.2%) patients recovered. A strong relationship was observed between the outcome of patient with age, number of risk factors, severity of illness according to gram - Covid score whereas insignificant relationship with the sex of patients.Conclusion: COVID-19 patients clinically present with fever, cough and breathlessness. Majority of patients present with moderate to high severity. Patient with advanced age, high risk on gram-Covid score with multiple comorbidities are particularly susceptible to adverse outcome.

scholarly journals Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

Infection ◽  
2021 ◽  
Author(s):  
Johanna Koehler ◽  
Barbara Ritzer ◽  
Simon Weidlich ◽  
Friedemann Gebhardt ◽  
Chlodwig Kirchhoff ◽  
...  
Keyword(s):  
High Risk ◽  
Tertiary Care Hospital ◽  
Severe Disease ◽  
Treatment Options ◽  
Tertiary Care ◽  
Antibody Therapy ◽  
Additional Treatment ◽  
Care Hospital ◽  
Cross Sectional ◽  
Asymptomatic Patients

AbstractAdditional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.

A comparative study of bone marrow aspirate with trephine biopsy in pancytopenia disorders

2021 ◽  
Vol 6 (3) ◽  
pp. 201-206
Author(s):  
Kavya J ◽  
Kalpana Kumari MK
Keyword(s):  
Bone Marrow ◽  
Sensitivity And Specificity ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Care Hospital ◽  
Trephine Biopsy ◽  
Hematological Disorders ◽  
Hematoxylin And Eosin

Pancytopenia is commonly reported in clinical hematology practice. Due to its varied marrow pathology and underlying ailments, diagnosis is often misleading and delayed. Bone marrow examination would provide a comprehensive diagnosis of both blood and bone marrow, since aspirate investigates the cytological morphology and biopsy evaluates the cellularity, architecture, and compact marrows.To compare bone marrow aspiration and trephine biopsy results in the diagnosis of pancytopenia, and to determine the sensitivity and specificity of aspirate examination in pancytopenia diagnosis.This prospective study was conducted at a tertiary care hospital from July 2014 to June 2016. A total of 320 samples were received at the department of pathology for bone marrow examination (aspirate and biopsy). Romanowsky (Leishman) stain was used to investigate aspirate samples. All biopsy samples were processed into 3-5 μ blocks and stained using hematoxylin and eosin after decalcification with 5.5% EDTA. Data analysis was performed using SPSS19.Pancytopenia constituted 56 (18.7%) cases with the mean age of 41.79 years. Of the total pancytopenia cases, hematological disorders constituted 50 (89.3%) cases and 6 (10.7%) were non-hematological cases. Aspirate and biopsy diagnosis positively correlated in 76.79% of cases. A 100% sensitivity and specificity of aspirate diagnosis was observed in, acute myeloid leukemia, hypersplenism, myelodysplastic syndrome, megaloblastic anemia, hematological malignancy in remission and negative for lymphoma infiltrate. Aspirate had no role in diagnosis of uremic osteodystrophy and myelofibrosis, whereas leishmaniasis was diagnosed on aspirate alone.Pancytopenia includes multiple underlying ailments which requires a differential diagnosis approach. Combining both aspirate and biopsy for diagnosis would benefit the patient in prognosis as they are complementary to each other.

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