scholarly journals Clinical Presentations of Monoclonal Gammopathy Cases in A Tertiary Care Referral Centre of Bangladesh

2020 ◽  
Vol 6 (1) ◽  
pp. 19-23
Author(s):  
Monwar Tarek ◽  
Latifa Rahman ◽  
Md Manirul Islam ◽  
Nilufa Parvin
Keyword(s):  
Multiple Myeloma ◽  
Monoclonal Gammopathy ◽  
Medical Condition ◽  
Tertiary Care ◽  
Armed Forces ◽  
Protein Electrophoresis ◽  
Clinical Profile ◽  
Biochemical Tests ◽  
Female Ratio ◽  
Referral Center

Background: Monoclonal gammopathy are haematologic disorder characterized by abnormal production of one or more immunoglobulin clone. Accurate detection and quantitation of monoclonal immunoglobulins is important for diagnosis and management of monoclonal gammopathies.There are very few studies related to monoclonal gammopathy in Bangladesh. This study wasaimed to observe the clinical profile and immunoglobulin pattern of monoclonal gammopathy cases in a tertiary care referral center. Objective: This study wasaimed to observe the clinical profile and immunoglobulin pattern of monoclonal gammopathy cases in a tertiary care referral center. Methodology: This cross sectional study was conducted in the Department of Haematology, Armed Forces Institute of Pathology (AFIP), Dhaka Cantonment, Dhaka. Study Period was July 2014 to Dec 2014. Patients with the age between 40 to 70 yearsof both sexes who were diagnosed as cases of monoclonal gammopathies was selected as study population. All patients were interviewed by using standard questionnaire and general medical condition of the patients was evaluated through history taking, clinical examination and laboratory investigations. Bone marrow microscopic examination, serum protein electrophoresis, immunofixationelectrophoresis (IFE), skeletal survey and relevant biochemical tests including serum creatinine, calcium, albumin and urinary BJP were performed. Protein electrophoresis of the samples was performed by automated capillary electrophoresis machine. Results: A total of 30 cases were recruited for this study. Out of 30 monoclonal gammopathy cases, majority of cases 17(56.7%) were between 60 to 70 years age group. Mean age was 57.13(±9.66) years. Male were predominant 19(63.0%) and Male female ratio was 1.72:1. Among the patients, low backache and pallor was common in majority (80%) of the cases, while fatigue and fever were present in 73.3% and 70.0% cases respectively. Among the patients, 7(23.3%) were hypertensive, 6(20.0%) were diabetic, 3(10.0%) patients were suffering from CKD with hypertension, 3(10.0%) had bronchial asthma, 1(3.3%) was with hypertension and Diabetes Mellitus. Depending on different laboratory findings, among all the 30 cases, 21(70%) cases were diagnosed as multiple myeloma, 5(16.6%) cases were MGUS and 2(6.7%) cases were Smouldering multiple myeloma and kappa light chain multiple myeloma each. Among the multiple myeloma cases, 11(36.6%) cases had IgG Kappa monoclonal gammopathy and 6(20.0%) cases had IgG Lambda monoclonal gammopathy. Conclusion: Monoclonal gammopathy occurs predominantly in male population at around sixth decade and mostly are presented with fatigue and bone pain. Majority of the patients suffered from multiple myeloma. Journal of National Institute of Neurosciences Bangladesh, 2020;6(1): 19-23

scholarly journals Descriptive study on the clinical profile and demography of patients with chronic folliculitis of leg attending a tertiary referral center

2020 ◽  
Vol 2 ◽  
pp. 104-109
Author(s):  
Thalekkara Madhavan Saranya ◽  
Sarita Sasidharanpillai ◽  
Kidangazhiathmana Ajithkumar
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Large Sample Size ◽  
Tertiary Referral ◽  
Female Ratio ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
Duration Of Disease ◽  
Chi Square Analysis

Objectives: The objectives are as follows: (1) To document the clinical profile and demography of patients attending a tertiary referral institution with chronic folliculitis of leg and (2) to document the bacteriological profile of pustular lesions of chronic folliculitis. Materials and Methods: After obtaining clearance from institutional research and ethics committees, consecutive patients who attended our tertiary care center with clinically diagnosed chronic folliculitis of the leg from December 1, 2016, to November 30, 2017, were included in this cross-sectional study. The data regarding patient characteristics and clinical profile of disease were collected using a preset pro forma. Pus culture and sensitivity study was carried out in all patients who had pustules at presentation. The association between duration of disease and extent of disease and duration of disease and clinical grading was evaluated by Pearson’s Chi-square analysis. Results: The study population comprised 39 (78%) males and 11 (22%) females with male to female ratio of 3.5:1. Study participants ranged in age from 16 to 67 years. In 15/24 (62.5%) patients who manifested pustules, pus culture isolated pathogenic bacteria, Staphylococcus aureus, sensitive to cloxacillin in 14 (58.3%) and methicillin-resistant S. aureus in one (4.2%). Limitations: A study conducted in a tertiary referral center not reflecting the disease profile in the community was the major limitation. Conclusion: Staphylococcus aureus sensitive to common antibiotics like cloxacillin being the most common pathogen isolated from pustular lesions signifies the need for more prospective studies with a large sample size to evaluate the role of environmental factors and individual’s immune system in maintaining the inflammation in chronic folliculitis of the leg.

scholarly journals Superiority of Serum Immunofixation Electrophoresis over Serum Protein Electrophoresis in the Diagnosis of Multiple Myeloma

2018 ◽  
Vol 36 (3) ◽  
pp. 95-100
Author(s):  
Mohammed Mosleh Uddin ◽  
Md Mizanur Rahman ◽  
Syeda Adib Sultana ◽  
Debashish Saha
Keyword(s):  
Multiple Myeloma ◽  
Serum Protein ◽  
Monoclonal Gammopathy ◽  
Plasma Cells ◽  
Cell Lineage ◽  
Armed Forces ◽  
Protein Electrophoresis ◽  
Serum Protein Electrophoresis ◽  
Suspected Case ◽  
Immunofixation Electrophoresis

Background: Multiple Myeloma (MM) is a neoplasm of B cell lineage characterized by excessive proliferation of abnormal plasma cells, secreting abnormal immunoglobulin causing monoclonal gammopathy which can be detected by the presence of M protein in serum and urine electrophoresis.Aim: Present study is aimed to detect and quantify monoclonal gamma globulins by SPEP and IFE in suspected case of MM and other plasma cell dyscrasias and also to find out the discrepant findings between SPEP and IFE.Methods: A retrospective observational study was carried out on clinically highly suspected cases of Multiple Myeloma (MM) presenting with backache, asthenia and generalized weakness at Armed forces Institute of Pathology(AFIP), Dhaka cantonment from January 2015 to July 2016. A total of 140 blood samples were collected and subjected to serum protein electrophoresis (SPEP) and Immunofixation electrophoresis (IFE). IFE identifies the type of heavy (IgG, IgM or IgA) and light chain (either kappa or lambda in suspected cases of MMResults: Out of 140 cases, SPEP identified monoclonal band in 62 cases and either non-specific findings or polyclonal band in 78 cases. At the same time immunofixation electrophoresis (IFE) which was done on all samples detected another 14 cases of M-band in addition to earlier 62 cases of monoclonal gammopathy by SPEP. Among 140 cases, SPEP detected M-band in 62 cases, whereas IFE identified monoclonal band in 76 cases. So in the remaining 14 cases (10%) small sharp spikes of monoclonal band was found only by IFE whereas SPEP failed to detect those 14 cases.Conclusion: SPEP is an easy to perform laboratory test which can be used for detection and quantification of monoclonal gammopathy but there is some limitation in detecting monoclonal band by SPEP. IFE is more sensitive to detect the monoclonal band than SPEP. So both SPEP and IFE should be done simultaneously for precise diagnosis of MM and related disorders.J Bangladesh Coll Phys Surg 2018; 36(3): 95-100

scholarly journals TO STUDY THE PREVALENCE AND CLINICAL PROFILE OF CHRONIC ATRIAL FIBRILLATION IN HOSPITALIZED PATIENTS

2014 ◽  
Vol 04 (02) ◽  
pp. 017-020
Author(s):  
Dharma Rao V. ◽  
Rajaneesh Reddy M. ◽  
Srikanth K. ◽  
Raj Kumar Prakash B. ◽  
Satya Prasad A. ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Chronic Atrial Fibrillation ◽  
Hospitalized Patients ◽  
Clinical Profile ◽  
Female Dominance ◽  
Elderly Age ◽  
Female Ratio

Abstract: Objective: To determine the prevalence of chronic atrial fibrillation (AF) in a tertiary care center and to identify the clinical profile of chronic AF in hospitalized patients. Methods: All patients admitted to Mamata General Hospital in medicine/cardiology wards with chronic AF (persistent and permanent) during the period January 2012 to December 2012 were included into the study. The principal exclusion criteria were new onset AF and acute AF. Results: During the study period, 49 patients were admitted with chronic AF with an average of 45.44 years. A slight female dominance was seen with male: female ratio of 1:1.2. Half of the patients (51%) were below the age 50 years. The elderly age group comprised of only 16.3% of cases. The commonest presenting complaint was dyspnea followed by palpitation. Rheumatic valvular heart disease was seen more commonly in people below the age of 50 years whereas hypertension and ischemic heart disease after 50 years. Heart failure was the commonest condition associated with the chronic AF and was the cause of hospitalization in almost fifty percent of cases Conclusion: Chronic AF is still a cause of concern in India in people below the age of 50 years due to high prevalence of rheumatic fever inspite of advances in the medical field.

scholarly journals Multiple Myeloma with Suspected Non-Secretory Type

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Annisa Ginar Indrarsi ◽  
Usi Sukorini
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Monoclonal Gammopathy ◽  
Plasma Cells ◽  
Immunoglobulin A ◽  
Protein Electrophoresis ◽  
Palpebral Conjunctiva ◽  
General Weakness ◽  
M Spike ◽  
G Ratio

Multiple Myeloma (MM) is a hematological malignancy characterized by clonal plasma cell in bone marrow that produceabnormal globulin, which resulted in monoclonal gammopathy. Multiple Myeloma Non-Secretory (MMNS) is a very rareform of multiple myeloma with monoclonal plasmocytic proliferation in bone marrow supported by clinical manifestationand radiological findings. However, plasma cells fail to secrete immunoglobulin. A 44-year-old female came to SardjitoGeneral Hospital with main complaints of weakness and back pain. General weakness and pale palpebral conjunctiva were6 observed (+/+), liver and spleen were not palpable. Blood test results were as follows: Hb 3.0 g/dL, RBC 1.07 x 10 / μL, WBC3 3 562 x 10 /μL, PLT 114 x 10 /μL, A/G ratio 1.07, BUN 51.5 mg/dL, creatinine 4.62 mg/dL, and calcium 3.1 mmol/L. Skeletalsurvey suggested a multiple osteolytic. Protein electrophoresis revealed hypogammaglobulinemia with no M-spike. Therewere 66% of plasma cells in bone marrow. Patient was diagnosed by MMNS. Diagnosis MMNS can be established if clonalplasmacytes is accompanied with renal insufficiency and hypercalcemia. However, monoclonal gammopathy was not foundin serum protein electrophoresis. A case reported of 44-year-old female diagnosed as MMNS with 'punched out' multipleosteolytic, increased plasma cells in bone marrow without evidence of paraprotein in circulation proved by low A/G ratio andnegative M-spike.

scholarly journals Descriptive study of clinical profile and outcome in patients of acute on chronic liver failure, at a tertiary care center in Northern India

2020 ◽  
Vol 7 (11) ◽  
pp. 1687
Author(s):  
Rakesh Kumar ◽  
Vandana Rana ◽  
Varghese Koshy ◽  
Vandana Gangadharan ◽  
George Koshy
Keyword(s):  
Liver Failure ◽  
Care Center ◽  
Tertiary Care ◽  
Descriptive Study ◽  
Chronic Liver ◽  
Clinical Profile ◽  
Chronic Liver Failure ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Common Cause

Background: Acute-on-chronic liver failure (ACLF) is a recently described syndrome that is characterized by abrupt deterioration in patients with chronic liver disease (CLD) and has high short-term mortality. The aim of this study was to describe the clinical profile, causes and outcomes of ACLF at a tertiary care centre in Northern India.Methods: In this descriptive study of 50 consecutive patients, were included, between August 2015 to January 2018, who were admitted and diagnosed as ACLF as defined by APASL. Causes of acute precipitating event and CLD and outcomes were assessed.Occurrence and severity of organ failure was also assessed.Results: 48 (96 %) were males and 2 (4%) were females with male to female ratio was 24:1. The mean age of male and female subjects was similar, 40.7±9.9 years and 39.2±9.4 years respectively. The most common cause of CLD was alcohol in 50% cases and next most common cause was hepato-tropic viruses HBV infection in 20%, HCV in 6% cases and there was unknown cause in 12 % cases. The most common precipitating factor of acute decompensation was alcohol in 50% cases, hepatotropic viruses in 30% cases. Excluded sepsis and GI bleed as precipitating events. The combined mortality at the end of 1-month and 3-months, in our study was 60%. CLIF-SOFA score was found to be the most reliable scoring system to discriminate between survivors and non survivors. Conclusions: Alcohol was the commonest precipitating cause of ACLF. Organ failures (OFs) are independently predictive of mortality.

scholarly journals Surgical Management and Early Outcome of Encephalocele

2021 ◽  
Vol 10 (1) ◽  
pp. 42-45
Author(s):  
Prakash Kafle ◽  
Mohan Raj Sharma ◽  
Sushil Krishna Shilpakar ◽  
Gopal Sedain ◽  
Amit Pradhanang ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Care Center ◽  
Tertiary Care ◽  
Surgical Excision ◽  
Clinical Profile ◽  
Bony Defect ◽  
Female Ratio ◽  
Early Outcome ◽  
Good Outcome ◽  
Occipital Encephalocele

Background: There are limited studies pertaining to management of encephalocele in Nepal. So the present study seems justifiable to bridge the gap in the literature on encephalocele from Nepal on its clinical profile and early outcome. This study aims to characterize the clinical profile, management and outcome of largest series of encephalocele at tertiary care center in Nepal. Materials and Methods: A retrospective analysis of encephalocele, managed surgically at two tertiary care centers between 2015 and 2020, was performed. Results: Total of 25 cases was surgically managed in the present study. The median age of study population was 2.5 months. There were 11 male and 14 female with male to female ratio of 1:1.26. Occipital encephalocele was the most common variant. Lump in the head (n=11) was the commonest clinical presentation followed by hyperteliorism (n=10). One patient presented with cleft lip and one had CSF discharge in a case of occipital encephalocele. Bony defect was the common radiological findings. Excision and repair was the most common mode of surgery leading to good outcome. Mortality rate was 4% with morbidity of 20%. Conclusion: Early surgical excision and tight dural closure with repair of bony defect is the standard treatment with relatively good outcome.

Feline Lymphoplasmacytic Stomatitis Associated with Monoclonal Gammopathy and Bence-Jones Proteinuria

1994 ◽  
Vol 11 (1) ◽  
pp. 25-27 ◽  
Author(s):  
Kenneth F. Lyon
Keyword(s):  
Multiple Myeloma ◽  
Oral Cavity ◽  
Serum Protein ◽  
Monoclonal Gammopathy ◽  
Alkylating Agent ◽  
Protein Electrophoresis ◽  
M Protein ◽  
Monoclonal Immunoglobulin ◽  
Urine Protein ◽  
Bence Jones Proteinuria

Lymphoplasmacytic stomatitis and gingivitis was diagnosed in an 8-year old female domestic shorthair. The cat had evidence of severe generalized inflammation of the oral cavity. Biopsy samples were evaluated and displayed a lichenoid, interface stomatitis which was predominantly lymphoplasmacytic. Serum protein electrophoresis confirmed a monoclonal gammopathy. Urine protein electrophoresis confirmed Bence-Jones proteinuria. Protein electrophoresis was used to diagnose monoclonal gammopathy (the production of a monoclonal immunoglobulin, or paraprotein, which is associated with a characteristic “M” protein spike on serum electrophoresis). Diseases associated with monoclonal gammopathy are similar in the dog and cat. Alkylating agent chemotherapy is used to rapidly reduce paraprotein concentrations in multiple myeloma. Multiple myeloma is the most common disorder associated with monoclonal gammopathy. This condition is less common in the cat, compared to the dog. This report examines the diagnosis and treatment of multiple myeloma in a cat presenting with severe stomatitis.

scholarly journals Clinical profile of ocular trauma in a tertiary care hospital of Southern Rajasthan

2021 ◽  
Vol 10 (1) ◽  
pp. 127
Author(s):  
Lipa Mohanty ◽  
Janki Bhayani ◽  
Abhishek Shah ◽  
Nishant Patel ◽  
Aval Patel
Keyword(s):  
Quality Of Life ◽  
High Risk ◽  
Ocular Trauma ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Care Hospital ◽  
Female Ratio ◽  
Farm Work

Background: Ocular trauma is a major cause of preventable visual impairment and blindness leading to permanent loss of vision and deterioration of quality of life. 90% of the injuries are preventable. Aim of the current study was to study the clinical profile of patients with ocular trauma at a tertiary care hospital in Southern Rajasthan. Current study was a cross- sectional, observational study was conducted at Geetanjali medical college and hospital, Udaipur.Methods: After taking a well-informed consent a generalized detailed history of 108 cases (123 injured eyes) was obtained. Assessment of best corrected visual acuity, near vision, intraocular pressure, slit-lamp evaluation and dilated fundus examination was carried out. Then injury was classified as per BETTS classification. Patients with corneal foreign bodies and chemical injuries were recorded separately. Imaging modalities like ultrasound B-scan, CT-scan and MRI were employed wherever required. Results: Number of males (98) was much higher than females (9) in our study. Male: female ratio was found to be 10.8:1. The most commonly affected age group was 21-30 years, this highlights the alarmingly high incidence of ocular injuries in economically active young males. Farming is the primary occupation across India, hence it deserves a special mention. 22% of injury cases in our study were farm- work related injuries. Farmers need to be educated and provided eye protective equipment during high-risk activities. Laws regarding agricultural code of practice should be implemented and followed.Conclusions: In our study, not a single case out of 108 had used eye protection at the time of injury. Every effort should be made to create awareness regarding use of safety measures during driving and engaging in high-risk occupations. This will help prevent sight-threatening complications of ocular trauma and the deleterious impact on quality of life.

Pyoderma Gangrenosum and IgA Myeloma

1997 ◽  
Vol 2 (2) ◽  
pp. 100-103 ◽  
Author(s):  
J. Mark Jackson ◽  
Jeffrey P. Collen
Keyword(s):  
Multiple Myeloma ◽  
Serum Protein ◽  
Pyoderma Gangrenosum ◽  
Monoclonal Gammopathy ◽  
Systemic Disease ◽  
Protein Electrophoresis ◽  
Serum Protein Electrophoresis ◽  
Potential Association ◽  
Uncommon Condition

Background: Pyoderma gangrenosum (PG) is an uncommon condition that is associated with a systemic disease in 50% of patients. The condition may be associated with a monoclonal gammopathy, usually of the IgA type. It is rare for PG to be associated with multiple myeloma. Observations: We report the case of an 83-year-old man with PG associated with an IgA myeloma. The myeloma was discovered after the diagnosis of PG had been made. This is the 22nd case of multiple myeloma associated with PG, and only the 14th case of PG with an IgA myeloma. Conclusions: We should be aware of the potential association of multiple myeloma with PG, and consider doing a serum protein electrophoresis in the evaluation of patients with PG.

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