A CLINICOPATHOLOGICAL STUDY OF ACUTE AND CHRONIC LEUKEMIA IN A TERTIARY CARE HOSPITAL

Introduction: Leukemias are neoplastic proliferations of haematopoietic stem cells and form a major proportion of haematopoietic neoplasms that are diagnosed worldwide. Typing of leukemia is essential for effective therapy because prognosis and survival rate are different for each type and sub-type Aims: this study was carried out to determine the frequency of acute and chronic leukemias and to evaluate their clinicopathological features. Methods: It was a hospital based cross sectional study of 60 patients carried out in the department of Pathology, JMCH, Assam over a period of one year between February 2018 and January 2019. Diagnosis was based on peripheral blood count, peripheral blood smear and bone marrow examination (as on when available marrow sample) for morphology along with cytochemical study whenever possible. Results: In the present study, commonest leukemia was Acute myeloid leukemia (AML, 50%) followed by Acute lymphoblastic leukemia (ALL 26.6%), chronic myeloid leukemia (CML, 16.7%) and chronic lymphocytic leukemia (CLL, 6.7%). Out of total 60 cases, 36 were male and 24 were female with Male:Female ratio of 1.5:1. Acute lymphoblastic leukemia was the most common type of leukemia in the children and adolescents. Acute Myeloid leukemia was more prevalent in adults. Peripheral blood smear and bone Conclusion: marrow aspiration study still remains the important tool along with cytochemistry, immunophenotyping and cytogenetic study in the diagnosis and management of leukemia.

Osteogenic differentiation of rat bone mesenchymal stem cells cultured on poly (hydroxybutyrate-co-hydroxyvalerate), poly (ε-caprolactone) scaffolds

Bioresorbable biomaterials can fill bone defects and act as temporary scaffold to recruit MSCs to stimulate their differentiation. Among the different bioresorbable polymers studied, this work focuses on poly(hydroxybutyrate-co-hydroxyvalerate) (PHBV) and poly(ε-caprolactone) (PCL). Were prepared blends of PHBV and PCL to obtain PHBV based biomaterials with good tenacity, important for bone tissue repair, associated with biocompatible properties of PCL. This study assesses the viability of Vero cells on scaffolds of PHBV, PCL, and their blends and the osteogenic differentiation of mesenchymal stem cells (MSCs). Materials were characterized in surface morphology, DSC and Impact Strength (IS). Vero cells and MSCs were assessed by MTT assay, cytochemical and SEM analysis. MSC osteogenic differentiation was evaluated through alizarin red staining and ALP activity. We found some roughness onto surface materials. DSC showed that the blends presented two distinct melting peaks, characteristic of immiscible blends. IS test confirmed that PHBV-PCL blends is an alternative for increase the tenacity of PHBV. MTT assay showed cells with high metabolic activities on extract toxicity test, but with low activity in the direct contact test. SEM analysis showed spreading cells with irregular and flattened morphology on different substrates. Cytochemical study revealed that MSCs maintained their morphology, although in smaller number for MSCs. The development of nodules of mineralized organic matrix in MSC cultures was identified by alizarin red staining and osteogenic differentiation was confirmed by the quantification of ALP activity. Thus, our scaffolds did not interfere on viability of Vero cells or the osteogenic differentiation of MSCs.

Study of the efficacy and safety of dimethyloxobutylphosphonyldimethylate in complex therapy of patients with the consequences of ischemic stroke

According to the instructions, Dimethyloxobutylphosphonyldimethylate stabilizes cell membranes, restoring the reactivity of cerebral vessels, improving the functions of the large hemispheres and the brain stem. Aim. To assess the effectiveness and tolerability of the preparation Dimephosphone in complex therapy in patients with the consequences of ischemic stroke, with chronic cerebrovascular insufficiency due to atherosclerosis and/or hypertension compared to traditional therapy in patients. Materials and methods. The study included patients of both sexes aged 35 to 80 years who had an ischemic stroke. The main criteria for clinical effectiveness were the assessment of cognitive functions by MoCA scales, FAB, Modified Strup Test. Secondary indicators confirming the effectiveness of therapy were the assessment of the dynamics of cytochemical study data (indicators of mitochondrial activity of enzymes in peripheral blood lymphocytes). Results. Dimephosphone had a positive impact on cognitive functions, improved indicators of flexibility/rigidity of control, automation of cognitive functions. Indicators of mitochondrial activity of enzymes require further study. Conclusion. Dimephosphone has proved to be an effective and well tolerated drug.

FEATURES OF A DIFFERENTIAL DIAGNOSIS OF PEDIATRIC ACUTE MONOCYTIC LEUKEMIA (AML-M5a) ON THE EXAMPLE OF A CLINICAL CASE

The aim of this work was to assess the significance of investigating clinical and laboratory parameters for diagnosing acute monocytic leukemia in children on the basis of a clinical case. The article demonstrates specific features of differentiating AML M5a from other forms of acute myeloid leukemia. According to the results of hematological, morphological and cytofluorimetric studies of blood and bone marrow samples, the diagnosis of acute myeloid leukemia was established. The morphological and phenotypic characteristics of blast cells hampered the diagnosis of an AML form. However, a comprehensive analysis of the expressed CD antigens allowed acute monocytic leukemia to be identified, which diagnosis was subsequently confirmed by a cytochemical study. Thus, the clinical diagnosis was established over a short period of time. This was of importance given the rising severity of the patient’s condition requiring immediate treatment, the initial hyperleukocytosis and the development of life-threatening complications associated with leukostasis in the lungs and the central nervous system. In the presented case, the clinical manifestations of the underlying disease and the results of flow cytofluorimetry were determining factors in initiating timely specific therapy.

Cytochemical study of Rhodnius neglectus and Rhodnius prolixus salivary gland cells (Hemiptera, Triatominae)

Triatomines are hematophagous bugs of medical interest in South and Central America, where they may act as invertebrate hosts of the hemoflagellate protozoa Trypanosoma cruzi (the causative of Chagas’ disease) and Trypanosoma rangeli (Tejera, 1920). Triatomines of Rhodnius genus have salivary gland formed by two close and independent units: the principal and the accessory. This gland secretes saliva that abounds in substances that facilitate and permit feeding. Despite this importance, there are few reports on its cytochemistry. In purpose of amplifying this understanding, in this work it was investigated the nuclear structures (chromatin and nucleolar corpuscles) of salivary gland cells of Rhodnius neglectus (Lent, 1954) and Rhodnius prolixus (Stål, 1859). The salivary glands were removed from adult insects, fixed and submitted to different cytochemical methods: lacto-acetic orcein, silver ion impregnation, Feulgen reaction, Toluidine Blue, Variant method of critical electrolyte concentration and C-banding. The results evidenced predominance of binucleated cells, with bulky and polyploid nucleus, decondensed chromatin and a large nucleolar area. In addition, cytoplasmic metachromasy and a clear association between nucleolar and heterochromatic corpuscles were observed. Such characteristics were associated with intense synthesis activity to produce saliva. Besides, the heterochromatic corpuscles observed with C Banding permitted the differentiation of sexes and species.