A REVIEW ON THE ROLE OF TYROSINE KINASE INHIBITORS AVAILABLE FOR THE MANAGEMENT OF CHRONIC MYELOID LEUKEMIA

The function of protein kinases is to transfer a γ-phosphate group from ATP to serine, threonine, or tyrosine residues. Many of these kinases are linked to the initiation and development of human cancer. The recent development of small molecule kinase inhibitors for the treatment of different types of cancer in clinical therapy has proven successful. Significantly, after the G-protein-coupled receptors, protein kinases are the second most active category of drug targets. Imatinib mesylate was the first tyrosine kinase inhibitor (TKI), approved for chronic myeloid leukemia (CML) treatment. Imatinib induces appropriate responses in ~60% of patients; with ~20% discontinuing therapy due to sensitivity, and ~20% developing drug resistance. The introduction of newer TKIs such as, nilotinib, dasatinib, bosutinib, and ponatinib has provided patients with multiple options. Such agents are more active, have specific profiles of side effects and are more likely to reach the necessary milestones. First-line treatment decisions must be focused on CML risk, patient preferences and comorbidities. Given the excellent result, half of the patients eventually fail to seek first-line treatment (due to discomfort or resistance), with many of them needing a third or even further therapy lines. In the present review, we will address the role of tyrosine kinase inhibitors in therapy for chronic myeloid leukemia.

THE 2019 NOVEL PANDEMIC OF CORONAVIRUS DISEASE (COVID-19): A STUDY OF EXISTING EVIDENCE IN THE INDIAN POPULATION

A novel spillover coronavirus (nCoV), with its epicenter in Wuhan, China's People's Republic, has emerged as an international public health emergency. This began as an outbreak in December 2019, and till November eighth, 2020, there have been 8.5 million affirmed instances of novel Covid disease2019 (COVID-19) in India, with 1,26,611 deaths, resulting in an overall case fatality rate of 1.48 percent. Coronavirus clinical signs are fundamentally the same as those of other respiratory infections. In different parts of the world, the quantity of research center affirmed cases and related passings are rising consistently. The COVID- 19 is an arising pandemic-responsible viral infection. Coronavirus has influenced huge parts of the total populace, which has prompted a global general wellbeing crisis, setting all health associations on high attentive. This review sums up the overall landmass, virology, pathogenesis, the study of disease transmission, clinical introduction, determination, treatment, and control of COVID-19 with the reference to India.

CERVICAL CANCER SCREENING IN RURAL WOMEN POPULATION OF LUCKNOW WEST, INDIA: PROBLEMS AND BENEFITS

Carcinoma cervix is a major health problem faced by Indian women and situation is very alarming in rural population because of illiteracy and poverty. There is urgent need of creating awareness regarding the risk factors of cervical cancer such as early marriage and multiparity in the rural women and the importance of early detection of the cervical cancer. With aim for providing single life time Pap smear cover to the rural women, cervical cancer screening program was initiated in May 2013 by Era's Lucknow, Medical College and Hospital, Lucknow, through organizing camps in the villages of Lucknow ,west. Till December 2019, a total of 183 camps have been organized and 5209 women attended these camps (28.5%). Pap smear examination could be done in only 2912 women (55.9%). The incidence of squamous intraepithelial lesions of cervix (SIL) was found to be very high in these women (17.1%) though majority of SIL were of low grade (LSIL). This may be related to the poor personal genital hygiene prevailing in rural women due to illiteracy. In the present review, the SIL incidence has been extensively analyzed in relation to different predisposing factors of cervical carcinogenesis and problems faced during camp organization and the benefits derived from these camps to rural women have been highlighted.

SEWAGE WATER AS INDICATOR FOR TRANSMISSION OF SARS-COV-2

Covid-19 disease, a pandemic condition, is extremely challenging for entire world and human being. The virus, officially called coronavirus 2 (SARS-CoV-2) severe acute respiratory syndromes, is widely recognized as the COVID-19 virus is recently discovered virus and the subsequent disease known as the COVID-19. In a large percentage of cases, SARS-CoV-2 was released due to faecal matter during in the currently underway outbreak of COVID-19. This eventually proves that human wastewater could be the cause of SARS-CoV-2. Through its function, the sewage filtration system is a manifestation of microbial pathogens with the potential to support transmissible of viruses such as SARS-CoV-2 in certain conditions. The involvement with sewage surveillance through monitoring the spread of SARS-CoV-2 among our populations has been underlined in the current review, which may integrate existing medical surveillance restricted to the most severe COVID-19 patients. Although there is little success here, sewage surveillance is nevertheless a continuous field of vigorous research and could be promising in future research.

CORRELATION OF SERUM CRP & LACTATE AS AN EARLY PREDICTOR OF STRANGULATION IN ACUTE ABDOMEN

Strangulation in acute abdomen is one of the dangerous complication in patients of acute abdomen and early diagnosis is necessary for prevention of mortality. Present study was aimed to find whether serum C-Reactive Protein (CRP) and Serum Lactate can be used as early predictor for strangulation in cases of acute abdomen. A total of 75 patients with acute abdomen were included in the study. The serum CRP and Lactate values were measured preoperatively and correlated with intraop findings postoperatively. ROC curve was drawn and cutoff value for prediction of strangulation and mortality based on which diagnostic value was calculated. At cutoff level of 45.5 mg/L, CRP was 85.0% sensitive and 85.7% specific with positive and negative predictive values of 87.2% & 83.3% for prediction of strangulation in acute abdomen while sensitivity, specificity, PPV and NPV of Serum lactate was 100.0%, 91.4% 93.0% & 100.0% respectively using cutoff value ≥23.5mg/dl. Serum CRPand Lactate could be useful markers in predicting strangulation in cases of acute abdomen.

ROLE OF miRNAs IN CORONARY ARTERY DISEASE: A MINI REVIEW

While coronary artery disease (CAD) has become a major threat worldwide, early diagnosis of CAD, based on timely biomarkers, remains a major unmet clinical challenge. Micro-RNAs (miRNAs) play a pivotal role in development of the cardiovascularsystem while they are associated with multiple cardiovascular diseases. Several cardiac miRNAs (circulating miRNAs) are observable in circulation and function as biomarkers for CVDs diagnosis and therapy. C-miRNAs display various critical features as biomarkers although their distribution is incredibly stable in circulation; their expression is tissue-/diseasespecific and can be easily identified using sequence-specific amplification methods. Such circulating-miRNAs features are useful in designing non-invasive assays to track the development of CVDs. Given substantial success in serum and plasma identification of c-miRNAs. There are several conflicting studies on the alterations of circulating miRNAs concentration in circulation system. Measurements of microRNA (miRNA, miR) in patients with coronary heart disease are impeded by the confoundingeffects of medication commonly used in cardiovascularpatients.

POSTOPERATIVE SURGICAL SITE INFECTION AND PROFILE OF MICROORGANISM IN ELECTIVE LAPAROTOMIES

Laparotomy is one of the most common surgical procedures done by a surgeon. It is performed both as elective and an emergency procedure. Laparotomy procedures are prone to post-operative complications such as pain, fever, wound infection, wound dehiscence, incisional hernia, etc. The rate of these complications depends on preoperative antibiotic prophylaxis, skin antisepsis, control of contamination and surgical skills. SSI is the most common health-care-associated infection and is a cause of one-third of post-operative deaths. A prudent antibiotic prophylaxis and post-operative antibiotic management should be done. For successful management knowledge is necessary regarding the possible pathogens and their antibiotic resistance patterns. The aim of the study is to find out the incidence of SSI in elective laparotomies and to find out the type of pathogenic organism causing wound infection. This prospective observational study was conducted on 180 patients who had undergone elective laparotomy after taking an informed consent.Asterile swab for culture and sensitivity was taken Pre-operatively from incision site and sent to laboratory for assessment with normal culture technique. Repeat swabs for culture and sensitivity was done for patients with post-operative wound infection. Patients were followed up for 1 month. Out of 180 cases incidence of the SSI was seen in 17 cases of elective laparotomy (9.4%). Out of 17 SSI swab specimens 2 (11.8%) were Gram positive involving CONS pathogen, 13 (64.7%) were Gram negative involving E. coli, K.pneumoniae and Pseudomonas (41.2%, 29.4%, 5.9%) while no growth was observed in 11.8% specimens. SSIs were unaffected by demographic or operative variables. Surgical site infections were instrumental in prolonging the duration of hospital stay. Tigecycline and colistin were found to be 100 % sensitive for all the pathogens.

POTENTIAL HEALTH HAZARDS OF FORMALDEHYDE USAGE IN GROSS ANATOMY DISSECTION HALL ON STUDENTS AND INSTRUCTORS

Formaldehyde is the most frequently used chemical for embalming in dissection halls and tissue fixation in histopathological laboratories. Exposure to formalin by direct contact or in vapourised form by inhalation can produce various local and/or systemic toxic effects in students, instructors and staff working in dissection rooms. Its toxicity ranges from local irritation and allergic reactions to congenital defects and certain malignancies. This account highlights these adverse effects on medical students, demonstrators, and other staff handling the cadavers at the Anatomy department. It also suggests certain measures and precautions that can minimize formaldehyde toxicity to students and staff in gross anatomy laboratories.

A COMPARATIVE STUDY OF CONSERVATIVE MANAGEMENT VERSUS ULTRASOUND GUIDED ASPIRATION OF SMALL AMOEBIC LIVER ABSCESS

To compare the outcome of patients undergoing conservative management versus ultrasound guided aspiration of small amoebic liver abscess (=<200ml). This observational prospective study was conducted on 60 patients, aged between 18 to 80 years,After confirming the diagnosis, patients were exposed to medical management or USG guided Aspiration. Patients coming for regular follow-up after completing treatment were included in the study. It was found that the majority of the patients were male (86.7%) and with mean age of the studied patients was 37.10±12.66 years. Chief complaints were pain (100%) followed by fever (85.0%) and Nausea/Vomiting (48.3%) pallor (33.3%), icterus (25.0%) and Tenderness (16.7%). Majority of patients had the right lobe of the liver affected (93.4 %) with Single abscess (94.0%). Duration of Hospital stay and time of half reduction in size was significantly higher in conservative management than the USG guided Aspiration. Reoccurrence of abscess in conservative management was in 6 (20.0%) and need of Surgical intervention was in 4 (13.3%) patients while in USG guided Aspiration group only 1 (3.3%) patient shows Reoccurrence. No mortality was observed in our study. In the present study abscess containing volume of pus (<200 cc) was treated with either conservative treatment or USG guidedAspiration. Our data suggested that the USG guided Aspiration and conservative medical management in treatment ofAmoebic liver abscess are almost equal.

OTOTOXICITY IN MDR-TB PATIENTS ON CATEGORY-4 REGIMEN: A CASE REPORT

Multiple drug-resistant tuberculosis (MDR-TB) is a critical situation affecting adults as properly as children across the globe (1). To determine the incidence and risk factors associated with Multiple Drug Resistant Tuberculosis (MDR-TB) (2), we studied Ototoxicity on 18 culture confirmed MDR-TB patients in Eras' Lucknow Medical College and Hospital, Lucknow from September, 2019 to January, 2020. This case follows a well documented report of a patient describing an unusual and novel occurrence of ototoxicity when undergoing treatment concerning multiple drug resistance tuberculosis along with symptoms, signs, diagnosis, treatment and follow-up (3). For descriptive convenience, the patient will be classified as patient 1. The following case is the cornerstones of medical progress and provides many new ideas in medicine. Containing an extensive review of the relevant literature on the topic, the case report is a rapid short communication between busy clinicians who may not have time or resources to conduct large scale research.(4)