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Introduction: Optimal DNA and RNA quantity and purity is essential for downstream molecular biology experimentation and to avoid re-processing of sample. Despite availability of different kits and automated systems for nucleic acid isolation there is limited data on their performance evaluation, more so with pediatric blood samples, that are usually compromised in quantity. Hence, we evaluated the performance of automated QIAcube platform using pediatric blood samples in parallel with manual Qiagen extraction kits. Materials and Methods: A total of 500 samples were analyzed based on groups of PBMC and direct blood input. The isolated DNA and RNA were surveyed for quantity and quality tests by spectrophotometric and downstream analysis. Results: There was no significant difference in the DNA quantity (ng/ul) between manual and automated method based on similar sample input but quality (260/280) was significantly better with the QIAcube platform when direct blood and or PBMCs were used for extraction respectively (1.82 ± 004 Vs. 1.84.002; P-0.000008 and 1.859 ± 005 Vs. 1.843 ± 0.003; P-0.02). Moreover, the standard error mean was low for both quantity and quality in the QIAcube method suggesting uniformity. Comparison of quality assessment by spectrophotometer and qubit fluorimeter showed that QIAcube sheared DNA less (P- 0.038) as compared to manual method (P-0.013). Also, time taken to process the samples in QIAcube was 23% less than the kit-based method. Conclusion: Overall analysis of QIAcube platform suggests that it yields more better, uniform, and less-sheared quality of nucleic acid in a relatively less time as compared to manual extraction kits.
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Acquired diaphragmatic hernias (ADH) are uncommon following penetrating thoraco-abdominal injuries. This is a case report of ADH with bowel obstruction following an old penetrating abdominal trauma without any signs and symptoms of respiratory distress.
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Primary retroperitoneal mucinous cystadenomas (PRMCs) are observed more frequently in women with no specific symptoms. A 35 Years old female patient presented with Intermittent abdominal pain in her left flank associated with fullness in abdomen. CECT confirmed a well-defined smoothly marginated homogenous non-enhancing unilocular cystic lesion in retroperitoneum in left lumbar region, separated from the pancreas, left kidney and ovary. On Laprotomy, the retroperitoneal tumor was completely removed, without spillage of its contents.
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Introduction: Objective of this study is to determine the knowledge, attitude and practice regarding type 2 diabetes in diabetics as well as in Non-diabetics and also to determine the knowledge versus practice gap among diabetics. There is almost no study of this kind from Uttar Pradesh region of India. Material and method: A pretested and validated questionnaire were used for assessment of these parameters. This questionnaire was divided in to 3 parts. First part used for assessment of knowledge in all the study subjects and had 8 questions. Second part had five questions based on risk factors and complication of diabetes. Third part was used only for diabetics and again had five questions based on their health care seeking behavior. A total of 412 study subjects (206 diabetics and 206 Non-diabetics) were interviewed and their responses were noted in this questionnaire form. Results: 50% of the diabetics are in the age group category of 41-60 years. > 50% of non-diabetics are in the age group category 21-40 years. Most of the respondents were aware of symptomatology, non-communicability, need of self-monitoring of glucose at home and rapidly increasing incidence of diabetes. Almost 70 % of diabetics were aware about foot care and Very nominal number of diabetics (7.8%) was consuming sweets daily. A disheartening fact revealed that approximately 87% of diabetics do not carry sugar candy or any form of sugar before leaving home to correct any hypoglycemic episode. Conclusion: Knowledge of symptomatology of diabetes and requirement of self-monitoring of blood glucose at home was adequate among most of the study subjects and uniformly distributed among diabetics and Nondiabetics. More than 80% of diabetics were not aware about hypoglycemia symptoms and its treatment. Training of health care providers and large-scale education and awareness campaigns are the need of the hour for this region to further improve the knowledge and to improve self-care practices among all Diabetics.
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Oculocutaneous albinism is characterized by partial or complete absence of melanin in retinal pigment epithelium (RPE) and uveal melanocytes. Absence of typical fundal background from RPE and choroid makes it difficult to diagnose retinal disorders in ocular albinism. Lack of melanin in RPE makes the laser photocoagulation very challenging in these cases. This report presents a unique case of preterm infant of oculocutaneous albinism diagnosed as aggressive posterior retinopathy of prematurity (APROP), which was successfully treated with diode laser photocoagulation. The parameters of the laser used in this case were higher than usual, just enough to achieve blanching of retina. This report highlights the fact that the diagnosis of APROP and its treatment with laser is challenging in the presence of oculocutaneous albinism, but it is possible to achieve complete regression using diode laser at higher parameters.
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Background: Awake fiberoptic intubation is the gold standard technique for the management of the predicted difficult airway. The patient’s tolerance and the success of fiberoptic-assisted nasotracheal intubation depends on the effectiveness of topical anaesthesia. Aim of this prospective randomized comparative study was to compare three techniques of spray-as-you-go using topical anaesthesia, namely lignocaine injected through working channel, epidural cathether and angiographic cathether taking into consideration - severity scale, patient reaction score, intubation time, total dose of lignocaine and complications in patients during intubation. Methods: Sixty ASA 1 or 2 patients of either sex aged 18-60 yrs scheduled for elective surgery with predicted difficult airway were equally divided into three groups(n=20),received 0.1% xylometazoline in both nostrils and 10% lignocaine sprayed into nares and posterior pharyngeal wall. Thereafter patients received 6ml of 4% lignocaine in four aliquots either by working channel in group A, or via epidural catheter in group B, or via angiographic catheter in group C along with oxygen attached through three way tap proximally. Intubation time, reaction score, cough count, stridor, extra local anaesthetic requirement, severity score were recorded. Vital parameters blood pressure, SpO2, ECG, pulse rate were monitored. Results: Group A patients showed shorter intubation time (p<0.0005) with better severity score and less local anaesthetic requirement maintaining stable vital parameters with lower incidence of cough. Reaction score was better in group A than Group B & C. Conclusion: In conclusion spraying directly through the working channel along with oxygen provided effective local anaesthesia and was preferred by both patient and endoscopist.
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Background & objectives: Significance of apoptosis as a prognostic marker is less well studied in paediatric acute lymphoblastic leukaemia (ALL) cases. Hence, a prospective study, involving 30 paediatric ALL cases, was done to assess the clinical relevance of in vivo apoptosis. Methods: Peripheral blood mononuclear cells from all patients were subjected to annexin V/propidium iodide staining to detect the degree of apoptosis [apoptotic index (AI)] at day 0 and day 35 post-induction chemotherapy. In addition, Bax and Bcl2 apoptotic protein expressions were studied at day 0 and their relative fluorescence mean intensity (RFMI) ratios were calculated. Results: Mean age of patients was 5.1 years. Of the 30 cases, 21 (70%) were at standard-risk, five (17%) at intermediate and four (13%) at high risk. Majority (83%) were B-ALL. Day 8 absolute blast count was >1000/?l in seven (23%) and <1000/?l in 23 of 30 (77%) cases. Day 35 marrow was M1 in 23 (92%) and M2 in two of 25 (8%) cases. AI at day 0 and day 35 ranged from 0.9 to16.6 per cent and 1.4 to 62.8 per cent with a mean of 5.90 and 19.64 per cent, respectively. The Bax/Bcl2 ratio ranged from 0.2 to 3.5 with a mean of 0.83. The ratio was predominantly anti-apoptotic, i.e. <1 (77%). A significant association was noted between low AI at day 0 and high total leucocyte count (P=0.02), T-cell phenotype (P=0.043) and high-risk as per NCI category (P=0.025). Significant increase (>30%) in day 35 AI was seen in only six cases. Interpretation & conclusions: Our study showed that low AI at day 0 was associated with a high-risk clinical phenotype in paediatric ALL. However, studies on larger group, especially with longer follow up or study of relapse cases, will help draw conclusions regarding apoptosis assessment in paediatric ALL.
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Children with high body mass index (BMI) are at risk of irondeficiency. In present study, 71 children with overweight or obesitywere screened for iron deficiency. Mean BMI, ferritin and plasmasoluble transferrin receptor (sTrfR) levels were 26.1 kg/m2, 41.9?g/L and 0.375 mg/L, respectively. Twenty (28%) children hadanemia, and 44 (62%) had an underlying hypoferraemic state.
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OBJECTIVE: The aim of the study was to evaluate the impact of traumatic lumbar puncture (TLP) at diagnosis of relapse in childhood acute lymphoblastic leukemia (ALL). Risk factors associated with TLP were assessed. MATERIALS AND METHODS: A retrospective analysis was performed from the records of children with ALL who were treated from January 2010 to December 2012. RESULTS: A total of 311 patients with median age of 5 years (range: 1–13) were treated for ALL. The cerebrospinal fluid analysis obtained from first LP revealed 275: Central nervous system 1 (CNS 1) (no blasts); 8: CNS 3 (blasts positive); and 28: TLP. Twenty‑eight (9%) patients relapsed. Twelve (3.9%) had a CNS relapse. A TLP at diagnosis was not associated with an increased risk of systemic or CNS relapse (P = 0.298, 0.295). Three years event‑free survival of patients with TLP and without atraumatic LP (ATLP) at diagnosis was 56 ± 5.2% and 51.8 ± 12.4%, (P = 0.520). Three years overall survival with TLP and ATLP was 73.3 ± 3.5% and 70.4 ± 12.5%, respectively, (P = 0.963). Median platelet count in patients with TLP was significantly lower than those without TLP (10,000/μL and 28,000/μL, P < 0.001). A receiver operating characteristic curve was constructed for predicting the risk of TLP based on platelet count. Area under the curve was 0.74 ± 0.05 (95% confidence interval 0.64–0.84). Platelet count < 23.5 × 109/L at the time of LP had 75% sensitivity and 64.4% specificity in predicting a TLP. CONCLUSIONS: Low platelet counts are significantly associated with risk of TLP. Traumatic LP at diagnosis was not associated with an increased risk of relapse.
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Malakoplakia cervix is still not reported in literature. Inflammatory lesions of cervix on visible appearance mimic as cervical malignancy. Histopathology confirms the diagnosis. Aim is to highlight the fact that errors occur in medical practice, if all differential diagnosis are not thought. A proper histopathological diagnosis is mandatory before final diagnosis.
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AIM: To assess the efficacy of internal sphincterotomy compared with application of topical 2% Diltiazem ointment after hemorrhoidectomy for pain relief. SETTINGS AND DESIGN: Prospective randomized study. MATERIALS AND METHODS: In an 18-month period, 108 subjects with uncomplicated Grade 3/ 4 hemorrhoids were enrolled in the study and were randomized into two equal groups: Subjects in Group A underwent internal sphincterotomy at time of primary surgery while those in Group B received 1 g of 2% Diltiazem ointment locally, thrice daily for seven days. Postoperative pain perception was measured using visual analog score (VAS) and on the basis of number of analgesic tablets (Tab tramadol 50 mg) required in each group. Time to discharge, time to return to work and incidence of complications measured and compared. STATISTICAL ANALYSIS USED: Statistical techniques applied were Student T test, Chi-square and Fisher's Exact Test. RESULTS: There were 102 analyzable subjects (Group A: 50 and Group B: 52). The mean VAS score was significantly less in the internal sphincterotomy group from the fourth postoperative day onwards compared to topical Diltiazem (2.23 vs. 3.72; P =0.031). Similarly, the mean requirement of analgesic tablets [10.54 vs. 15.40; P =0.01] was much lower in Group A. There was no significant difference in terms of time to discharge and time to return to work between the two groups. The incidence of complications was more with the internal sphincterotomy group (11.5% vs. 3 %; P =0.488). CONCLUSIONS: In patients undergoing hemorrhoidectomy, addition of surgical internal sphincterotomy results in lesser pain in the postoperative period as compared to those receiving topical application of Diltiazem.