ABSTRACT
Background: Chronic myeloid leukemia (CML) is relatively rare in pediatric and adolescent age groups. The purpose of this study was to evaluate the clinical, hematopathological, and biochemical parameters of CML in pediatric and adolescent age groups, along with an assessment of the treatment response with first-line tyrosine kinase inhibitors (TKI) and its correlation with the prognostic scoring systems of adults. Materials and Methods: A retrospective study of 44 Breakpoint Cluster Region-Abelson leukemia virus (BCR-ABL1)-positive pediatric and adolescent CML cases registered at our hospital was done. The clinical and laboratory parameters were evaluated using hospital software. The treatment response was monitored and scoring was performed using mathematical calculations. Results: The mean age was 11.6 (±4.7) years. The median hemoglobin was 8.4 g/dL and 63.6% of the cases showed white blood cell (WBC) counts >250,000/?L. The average follow-up was 21 months. A total of 97.7 and 78.1% cases achieved complete hematological response (CHR) and molecular response, respectively, during the treatment course. The maximum number of patients had low Sokal and European treatment and Outcomes Study (EUTOS) scores. Seventy-five per cent of the cases achieved CHR at 3 months, while 73.6 and 78.6% CML-Chronic phase (CP) cases with low Sokal and EUTOS scores achieved CHR at 3 months, respectively. Conclusion: This study revealed that the CML cases in pediatric and adolescent age groups are normally present with higher WBC counts at the time of diagnosis. The association of the prognostic scoring system with treatment response was statistically insignificant. However, a larger cohort study is needed to determine the treatment response of TKI in children and adolescent CML and its correlation with the prognostic scoring systems.
ABSTRACT
Background: Stress is an inevitable and important part of being a student: It motivates and stimulates learning. However, intense stress can arouse feelings of fear, uselessness, anger, incompetence, and guilt. Aims and Objectives: The study aimed to assess stress levels, sources, and its associated determinants and hence appropriate measures can be taken in tackling them at the earliest stage. Materials and Methods: Before the study each subject was told about the purpose and nature of the study. They were also counseled about the maintenance of confidentiality, in addition to their informed consent. A cross-sectional questionnaire-based survey was given to the undergraduate medical students of Apollo Institute of Medical Sciences and Research, Murukambattu, Chittoor who were willing to participate in the study. The medical student stressor questionnaire was be used to assess the sources of stress. Results: Highest stressors domain was dominated by Domain I: Academic related stressor. For 1st and 4th year students, large amount of content to be learnt had the highest score. For 3rd year students, falling behind in reading schedule is said to be the major stress factor. For 2nd year students the major stress was getting poor marks. Severe stress was present in 4 out of 6 domains for 3rd year MBBS students. When we compared the stress levels in female and male students, the stress levels of all six domains were more in females as compared to males and P value of 4 out of 6 domains were statistically significant. Conclusion: Academic-related problems were the major stressors among medical students. Females had a significantly high level of stress. Year of study was the best predictor of a medical student’s stress level. The findings can help medical teachers understand more about stress among their students and guide the way to improvement in an academic context, which is important for student achievement.