Role of granulocyte colony stimulating factor (G-CSF) in chemotherapy induced neutropenia.

BACKGROUND: In the past decade, there have been many clinical trials investigating the potential benefits of adjunctive therapy with colony stimulating factors (CSFs) both to ameliorate or prevent profound neutropenia and its potentially life threatening consequences. Neutropenia is the most common dose limiting side effects of cytotoxic chemotherapy. We decided to study the effect of same in our patients coming to haematology clinic. AIMS AND OBJECTIVES: To see the effect of G-CSF on severity of neutropenia following chemotherapy in patients of haematological malignancies and to see the effect of G-CSF on duration of hospitalization, documented infections and duration of fever as compared to control group in patients with neutropenia following chemotherapy in haematological malignancies. MATERIAL AND METHODS: Thirty patients of acute leukemia were prospectively studied. Patients were given G-CSF 24.hours following chemotherapy induced neutropenia and following parameters were observed. (a) median time to ANC recovery (b) incidence and duration of fever (c) duration of hospitalization following chemotherapy (d) incidence of documented infections. The patients were given G-CSF until the neutrophil count was >1000/ml for 3 days or maximum of 7 days. RESULTS: Mean age was 29.33 +/- 14 years in G-CSF group and 27.53 +/- 13.75 in control group. Mean duration of neutropenia was 11.4 days (p < 0.05) in G-CSF group and 15.8 days in control group. Mean duration of fever was 8.2 days in G-CSF group and 13.53 days in control group (p < 0.05). Mean duration of hospital stay was 21.33 days in G-CSF group and 25 days in control group (p > 0.05). CONCLUSIONS: The study demonstrates that G-CSF administration is efficacious in chemotherapy induced neutropenia by decreasing the duration of neutropenia and duration of fever.

A study of two-weekly incidence of ARI in under-five children of rural area of Alwar (Rajasthan).

A retrospective study of two-weekly incidence of acute respiratory infections (ARI) in the under-five children of rural area of Alwar District (Rajasthan) based on the previous fourteen days' recall by the mothers was undertaken during December 1989 to assess the magnitude of the problem and its' risk factors. The two-weekly ARI incidence was reported to be 33 episodes per 100 under-fives. Mothers in higher socio-economic strata reported higher incidence of ARI for their children due to more accurate recall. Majority of ARI cases (76 per cent) were found to be of mild degree. 26 per cent of deaths in under-fives during the previous year were reported to be ARI-related. 50 per cent of ARI cases were left untreated. Among the treated group, private practitioners were found to be the main source of health care.

Outbreak of cholera in Berasia block of Bhopal District in Madhya Pradesh.

Bhopal district, Madhya Pradesh has been considered to be free of cholera. In an outbreak of gastro-enteritis in Berasia block of Bhopal district, Cholera vibrio Inaba and Ogawa were isolated from 17.64 per cent of stool samples collected. Extreme insanitary conditions, large aggregation of uncontrolled population and probably consumption of infected ice candies were responsible for the outbreak of cholera.