Epidemiology and Spectrum of lymphoma in a single tertiary care hospital of North India

Background: Non-Hodgkin抯 Lymphoma is a common hematological malignancy. Its incidence and distribution in India are slightly different from developed nations. The study was initiated to obtain the epidemiological, clinical and histopathological spectrum of lymphoma in a single tertiary care hospital of North India. Methods: 104 eligible consecutive cases of lymphoma were retrospectively analyzed from January 2016 to March 2020. Morphology and immunohistochemistry were performed and clinical details were captured from hospital information system. Cases were reclassified according to WHO classification of Tumors of Hematopoietic and Lymphoid Tissue 2017 and also clinically as nodal and extra nodal lymphomas and analyzed. Results: Among the included patients 14.4% patients are diagnosed as Hodgkin抯 lymphoma (HL) while 85.5% belonged to non-Hodgkin抯 lymphoma (NHL). Median age for NHL is 52.5 years. Male outnumbered females in both NHL and HL with ratio of 1.87 and 1.5. Majority of NHL are mature B-cell neoplasm (83.1%), while mature T-cell and NK cell neoplasm are less (14.6%). Most common subtype found is Diffuse large B-cell lymphoma (52.8%) followed by Primary diffuse large B cell lymphoma of CNS (15.7%). Primarily nodal Vs extranodal involvement is seen in 51.9% and 48% of cases. Most common extranodal site is CNS followed by GIT and spine. Conclusion: In the present study DLBL is the most common subtype seen in 52.8% of cases in concordance with other studies but the sticking difference here is low incidence of follicular lymphoma and CLL/SLL and a much higher incidence of Primary DLBCL of CNS. There is an Inherited selection bias because the cases are collected from single institution; however, causes and reasons should be more extensively investigated.

Bioconjugate-loaded solid lipid nanoparticles for enhanced anticancer drug delivery to brain cancer cells: An in vitro evaluation

Background & objectives: The treatment of brain cancer is still challenging for an oncologist due to the presence of the blood-brain barrier (BBB) which inhibits the entry of more than 98 per cent of drugs used during the treatment of brain disease. The cytotoxic drugs used in chemotherapy for brain cancer treatment also affect the normal cells due to lack of targeting. Therefore, the objective of the study was to develop tween 80-coated solid lipid nanoparticles (SLNs) loaded with folic acid-doxorubicin (FAD) conjugate for site-specific drug delivery to brain cancer cells. Methods: The FAD conjugate was synthesized by the conjugation of folic acid with doxorubicin and characterized by Fourier transform infrared spectroscopy and proton nuclear magnetic resonance spectroscopy. SLNs loaded with FAD were prepared by the solvent injection method. The SLNs were characterized by the particle size, zeta potential, surface morphology, entrapment efficiency, etc. Results: The average particle size of FAD conjugate-loaded SLNs (SLN-C) was found to be 220.4±2.2 nm, with 36.2±0.6 per cent entrapment efficiency. The cytotoxicity and cellular uptake were determined on U87 MG cell lines. Half maximal inhibitory concentration value of the SLN-C was found to be 2.5 ?g/ml, which confirmed the high antitumour activity against brain cancer cells. Interpretation & conclusions: The cell line studies confirmed the cytotoxicity and internalization of SLN-C in U87 MG brain cancer cells. The results confirmed that tween 80-coated SLNs have the potential to deliver the doxorubicin selectively in the brain cancer cells.

Knowledge, Attitude, And Practices Of General Practitioners And Homeopaths Regarding Food Allergy And Anaphylaxis In India- A Comparative Study

Food allergy (FA) is a growing health problem in India and worldwide with notable prevalence in infants when compared with children and adults. Multiple genetic and nutritional factors play an important role in etiology of FA leading to morbidity and mortality. As general practitioners (GPs) and homeopaths are the first persons to be approached by patients with possible FA, the need for evaluating their Knowledge, Attitude and Practices (KAP) towards the same are essential to be studied.A total of 214 participants- 107 GPs with or without specialization in Internal Medicine and 107 homeopaths participated in the study. A validated questionnaire was adopted to assess their KAP. The questionnaire had 31 parameters (demographic details-5, knowledge-21 and attitude and practices-5) regarding symptoms, severity, risk factors, diagnosis and treatment of FA. The score was recorded and results with p-value ≤0.05 were considered statistically significant.A significant difference in the perception of FA was observed between GPs (42.1%) and homeopaths (10.3%) regarding the safety of administering influenza vaccines in children with egg allergy (p=0.003). 80.4% of GPs and 23.3% homeopaths believed that epinephrine is the 1st line choice for treatment of anaphylaxis (p=0.035). 64.5% GPs and 28.1% homeopaths opined that timely administration of epinephrine prevents fatal anaphylaxis which was statistically significant. (p=0.046). However no statistically significant difference (p=0.112) was found between GPs (65.4%) and homeopaths (58.9%) in their opinion regarding the reliability of positive skin prick test or radioallergosorbent test (RAST) as sufficient FA diagnostic tool. The total scores obtained regarding the knowledge in FA and anaphylaxis by GPs and homeopaths was 66.4% and 46.8% respectively which was not found to be statistically significant (p=0.172).Overall knowledge of FA in GPs and homeopaths was comparable with strengths and weakness in each domain. GPs had more precise knowledge than homeopaths, regarding the treatment schedule, in case of anaphylaxis, which in turn reflects the differences in attitude and approach in treating FA among the two groups. Periodic educational programs focused at improving the knowledge regarding food allergy and treatment options is a prerequisite among GPs and homeopaths help them to understand better as well as treat the adverse effects of FA

Familial calcific band-shaped keratopathy: report of two new cases with early recurrence.

We report two siblings with the rare entity of familial calcific band-shaped keratopathy (BSK). Detailed ophthalmic and systemic investigations failed to reveal any underlying causative pathology. Topical disodium ethylenediamine-tetraacetate (EDTA) was applied for 30 min to all four eyes. In addition the right eye of the younger sibling required a superficial keratectomy. An improvement in corneal clarity was seen in the immediate postoperative period in both siblings. Histopathology of the keratectomy specimen revealed linear extracellular sub-epithelial granular calcium deposits. However, an early recurrence was noted in all four eyes at four weeks postoperatively. We report the second instance in the English literature of this entity. Band-shaped keratopathy presenting without an obvious etiology merits a complete systemic and ophthalmic workup. Patients with familial idiopathic BSK could be cases with poor prognosis for treatment with EDTA due to an early recurrence of the disease.

Hypolipidemic activity of silver preparations in chicks, Gallus serregineus.

Three silver preparations (Varak or foil, ash or Raupya bhasma and sol or colloidal solution) were fed to three groups of young, male chicks for 10 days. There was significant fall in all the plasma lipid fractions--total lipids, phospholipids, triglycerides and total cholesterol. There was a marked rise in silver content of plasma and whole blood, ranging from 4 to 13 times, suggesting that the observed hypolipidemic action may be due to silver. The administration of the three silver preparations did not cause any retardation in growth, toxic manifestation, side effect or untoward reaction.