ABSTRACT
Background: Hairy cell leukemia is a mature lymphoid B cell disorder, characterized by hairy cells, a specific genetic profile, different clinical course and the need for an appropriate treatment. It is seen primarily in elderly, characterized by a triad of splenomegaly, pancytopenia and monocytopenia. Aim: To evaluate clinicopathologically and with immunophenotyping hairy cell leukemia cases received at our institute in conjunction with similar studies. Material and methods: This is a retrospective study which included 7 cases over a period of 3 years (2019-2021) confirmed on morphology and flow cytometry. Results: The study revealed 7 cases which showed patients with age ranging from 34-65 years. M:F ratio was 6:1. Two cases were covid positive (28.5%). Most of the cases presented with fever, weakness (28.5%). Splenomegaly was seen in three of the cases (42.6%). Laboratory investigations revealed anemia in 71% cases, leucopenia in 56.8%, lymphocytic prominence in 100% and pancytopenia in 14.2%. One patient presented with leukocystosis (14.2%). Marrow was hemodiluted and aparticulate in 3(42.6%) cases. Hairy cells were seen on morphology of peripheral smear and marrow aspirate. On flow cytometry, CD5 negative in all cases (100%), CD10 positive in 2(28.5%) and CD23 in 2 cases (28.5%). Few cases confirmed BRAF v600e mutations. Conclusion: Unusual findings like leukocytosis, absence of spleen, presence of lymphadenopathy can be present in hairy cell leukemia. Classical fried egg appearance in trephine biopsy may not be afeature in all the cases. CD123 is expressed in covid patients unlike other studies and further research is needed to establish the loss of CD123 in covid patients.
ABSTRACT
Introduction: Antimicrobial-resistant HAI (Healthcare associated infection) are a global challenge due to their impact on patient outcome. Implementation of antimicrobial stewardship programmes (AMSP) is needed at institutional and national levels. Assessment of core capacities for AMSP is an important starting point to initiate nationwide AMSP. We conducted an assessment of the core capacities for AMSP in a network of Indian hospitals, which are part of the Global Health Security Agenda-funded work on capacity building for AMR-HAIs. Subjects and Methods: The Centers for Disease Control and Prevention's core assessment checklist was modified as per inputs received from the Indian network. The assessment tool was filled by twenty hospitals as a self-administered questionnaire. The results were entered into a database. The cumulative score for each question was generated as average percentage. The scores generated by the database were then used for analysis. Results and Conclusion: The hospitals included a mix of public and private sector hospitals. The network average of positive responses for leadership support was 45%, for accountability; the score was 53% and for key support for AMSP, 58%. Policies to support optimal antibiotic use were present in 59% of respondents, policies for procurement were present in 79% and broad interventions to improve antibiotic use were scored as 33%. A score of 52% was generated for prescription-specific interventions to improve antibiotic use. Written policies for antibiotic use for hospitalised patients and outpatients were present on an average in 72% and 48% conditions, respectively. Presence of process measures and outcome measures was scored at 40% and 49%, respectively, and feedback and education got a score of 53% and 40%, respectively. Thus, Indian hospitals can start with low-hanging fruits such as developing prescription policies, restricting the usage of high antibiotics, enforcing education and ultimately providing the much-needed leadership support.
Subject(s)
Burkitt Lymphoma/diagnosis , Humans , Infant , Male , Nasopharyngeal Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
Agarose Gel Serum Electrophoresis is a simple, rapid and sensitive technique routinely used for diagnosis of Multiple Myeloma. Its effectiveness as a screening tool for detecting infraclinical cases of Multiple Myeloma is brought out in this study. 29 out of the 219 patients presenting with unexplained osteoporosis and pain are found to be positive for M proteins. These patients were earlier adjudged organic disease free after preliminary investigation and examination.