[ unusual cause of acute central chest pain during advanced pregnancy]

Acute chest pain in pregnancy can have diverse etiologies ranging from simple to life threatening conditions. A structured approach is needed to reach the correct diagnosis in these cases. We report a case of acute chest pain due to chicken bone impaction in esophagus in advanced pregnancy

Tumour lysis syndrome in haematological malignancies

Objectives: this study was conducted to determine the frequency of tumor lysis syndrome [TLS] in hematological malignancies

Materials and methods: this descriptive study was conducted at Liquate National Postgraduate Medical Centre from October 2005 to April 2006 over a period of six months. Total 50 patients with diagnosed hematological malignancies were included in the study and data were collected by non-probability convenient sampling. Patients pretreated for their malignancy were excluded from the study. Venous samples for serum uric acid, LDH, phosphorus, calcium, potassium and creatinine were collected on admission, before starting chemotherapy and then for four days after starting the chemotherapy. All patients received adequate hydration, allopurinol and induction chemotherapy. Data were analyzed by statistical package for social sciences [SPSS] version16.0

Results: out of 50 patients 10 fulfilled the criteria for TLS. Six patients developed laboratory tumor lysis syndrome [LTLS], whereas 4 developed clinical tumourlysis syndrome. Acute renal failure was observed in 4 out of 10 patients. Overall 3 patients died because of TLS. Hyperuricemia and lactate dehydrogenase above 2000 IU were the most prominent findings in patients with TLS

Conclusion: it is concluded that 20% of the patients developed TLS [including both laboratory and clinical TLS and despite all measures of prevention it can occur and result in devastating clinical effects