Successful Pregnancy and Delivery with Good Maternal and Fetal Outcome in a Kidney Transplant Recipient.

Conception and successful completion of pregnancy is rare in women with end-stage kidney disease. Given the rising burden of chronic kidney disease, it is quite common to see more women in their childbearing ages being diagnosed with the condition. As the kidney disease progresses, fertility chances reduce and pregnancy becomes a rarity. In addition to dealing with dialysis and its consequences, the women with end-stage kidney disease also face the trauma of infertility and inability to start their families. At such times, pregnancy and delivery following successful kidney transplantation with return of normal kidney function, offers a ray of hope to women of childbearing ages. We report the case of a young woman with end-stage renal/kidney disease (ESRD) on hemodialysis for 2 years, who underwent cadaveric kidney transplantation with subsequent excellent allograft function. Two years post-transplantation, she went ahead with a successful pregnancy and delivery of a normal birth weight baby, and preserved renal allograft function.

Study of interleukin-6 levels in early diagnosis of neonatal sepsis.

Background: Neonatal septicemia is one of the commonest causes of neonatal mortality and morbidity. Interleukin-6 Levels appears to be one of the most promising candidate cytokine for early diagnosis of neonatal septicaemia. The aim and objectives of this study was to study the role of IL-6 levels as an early marker for diagnosis of neonatal sepsis and to compare IL-6 levels with other septic markers. Methods: This is a hospital based prospective study to evaluate the efficacy of IL-6 as an early diagnostic marker of neonatal sepsis. Eighty neonates, delivered in the hospital, having risk factors for neonatal sepsis, along with those coming to hospital with signs and symptoms of sepsis up to 28 days of life (as study group ) along with normal newborns admitted to the postnatal ward without high risk factors (control group) were enrolled for this study. Results: IL-6 Levels has shown maximum sensitivity of 95.83%, specificity of 87.50%, positive predictive value of 92%, negative predictive value of 93.33% and accuracy of 92.50 %. E. coli was the most common organism responsible for sepsis. CRP was reported to be highly sensitive (84.21%), and CBC was highly specific (75.00%), IT ratio has sensitivity of 62.5% and specificity of 56.25% while micro-ESR has shown sensitivity of 50.0% and specificity of 62.5%. Out of 80 cases, blood culture (BacTalert) showed growth in 48 cases in study group while two cases in control group. Thus blood culture positivity was 60%. Conclusion: IL-6 test has maximum sensitivity as well as specificity in comparison with other septic markers. Blood culture is the gold standard for the diagnosis of septicemia. CRP is most sensitive while CBC is most specific marker in neonatal sepsis.

Conventional and fluorescence in situ hybridization analysis of three-way complex BCR-ABL rearrangement in a chronic myeloid leukemia patient.

Chromosomal analysis was carried out in bone marrow sample of an 11-year-old girl suspected of myeloproliferative disorder. Conventional G-banding study detected a complex three-way translocation involving 7, 9 and 22, which has resulted in the formation of a variant Philadelphia chromosome causing rearrangement of abl and bcr genes in 87% cells. Fluorescence in situ hybridization (FISH) confirmed the fusion of bcr-abl oncogene. Thus the bone marrow karyotype was observed as 46,XX (13%)/46,XX,t(7;9;22)(q11;q34;q11) (87%). Hyperdiploidy was present in two cells. In this study, both conventional cytogenetic and FISH diagnosis proved to be significant to identify the variant nature of the Philadelphia chromosome and hyperdiploid condition for introduction of a suitable treatment regimen and estimation of life expectancy of the young girl.