Characterization and anti‑microbial susceptibility of bacterial isolates: Experience from a tertiary care cancer center in Delhi.

BACKGROUND: Hospitalization for fever in cancer patients is associated with considerable morbidity, mortality, and cost. AIM: The aim of this study was to study the bacterial spectrum and susceptibility patterns of pathogens in culture positive patients from the oncology unit of our hospital. METHODS: We retrospectively reviewed the medical records of patients admitted in our cancer center (medical, radiation, and surgical oncology) from January to December 2013. Blood and respiratory secretions from the indoor patients were evaluated. RESULTS: Of the total 693 samples, 76.4% were Gram‑negative and 23.6% were Gram‑positive. The most common bacterial isolates among Gram‑negative organisms in blood were Escherichia coli, Salmonella and among the Gram‑positive organism were Staphylococcus aureus and Enterococcus. Among the blood isolates extended spectrum of beta‑lactamase, multidrug‑resistant (carbapenem‑resistant) and pan resistant bugs were seen in 47%, 15%, and 5% of the blood isolates. Among the Gram‑positive organisms, 25% respiratory isolates were vancomycin‑resistant Enterococci. CONCLUSION: We observed a high incidence of Gram‑negative isolates with clinically significant resistance to first‑line antibiotics such as cephalosporin’s, piperacillin tazobactum, and fluoroquinolones.

Hairy cell leukemia: Clinical, pathological and ultrastructural findings in Asian-Indians.

Background: Hairy-cell leukemia (HCL), lymphoproliferative disease of older age, is characterized by projections from surface of abnormal cells. Aim: The aim was to study the clinical presentation and ultrastructural changes in hairy cells (HCs) following cladribine treatment. Settings and Design: Clinical presentation, peripheral smear, bone marrow aspiration and biopsy of HCL cases diagnosed over a period of three years were reviewed. Materials and Methods: Consecutive HCL cases in Hematology clinic of a tertiary care center were enrolled. Tartarate-resistant acid phosphatase (TRAP) test was done to detect HCs and electron microscopy was done to demonstrate initial ultrastructural changes and alterations following cladribine therapy. Results: Fifteen cases of HCL, aged 32-57 years (median 47 years) were studied. The clinical presentation included splenomegaly in 15 (100%), fever in 10 (67%), hepatomegaly and pain abdomen in eight (53%), fatigue in nine (60 %) cases. The commonest laboratory features were monocytopenia in 13 (87%), neutropenia in 12 (80%), anemia in 10 (67 %) and pancytopenia in nine (60%). All patients showed symptomatic improvement on cladribine therapy. Electron microscopy after treatment (three months) showed loss of the finger like projections, characteristic bald lymphocytes, loss of ribosomal lamellar complexes, as well as decrease in mitochondria and vacuoles. Conclusions: Indian patients with HCL are younger. Cladribine is an effective therapy for these patients and leads to complete response in most of the patients. There is a significant improvement in the ultrastructural features following cladribine therapy.

Imatinib mesylate: A designer drug.

Molecularly targeted therapy is a novel approach in cancer treatment. Imatinib, a specific tyrosine kinase inhibitor, since its inception in 1990s, has become the first-line drug in management of chronic myelogenous leukemia (CML) chronic phase. It has also shown promising results in treatment of gastro-intestinal stromal tumors, clonal eosinophilic disorders and Philadelphia chromosome positive acute lymphatic leukemia. The efficacy of imatinib has geared up further research into development of designer drugs with molecular targets. This review gives a comprehensive description of the development, biology, utility, dosing, and limitations of imatinib mesylate.

Ascorbic acid metabolism in ageing recalcitrant sal (Shorea robusta Gaertn. f.) seeds.

Changes in ascorbate content and its enzymatic utilization pattern were studied in embryonic axes and cotyledons of sal seeds undergoing rapid loss of viability, at ambient conditions. Ascorbate levels were significantly higher initially in the embryonic axes (0.32 mg/g fresh weight) and cotyledons (0.21 mg/g fresh weight) of freshly mature, relatively hydrated (42.2% moisture content) and 100% viable sal seeds. It declined sharply as the tissues; embryonic axes and cotyledons, desiccated with absolutely no detectable amount in non-viable seeds (21% moisture content). Significantly strong correlation was obtained between desiccation of embryonic axes (r = 0.96) and cotyledon (r = 0.97) with loss of ascorbate levels and loss of germinability. Higher rates of ascorbic acid utilization (AAU) recorded in the embryonic axes of 100% viable seed declined sharply as the seed viability reduced due to desiccation below 36.8% moisture content. AAU was not detected in the cotyledons.