Sputum Inflammatory Cells and their Impact on Asthma Control in Adults: A Prospective Study

Background: Asthma is broadly categorized as eosinophilic or noneosinophilic. Noneosinophilic asthma (NEA) can be paucigranulocytic asthma (PGA), mixed granulocytic asthma (MGA), or neutrophilic asthma (NeuA). A relationship between the cytological type of inflammation and response to treatment with inhaled corticosteroids (ICS) in asthma has been of great interest. The objective of the current study was to predict the control of asthma according to sputum inflammatory cells. Materials and methods: A total of 58 patients were evaluated. Sputum was induced and sent for cytological examination. Patients were prescribed controller and reliever medications as per the GINA guidelines. Accordingly, subjects were divided into eosinophilic, neutrophilic, mixed granulocytic, and paucigranulocytic asthma. The response to treatment was classified as poorly controlled based on ACT score. Results: Out of 58 patients, eosinophilic asthma (EA) was 24% and noneosinophilic 76% (NeuA 17%, MGA 23%, and PGA 36%). After treatment, 14 (24.13%) patients were found poorly controlled. Poor control was in 5.17% among EA and 18.97% in NEA phenotypes. Poor control was significantly higher in females, NeuA, and MGA. Peripheral eosinophilia affects control of asthma adversely. Conclusion: Pretreatment sputum analysis can predict the asthma control and steroid responsiveness. Mixed granulocytic asthma and NeuA are difficult to control, and PGA is the best responder.

Prevalence of psychiatric ailments among patients with sexually transmitted disease.

A cross-sectional descriptive study conducted on 250 sexually transmitted disease patients was carried out in two teaching institutes and their tertiary hospitals. These subjects constitute a special group of population for psychiatric diagnosis by using Structured Clinical Interview for Diagnostic and Statistical Manual IIIR. The study was done in the dermatology and venereology outpatient department of two tertiary hospitals of Dhaka, between January 1998 and January 1999. The findings show that 34% of total sexually transmitted disease patients had psychiatric disorders. Anxiety disorders (11.2%) were found to be the most common disorder among these psychiatric patients; this was followed by depressive disorder (8.4%), psychoactive substance use disorder (6.8%), sexual dysfunction (6.8%), bipolar mood disorder (0.4%), and schizophrenia (0.4%). Four percent of anxiety disorder was associated with psychoactive substance use disorder and sexual dysfunction. Similarly 3.6% of depressive disorder was found with psychoactive substance use disorder and sexual dysfunction while 1.6% of sexual dysfunction was associated with substance use disorder. Most of the patients in the sexually transmitted disease population recruited in the present study had both anxiety disorder and depressive disorder though majority of them were undetected and untreated. These findings underscore that special attention needs to be given to the mental health component of our health care delivery system.

Lipoblastoma of the neck.

Lipoblastoma and lipoblastomatosis are benign tumours arising from embryonal fat cells. These rare tumours essentially occur in infancy and early childhood. The males are affected more than females often in the ratio of 3:1. These tumours usually arise in extremities. The involvement of neck is rare with only 10 cases reported so far in English literature. We herein report lipoblastoma of the neck in a 3 year old girl.

Humoral immunity response in malignancies with special reference to the effect of radiotherapy.

In view of the variability in the findings recorded by different authors in the level of immunoglobulins in patients suffering from malignancies, a study on 34 cases of six types of malignancies treated with radiotherapy (telecobalt and telecesium) was carried out to record the humoral response and also to compare the response during radiotherapy and after radiotherapy in these cases. Serum of 20 age-matched normal volunteers served as normal control. The study recorded that the pretherapy levels of IgA and IgG were raised in most of the cases; but the IgM was decreased than that of the control level. This is probably due to the fact that the selective clones of cells producing different types of immunoglobulins are responding to the malignancies in different ways. The midtherapy level of all immunoglobulins showed the value lower than the pretherapy level, but recovery was observed in the post-therapy period with all immunoglobulins in all the cases irrespective of the histological types of malignancies. It was also apparent from this study that the post-therapy gain in the level of immunoglobulins over midtherapy level was more pronounced in cases having telecobalt therapy. Assessment of humoral response in 25 patients suffering from squamous cell carcinoma of different grades revealed that the midtherapy fall and subsequent post-therapy gain had no definite correlation with grading.