ABSTRACT
BACKGROUND: Hemoglobin disorders are the leading health concern in the world including India. There is a paucity of literature on the spectrum of hemoglobin disorders in southern districts of Odisha state. This study was undertaken to elucidate the occurrence of different hemoglobin disorders in a tertiary health care facility of Odisha state, India. METHODS: The study cases were suspected patients of all age groups advised for screening of different hemoglobin disorders. Hemoglobin disorders were screened by sickling slide test and high-performance liquid chromatography (HPLC) using the Variant-II hemoglobin testing system as per the manufacturer's guidelines. RESULTS: Over 2 years, 2332 blood samples (including 1102 pediatric and 1230 adult cases) were investigated, out of which, 1380 (59.2%) of cases had abnormal hemoglobin disorders. The most common was sickle cell disorders (48.67%, 1135/2332) followed by ß-thalassemia (11.32%, 264/2332). Some rare variants were detected as hemoglobin D-Punjab, hemoglobin E, hemoglobin Lepore, hereditary persistence of fetal hemoglobin, hemoglobin with high P2 window, hemoglobin with high P3 window etc, Among the cases with abnormal hemoglobin disorders, 744 (53.9%), 545 (39.5%) and, 91 (6.6%) cases were found to have the heterozygous, homozygous and, double heterozygous state. Of the 188 ante-natal cases screened, 31.4% of cases had abnormal hemoglobin variants with sickle cell disorders being the most prevalent one. CONCLUSION: Along with the high occurrence of sickle cell disorders in the study area, some other rare hemoglobin disorders are also prevalent which calls for a large community-based cohort study.
ABSTRACT
After performing its role in procreation during the reproductive years, the fallopian tube harbours a malignancy during the postmenopausal years like any other reproductive organ and putting a diagnostic dilemma as to the source of primary focus. A rare case of primary adenocarcinoma of fallopian tube is reported in a 71 years postmenopausal P6L5, presented with pain abdomen for 6 months, loss of appetite and abdominal distension for 4 months and on and off serosanguineous vaginal discharge for 1 month. After clinical and laboratory evaluation it was provisionally diagnosed as a case of adenocarcinoma of ovary. Exploratory laparotomy was carried out and the intra-operative diagnosis was fallopian tube carcinoma with intraperitoneal metastasis--surgical stage III disease. Cytoreductive surgery was performed. Histopathology confirmed the diagnosis. Surgery was followed by chemotherapy with cisplatin and cyclophosphamide regime. Due to advanced stage of the disease and general debility of the patient, although dubulking and chemotherapy course was not perfect but patient improved in her general condition. Now she is leading a symptom-free healthy life after 3 years of treatment; follow-up with CA-125 and USG showing no evidence of secondaries. The disease process is presented in advanced stage early in the course of disease even without involving the muscularis and serosa in contrast to ovarian carcinoma which has to come through the capsule.
