RESUMO
BACKGROUND: With the incorporation of molecular subtyping in glioma patients in 2016 WHO classification, there is a need to understand the immunohistochemistry (IHC) marker expression in various glioma patients and to clinically correlate with various subgroups. OBJECTIVE: Aim of the study was to assess IHC marker expression profile in glioma patients and to clinically correlate them in various subgroups. MATERIALS AND METHODS: The prospective study included 115 glioma patients. IHC markers (isocitrate dehydrogenase [IDH] 1, ATRX, P53, Ki-67 antibody) were done in all patients. Patients received treatment as per the grade of tumor. The patients were followed in 3 monthly intervals, for a period of 12 months. SPSS software version 20.0 was used for statistical analysis. Tables were prepared in Microsoft Excel sheet. Kaplan-Meier method was used for survival analysis. RESULTS: There were 11 Grade 1, 33 Grade 2, 26 Grade 3, and 45 glioblastoma multiforme (GBM) patients out of which 10 patients were secondary GBM cases. IDH1 mutation is frequent in Grade 2 and Grade 3 tumors of both astrocytic and oligodendroglia tumors. Its mutation is also common in secondary GBM patients. ATRX mutation is specific to astrocytic lineage, Grade 2, Grade 3, and secondary GBM patients. CONCLUSION: Molecular nature of DA and AA cases can be accurately confirmed by combined IDH1 and ATRX IHC thereby avoiding costly investigations such as fluorescence in situ hybridization. In astrocytic tumors, p53 can act as a surrogate marker. IDH-mutant glioma patients have better prognoses than IDH wild gliomas.
RESUMO
Spinal cord compressing syndrome due to synovial cyst (SC) of the thoracolumbar spine is a rare clinical condition. In this report we aim to heighten awareness of the thoracolumbar facet synovial cyst as a possible cause of thoracic myelopathy. The SC was removed thoroughly by laminectomy. The patient had an excellent recovery. The etiological and therapeutic aspects are discussed.
RESUMO
Total knee arthroplasty(TKA) is associated with extensive postoperative blood loss. Despite various studies proving the efficacy of Tranexamic Acid (TEA) with single or multiple boluses of different sizes with or without subsequent infusions, no consensus has been reached on the dose of tranexamic acid to be administered or the duration of treatment. In this study, we have investigated in a homogenous healthy population undergoing total knee arthroplasty, if administration of a high dose of tranexamic acid has a blood sparing effect. They were found to be significant with high power concluding a decrease in total blood loss in patients who were administered Tranexamic Acid (TEA) during Total Knee Arthroplasty (TKA). A dose regimen of 15 mg/kg every 8 h for 24 h would seem appropriate as longer administration of TEA was not accompanied by further reduction in blood loss.
