Reticulocyte Count and Platelet Count as Predictors of Morphological Remission/Hemopoitic Recovery in Acute Lymphoblastic Leukemia (ALL) after Induction Chemotherapy

Objectives: To determine the predictive values of reticulocyte and platelet count for remission in cases of acute lymphoblastic leukemia after induction therapy.   Materials and Methods:This cross-sectional observational study was conducted in the department of hematology, MTI Hayatabad Medical Complex, Peshawar. All cases of ALL referred to the department for remission after taking induction therapy, irrespective of age and gender were included. Relevant information wascollected on a predesigned proforma prepared in accordance with the objectives of the study.   Results: A total of 84 cases referred for remission were included, 56(66.7%) were males and 28 (33.3%) were females. 50(59.5%) cases were in the age range of 5-18 years. The mean with a standard deviation of the age of patients was 15+ 4 years. 75(89.3%) of the cases were classified into ALL-1) by FAB classification. 50(59.5%) of the referred cases had achieved morphological remission by bone marrow aspiration. There was a statistically significant rise in Platelet count of the remission vs non-remission cases (p-0.001). Again there was a statistically significant difference in the retic count of the cases with remission (p-0.05). We observed a statically significant downhill moderate correlation ofretic count with remission (in termsof blast count of BM aspiration) (p-0.04, r:-0.32). Platelet count also had an inverse significant correlation with remission ( p-0.01, r:-0.37). The diagnostic roles of the peripheral platelet count and retic yielded an area under curves of (0.768 and 0.648 respectively) to predict remission.We observed that the retic count and platelet count havebeen shown to have strong predictive valuesfor remission in ALL with interaction values of (R= 0.28**, ΔR²=0.02, p=0.08). Similarly, an increase in platelet also has a strong predictive value for remission in ALL cases with interaction values of (R= 0.41**, ΔR²=0.16, p=0.001)   Conclusion: In ALL cases of post-induction therapy, The peripheral blood reading for an increase in Retic and platelet count predictsremission with 95% confidence. These values if strictly observed can reduce the frequency of invasive procedures like bone marrow aspiration.   Keywords: ALL, Remission, Reticulocyte count, Platelet count

Reticulocyte Count and Platelet Count as Predictors of Morphological Remission/Hemopoitic Recovery in Acute Lymphoblastic Leukemia (ALL) after Induction Chemotherapy

Objectives: To determine the predictive values of reticulocyte and platelet count for remission in cases of acute lymphoblastic leukemia after induction therapy.   Materials and Methods:This cross-sectional observational study was conducted in the department of hematology, MTI Hayatabad Medical Complex, Peshawar. All cases of ALL referred to the department for remission after taking induction therapy, irrespective of age and gender were included. Relevant information wascollected on a predesigned proforma prepared in accordance with the objectives of the study.   Results: A total of 84 cases referred for remission were included, 56(66.7%) were males and 28 (33.3%) were females. 50(59.5%) cases were in the age range of 5-18 years. The mean with a standard deviation of the age of patients was 15+ 4 years. 75(89.3%) of the cases were classified into ALL-1) by FAB classification. 50(59.5%) of the referred cases had achieved morphological remission by bone marrow aspiration. There was a statistically significant rise in Platelet count of the remission vs non-remission cases (p-0.001). Again there was a statistically significant difference in the retic count of the cases with remission (p-0.05). We observed a statically significant downhill moderate correlation ofretic count with remission (in termsof blast count of BM aspiration) (p-0.04, r:-0.32). Platelet count also had an inverse significant correlation with remission ( p-0.01, r:-0.37). The diagnostic roles of the peripheral platelet count and retic yielded an area under curves of (0.768 and 0.648 respectively) to predict remission.We observed that the retic count and platelet count havebeen shown to have strong predictive valuesfor remission in ALL with interaction values of (R= 0.28**, ΔR²=0.02, p=0.08). Similarly, an increase in platelet also has a strong predictive value for remission in ALL cases with interaction values of (R= 0.41**, ΔR²=0.16, p=0.001)   Conclusion: In ALL cases of post-induction therapy, The peripheral blood reading for an increase in Retic and platelet count predictsremission with 95% confidence. These values if strictly observed can reduce the frequency of invasive procedures like bone marrow aspiration.   Keywords: ALL, Remission, Reticulocyte count, Platelet count

Biometric and Ultrasonographic Evaluation of the Testis of One-humped Camel (Camelus dromedarius)

Twenty four adult clinically healthy one-humped male camels (Camelus dromedarius) were examined three times (beginning, mid and end) in each season (winter, spring, summer and autumn) for establishing the normal ultrasonic appearance and seasonal changes in the testicular parenchyma in the natural ecology of Punjab, Pakistan. The testes of each camel were scanned by using a B-mode real time ultrasound scanner fitted with a 7.5-MHz linear-array transducer. Scrotal biometry was done with the measuring tape during all the seasons of year. The tunics of the testes appeared as hyperechoic lines surrounding the homogenous, moderately echogenic parenchyma of the testis. The mediastinum testis was visualized as hyperechoic central line and a spot, in longitudinal and transverse sections, respectively. During winter season, the parenchyma was hyperechoic and mediastinum testis was seen as thin hyperechoic line. In spring, the echogenicity of parenchyma was moderate and mediastinum appeared relatively thick central hyperechoic line. In summer and autumn, less echoic parenchyma and thick band of mediastinum was recorded. Biometric studies showed significantly (P<0.01) higher scrotal length and width of the testis during winter and spring season as compared to summer and autumn. Present study revealed that the ultrasonic structure of camel testis resembles other mammals and season has an apparent effect on the testicular size and echogenicity of the testicular parenchyma in the one-humped camel

Neural Signaling and Communication

To understand the complex nature of the human brain, network science approaches have played an important role. Neural signaling and communication form the basis for studying the dynamics of brain activity and functions. The neuroscientific community is interested in the network architecture of the human brain its simulation and for prediction of emergent network states. In this chapter we focus on how neurosignaling and communication is playing its part in medical psychology, furthermore, we have also reviewed how the interaction of network topology and dynamic models of a brain network

Genetic Polymorphism of UDP-Glucuronosyltransferase

Genetic polymorphism is referred to the discontinuous interspecies genetic variability among individuals having distinct alleles on a particular locus. Genetic polymorphism of genes encoding drug-metabolizing enzymes constitutes individual’s susceptibility to drugs, affirmed by having discrete allelic frequencies by the individual, strengthening the concept of precision medicine. To combat with toxic consequences of drugs, the polymorphic genes associated with xenobiotic metabolism must be studied. Up to 70% xenobiotic elimination is believed to be dependent on UDP-glucuronosyltransferase (UGT), an enzyme encoded by polymorphic UGT1A and UGT2B genes. Both bimodal and trimodal distribution patterns of UGT have been reported in various human populations studied. Genetic polymorphisms of UGT may even lead to truncated and shorter gene with grossly diminished enzymatic activity. The extent of phenotypic alteration inflicted by genetic polymorphisms depends on its nature and position on gene locus. The different isoforms of UGT superfamily differ from each other regarding substrate specificity and selectivity. The incidence of genetic polymorphisms and associated altered gene functions results in inter-individual variability in metabolic clearance and elimination of drugs. Hence, the critical interaction between genetics and biotransformation of drugs has recently been the focus of pharmacology research

Determination of risk factors for hepatitis B and C in male patients suffering from chronic hepatitis

<p>Abstract</p> <p>Background</p> <p>Hepatitis B and C is common in Pakistan and various risk factors are attributable to its spread.</p> <p>One thousand and fifty consecutive male cases suffering from chronic liver disease (327 HBV and 723 HCV) were selected from the OPD of public sector hospital and a private clinic dealing exclusively with the liver patients. To compare the results 723 age and gender matched controls were selected from the blood transfusion services of the public sector hospital. A standard questionnaire was filled for all patients and controls which included the information on possible risk factors.</p> <p>Findings</p> <p>Family history of liver disease was significantly higher (43% and 34%) in HBV and HCV positive cases as compared to 5% in controls [odds ratio 15.6; 95% Confidence Interval CI: 10.1 -- 24.1, 10.9; 95% Confidence Interval CI: 7.3 -- 16.4] and same trend was seen for death due to liver disease in the family. Majority 74% hepatitis B positive cases had their shaves done at communal barbers but this practice was equally prevalent amongst controls (68%), thus negating it as a possible risk factor, but there is a significant risk with p < 0.05 associated with HCV in male that get their shave in barber. Very strong association of the disease was found with history of dental treatment (38% HCV 36% HBV and 21% controls) [Odd ratio 2.3; 95% CI: 1.8-3.0, Odd ratio 2.1; 95% CI: 1.5-2.8], surgery (23% HCV cases,14% HBV cases and 12% controls), history of blood transfusion was significantly higher in HCV (6%) as compared to controls (2.1%) [Odd ratio 2.9; 95% CI: 1.5-5.5]. History of taking injections for various ailments by the general practitioners (over 90% patients in both hepatitis B and C cases) was significantly higher as compared to 75% in controls [Odds ratio 3.8, 6.9; 95% CI: 2.4-6.1, 4.5-10.4] but hospitalization was not significant in HBV and HCV cases.</p> <p>Conclusion</p> <p>Injections, surgery and dental treatment appear as major risk factors for the transmission of hepatitis B and C in the community. Massive health care awareness drives need to be done for both health care providers and the public to reduce this menace.</p

Deep Learning Assisted Automated Assessment of Thalassaemia from Haemoglobin Electrophoresis Images

Haemoglobin (Hb) electrophoresis is a method of blood testing used to detect thalassaemia. However, the interpretation of the result of the electrophoresis test itself is a complex task. Expert haematologists, specifically in developing countries, are relatively few in number and are usually overburdened. To assist them with their workload, in this paper we present a novel method for the automated assessment of thalassaemia using Hb electrophoresis images. Moreover, in this study we compile a large Hb electrophoresis image dataset, consisting of 103 strips containing 524 electrophoresis images with a clear consensus on the quality of electrophoresis obtained from 824 subjects. The proposed methodology is split into two parts: (1) single-patient electrophoresis image segmentation by means of the lane extraction technique, and (2) binary classification (normal or abnormal) of the electrophoresis images using state-of-the-art deep convolutional neural networks (CNNs) and using the concept of transfer learning. Image processing techniques including filtering and morphological operations are applied for object detection and lane extraction to automatically separate the lanes and classify them using CNN models. Seven different CNN models (ResNet18, ResNet50, ResNet101, InceptionV3, DenseNet201, SqueezeNet and MobileNetV2) were investigated in this study. InceptionV3 outperformed the other CNNs in detecting thalassaemia using Hb electrophoresis images. The accuracy, precision, recall, f1-score, and specificity in the detection of thalassaemia obtained with the InceptionV3 model were 95.8%, 95.84%, 95.8%, 95.8% and 95.8%, respectively. MobileNetV2 demonstrated an accuracy, precision, recall, f1-score, and specificity of 95.72%, 95.73%, 95.72%, 95.7% and 95.72% respectively. Its performance was comparable with the best performing model, InceptionV3. Since it is a very shallow network, MobileNetV2 also provides the least latency in processing a single-patient image and it can be suitably used for mobile applications. The proposed approach, which has shown very high classification accuracy, will assist in the rapid and robust detection of thalassaemia using Hb electrophoresis images. 2022 by the authors.A part of the research was funded by the Higher Education Commission of Pakistan through its funded project of Artificial Intelligence in Healthcare, Intelligent Information Processing Lab, National Center of Artificial Intelligence.Scopu

Dental implants and Diabetes Mellitus - a systematic review

A colocação de implantes dentários é um procedimento médico dentário amplamente utilizado na reabilitação dentária. Variáveis de risco próximas e fundamentais, como diabetes mellitus, podem trazer taxas de falha mais altas. O número de pacientes com diabetes está a aumentar a cada dia, o que denota melhorias nos métodos e técnicas de tratamento para pacientes diabéticos. Optou-se por realizar uma revisão sistemática com intuito de analisar e investigar o risco associado à colocação de implantes dentários em doentes com diabéticos mellitus. Este estudo também tentou identificar os efeitos e as medidas preventivas a ter em consideração durante o procedimento de colocação de implante em indivíduos com diabetes mellitus. Para a realização desta revisão, foram utilizados 10 estudos clinicos, ́ foram analisados e obtivemos os seguintes resultados: foi evidente que os indivíduos ́ com diabetes não controlados podem ter redução da osteointegração e diminuição da sobrevida do implante dentário. Concluiu-se que o sucesso dos implantes dentários dependia principalmente do controle glicémico se os tratássemos em pacientes normais e saudáveis.Dental implant is a medical procedure broadly utilized for dental recovery. Nearby and foundational hazard variables such as diabetes mellitus can bring out higher failure rates. The number of patients experiencing diabetes is increasing day by day, which demands improvements in the treatment methods and techniques for diabetic patients. We aimed to carry out a systematic review to analyze and investigate the risk associated with dental implants to diabetic mellitus subjects. This study also attempted to identify the effects along with preventive measures taken into consideration while implanting the subjects with diabetic mellitus. To proceed with the systematic review 10 clinical studies were identified, analyzed and results obtained. It is evident that the subjects with uncontrolled diabetes may have reduced osseointegration and decreased dental implant survival. The success of dental implants mainly depended on the glycemic control of diabetes if we treat them among the normal healthy patients

New innovation in prevention of dental caries - bibliographic review

O controlo da saúde oral é essencial para a saúde do Ser Humano. Um dos grandes desafios de saúde pública continua a ser a cárie dentária. O método mais eficiente de prevenir a cárie é aplicando o flúor. O objectivo deste trabalho é o de identificar os desenvolvimentos de pesquisa e inovação na prevenção da cárie dentária. Foi realizada uma pesquisa bibliográfica recorrendo á base de dados Google Scholar, Science Direct, Research Gate, FDI report e IOSR Journals . Apenas foram incluídos artigos publicados nos últimos 10 anos em língua inglesa. Os produtos remineralizantes podem aumentar a eficácia dos iões flúor ou cálcio / sódio no uso normal de pastas dentífricas para prevenir a cárie dentária. As técnicas biomiméticas que inibem a desmineralização do esmalte e têm efeitos sinérgicos com o flúor.The control of oral health is essential for the health of the Human Being. One of the major public health challenges remains dental caries. The most efficient method of preventing cavities is to apply fluoride. The aim of this work is to identify developments in research and innovation in the prevention of dental caries. A bibliographic search was carried out using the Google Scholar database, Science Direct, Research Gate, FDI report and IOSR Journals. Only articles published in the last 10 years in English language were included. Remineralizing products can increase the effectiveness of fluoride or calcium / sodium ions in the normal use of toothpaste to prevent tooth decay. Biomimetic techniques that inhibit enamel demineralization and have synergistic effects with fluoride