B-cell Prolymphocytic Leukemia in a Young Male

B-cell prolymphocytic leukemia [B-PLL] is a neoplasm of B prolymphocytes affecting the peripheral blood, bone marrow and spleen. The principal disease characteristics are massive splenomegaly with absent or minimal peripheral lymphadenopathy and a rapidly rising lymphocyte count. Here, we report a case of B-PLL in a 42 year old male who had come for routine health check up

Maanasa: An early individualized remedial educational intervention model for scholastic backwardness among upper primary students

Background: Scholastic backwardness is called as the learning achievement which is below the expected for a given age, cognitive skills, and schooling. Early identification and remedial measures are to be initiated at school level to control its lifelong impact. Objective: The objective of this study is to evolve an early individualized, remedial educational intervention model for the scholastic backwardness among upper primary students at the school level by the resource teachers. Materials and Methods: Whole upper primary students of the four government schools of the South Maararikkulam Grama Panchayath constituted the study population. The scholastic backwardness among them was identified and referred to specially trained resource teachers who were appointed in the schools under Maanasa project. They were graded as mild, moderate and severe category based on the level of scholastic backwardness. Children were given 1 academic year of individualized educational intervention along with inclusive education. Apart from these interventions, families of the identified students were given psychosocial interventions to create a learningfriendly atmosphere in their families. Learning skills of the scholastically backward students were re-assessed at the end of academicyear. Results: Out of total 629 students, 147 had scholastic backwardness (23.7%). Among these, 68 had mild, 60 moderate, and 19 had severe scholastic backwardness on reading skill grading. Psychosocial problems including alcoholism, domestic violence, quarrelsome events, and abandoned family were noticed among 48.7% of the parents of scholastically backward students. Reassessment at the end of academic year showed improvement of scholastic skill among 52.38% of the students. Conclusion: The present study proves that scholastic backwardness can be successfully approached and intervened at school level itself by impartingindividualized educational interventions by trained resource teachers. The parents should be taken into confidence for successful intervention

Chondroid Syringoma and Eccrine Spiradenoma

Fine needle aspiration cytology (FNAC) is a well established diagnostic tool. However, most clinicians prefer to diagnose suspected skin tumors by excisional biopsy as they are easily accessible and hence benign skin adnexal tumors are rarely encountered on FNAC. There are only a very few case reports describing the fine needle aspiration cytologic features of chondroid syringoma and eccrine spiradenoma for diagnosis. Cases: First case was a 20 year old female who presented with firm,non-tender swelling in the left little finger measuring 1 cm in diameter. Smears showed clusters of round to plasmacytoid cells with moderate to abundant cytoplasm embedded in a chondromyxoid ground substance . Hence, a diagnosis of chondroid syringoma was made. Another case was a 40 year old lady who presented with a painful swelling on the anterior chest wall measuring approximately 0.8 cms in diameter. Smears were moderately cellular with cohesive sheets and clusters of bland cells of three different cell types. Hence, a probable diagnosis of eccrine spiradenoma was made and both the cases were confirmed histologically. Conclusion: Appropriate knowledge of the cytologic features of chondroid syringoma and eccrine spiradenoma helps in providing a definitive diagnosis and correct management of the patient

Clash between purse seine and artisanal fishermen at cochin

The introduction of purse seining in Kerala in the traditional grounds has been vehemently opposed by the indigenous fishermen and has, on many occasions, resulted in skirmishes between the two from the very beginning. This articles discusses about the conflict between purse seine and artisanal fishermen and suggestions to minimize this conflicts are specified

TMC (Thrissur Medical College) modified Robson criteria for caesarean sections

Background: The Robson system is the most widely accepted classification system available for analysing characteristics of delivering women worldwide. Several authors have tried modifications in the existing system. The objective of this study was to modify the existing system with relevance to caesarean section rates in various obstetric population and to identify major factors contributing to it.Methods: This study was performed in Government Medical College, Thrissur from January 2017 to June 2017. All women delivered during this period were classified according to the modified system consisting of 8 groups using their maternal characteristics and obstetric history. Each major group were sub classified into 3: women who went into spontaneous labour/ induced labour/ CS done before labour. For each group, we calculated the contribution to overall CS and Primary CS separately. Women with Previous CS were analyzed as a separate group. This classification was intended to directly estimate primary as well as repeat CS rates and indirectly the VBAC rates. Results: Out of total 1337 women delivered, 413 underwent CS (30.8%). The contribution made by previous CS group to overall CS was 61.5%, and the repeat section rate was 91.3%. The primary CS rate was 15% and the maximum contribution was made by term induced primigravida followed by Primigravida with Breech presentation. VBAC rate was 8.6%.Conclusions: Our modified Robson system can be effectively utilized in analysing delivering women and provide valuable information regarding the delivery characteristics with particular relevance to Caesarean sections

The Indian oil sardine

The Indian oil sardine, Sardinella longiceps Val, supports a neritic pelagic fishery contributing 2 to 33 % of the annual marine fish production in India. Though distributed all along the Indian coast the species sustains a commercial fishery of high magnitude along the coasts of Kerala, Karnataka , Goa and southern part oJ Maharashtra. During the last fifty years the annual all India production oscillated between 14.000 t in 1952 to 3 lakh t during 1968. Presently the west coast indicates a declining trend compared to an ascending pattern along the east coasl. The production from east coast surpassed that of the west coast contributing 52% of the all India production of 2.03 lakh t in 1998. The fishery along the west coast is known for its fiuctuating nature. Further, the species indicates a cyclic pattern of abundance. A variety of traditional gears were engaged in exploiting the resource till the introduction of modern and sophisticated gear like the purse seines in the late seventies and the ring seines in the late eighties. In fact oil sardine is one among the few species that have ever remained a subject matter of intensive research. The focus of this compilation is to present a comprehensive picture of the Indian oil sardine, its fishery, biology, stock, future prospects of exploitation and management measures needed for yield optimisation

An Investigation on Prevalence of Abnormalites in Hypertensive Patients in Laboratory Parameters Under Various Classes of Antihypertensive Drugs

Hypertension is a leading risk factor affecting mortality and disability-adjusted life years worldwide.55 It is considered to be the third major cause of disease burden, globally. Regardless of the advancement in medical science, reports have shown a rising trend in hypertension prevalence among Indians. It is a chronic disorder, so long term intake of medicine is necessary to control elevated blood pressure. Long term usage of drugs may have adverse impacts on patients health and quality of life. This study specifically tried to find out the prevalence of Cardiac Events and investigation of abnormalities in ARB inhibitors. The total outcome of the study was clear and demonstrative. This study comprised of 112 patients, out of which, most patients were in the age group of 50-59 years Mean age of the study population was 55.7 ± 6years. In this study, the male patients 61% were more predominant in number than the female patients 39%. A study conducted by Aslam et al. showed that the patients were in the age group of 50-59 years with regard to gender distribution, 59.7% were males. In this study shows majority of the patients were overweight. Out of 112 patients, non smokers and non alcoholic were more exposed to drug related outcomes than smokers and alcoholics. A total of 112 patients, 51.07% (59) were having 1 year duration of Hypertension, 12.1% (13) were having 2-4years duration of Hypertension, 18.01% (20) were having 5-10 years duration of hypertension, and 18.01% (20) were having 10-15 years duration of Hypertension. (Table 6, Figure 6). The co-morbidities like diabetes mellitus and other complications co-exist with hypertension. But patients with no co-morbidity other than hypertension are more predominant in this study. (Table 7, figure 7) A total of 112 patients, 6.6% (7) prescribed with candesartan , 20.53% (23) prescribed with telmesartan, 54.46% (61) prescribed with losartan, 12.5% prescribed with (14) prescribed with olmesartan and 6.25% (7) prescribed with valsartan. (Table 8, Figure 8) This shows that losartan is the most prescribed drug in the study population. This shows that losartan is the most prescribed drug in the study population PREVALENCE OF CARDIAC EVENTS The prevalence of cardiac events in hypertensive patients with ARB inhibitors were found to be 20.53%. Our study also shows that the Prevalence of Angina pectoris and Myocardial infarction were predominant among cardiac events which were 10.71 % and 9.8% respectively. Males were more prone to the incidences of Angina and myocardial infarction. INVESTIGATION OF LIPID PROFILE CHANGES AMONG THE STUDY POPULATIONS In this study we evaluated the ARB using patient on lipids level like TC, LDL, and HDL. We noted a positive effect of ARB on most lipids indices. As well as different alterations in lipid level according to the individual agent used. More precisely, TC and LDL level were mostly decreased in Losartan subgroup. (Table 14,15 and Figure 14, 15 ). While the reduction in HDL level was best in the Olmesartan as well as Losartan. (Figure16) Compared to all ARB drugs losartan was controlled the lipid level in hypertension patients. Similarly another study conducted by Kyvelou et al.55 reported that TC and LDL levels were mostly decreased in the candesartan. while the reduction in ApoB levels and TC/HDL ratio was best in the valsartan. TGL levels were decreased only by the valsartan and losartan drugs. CONCLUSION: The prevalence of Cardiac events like Angina pectoris and myocardial infarction in males were much higher than in females. This indicates that hospitalization of cardiac events for males has increased who were in the age group of 50-59. Patients who are overweight according to BMI are having the highest risk of cardiac events. Moderate exercises can be recommended to the patients so that the prevalence of cardiac events can be possibly reduced. Patients prescribed with Telmesartan are having higher Prevalence of cardiac events among all the ARB inhibitors prescribed. So the pharmacist should actively participate and intervene to reduce the Prevalence and recommend alternate drug therapy to the physician. The Investigation of Lipid Profile Changes like TC, LDL and HDL levels were more in male population and also predominant with alcoholics . Compared to all ARB drugs, the drug losartan was controlled the lipid level in hypertension patients. Further studies may be carried out with other classes of drugs

A Study of Catheter Related Infection in Haemodialysis Patients

BACKGROUND: Haemodialysis is a procedure to remove extra salt, fluids and toxins through a dialysis machine. Central venous catheters are frequently used to initiate the dialysis before the arteriovenous fistulas mature and starts functioning. Bacteremia complicates the central venous catheter use in haemodialysis patients. Catheter related blood stream infection is the most common indication for the catheter removal. AIM OF THE STUDY: To study the incidence of temporary vascular catheter related infection in haemodialysis patients and to study the most common risk factors for catheter infection. Also to study about the bacteriological profile of catheter related infection. METHODS: This is a prospective study done for one year from June 2017 to June 2018 in Tirunelveli medical college. About 75 patients undergoing haemodialysis via central venous catheters were included in the study. Patients with signs of catheter related infection like fever, chills, hypotension, local catheter site infection were subjected to blood culture and catheter tip culture. RESULTS: Totally 75 patients with central venous catheter for haemodialysis were studied. Among 75 patients, 37 patients had Diabetes, 60 patients had chronic kidney disease. Regarding the type of venous access, 56 of them had femoral vein catheterization, 19 had jugular vein catheterization. 39 patients had febrile episodes, hypotension occurred in 33 individuals during dialysis. Blood culture positivity was observed in 23 patients. The most common organism isolated was gram positive staphylococci aureus followed by gram negative klebsiella and pseudomonas. Culture from catheter tip by semi quantitative method showed growth in 23 patients. From our study, we come to a conclusion that there is no significant association between the site of catheter insertion and blood stream infection. Patients with Diabetes, hypoalbuminemia has significant association with the blood Culture positivity for infection. CONCLUSION: Out of 75 patients who were randomly selected, blood culture positivity was observed in 23 patients. The incidence of catheter related infection and blood stream infection is 30.7%. The most common organism isolated was staphylococcus aureus followed by klebsiella, pseudomonas. Catheter related infection and blood stream infection showed significant association with Diabetes, hypoalbuminemia, local catheter site infection and prolonged duration of catheterization