Pulmonary function analysis in carpenters: a study from Kerala

Background: There has been an increase in proportion of workers suffering from occupational diseases compared to past. Only limited studies have been conducted to evaluate the pulmonary functions of carpenters, exposed to wood dust. Hence the present study was undertaken to find out any functional impairment in carpenters due to their occupational environment.Methods: Study was done in 300 subjects who were divided into two groups of 150 each. One group comprised carpenters with minimum 5 years exposure to wood dust. Other group comprised matching healthy subjects who served as controls. Pulmonary function parameters were recorded from all subjects. Parameters recorded were SlowVital Capacity (SVC), Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), and Peak Expiratory flow Rate (PEFR).  ‘Knudson and Collagens’ standard reference values for south Indians were used here for interpretation. Statistical analysis of the data of study subjects and the controls were done by using student’s ‘t’ test. The level of significance was fixed as 5%.Results: A statistically significant reduction in SVC, FVC, FEV1and PEFR was seen in the study group compared to control group. FEV1/FVC was less than 80% of the predicted values in 8% of the study population. Seventeen percentage of the study population had less than 80% of predicted value of both FEV1 and FVC with normal FEV1/FVC.Conclusions: Lung functions of carpenters show statistically significant reduction compared to normal healthy adults. This could be due to their exposure to wood dust

Oral Hygiene and Dentition Status in Patients with Congenital Hemorrhagic Disorders: A Comparative Study

Objective: To compare the status of oral hygiene and dentition in patients with congenital hemorrhagic disorders with their age-matched healthy counterparts. Also, the prevalence of fear of dentists/ dental treatment among these patients was assessed. Material and Methods: This study was performed on children and adults with von Willebrand disease (vWD), hemophilia (A or B), and healthy subjects. Oral health and dentition status was assessed using the simplified oral hygiene index (OHI-S), plaque index, and the decayed, missing, filled teeth (dmft/DMFT) index. One-way ANOVA test was employed to compare the oral hygiene and dentition status of subjects in the three groups. A p-value of <0.05 was considered statistically significant. Results: The DMFT score did not vary significantly between the groups (p>0.05). Higher OHI-S scores and a poor oral hygiene status was observed more in the hemophilia group than the vWD group and healthy controls. A total of 27.3% of the subjects in the vWD group, 18.2% of subjects in the hemophilia group, and no subjects in the healthy group had a fear of dentists or dental treatment. Conclusion: Subjects with vWD had a higher number of carious teeth when compared to the other groups. Poor oral hygiene status was observed in subjects with hemophilia

CORRELATION OF CLINICAL AND LABORATORY ASPIRIN RESISTANCE: A PILOT STUDY

Aspirin resistance may be biochemical or clinical. Data related to the presence of aspirinresistance in the Indian population is scarce. We conducted a cross sectional study toaddress the issue of clinical aspirin non responsiveness and to assess the associationbetween inhibition of platelet aggregation, clinical risk factors and occurrence of vascularevents. We studied platelet aggregation by optical aggregometry in 20 patients on aspirin.No patient was found to be aspirin-resistant on the basis of previously defined criteria.This led us to relook at the current cut offs for resistance, and an analysis of 60 normalpatients showed lower cut off values suggesting ethnic variability. The data wasreanalyzed using these cutoffs. An association between poor clinical aspirin response,older age, male sex, smoking and dyslipidemia was found, suggesting a trend, though notsignificant. 25% of patients had vascular events on aspirin suggesting clinical aspirinresistance. A lower cut off value for aspirin resistance in normal Indians may be neededto detect true prevalence of this entity. In patients with multiple atherothrombotic riskfactors lab detection of resistance may be useful in identifying patients with high risk forrecurrent vascular events. This may help to modify antiplatelet therapy to preventvascular events

Spontaneous Tumor Lysis Syndrome in a Case of Multiple Myeloma

We describe a case of a 40-year-old male patient who was found to have multiple myeloma with spontaneous tumour lysis syndrome (TLS), following a compression fracture of the L–2 vertebrae. Multiple myeloma was confirmed by bone marrow analysis and the M–band on serum protein electrophoresis. Hyperuricaemia (26.2 mg/dL), hyperkalaemia (> 7.0 mEq/L), hyperphosphatemia (16.2 mg of phosphorus/dL), normocalcemia and acute kidney injury, prior to anticancer treatment suggested spontaneous TLS. Inciting events for tumour lysis, such as chemotherapy, dehydration and exposure to steroids were absent. Patient received hydration, hypourecemic drugs and haemodialysis. This case report highlights the rare presentation of multiple myeloma with spontaneous TLS

Correlation of morphologic and cytochemical diagnosis with flowcytometric analysis in acute leukemia

Introduction: The classification of acute leukemias has revolutionized over the years. Immunophenotyping of acute leukemia has gained popularity because of its influence on treatment and prognosis of the disease. The various antigens expressed by the leukemic cells can be assessed by flowcytometry (FCA) and can be used in rendering specific treatment and predicting the outcome of the different types of acute leukemia. Aims: The main aim of this study was to compare the morphologic and cytochemical diagnoses with flowcytometric diagnoses in acute leukemia and to analyze the usefulness of FCA over morphology. Results: In this study we analyzed 50 cases of acute leukemia and found concordance rate as high as 86% between morphologic/cytochemical diagnosis and flowcytometric diagnosis. Of these, complete concordance was seen in 58% of the cases and partial concordance was seen in 22% of the cases. Non-concordance was seen in only 4% of our cases. In remaining 16% of our cases FCA helped in sub classifying the acute leukemia where morphology and cytochemistry had failed to do so. CD19 and 20 were found to be consistent B-cell markers and CD3 was a very specific marker for T-cell leukemia. CD13 and 33 were important myeloid markers and were aided by other secondary panel of markers like CD14, CD117 and CD41. Conclusion: FCA not only helps in confirming morphologic diagnosis in acute leukemia but also helps in assigning specific lineage to the blasts, particularly in acute lymphoid leukemia. Immunophenotyping is of utmorst importance in classifying acute leukemia as it greatly influences the treatment and the prognosis

PREVALENCE OF HYPERTENSION AND ITS IMPACT ON GLOMERULAR RATE IN A POPULATION OF KERALA

BACKGROUND Kidney function and hypertension are closely linked. What is the prevalence of hypertension and how one is affecting the other? Different studies show different results. Such a study in Keralite population is planned. The objectives of the study are to find the prevalence of hypertension and prehypertension in a population of Kerala and its effect on GFR. MATERIALS AND METHODS A total of 519 subjects of all ages from the community are screened. Blood pressure and serum creatinine were assessed. eGFR found using MDRD (modification of diet in renal disease) formula. RESULTS Prevalence of hypertension in the study population is 13.9% and prehypertension is 26.8%. Incidence of hypertension is increasing with age. Estimated GFR showed a decrease in hypertensives and prehypertensives. CONCLUSION Kidney function is affected by an increase in blood pressure

Nasal pseudotumour in a haemophilic: A case report

Haemophilia is an X linked inherited coagulation disorder. A haemophilic pseudotumour is one of the rarer complications of haemophilia, which results from repetitive bleeding. These have become scarcer over the years with better treatment facilities for bleeding disorders like factor replacement (Pakala, Thomas, & Philip, 2012). The present case report details the history and clinical course of a 23–year-old case with recurrent nasal bleed and nasal pseudotumour, which showed a positive outcome after surgical intervention and factor replacement. At 3-month follow-up, the patient was evaluated by endoscopy, CT scan, and there was no evidence of recurrence