Multiple Choriangiomas of Placenta

Placental chorangiomas, not an uncommon condition is often small and hence usually goes unnoticed . However the incidence of complications is high when the chorangioma is large. We hereby present an unusual case of large and multiple choriangiomas with secondary changes and associated congenital anomalies with hydrops fetalis

The profile and treatment outcomes of the older (aged 60 years and above) tuberculosis patients in Tamilnadu, South India

Background: With changing demographic patterns in the context of a high tuberculosis (TB) burden country, like India, there is very little information on the clinical and demographic factors associated with poor treatment outcome in the sub-group of older TB patients. The study aimed to assess the proportion of older TB patients (60 years of age and more), to compare the type of TB and treatment outcomes between older TB patients and other TB patients (less than 60 years of age) and to describe the demographic and clinical characteristics of older TB patients and assess any associations with TB treatment outcomes. Methods: A retrospective cohort study involving a review of records from April to June 2011 in the 12 selected districts of Tamilnadu, India. Demographic, clinical and WHO defined disease classifications and treatment outcomes of all TB patients aged 60 years and above were extracted from TB registers maintained routinely by Revised National TB Control Program (RNTCP). Results: Older TB patients accounted for 14% of all TB patients, of whom 47% were new sputum positive. They had 38% higher risk of unfavourable treatment outcomes as compared to all other TB patients (Relative risk (RR)-1.4, 95% CI 1.2–1.6). Among older TB patients, the risk for unfavourable treatment outcomes was higher for those aged 70 years and more (RR 1.5, 95% CI 1.2–1.9), males (RR 1.5, 95% CI 1.0–2.1), re-treatment patients (RR 2.5, 95% CI 1.9–3.2) and those who received community-based Direct Observed Treatment (RR 1.4, 95% CI 1.1–1.9). Conclusion: Treatment outcomes were poor in older TB patients warranting special attention to this group – including routine assessment and recording of co-morbidities, a dedicated recording, reporting and monitoring of outcomes for this age-group and collaboration with National programme of non-communicable diseases for comprehensive management of co-morbidities

Management of Multi Drug Resistance Tuberculosis in the Field: Tuberculosis Research Centre Experience

Setting: Multi-drug TB resistant (resistant to isoniazid and rifampicin) patients identified from a rural and urban area. Objective: To study the feasibility of managing MDR TB patients under field conditions where DOTS programme has been implemented Methods: MDR TB Patients identified among patients treated under DOTS in the rural area and from cases referred by the NGO when MDR TB was suspected form the study population. Culture and drug susceptibility testing were done at Tuberculosis Research Centre (TRC). Treatment regimen was decided on individual basis. After a period of initial hospitalization, treatment was continued in the respective peripheral health facility or with the NGO after identifying a DOT provider in the field. Patients attended TRC at monthly intervals for clinical, sociological and bacteriological evaluations. Drugs for the month were pre-packed and handed over to the respective center. Results: A total of 66 MDR TB patients (46 from the rural and 20 from the NGO) started on treatment form the study population and among them 20 (30%) were resistant to one or more second line drugs (Eto, Ofx, Km) including a case of “XDR TB”. Less than half the patients stayed in the hospital for more than 10 days. The treatment was provided partially under supervision. Providing injection was identified to be a major problem. Response to treatment could be correctly predicted based on the 6-month smear results in 40 of 42 regular patients. Successful treatment outcome was observed only in 37% of cases with a high default of 24%. Adverse reactions necessitating modification of treatment was required only for three patients. Implications Despite having reliable DST and drug logistics, the main challenge was to maintain patients on such prolonged treatment by identifying a provider closer to the patient who can also give injection, have social skills and manage of minor adverse reactions

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Building a tuberculosis-free world: The Lancet Commission on tuberculosis

___Key messages___ The Commission recommends five priority investments to achieve a tuberculosis-free world within a generation. These investments are designed to fulfil the mandate of the UN High Level Meeting on tuberculosis. In addition, they answer

Genotyping of XRCC1 polymorphisms in breast cancer

Breast cancer is most common cancer among women in Malaysia. The second report of the Malaysian National Cancer Registry in 2004 alluded that 46.2 in 100,000 populations diagnosed with breast cancer in 2003. Breast cancer is more common amongst Chinese and Indian women compared to Malay women in Malaysia. Although the incidence is low, breast cancer in Malaysia could be considered as the leading cause of cancer death among women. This study investigated the genetic polymorphisms of DNA repair gene X-ray repair cross complementing factor 1 (XRCCI) at codon 194 (Arg to Trp), may increase the susceptibility to breast cancer by modifying individual DNA repair capability. Arg194Trp polymorphism at the XRCCI gene were analyzed by using Restriction Fragment Length Polymorphisms (RFLP) assay based on DNA samples of five patients with breast cancer and one healthy subject. Polymerase Chain Reaction (PCR) was carried out by using specific primers to amplify the region XRCCI containing Argl94Trp site. The PCR product generated a single band at 485 bp as expected. Then, the PCR product digested with restriction enzyme PvuII and the products were analyzed with 2% agarose gel electrophoresis. The frequency of the wild type Arg/Arg genotype was more pronounced among cases (80%) compared with heterozygote variant Arg/Trp (20%). No subjects carried the codon 194-Trp/Trp (0%). There is no polymorphism detected in control. In conclusion, based on this limited data, XRCC1 Arg194Trp does not contribute to breast cancer in Sabah bumiputera population. However, for this type of analysis a very large sample size is essential to get an accurate resul

Not Available

Not AvailableNot AvailableOrnamental fish trade is a multibillion dollar industry globally,with an annual turnover of more than 6 billion US$. India still remains a sleeping giant with a contribution of less than 1% of the global ornamental fish trade. The present study examines the export performance of Indian ornamental fish trade based on the data pertaining from 1991 to 2009. Fisheries exports form a lion’s share (51% on an average) of GDP in fisheries sector. The share of ornamental fish exports to the total value of fisheries export has increased from 0.04% in 1991 to 0.15% in 2008. Indian ornamental fish export registered a higher positive compound growth rate of 14.4% in terms of export value, 12.1% in terms of quantity exported and 2.1% in terms of unit value. India can be considered as one of the gold mines for ornamental fishes considering the existing potential. One hundred eighty seven species are traded from India, of which 85% are collected from the wild. The new schemes of the Marine Products Export Development Agency (MPEDA) and research support can soon make India a major player in international ornamental fish trade thereby, greatly increasethe foreign exchange earnings, employment and rural livelihood.Not Availabl

Economic analysis of tuna pole and line fisheries in Lakshadweep

947-957Economic analysis of tuna fisheries of selected islands of Lakshadweep showed differential levels of profitability with maximum observed BC ration of 1.55 for Agatti followed by Kavaratti (1.38) and Minicoy Island (1.27 in 1/2 sharing system and 1.26 in 1/3 sharing system). On harvest side, major contribution to the fixed cost comes from interest on fixed capital ranging from minimum of 52.67% (Kavaratti) to maximum of 61.33% (Minicoy) owing to high initial investment. Among variable cost the percentage contribution of crew and non-crew manpower accounts to be 78%, 84.14% and 88.98% (89.08% in 1/3 share system) respectively in Kavaratti, Agatti and Minicoy emphasizes labour intensive nature of pole and line fishery in Lakshadweep