Immunophenotyping of actue leukaemias by flow cytometry: a review

Objective: To provide an overview of the utility of flow cytometry for phenotyping of acute leukaemias and selection of monoclonal antibodies.Data sources: The literature review was obtained through internet, journals and chapters in the relevant books.Data selection: Relevant articles and chapters on immunophenotyping of acute leukaemias were selected from respected international journals and books in the field of haematology and were reviewed.Data extraction and synthesis: Complete articles relevant to the topic were selected and reviewed and the necessary information extracted for this review.Conclusions: Flow cytometry has been used extensively in recent years to characterise haemopoeitic malignancies and done routinely in the developed world. This technique has greatly improved the diagnosis and classification of haemopoeitic malignancies and has been recommended by World Health Organisation classification (WHO) of tumours of haemopoeitic and lymphoid tissue. Application of flow cytometry for the diagnosis of leukaemias has been recently introduced in Kenya and is currently being undertaken in research using limited but appropriate panels of monoclonal antibodies. It is hoped that findings of this research will inform the use of flow cytometry as an ancillary diagnostic technique in our resource-constrained set up

President Jimmy Carter as an Activist?: Understanding President Carter’s Human Rights Policy in El Salvador during 1980 through a Social Justice Lens

During 1980, Salvadoran citizens endured increased violence, torture, and overall suppression of their basic human rights. Many prominent figures were assassinated by either right-wing death squads or leftist insurgents. Then on December 2, 1980 came the murder of four American churchwomen from the Maryknoll Order. Their purpose was to aid the poor within Latin America; El Salvador gave them the opportunity to help the Salvadoran poor in the midst of this violence. However, they were met with suspicion by security forces and, as a result were raped and killed on a dirt road. Within a week, President Jimmy Carter cut economic and military aid as well as launched an investigation in El Salvador to find and hold the perpetrators accountable for the four murders and further, investigate the Salvadoran government’s involvement in the ongoing murders of 1980

A STUDY ON THE EFFICACY OF ERANDADI TAILA NASYA AND SARSHAPA TAILA KARNAPURANA IN THE MANAGEMENT OF KARNA NADA (TINNITUS)

Tinnitus is the sensation of hearing ringing, buzzing, hissing, chirping, whistling, or other sounds. The noise can be intermittent or continuous, and can vary in loudness. It is often worse when background noise is low. On analyzing the disease condition with Ayurvedic approach, it seems to be nearer to Vata Kapha dominant Karna Nada and needs to be treated at local as well as systemic level.  Aim: To evaluate the effect of proposed Ayurvedic treatment protocol in the patients of tinnitus.  Materials and Methods: The studies were conducted in 15 patients of Karna Nada and in all of them Nasya with Erandadi Taila and Karnapurana with Sarshapa Taila were given for 1 months.  Results: It revealed statistically extremely significant relief in tinnitus. Furthermore, sustained relief was found in follow-up.  Conclusion: Ayurvedic treatment protocol is effective in the management of tinnitus

A COMPREHENSIVE AYURVEDIC REVIEW ON LAVANGA (SYZYGIUM AROMATICUM)

Ayurveda means science of life. Ayurveda was from time immemorial and still it has its own importance in field of medical science. Ayurveda is divided into eight branches. Out of all these branches Dravyguna vijnana is one of them. It includes information about herbs which is described in ancient classical text of Ayurveda. In Ayurveda there is a saying if a Vaidhya has no proper knowledge regarding these herbs he is unable to provide proper treatment to patients. These herbs are backbone of Ayurveda. Among all herbs, Lavanga is a well known Ayurvedic herb. Lavanga are aromatic flower buds of a tree Latin named as Syzygium aromaticum which comes under myrtaceae family. It is known as Lavanga due to its Kapha lysing property. It posses other properties such as Deepana, Pachana, Ruchya, Chakshushya, Kapha-Pittaghana properties. It is used in Trishna, Chhardi, Aadhmana, Shoola, Kasa, Shwasa, Hikka, Kshaya named diseases

Clinico-pathologic characteristics and treatment outcomes in children with neuroblastoma at the Kenyatta National Hospital, Nairobi.

Objective: To determine clinical-pathologic characteristics, treatment modalities and treatment outcomes of children diagnosed with neuroblastoma. Design: Cross- sectional descriptive study based on secondary data from patient records. Setting: Records department of Kenyatta National Hospital (KNH), a tertiary teaching and referral hospital based in Nairobi. Subjects: Children aged 15 years and below, admitted with the diagnosis of neuroblastoma, between January 1997 and December 2005. Main outcome measures: Presenting clinical features, diagnostic modalities including laboratory and imaging data, treatment modalities, response to treatment and patient survival. Results: Twenty six patients were eligible for the study; 13 males and 13 females giving a M: F ratio of 1: 1. The age range was 5 days to 12 years, with a median age of five years. Abdominal swelling (53.8%), inability to walk due to bone pains,(50%), and cranial or periorbital swelling, (38.5%) were the commonest presenting features. Diagnosis of neuroblastoma was based on tissue biopsy in 50% (95% CI40.6-79.8%) of the patients, and on fine needle aspiration cytology of mass or bone marrow in the rest. Bone marrow involvement was present in 16, (75%). Anaemia,was common with 72.7% patients having a haemoglobin (HB) \u3c8g/dl at presentation. Immunohistochemistry and cytological grading were done in two, (8%), patients. Urinary vanilly l mandelic acid (VMA), screening was positive in 50% (95% CI 29.9%-70.1%). The most frequently involved organs were abdomen (88.9%), and skeleton,(84.6%). Majority of patients, (92.3%), presented with advanced stage IV disease. Three patients died before commencement of treatment. All treated patients (100%), received cytotoxic therapy. Only two patients (8.6%) had surgery as part of treatment while one, (4.3%) was treated with radiotherapy. The initial treatment regimen was similar for all the patients. Although most patients had a complete initial response to treatment, early relapse, treatment failure, death or loss to follow up of patients with progressive disease were common. Overall survival (OS) at one year and two years were 19.2% (95% CI 6.6-39.4%) and 7.7% (95% CI 0.9%-25 1%) respectively. Only one patient was alive, (also free of disease), five years after diagnosis. Conclusion: Although other clinical- pathologic findings of the patients were similar to those reported elsewhere, virtually all study patients presented with advanced stage IV disease, which would be associated with poor prognosis irrespective of quality of care. Priority must therefore be on ensuring early diagnosis and referral of patients with neuroblastoma before any other interventions can be expected to positively impact on outcome. The limited role of surgery and radiotherapy observed over the study period may be attributed to late presentation of the patients. Pathologic evaluation of patients was inadequate, to some extent due to unavailability of facilities, but extra important information could have been availed at minimal extra cost. To be at par with current internationally accepted treatment approaches that have been associated with improved survival, there is need to base choice of regimens for individual patients on clinical and readily accessible pathologic markers

Acute Leukemias Immunophenotypes at Agakhan University Hospital, Nairobi

Objective: The aim was to determine relative frequencies of acute  leukemia immunophenotypes using commonly expressed markers and to describe the clinicopathological characteristics.Design: This was a prospective cross-sectional study.Setting: The study was based at Aga khan clinical laboratory department.Subjects: One hundred and thirty two (132) consecutive blood and bone marrow specimens from patients suspected to have acute leukemia were analysed for cytomorphological characteristics and immunophenotyping. The clinical-pathological characteristics were also recorded. Immunological category was assigned using the EGIL criteria.Results: There were 88 AML and 42 ALL patients analysed for  immunophenotypes. Only tw cases of biphenotypic leukemia were found. The commonest overall AML morphological sub-type was AML-M2, 26 (29.5%). Majority of ALL cases were B-cell immunological sub-type (96.6%). Early pre-B phenotype constituted 62.07% and Common B-cell ALL 37.93%. There were only 4 cases of T-cell ALL. Majority of patientspresented with anaemia with a median hemoglobin of 7.5g/dl (range 2-15g/dl). The median platelet count was 55 (range 4-462 × 109/L).Conclusion: Immunophenotyping of acute leukemia is beneficial in accurate diagnosis of patients with these malignancies in this setup. T-cell ALL, AML-M6 and M7 are less frequent than what has been reported in most studies in Africa.Key words: acute leukemia, immunophenotype, WHO, EGIL, CD marker

Diabetes Risk Score in Indian Population: Experience from Central India

Introduction: Diabetes is a major health problem in the world causing significant morbidity and mortality. Currently, 77 million people in India and 463 million people are living with diabetes across the world, and this number is expected to rise to 101 million in India and 578 million globally by 2030. The key to reduce the morbidity and mortality is early diagnosis and management. The Madras Diabetes Research Foundation (MDRF) has developed an Indian Diabetes Risk Score (IDRS) to identify people who are at risk of developing diabetes or are undiagnosed. Thus, we conducted a study to calculate the IDRS of people from Central India and identify those who are at risk of getting diabetes. Methods: A total of 1,500 patients or attendants, aged 18 to 60 years (mean age 41.2 years), visiting the Endocrinology clinic, and not diagnosed with diabetes earlier were included in the study after taking proper consent and IDRS was calculated. Results: The male-to-female ratio was 914:586. The mean IDRS was 51.29 in our population with 35.93%, 18.2% and 45.87% of screened subjects having a score of <30, 30-60 and ≥60, respectively. Conclusion: Forty-five percent people of the population was at high risk of diabetes as estimated by IDRS, which proved to be an effective and economical tool to identify persons at increased risk of diabetes and diagnose the undiagnosed cases and start early management to reduce the morbidity and mortality

Diabetes Risk Score in Indian Population: Experience from Central India

ntroduction: Diabetes is a major health problem in the world causing significant morbidity and mortality. Currently, 77 million people in India and 463 million people are living with diabetes across the world, and this number is expected to rise to 101 million in India and 578 million globally by 2030. The key to reduce the morbidity and mortality is early diagnosis and management. The Madras Diabetes Research Foundation (MDRF) has developed an Indian Diabetes Risk Score (IDRS) to identify people who are at risk of developing diabetes or are undiagnosed. Thus, we conducted a study to calculate the IDRS of people from Central India and identify those who are at risk of getting diabetes. Methods: A total of 1,500 patients or attendants, aged 18 to 60 years (mean age 41.2 years), visiting the Endocrinology clinic, and not diagnosed with diabetes earlier were included in the study after taking proper consent and IDRS was calculated. Results: The male-to-female ratio was 914:586. The mean IDRS was 51.29 in our population with 35.93%, 18.2% and 45.87% of screened subjects having a score of <30, 30-60 and ≥60, respectively. Conclusion: Forty-five percent people of the population was at high risk of diabetes as estimated by IDRS, which  proved to be an effective and economical tool to identify persons at increased risk of diabetes and diagnose the undiagnosed cases and start early management to reduce the morbidity and mortality

Review of Cataract w.s.r. to Kacha

Cataract is a vision impairing disease characterized by gradual, progressive thickening of the lens. It is one of the leading causes of blindness in the world now a days. This is unfortunate, considering that the visual morbidity brought about by age-related cataract is reversible. As such, early detection, close monitoring and timely surgical intervention must be observed in the management of senile cataracts. Clinically the symptoms of Kacha can be correlated with Cataract

Diabetes Risk Score in Indian Population: Experience from Central India

Introduction: Diabetes is a major health problem in the world causing significant morbidity and mortality. Currently,77 million people in India and 463 million people are living with diabetes across the world, and this number is expected to rise to 101 million in India and 578 million globally by 2030. The key to reduce the morbidity and mortality is early diagnosis and management. The Madras Diabetes Research Foundation (MDRF) has developed an Indian Diabetes Risk Score (IDRS) to identify people who are at risk of developing diabetes or are undiagnosed. Thus, we conducted a study to calculate the IDRS of people from Central India and identify those who are at risk of getting diabetes. Methods: A total of 1,500 patients or attendants, aged 18 to 60 years (mean age 41.2 years), visiting the Endocrinology clinic, and not diagnosed with diabetes earlier were included in the study after taking proper consent and IDRS was calculated. Results: The male-to-female ratio was 914:586. The mean IDRS was 51.29 in our population with 35.93%, 18.2% and 45.87% of screened subjects having a score of <30, 30-60 and ≥60, respectively. Conclusion: Forty-five percent people of the population was at high risk of diabetes as estimated by IDRS, which proved to be an effective and economical tool to identify persons at increased risk of diabetes and diagnose the undiagnosed cases and start early management to reduce the morbidity and mortality