A case report of recurrent hypokalaemic periodic paralysis in a young male patient

A 21-year-old normotensive male patient presented with acute-onset flaccid paralysis with the history of a similar episode a few months back. Clinical and laboratory evaluation revealed lower motor neuron type of flaccid quadriparesis with hypokalaemia, normal anion gap metabolic acidosis, bicarbonaturia and transtubular potassium concentration gradient more than 7. Subsequently, urine acidification test (by ammonium chloride challenge test) was performed and diagnosis of renal tubular acidosis was established. The patient ultrasound did not show nephrocalcinosis, and history of recurrent diarrhoea preceding the attack revealed that the patient also had coeliac disease. The patient responded to conservative management (Sohl′s solution) and gluten-free diet

A case report of distal RTA presenting as hypokalaemic periodic paralysis in young male

A 21-year-old normotensive male presented with acute onset flaccid paralysis with the history of a similar episode a few months back. Clinical and laboratory evaluation revealed lower motor neuron type of flaccid quadriparesis with hypokalaemia, normal anion gap metabolic acidosis, bicarbonaturia, and transtubular potassium concentration gradient (TTKG) more than 7. Subsequently urine acidification test (by NH4CI challenge test) was done and diagnosis of distal renal tubular acidosis was established. The patient responded to conservative management (Sohl′s solution)

A case report of primary Hodgkin′s disease of bone marrow

Hodgkin′s disease (HD) is a malignant neoplasm of the lymphoid tissues. It arises almost invariably in a single node or chain of nodes. Extranodal disease can be primary or can result from the spread of primary nodal disease to these sites. Primary bone marrow HD is very rare. Here, we present the case of an elderly male, who presented with primary HD of bone marrow

Development of bi-metal doped micro- and nano multi-functional polymeric adsorbents for the removal of fluoride and arsenic(V) from wastewater

The contamination of ground water by fluoride and arsenic has recently considerably increased, especially in some regions of India. In this context, the development of efficient adsorbents for the control of fluoride and arsenic, which are the common pollutants in wastewater, assumes significance. Herein, we describe the synthesis, characterization, and application of bi-metals (Fe and Al) doped micro- and nanoparticles based adsorbents for the removal of fluoride and arsenic(V) ions from water. The adsorbents were prepared by suspension polymerization. Fe and Al were incorporated during a polymerization step. The bi-metals doped beads (~ 0.8 mm) thus prepared were carbonized and activated to create porous structure inside the materials. Nanoparticles (~ 100 nm) were produced by milling of the beads, which were carbonized and activated. The adsorption tests carried out on Al/Fe-doped adsorbents revealed significant loading of those ions. The equilibrium loading of fluoride on nanoparticles based adsorbents was determined as ~ 100 mg/g corresponding to the aqueous phase concentration range of 0–90 ppm, whereas that of arsenic(V) was determined as 40 mg/g corresponding to the range of 0–70 ppm. The methodology adopted in this study is a step towards developing multi-functional adsorbents for the removal of different types of solutes from wastewater

Metronomic palliative chemotherapy in maxillary sinus tumor

Background: Metronomic chemotherapy consisting of methotrexate and celecoxib recently has shown promising results in multiple studies in head and neck cancers. However, these studies have not included patients with maxillary sinus primaries. Hence, the role of palliative metronomic chemotherapy in patients with maxillary sinus carcinoma that is not amenable to radical therapy is unknown. Methods: This was a retrospective analysis of carcinoma maxillary sinus patients who received palliative metronomic chemotherapy between August 2011 and August 2014. The demographic details, symptomatology, previous treatment details, indication for palliative chemotherapy, response to therapy, and overall survival (OS) details were extracted. SPSS version 16 was used for analysis. Descriptive statistics have been performed. Survival analysis was done by Kaplan-Meier method. Results: Five patients had received metronomic chemotherapy. The median age was 60 years (range 37-64 years). The proportion of patients surviving at 6 months, 12 months, and 18 months were 40%, 40%, and 20%, respectively. The estimated median OS was 126 days (95% confidence interval 0-299.9 days). The estimated median survival in patients with an event-free period after the last therapy of <6 months was 45 days, whereas it was 409 days in patients with an event-free period postlast therapy above 6 months (P = 0.063). Conclusion: Metronomic chemotherapy in carcinoma maxillary sinus holds promise. It has activity similar to that seen in head and neck cancers and needs to be evaluated further in a larger cohort of patients

Outcomes in Treatment-Naïve Patients With Metastatic Extremity Osteosarcoma Treated With OGS-12, a Novel Non–High-Dose Methotrexate–Based, Dose-Dense Combination Chemotherapy, in a Tertiary Care Cancer Center

Purpose: Metastatic osteosarcoma is largely treated with high-dose methotrexate (HDMTX)–based therapy, especially in the pediatric population. This mandates complex pharmacokinetic monitoring in a costly inpatient setting to mitigate unpredictable serious toxicities. Hence, a non-HDMTX–based regimen is worth exploring, especially in India and low- and middle-income countries. Materials and Methods: All consecutive treatment-naïve patients with metastatic osteosarcoma were prospectively treated on the novel OGS-12 protocol consisting of sequential doublets of doxorubicin, cisplatin, and ifosfamide. Four cycles were administered as neoadjuvant therapy followed by planned curative intent surgery and metastasectomy when feasible, followed by four cycles of adjuvant chemotherapy. Baseline characteristics, histologic response, event-free survival (EFS), overall survival (OS), and toxicity data were prospectively collected. Results: Three hundred seventeen patients were enrolled onto the OGS-12 protocol from 2011 to 2014, of whom 80 (25%) had metastatic disease; median age was 17 years. The majority of patients were nutritionally challenged with high-risk features. At presentation, 83% of patients (66 patients) had lung metastases. After neoadjuvant chemotherapy, 57% of patients were histologically good responders. Four-year EFS and OS rates were 24% and 27%, respectively, in the intent-to-treat population and 27% and 29%, respectively, in the per-protocol analysis. Significant grade 3 or 4 toxicities were febrile neutropenia (51%), thrombocytopenia (36%), and anemia (54%). Histologic response was an independent predictor for EFS and OS in patients who underwent surgery. Surgical intervention was found to be significant for survival in univariable analysis. Conclusion: The novel, low-cost, non-HDMTX–based, dose-dense OGS-12 regimen has shown comparable outcomes to international standards in metastatic osteosarcomas and is worthy of wider clinical application. An aggressive multimodality approach may result in long-term survival in a select group of patients and, hence, is worth considering