The occurrence of deep-vein thrombosis (DVT) in patients with newly diagnosed multiple myeloma, who were randomly assigned to receive identical induction chemotherapy with or without thalidomide, are reported in this study. The 2 study arms were comparable with respect to key myeloma prognostic factors and known risk factors for DVT. One hundred patients received induction chemotherapy including 4 cycles of continuous infusion of combinations of dexamethasone, vincristine, doxorubicin, cyclophosphamide, etoposide, and cisplatin, and each patient completed at least one induction cycle. DVT developed in 14 of 50 patients (28%) randomly assigned to receive thalidomide but in only 2 of 50 patients (4%) not given the agent (P ؍ .002). All episodes of DVT occurred during the first 3 cycles of induction. Administration of thalidomide was resumed safely in 75% of patients receiving anticoagulation therapy. Thus, thalidomide given in combination with multiagent chemotherapy and dexamethasone is associated with a significantly increased risk of DVT, which appears to be safely treated with anticoagulation and does not necessarily warrant discontinuation of thalidomide. (Blood. 2001;98: 1614-1615)
BACKGROUNDA hernia is defined as an abnormal protrusion of an organ or tissue through a defect in its surrounding walls. Although a hernia can occur at various sites of the body, these defects most commonly involve the abdominal wall, particularly the inguinal region. Hernia repair is one of the most common operations performed by general surgeons. About 75% of all hernias occur in the inguinal region. Two thirds of these are indirect and the remainder are direct inguinal hernias. Femoral hernias represent only 3% of all groin hernias. Open Lichtenstein 'mesh repair and laparoscopic mesh repair are widely being practiced across the world. The aim of this study is to demonstrate the difference in post-operative pain and length of hospital stay in open and laparoscopic methods.
MATERIALS AND METHODSThe study population included 48 patients who underwent hernia repair surgery in a tertiary care hospital in North Kerala during the period of 2015 to 2017. Patients presented with direct inguinal hernia in surgical OPD were selected and divided into two groups. One group underwent open Lichtenstein s mesh repair and the other group underwent laparoscopic TAPP repair. Postoperatively, pain was assessed 5 hrs after surgery on day 1, 24 hours post-surgery, and on day 7. Length of hospital stay was measured in hours.
Background: Primary Thyroid Lymphoma (PTL) is uncommon, accounting for only 5% of thyroid neoplasms and less than 2.5 to 7% of extranodal lymphomas. The study aims to analyze the histopathological findings and to correlate it with clinical features. Methods: This study includes cases of PTL received in the department of pathology in a tertiary care center, Kerala, south India over a period of 5 years. Patient details and follow up data were obtained by communication with treating doctors and reviewing the hospital records. All cases had a minimum follow up of 6 months. Results: 15 cases of PTL were diagnosed over the five year period. In total 72 cases of extranodal lymphomas were diagnosed, thus forming 20.83% of extra nodal lymphomas. Lymphocytic thyroiditis was present in 93.3%. Most of the cases were Extranodal Marginal Zone B Cell Lymphoma (EMZBCL) and Diffuse Large B Cell Lymphoma (DLBCL). Conclusion: It is important to consider the diagnosis of primary thyroid lymphoma in patients presenting with an enlarging neck mass especially with the history of Hashimoto's thyroiditis. Random microscopic foci of DLBCL or small areas of MZBL could be overlooked examination or missed with limited sampling. The distinction between MZBL and DLBCL in the thyroid is clinically significant.
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