Introduction: End Stage Renal Disease (ESRD) is the last stage of Chronic Kidney Disease (CKD), where kidneys solely functions at 10 to 15 percent of their normal capacity. Efficacious treatment for ESRD is renal replacement therapies like dialysis and renal transplantation. Health related quality of life (HRQoL) is a neglected aspect of CKD care. Objective: To assess the acute complications and quality of life in hemodialysis patients. Methods: This prospective observational study was conducted for 6 months, 90 patients undergoing hemodialysis were enrolled in the study. Acute complications were assessed during and post dialysis and Health Related Quality of Life were analysed using KDQoL-36TM questionnaire. Result: Among patients assessed; majority of the patients belonged to the age group 30 to 60 years. Acute complications were evaluated and oedema was found in maximum patients followed by muscle cramps, loss of appetite, itching etc. Based on KDQoL-36TM questionnaire, physical functions was mainly affected due to the disease. Oedema and muscle cramps had an impact on the patients physical and mental functioning whereas educational status and addictions showed significance in all domains of KDQOL-36TM. Conclusion: CKD patients undergoing hemodialysis has an intense effect on HRQoL. A better understanding on QOL issues will enable providers to deliver better patient centred care and enhance the overall well-being of the patients.
BACKGROUND Appendix is considered as a vestigial organ in medical history. But recent studies reveal its importance in immunological function. Appendicectomy is one of the most common surgeries performed and acute appendicitis being the most frequent pathology noted. Various less common pathologies like parasitic infestation, granuloma, diverticulum, neoplasms are also described. In our institute, we have seen an increased rate of acute appendicitis and a relative increase in neoplastic conditions. The purpose of this study was histopathological evaluation of lesions of appendix over a period of five years and its association with demographic data. METHODS This cross-sectional study included all specimens received in the department of pathology with primary pathology in appendix. Appendix removed as a part of other surgical procedures were excluded. Relevant clinical data, gross findings and histopathological diagnoses were retrieved from pathology records and computer databases and statistical analysis was done using Statistical Package for Social Sciences (SPSS 16.0). RESULTS Out of the 576 cases, 485 (84 %) patients showed findings consistent with acute appendicitis on histopathological examination. Perforation rate was 4.86 % and was higher in male patients. Other pathologies include chronic appendicitis in 58 cases (10.06 %), eosinophilic appendicitis in one case (0.17 %), appendix with lymphoid hyperplasia in 14 cases (2.43 %), periappendicitis in 4 cases (0.69 %), fibrous obliteration of appendix in 2 cases (0.34 %), granulomatous appendicitis in 4 cases (0.69 %), appendix with lymphoid hyperplasia in 14 cases (2.43 %), diverticulitis in one case (0.17 %), tubular adenoma with low grade dysplasia in one case (0.17 %), neuroendocrine tumour in one case (0.17 %) and mucinous neoplasms in 5 cases (0.86 %). CONCLUSIONS The study supports routine histological examination of all the appendicectomy specimens to avoid missing of any clinically important condition which has significant impact on treatment and prognosis. Also noted an increased number of mucinous neoplasms suggesting the importance of future studies in this field. KEYWORDS Appendix, Acute Appendicitis, Chronic Appendicitis, Mucinous Neoplasms of Appendix, Diverticulitis
INTRODUCTION: Cutaneous metastasis of follicular carcinoma of thyroid is rare. There are fewer than 30 cases reported in the literature, majority affecting the scalp. CASE HISTORY: 55yrs old female presented with swelling over right side of the forehead. FNAC from the nodule showed uniform sized epithelial cells arranged in repetitive follicular pattern & rosettes, suggestive of follicular carcinoma of thyroid. RESULTS: Morphological features of follicular carcinoma thyroid are unique in FNAC smears & hence we came to the diagnosis of follicular carcinoma thyroid on FNAC of forehead nodule. DISCUSSION: Cutaneous metastasis explains the aggressive nature of the disease & they have contributed to poor outcome. Average length of survival after diagnosis of cutaneous metastasis from follicular carcinoma thyroid is 19 months. CONCLUSION: We have presented an unusual case of aggressive follicular carcinoma thyroid with wide spread cutaneous metastases.
BACKGROUND Microcytic hypochromic anaemia is commonly due to iron deficiency, anaemia of chronic disorder [ACD] and thalassaemic syndromes. Reticulocyte count reflects the erythropoietic activity of bone marrow and is thus useful in both diagnosing anaemias and monitoring bone marrow response to therapy METHODS All samples were selected from routine blood counts, and sent for investigation of anaemia, over a period of two years. These samples were run on the DxH800 (Beckman Coulter). 385 cases were selected for the study. Blood analysis for all these cases had been requested by general practitioners to investigate anaemia. These blood samples had been collected in ethylenediaminetetraacetic acid (EDTA) anticoagulant vacutainers and processed within 2 hours of collection. Determination of red cell and reticulocyte parameters in all blood samples, was performed using the Beckman Coulter 7-part analyser [Unicell DxH 800]. RESULTS Of the 156 cases of microcytic hypochromic anaemia studied, iron deficiency anaemia (IDA) was present in 91 cases, anaemia of chronic disorder (ACD) in 50 cases, beta thalassemia trait (BTT) in 15 cases. Of the 50 ACD cases, 37 were associated with IDA. The control group comprised of 229 adult medical students (143 women and 103 men) with a median age of 18.84 ± 0.98 years. We also had 4 cases of other haemoglobinopathies, which were microcytic hypochromic, but were not included in our study as the number of cases was too less to be analysed. CONCLUSIONS New reticulocyte parameters are useful for evaluation of iron status and diagnosing iron deficiency anaemias. They also are reliable parameters for recognising subsets of anaemic patients thereby improving the management of anaemia. KEYWORDS Reticulocyte, Microcytic, Hypochromic, Anaemia, Beckman Coulter
BACKGROUNDThe haematological parameters in a newborn are distinctly different from the normal adult values. NRBCs are immature RBCs normally seen in the peripheral blood of neonates up to 5 th day of life. At birth, 3 to 10 NRBCs per 100 WBCs are present. Premature birth and foetal hypoxia can cause the number to increase. NRBC count in umbilical venous blood of neonates has been reported as a possible marker of perinatal asphyxia. Leukocytosis refers to an increase in the total number of WBCs due to any cause. Thrombocytopenia can be a marker of an underlying disease as well as an obvious risk factor for haemorrhage. We wanted to study the variations in RBC, WBC, and platelets in peripheral smear of neonates and correlate them with the clinical findings.METHODS 300 cases were undertaken in this prospective study held between January 2012 and September 2013. Peripheral smear slides of all term neonates born in A. J. Hospital, Mangalore during this time period were taken and stained with Leishman's stain. The data obtained was extensively studied and statistical analysis was done by Pearson's Chi square test and Fischer's Exact test. RESULTSThe mean age of the study group was 1.29 days with female predominance, constituting 67%. 94.3% cases had normal RBC morphology. Anaemia amounted to 5.7% (17) cases. 91% cases had normal WBC count and 9% (27) cases had leukocytosis. HSS score was 4 for 8% (24) cases of which 7% (21) cases had leukocytosis and 1% (3) cases had normal WBC count. HSS score was 5 for 10% (3) cases, of which 7% (2) cases had leukocytosis and 3% (1) cases had normal WBC count. Normal platelet count was seen in 89.7% (269) cases with thrombocytopenia in 10.3% (31) cases. CONCLUSIONSPeripheral blood film remains a very useful diagnostic tool in haematological assessment, and assessing the HSS score is important as it is a useful test to distinguish the infected from the non-infected newborn which will help the clinicians to reach a probable diagnosis, decreasing the death toll and institute a rational approach towards patient medication.
Hamartoma is a local malformation resulting from faulty development in an organ. It was first described in breast in 1971 by Arrigoni et al and its occurrence in breast is very rare. This tumor is composed of breast lobules admixed with fibrous tissue and fibroadipose tissue. Myoid hamartoma, also called as muscular hamartoma , is composed of smooth muscle cells in addition to ducts, lobules, and stroma. Here, we report a case of myoid hamartoma which occurred in a 53year old lady with a lump in the right breast.
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