Sickle cell-beta thalassemia is a double heterozygous state. Red cell exchange (RCE) transfusion reduces the concentration of sickle cells without increasing the hematocrit or whole-blood viscosity. It can be performed manually or by erythrocytapheresis. RCE transfusion is an effective tool for both acute and chronic complications of sickle cell disease. In patients unaffording erythrocytapheresis, even manual RCE can give favorable results. A 37-year-old male, a known case of sickle cell-beta+ thalassemia (βsβ+), presented with avascular necrosis of right femur and humeral head. He was posted for the right hip arthroplasty and shoulder hemiarthroplasty. Successful manual RCE transfusions were done. The hemoglobin S levels decreased postmanual RCE procedures, and the patient was operated successfully.
Thalassemics require regular blood transfusion therapy leading to iron overload in the body tissues, which is a major cause of morbidity and mortality in these patients. We hereby attempted to measure this iron overload by means of exfoliative cytology, a non-invasive and inexpensive technique. The aims and objectives of our study were: 1. To detect iron overload by oral exfoliative cytology using Perl's Prussian blue stain in β-thalassemia major patients. 2. To correlate staining positivity with serum ferritin levels. Smears were obtained from buccal mucosa of 50 β-thalassemia major patients (who had taken more than 12 transfusions) and 25 healthy subjects of the same age group as controls. Smears were stained with Perl's Prussian blue. Blood samples were taken from the study group for estimation of serum ferritin levels. Grading criteria were defined for assessing the Prussian blue positivity. Perl's positivity was observed in 49 out of 50 of thalassemic patients (98%). 1 patient had Grade 0, 7 patients had Grade I, 5 had Grade II, 12 had Grade III, 14 had Grade IV while 11 patients had Grade V positivity. Spearman Rank's Correlation Co-efficient was 0.38, signifying a weak positive correlation between positivity of buccal smears for Perl's Prussian blue staining and respective serum ferritin levels. Perl's Prussian blue staining of exfoliated cells from buccal mucosa can be used to assess iron overload in β-thalassemia major patients, as a screening as well as diagnostic tool. With the grading system we can give a semi-quantitative assessment of the same.
A study of analysis of 50 pleural fluids was carried out at major teaching hospital, in Mumbai over a period of three years. Of these 50 fluids were 33 were transudates and 17 exudates. Male predominance (72%) was observed with the majority in 3 rd decade. Tuberculosis (30 cases) was the commonest conditions associated with exudates followed by synpneumonic effusions. Majority of the tuberculous cases (80%) showed WBC count between 1000-5000 cells/cmm. Polymorphs were predominant in synpneumonic effusions. Of the 2 cases of malignant effusion, malignant cells (well differentiated adenocarcinoma) were detected in both the cases, with total WBC counts ranging between 1000-5000cell/cmm. The correct diagnosis of the fluid as transudate or exudate is important because if the fluid is exudative then further diagnostic procedures like cytopathology, pleural biopsy and other invasive procedure can be done for definite diagnosis. On the other hand, if the fluid is transudative then treatment for underlying conditions like CCF, nephrotic syndrome, cirrhosis is given. The presence of cancer cells in the fluid is a proof positive of malignancy related fluid but in 30 to 60 percent of cancer cases, cancer cells are not detected. Exfoliative cytology for malignant cells is highly specific though less sensitive (40-60%). Definitive diagnosis may depend upon clinical correlation and histological examination.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.