Background & objectives
:
Diagnosis of myelodysplastic syndromes (MDS) is subjective in low-grade cases with <5 per cent blasts or <15 per cent ring sideroblasts. Flow cytometry (FCM) has been used to diagnose MDS; but, it still has only an adjunctive role. This study was conducted to evaluate the role of FCM to diagnose MDS and correlate the number of aberrancies with revised international prognostic scoring system (R-IPSS).
Methods
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This study included 44 consecutive clinically suspected cases of MDS with refractory cytopenia(s) and 10 controls. Patients were divided into two groups: (
i
) proven MDS cases (n=26), and (
ii
) suspected MDS (n=18). Ogata quantitative approach, pattern analysis and aberrant antigen expression were studied.
Results
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Ogata score ≥2 correctly diagnosed 80.7 per cent (21/26) while aberrant antigen and pattern analysis with flow score of ≥3 could diagnose 92.3 per cent (24/26) patients with proven MDS. Combination of both with flow score ≥3 could diagnose 100 per cent patients. Eight patients in suspected MDS group with persistent cytopenia on follow up were labelled as probable MDS. Ogata score ≥2 was present in 5 of 8 and pattern analysis score ≥3 was present in six probable MDS patients. Combination of both with flow score ≥3 was present in seven of eight patients. Spearman's correlation between Ogata score and R-IPSS, pattern analysis and R-IPSS and combination of both scores and R-IPSS showed significant positive correlation in proven MDS as well as when proven and probable MDS patients were combined.
Interpretation & conclusions
:
Our results showed that combined Ogata approach and pattern analysis, demonstration of ≥3 aberrancies in >1 cell compartment could diagnose most MDS patients. Patients with high flow scores had high R-IPSS scores. Patient with flow score ≥3 and borderline cytomorphology should be observed closely for the development of MDS.
Traffic is one of the major problems in most of the metropolitan cities. Classifying the traffic conditions are important for determining traffic control strategies and management. Traffic congestions have negative impact on society, as a lot of time is wasted in it and controlling the congestions is necessary. By classification we can get to know which lane has traffic, from which we can further check the reasons for traffic and to take appropriate decisions to improve the performance. Video on traffic data is suitable source for traffic analysis. In this paper, video surveillance data is used for classification of road traffic using Convolution Neural Network. Convolution Neural Network requires minimal preprocessing when compared to other classification algorithms and is known for its accuracy. The video is classified based on rating of the traffic of its content. The Convolution Neural Network is first trained and then it is evaluated and updated using validation set. Once the model is completely trained it is tested with the testing set. This trained model is capable of processing the live streaming video and classifies each of the frames and gives the rating of the traffic for each lane, which can be helpful for traffic management.
BackgroundRomiplostim, a thrombopoietin (TPO) receptor antagonist, promotes tri-lineage hematopoiesis in patients with acquired aplastic anemia (AA). However, its efficacy as a first-line treatment in combination with an immunosuppressant, i.e., anti-thymocyte globulin (ATG) and cyclosporine (CSA), remains unexplored.
ObjectiveTo assess the efficacy and safety of romiplostim in combination with ATG and CSA as first-line treatment in patients with AA.
MethodA single-center, retrospective study of AA patients, where data of patients administered with ATG + CSA + romiplostim as a first-line treatment was included. Romiplostim 5 µg/kg weekly for one month; post that, the dose was increased to 10 µg/kg weekly for the next five months. The primary outcome involves the overall response rate and hematological response at baseline, three months, and six months.
ResultData from 12 patients with a median age of 18 years was evaluated. At a median follow-up of six months, 25% achieved a complete response, 41.6% achieved a partial response, and 16.7% had no response. Improvement in tri-lineage hematopoietic response had been seen at six months from baseline, with improvement in absolute neutrophil count (ANC) and platelet count (PC) being the most significant, with an increase of >100% from baseline, followed by total leukocyte count (TLC) (75.13%) and hemoglobin (Hb) (66.07%) from baseline. Two deaths were reported during the treatment.
ConclusionRomiplostim, in combination with ATG plus CSA, demonstrated clinically significant outcomes as a firstline treatment in patients with AA. Further studies are required to confirm these findings in larger populations to assess long-term outcomes.
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