Background: Although COPD is traditionally associated with polycythemia, the systemic inflammation that is now recognized as a feature of COPD makes it a possible cause of Anemia of Chronic Disease (ACD). Preliminary evidences suggest that anemia in COPD may be more prevalent than expected occurring in 10% -15% of patients. While in states like chronic heart failure and renal insufficiency, anemia has been extensively studied; little attention has been given to it in COPD. Objectives: To see the prevalence of anemia in patients with COPD and its potential impact on morbidity of COPD patients. Design and Setting: A university hospital-based cross-sectional study in Kashmir, India. Methods: Two hundred patients (119 males and 81 females) with spirometery documented COPD were evaluated for frequency of anemia. In addition to routine investigations, erythropoietin levels were done in a subgroup of patients. Results: A total of 36 cases (20 males and 16 females) of anemia were detected giving a frequency of 18%. Normocytic normochromic type of anemia was present in 32 (88.89%) patients while the rest had normocytic hypochromic type of anemia. Majority of patients were in GOLD stage 11 and had decreased serum iron, transferrin saturation and TIBC. Erythropoietin levels were significantly raised in anemic COPD patients compared to non-anemic COPD patients. The various factors significantly associated with anemia were: No. of exacerbations of COPD, No. of hospital admissions, BMI and erythropoietin levels. Conclusion: Anemia occurs frequently in patients of COPD and is associated with increased morbidity in the form of No. of exacerbations and hospital admissions. Correcting anemia in these patients may improve their clinical outcome.
Central venous catheters (CVCs) are used in intensive care units (and, increasingly, in other locations) to administer intravenous fluids and blood products, drugs, parenteral nutrition, and to monitor haemodynamic status. The risk of complication during the insertion or exchange of central venous catheters has been well documented. The majority of complications involve mechanical problems, although rarely it may induce arrhythmias as well [1]. Herein we present a case of peripheral central venous catheter induced supraventricular tachycardia in a young patient of acute lymphoblastic leukemia.
Aim:This prospective, randomized comparative study conducted in Kashmir evaluated the clinical profile of colonic carcinoma and the efficacy, side effects and survival advantage of adjuvant treatment with 5FU/CLV versus FOLFOX7.Materials and Methods:Between 2007 and 2009, the clinical profiles of 50 patients enrolled and randomized equally into Arm A receiving 5FU/CLV alone (Mayo Clinic Regimen) and Arm B receiving the FOLFOX7 regimen (including oxaliplatin) were evaluated.Results:Majority of the patients were in the 5th and 6th decade of life (males 70% versus females 30%), and most were from urban dwellings. Consumption of red meat, obesity and physical inactivity were common risk factors. A family history of colonic carcinoma was reported in 12% of the patients. Event-free and disease-free survival for the two arms were: Arm A – 12.8 ± 5 months and 14.2 ± 6 months; Arm B – 13.0 ± 6.7 months and 13.1 ± 6 months, respectively. Treatment-related morbidity was significant in Arm B whereas general well being and surrogate laboratory markers including a hemogram, favored Arm A.Conclusion:The clinical profile, risk factors and familial predisposition of Kashmiri colonic carcinoma patients matches that of colon cancer patients elsewhere. There was no added survival advantage by adding oxaliplatin to 5FU and CLV. Although the interim results showed that the Mayo Clinic Regimen has a better total survival advantage compared with the FOLFOX7 regimen, the results were not statistically significant. The Mayo Clinic Regimen was better than the FOLFOX7 regimen in terms of the toxicity profile. However, this finding needs to be studied further. The main idea of conducting this study was to reveal that there is no added advantage of adding oxaliplatin to 5FU and CLV, thereby (a) reducing the toxicity (b) and lowering cost of therapy.
Tuberculosis has varied clinical and radiological presentations, ranging from constitutional symptoms with segmental involvement to severe forms with multiple lobar consolidation and high mortality. Though uncommon, respiratory failure can be a presenting feature of tuberculous consolidation of lungs, rarely requiring mechanical ventilation. We report a 27 year female diagnosed as having total left lung consolidation and respiratory failure who showed marked clinical and radiological improvement after taking anti-tubercular drugs. Knowledge of radiological presentations of the pulmonary tuberculosis such as patchy, poorly defined consolidation with/without cavitation, fibrosis, calcification, lung destruction, pleural effusion or miliary lesions can help in timely diagnosis and proper management of these cases. JMS 2016; 19(1):29-31
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