Indian Journal of Public Health Research & Development

Abstract

Aortic dissection: is a catastrophic illness characterized by dissection of blood between and along the laminar planes of the media with formation of blood filled channel within the aortic wall which often ruptures out ward and cause severe hemorrhage.3 In such cases quick and timely diagnosis can save a life from Aortic catastrophe. Therefore we think it is important to report this case.

Case Presentation: This case is young man who presented with pain in abdomen, dizziness and loss of sensation in right hand in Sharda Hospital Greater Noida. The patient was referred to Cardiology Department and Echocardiography was done which suggested the diagnosis of Dissection of ascending aorta with aortic regurgitation. Case was referred for Surgery.

Bentall procedure: through sternotomy on CPB was performed and life was saved.

Conclusion: Aortic dissection is a fatal condition .A high clinical index of suspicion and correct diagnosis on Echocardiography is essential to save the life. If the patient 's history suggests neurovascular deficit as in our case , non invasive diagnostic procedure such as ECHOCARDIOGRAPHY should be performed promptly to rule out aortic dissection which is life threatening condition.

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Abstract

Abstract: This study was conducted to determine the distribution of ABO& Rh Blood groups in western U.P, India as no data is available from this region.

This study will help in planning and establishment of functional blood bank services that would meet the ever-increasing demand for safe blood and blood products.

It was conducted on 6000 blood donors over a period of four years from Jan 2008 to Jan 2012. at the School of Medical sciences & research, Sharda Hospital, Sharda university, Greater Noida.

The donors were both males & females which included both voluntary & replacement donors. The results were analyzed and the data was compiled. Our study which involved 6000 donors, both male and female, showed' B' blood group type to be the most common, viz., 1964 (32.73%) donors, followed by the 'O' blood group which had 1856 (30.93%) donors, 'A 'blood group 1349 (22.48 % ) and 'AB 429 (7.15 %) donors being the least common which shows that it follows the Asiatic trend of B > O > A > AB.

Rh-D blood group frequency was 93.310% positive and 6.69% negative.

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Abstract

Introduction: Bone marrow is not only a reservoir of stem cells but also provides microenvironment for proliferation and development of precursors and regulate the release of mature cells in to circulation. Bone is commonly involved in metastatic tumors and rank third most common site of metastasis after lung and liver. Metastasis may be present in the bone marrow without any abnormalities recognized in bone scans, radiographic pictures, serum chemistry and hematological parameters and remain the only procedure to diagnose the presence of metastatic tumor.

AIMS: To study the clinical features&characteristics of BM involvement in NHL& HL cases with respect to morphology of infiltration for staging and their prognosis.

Materials and Method: A prospective study was conducted on 38cases who had not received any prior specific treatment (chemotherapy and radiotherapy) for both Hodgkin's and non-Hodgkin's lymphoma from northern India, . Out of 38 cases Hodgkin's lymphoma were 08 cases and non- Hodgkin's lymphoma were 30 cases . All cases were examined clinically and later on Bone marrow aspiration and Bone marrow biopsy was obtained from the posterior superior iliac spine. The biopsies were fixed in 10% buffered formalin solution and decalcified using 10% formal - formic acid for 4 - 6 h followed by routine processing. The serial sections were stained by hematoxylin and eosin and reticulin stains. The smears were air dried and immediately fixed in methanol for one of the Romanowsky stain (We used Leishman stain and May-Grunwald Geimsa stain) for cellularity and morphology1. Serial aspiration and biopsies were done in all cases of Hodgkin's and non-Hodgkin's lymphoma

Observations: The most prominent clinical feature was cervical lymphadenopathy. Patients with advanced disease had systemic features like fever, weight loss and hepatosplenomegaly.

The incidence of marrow involvement in known case of Hodgkin's and non-Hodgkin's lymphoma was 25% and 43.33% respectively. The incidence of bone marrow involvement was found in mixed cellularity and in lymphocyte depletion type of Hodgkin Lymphoma cases and the pattern of involvement of bone marrow was diffuse in all the cases.

The extent of marrow involvement was greatest in Non Hodgkin lymphomas that exhibit a diffuse pattern of infiltration. In thirteen cases (43.33%) of bone marrow involvement, seven cases (53.8%) showed presence of neoplastic cells in both aspiration and biopsy while six cases (46.2%) showed presence of neoplastic cells in bone marrow biopsy.

Serial aspiration and biopsies revealed that both cases (100%) of Hodgkin's lymphoma improved with systemic chemotherapy, while five cases (38.46%) of non-Hodgkin's lymphoma showed clearance of bone marrow by the neoplastic cells on completion of chemotherapy.

Conclusion: In all the cases, which infiltrated to bone marrow, histological grades were same as in the FNAC / Histopathology examination at the time of diagnosis from the primary site.

Bone marrow aspiration and biopsy were performed as complimentary procedures.

But Bone marrow biopsy was found superior to bone marrow aspiration.. It was also helpful in the management strategy of the disease as well as to see the response of the therapy by serial aspiration and biopsies10. It was found that in five cases (38.46%) of non-Hodgkin's lymphoma bone marrow showed clearance of tumor cells after completion of chemotherapy.

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Abstract

Giant cell tumor is relatively uncommon benign locally aggressive neoplasm. and is still a challenge to the Surgeons in the developing countries due to limited diagnostic and therapeutic facilities.

Aim of study: This study was conducted to determine the clinical pattern of Giant cell tumors including their relative frequencies as per age and sex distributions, anatomical sites of occurrence, radiological features, histopathology features analysis and treatment approach in a tertiary care hospital of North India.

Materials and Method: This is a retrospective study of all the histopathologically confirmed Giant cell tumors seen at Safdarjang Hospital New Delhi and S.M.S. Greater Noida over a 9 year period. During this period total number of primary bone tumors were 1170.Out of these 128 were diagnosed as Giant Cell tumors and 108 cases were followed up and forms the basis of the study.

Results: Out of 108 patients there were 57 males and 51 females. Their ages ranging from 11 to 55 years with an average of 28 years. The most common sites of the lesions were the ends of long bones (90 cases), especially the distal femur (24 cases), proximal tibia (31 cases) and distal radius (11 cases). The histological pattern of giant cell tumor was rather uniform. The indispensable feature of giant cell tumor was, giant cell itself. Microscopic evidence of malignancy was found in one of our cases of giant cell tumour of recurred lesion.Various forms of treatment included were curettage, en- bloc resection and radiation.

Conclusion: Incidence of GCT was 9 % of all primary tumors. Microscopic evidence of malignancy was found in one of our cases of giant cell tumour of recurred lesion.Histological grading has little prognostic value. Benign histology does not necessarily relate to the clinical behavior of the tumor. Resection yielded the best result. Radiation therapy should be reserved for surgically inaccessible tumor because of high risk of recurrence and malignant transformation.

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Blood transfusion is an effective mode of transmission of hepatitis C infection. In developed countries various measures have been taken to reduce the spread of infection through this route. In India, mandatory screening for HCV was introduced as late as 2002 though it was started in Japan&US in 1990. Still, the studies all over India suggest that despite testing of blood units HCV infection is still a significant problem.

HCV is transmitted by blood to blood contact. In developing countries about 90 % of persons with chronic HCV were infected through transfusion of unscreened blood or blood products or via intravenous drug abuse or sexual exposure. Also, in developing countries, the primary sources of HCV infection may be unsterilized injection equipment.

The present study was conducted to find out seroprevalence of hepatitis C in 6000 donors in greater noida. The screening was done by ELISA third generation microelisa kit.

Seroprevalence of anti HCV in 6000 donors was 1.28 % with the prevalence of 1.34 % in voluntary&of 1.28% in replacement donors.

Males show higher incidence of 1.29%&females 0.66 %.

Blood group B negative showed higher positivity (1.886%) followed by A positive (1.408%) closely followed by O positive (1.4008%).

Age group >51 yrs show positivity of 5.405% followed by age group of 31-40 yrs ( 1.745 %)

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Giant cell tumour of tendon sheath is second most common tumour of hand with high incidence of recurrence. It is slowly progressing benign tumour arising from synovial cells of tendon sheath. It occurs at any age with peak incidence in third to fourth decade. Trauma, inflammation, metabolic diseases and a neoplastic etiology are considered as etiological factors.

Aim of study: This study was conducted to share our experience of Clinicopathological aspects of Giant cell tumours of tendon sheath including their relative frequencies as per age and sex distributions, anatomical Sites of occurrence, Fine needle aspiration cytology findings &, histopathology features in School of Medical Science Greater Noida.

Material & Methods: This is a retrospective study of Giant cell tumour of tendon sheath which was done at School of Medical sciences & Research Gr. Noida U.P India during four years from 2008 t0 2012.P atients were examined clinically, FNAC & Biopsy were done and FNAC and histopathological features were studied .

Results: There were total 5 cases of giant cell tumour of tendon sheath. Most common site was fingers of hand. Age of patients varied from 25 yrs to 60 yrs. Duration of swelling were from 1 year to 3 years. Most of the swelling were approximately 2cms in diameter, firm and painless.

FNAC of the swellings revealed sheets and clusters of oval to spindle cells intermixed with mononuclear cells and osteoclast type of giant cells, suggestive of Giant cell tumour of tendon sheath.

Histopathological findings were characteristic of GCT-TS showing foamy histiocytes, multinucleate giant cells, fibroblast like cells and foamy histiocytes. Hemosiderin laden macrophages were seen in two cases ,one case revealed diffuse fibro histiocytic proliferation

Conclusion: Giant Cell tumour is a relatively rare soft tissue tumour of uncertain histogenesis. Clinical and pathological features identified were same as those of previous studies .The basic aim of management should be early diagnosis with meticulous and complete excision to prevent recurrence.

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This study was conducted to identify the factors that increase the risk for coronary artery disease and is an extremely important area in health sciences. A total number of 300 patients (92% males and 8% females) were studied. They were divided into two groups, above 40 yrs and below 40 yrs of age.

In the first group (> 40 yrs.) total number of patients were 240 (80% of total 300 patients) .Among 240 patients males were 216(90 %) and females were 24 (10%). High cholesterol more than 200 mg /dl was present in 55% males and in 50 % females. High triglyceride >150 mg % was present in 50 % males and in 48 % female patients. High LDL was present in 30 % males and 25 % females. Low HDL was present in 50 % males and 45 % females. In second group (<40 yrs), all patients were males. High cholesterol was present in 58 % of cases. high triglyceride in 60 % cases low HDL in 50 %, and high LDL in 45 % . Smoking was present in 30 % cases. Hypertension was present in 35 % cases. Obesity was present in 40 % males and 45 %, females. Central obesity was present in 60 % males and 79 % females.

Association of age, high LDL cholesterol, and hypertension, high triglyceride in males and central obesity in females were recorded with CAD patients.

In the younger patients dyslipidemia was more common. Inflammatory markers such as CRP has limited usefulness in the prediction of CAD events over and above conventional risk factors.

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Background: Blood transfusion service (BTS) is an integral part of health care system which primarily aims at providing adequate and safe blood. Transfusion transmitted infections (TTI) pose constant threat to safety of recipients of blood. Therefore all donated blood should be screened against these infections.

Aims &objectives: This retrospective study was carried out to know seroprevalence of different Transfusion transmitted infections in healthy blood donors of Western U.P.to prevent transmission of diseases.

Material and method: Blood units collected from healthy non remunerated , replacement and voluntary donors within blood bank premises of Sharda hospital, Greater Noida, over a period of 6 years(2007-2012) were screened against NACO recommended TTI- HIV, HBsAg, HCV, Syphilis and Malaria parasite.

Results: Total donations were 9592. Out of which 330 donors were sero reactive and 18 showed co infections (dual infection). Seropositivity for HBsAg was present in 168 donors (1.75%), HCV - 116(1.208%), RPR for syphilis 52 (0.54%) and HIV - 12 cases (0.12%) . Majority of single and co infections were in 21-40 yrs age group .Co infection was present in 18 cases. RPR done for syphilis was a common positive marker in all 18 cases of co infection. Other infections were HBsAg -11 cases (61.1%), HCV - 6 cases (33.3%) and HIV - one case (5.55%).

Conclusion: Blood bank should follow more stringent donor selection criteria and promote voluntary donation. Public awareness regarding mode of spread of TTI and judicious use of blood will reduce the threat of transfusion transmitted infections.

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