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Arterial stiffness is a non-traditional risk factor of cardiovascular disease and may explain part of the excess cardiovascular risk in chronic kidney disease patients. Successful renal transplantation (RT) may restore renal function and improve several metabolic abnormalities involved in arterial stiffness. This prospective study conducted non-invasive assessments of arterial stiffness indices [the augmentation index (AI) and pulse wave velocity (PWV)] in end-stage kidney disease (ESKD) patients before RT and 3 and 6 months after living-donor RT, alongside the effects of age and calcineurin inhibitors on arterial stiffness. The study included 26 ESKD patients (22 males and 4 females; mean age, 34.07 years; median duration of dialysis, 10 months) scheduled for RT and followed up for three visits (within 1 week before transplantation, and 3 and 6 months after transplantation). Six months after successful RT, the patients had nearly normal serum creatinine and significantly improved serum phosphate and intact parathyroid hormone levels. The pretransplant AI was 21.53% ± 13.61% which reduced significantly 6 months after RT to 16.19% ± 10.74% (P

Blast ploidy is a distinctive cytogenomic feature related to the prognostic outcome of acute lymphoblastic leukemia (ALL) patients. Near tetraploidy (NT) (81–103 chromosomes) is a very rare ploidy anomaly in (ALL). It is observed in approximately 1% of childhood B-cell precursor ALL (BCP-ALL). In T-ALL specifically in adult T-ALL, it is furthermore rare entity. Only few case reports are found in the existing literature. Compared to BCP-ALL, T-ALL lacks recurrent genetic anomalies with independent prognostic value. Although B-cell ALL associated with NT is related to a standard cytogenomic risk, the prognostic outcome of NT in T-cell ALL is yet to be determined. Conventional karyotyping of this entity is difficult to perform and interpret. Thus, it is recommended that karyotype results should be supplemented by fluorescence in situ hybridization. Herewith, we present an adult T-ALL case detected with NT karyotype with emphasis on prognostic significance.

Tyrosine kinase inhibitors (TKI) (imatinib, dasatinib, and nilotinib) are used for the treatment and long-term control of chronic myeloid leukemia (CML). TKIs rarely cause systemic side effects with atypical presentations, and these must be borne in mind while prescribing these drugs over a prolonged period. Dasatinib-induced cardiopulmonary toxicity should be suspected in patients presenting with new-onset cardiac or pulmonary symptoms, with features of congestive cardiac failure and pulmonary infiltrates. We report a rare presentation of simultaneous occurrence of pleural effusion, interstitial pneumonitis, pulmonary hypertension, and heart failure in a CML patient on dasatinib for >6 years, which was successfully treated with discontinuation of the drug and oral steroids.

Background: Incidence of breast cancer has increased globally over the past several decades with the greatest increase in the Asian countries. The hormone status perhaps plays the most vital part in disease discordance and impacts the clinical behavior of the disease. This study attempts to study the receptor status in carcinoma breast in the Indian Population and study any change in its correlation with the clinical profile, tumor characteristics, and metastatic profile. Methods: This was a prospective observational study done on all patients with breast cancer treated at Command Hospital Airforce, Bangalore, between January 2017 and December 2019. Two hundred and eight female patients with breast carcinoma were included in the study. Results: Estrogen (ER) and progesterone receptors (PR) are found positive in only 20%–45% of Indian patients. ER-positive rates are lower in Indian patients than those in Western countries. Triple-negative breast cancer (TNBC) metastasizes especially to the liver and lung; however, Her 2nu-positive tumors present as Stage III rarely metastasize. Hormone-positive tumor showed a bimodal peak pattern, while TNBC is seen uniformly in all age groups now. BIRADS 5 was seen exclusively in triple-positive disease. Grade I tumors are exclusively seen in hormone-positive tumors, but 25% of these tumors present with distant metastasis and 90% with node-positive disease. Conclusion: Breast cancer patients of Indian origin tend to be younger; tumors are often large when rst diagnosed, and of a high grade as compared to Western countries. The hormone receptor status still determines and drives the disease; however, there is a major paradigm shift in the disease behavior now as compared to the earlier data. The biology of the disease and the clinicoepidemiological profile of breast cancer in relation to the receptor status is an ever-evolving event and periodic evaluation of their correlation is the need of the hour. This will improve the further understanding of the disease, help in therapeutics, and improve outcomes in such patients

Introduction: Acute myeloid leukemia (AML) is the commonest leukemia in adults. Mortality in thew first 30-days ranges from 6% to 43%, while infections account for 30–66% of early deaths. We aim to present our experience of infections in newly-diagnosed AML. Method: This prospective, observational study, was undertaken at a tertiary care hospital in Northern India. Patients with confirmed AML (bone marrow morphology and flow cytometry) and who had developed febrile neutropenia (FN), were included. Result: A total of fifty-five patients were included in the study. The median age of the patients was 47.1 years (12–71) and 28 (50.9%) were males. Fever (33, 60%) was the commonest presentation at the time of diagnosis. One or more comorbid conditions were present in 20 patients (36.36%). Infection at presentation was detected in 17 patients (30.9%). The mean duration to develop febrile neutropenia since the start of therapy was 11.24 days. With each ten-thousand increase in white blood cell (WBC) count, the mean number of days of FN development decreased by 0.35 days ( p = 0.029). Clinical and/or radiological localization was possible in 23 patients (41.81%). Thirty-four blood samples (34/242, 14.04%) from 26 patients (26/55, 47.3%) isolated one or more organisms. Gram negative bacilli (GNB) were isolated in 24 (70.58%) samples. Burkholderia cepacia (8/34, 23.52%) was the commonest organism. The number of days required to develop febrile neutropenia was inversely associated with overall survival (OS). However, when compared, there was no statistically significant difference in OS between patients developing fever on day-10 and day-25 ( p = 0.063). Thirteen patients (23.63%) died during the study period. Discussion: Low percentage of blood culture positivity and high incidence of MDR organisms are a matter of concern. Days to develop febrile neutropenia were inversely associated with overall survival (OS), emphasizing the importance of preventive measures against infections. Conclusion: Infections continues to be a major cause of morbidity and mortality among AML patients.

Hemophilia B is a hereditary bleeding disorder characterized by deficient or defective coagulation factor IX, leading to a propensity for recurrent bleeding episodes, particularly in the joints. Management of Hemophilia B in surgical settings poses unique challenges due to the risk of excessive bleeding. This paper presents a series of two cases that demonstrate the effective use of perioperative extended half-life (EHL) factor IX products, specifically N9-GP (Refixia), in the surgical management of Hemophilia B. The cases include total knee replacement and total hip replacement. In each case, early initiation of EHL was observed to maintain adequate factor IX levels and control perioperative bleeding effectively, leading to successful surgical outcomes. These findings support the growing body of evidence suggesting the advantages of EHL perioperative treatment in patients with Hemophilia B, particularly in preparation for surgery. The implementation of EHL factor IX products as part of perioperative management plans may contribute to improved surgical outcomes and overall quality of life in Hemophilia B patients.