Iron supplement in pregnancy and development of gestational diabetes—a randomised placebo-controlled trial

Objective  To test the hypothesis that iron supplement from early pregnancy would increase the risk of gestational diabetes mellitus (GDM).
Design  Randomised placebo-controlled trial.
Setting  A university teaching hospital in Hong Kong.
Population  One thousand one hundred sixty-four women with singleton pregnancy at less than 16 weeks of gestation with haemoglobin (Hb) level between 8 and 14 g/dl and no pre-existing diabetes or haemoglobinopathies.
Methods  Women were randomly allocated to receive 60 mg of iron supplement daily ( n = 565) or placebo ( n = 599). Oral glucose tolerance tests (OGTTs) were performed at 28 and 36 weeks. Women were followed up until delivery.
Outcome measures  The primary outcome was development of GDM at 28 weeks. The secondary outcomes were 2-hour post-OGTT glucose levels, development of GDM at 36 weeks and delivery and infant outcomes.
Results  There was no significant difference in the incidence of GDM in the iron supplement and placebo groups at 28 weeks (OR: 1.04, 95% confidence interval [CI]: 0.7–1.53 at 90% power) or 36 weeks. Maternal Hb and ferritin levels were higher in the iron supplement group at delivery ( P < 0.001 and P = 0.003, respectively). Elective caesarean section rate was lower in the iron supplement group (OR: 0.58, 95% CI: 0.37–0.89). Infant birthweight was heavier ( P = 0.001), and there were fewer small-for-gestational-age babies in the iron supplement group (OR: 0.46, 95% CI: 0.24–0.85).
Conclusion  Iron supplement from early pregnancy does not increase the risk of GDM. It may have benefits in terms of pregnancy outcomes.     

Absence of polysialylated NCAM is an unfavorable prognostic phenotype for advanced stage neuroblastoma

Background  

The expression of a neural crest stem cell marker, polysialic acid (polySia), and its main carrier, neural cell adhesion molecule (NCAM), have been detected in some malignant tumors with high metastatic activity and unfavorable prognosis, but the diagnostic and prognostic value of polySia-NCAM in neuroblastoma is unclear.     

Validation of a prognostic scoring system for locally recurrent nasopharyngeal carcinoma treated by stereotactic radiosurgery

Background  

Selection of patients with local failure of nasopharyngeal carcinoma (NPC) for appropriate type of salvage treatment can be difficult due to the lack of data on comparative efficacy of different salvage treatments. The purpose of the present study was to validate a previously published prognostic scoring system for local failures of NPC treated by radiosurgery based on reported results in the literature.     

Comparison of single versus fractionated dose of stereotactic radiotherapy for salvaging local failures of nasopharyngeal carcinoma: a matched-cohort analysis

Background

Oral submucous fibrosis is a common oral health problem in India. This study was conducted to correlate the histopathological diagnosis with habits and clinical findings in patients suffering from oral submucous fibrosis (OSF).

Methods

Patients suffering from oral submucous fibrosis from the Departments of Otorhinolayngology and Pathology, Moti Lal Nehru Medical College, Allahabad, India were studied from 2004–2008. Detailed information was gathered in a pretested proforma. Emphasis was given to the various addictions, clinical findings and histological examination was done.

Results

Two hundred and thirty nine patients were studied, yielding a male to female ratio of 6.8:1. Maximum patients were in the 21–30 years age group with a marked male predominance. Of these, 197 (82.4%) patients chewed areca nut/dohra, 14 (5.8%) were smokers and 2 (0.8%) patients were habituated to alcohol. 89(37.2%) patients reported difficulty in opening of the mouth (trismus). 51 (57.4%) patients were found to have stage II (2–3 cm) trismus while rest had stage I and III. The buccal mucosa was found to be the most commonly involved site. On the basis of histopathological examination, 52(21.7%) were classified as OSF grade I, 75(31.3%) patients as grade II and 112(46.8%) had grade III disease.

Conclusion

The widespread habit of chewing dohra/paan masala is a major risk factor of OSF, especially in the younger age group. In this study, an increase in histopathological grading was found with severity and duration of addiction habit. However no significant correlation was found between clinical staging and histopathological grading.     

RP-HPLC测定立复欣注射液的含量

目的：建立一种快速简便的反相HPLC法测定立复欣注射液的含量,同时考察25度立复欣注射液在5％GS,0．9％NS和10％GNS中的稳定性,方法：采用Lichrospher 100(RP-8.5um*250mm)柱,以甲醇－乙腈－0．04M KH2PO4溶液（31．5：31．5：37）为流动相,流速1ml/min,柱温40度,254nm柴外检测;观察溶液的外观并用酸度计测定其PH值,结果：回收率为100．5：37）为流动相,流速1ml/min,柱温40度,254nm紫外检测,观察溶液的外观并用酸度计测定其PH值,结果：回收率为100．87％,RSD＝1．4％（n=5),在4－120mg/l范围内,峰面积对浓度呈良好的线性关系,r=0\99989,25度下样品在输液中的PH值,含量及颜色在0－6h内均无明显变化。结论：本法简速,灵敏底高,准确性好;25度,6h内样 在上述输液中稳定性好。     

Systemic Irradiation Therapy of Myelomatosis—The Therapeutic Implications of Technique

The pattern of disease relapse in nine patients with multiple myeloma who had received double hemi body irradiation therapy is analysed. This analysis highlights the localisation of these relapses to skeletal areas excluded from initial radiation fields. This phenomenon was also documented in a patient who received systemic irradiation as part of a conditioning regimen per allogeneic bone marrow transplantation.     

The clinical indications for identical pathogenesis of isolated and non-isolated testicular relapses in acute lymphoblastic leukaemia

In the present population-based study, we compared the clinical data of testicular relapses with and without concurrent bone marrow relapse and clinical data of the relapses in other locations among boys with acute lymphoblastic leukaemia (ALL), in order to study the possible evidence of early sequestration and local regulation of leukaemic lymphoblast in the testis of humans. The results suggest that the pathogenesis of isolated testicular relapse (T) and testicular relapse with a concurrent bone marrow relapse (T+BM) is likely to be similar. Isolated and non-isolated testicular relapses appeared late after the achievement of remission (T 34±16 months, T+BM 32±15 months) in ALL compared to relapses in other locations (CNS 23±11 months, BM 25±19 months). The better prognosis after testicular relapses (estimated second event free survival probability, 2-EFS: T 0.63, T+BM 0.32) compared to bone marrow relapse (2-EFS: BM 0.13) further suggests that testicular relapse with a concurrent bone marrow relapse possibly originates from the isolated testicular relapse, and that the isolated testicular relapse is a separate entity and not a manifestation of systemic recurrence. Higher frequencies of isolated and non-isolated testicular relapses (T 9%, T+BM 5%) were observed among boys with onset of ALL in early puberty (10-12y) compared to those among younger (T 4%, T+BM 2%) and older (T 0%, T+BM 0%) boys. The late occurrence, the possible association with hormonal maturation and the good prognosis after testicular relapses suggest a possible local regulation of the residual leukaemic lymphoblast in human testis.