Serum amyloid a as an independent prognostic factor for renal cell carcinoma--a hospital based study from the Western region of Nepal

Objective: The objective of our present study was to assess the role of serum amyloid A (SAA) in stages andprognosis of renal cell carcinoma. Material and Methods: It was a hospital based retrospective study carriedout in the Department of Medicine and Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal between1st January 2008 and 31st December 2011. The variables collected were SAA, CRP. Approval for the study wasobtained from the institutional research ethical committee. Quantitative analysis of human SAA and C-reactiveprotein (CRP) was performed by radial immune diffusion (RID) assay for all cases. Results: Of the 422 total casesof renal cell carcinoma, 218 patients had normal and 204 abnormal SAA. SAA levels were grossly elevated in T3stage (122.3 ± SD35.7) when compared to the mean for the T2 stage (84.2 ± SD24.4) (p value: 0.0001). Similarly,SAA levels were grossly elevated in M1 stage (190.0 ± SD12.7) when compared to the M0 stage (160.9±SD24.8)(p: 0.0001). There was no significant association with elevated CRP levels (209.1 ± SD22.7, normal 199.0 ±SD19.5) . Conclusion: The validity of SAA in serum as being of independent prognostic significance in RCC wasdemonstrated with higher levels in advanced stage disease.     

Ocular manifestations of COVID-19: facts and figures from a tertiary care center

IntroductionCOVID-19 patients presenting with ocular manifestations are from 0.8% to 32% of patients seen in the ED. The available literature is scarce regarding COVID-19 patients presenting with ocular manifestations from the Middle Eastern region.PurposeThis study aims to report the incidence of ocular signs and symptoms in COVID-19 patients and find any correlation between the occurrence of ocular manifestations and patients’ comorbidities.MethodsAll patients having the primary diagnosis of COVID-19 infection and concurrent ocular manifestations on admission to our tertiary COVID-19 health care centre were included in the study. The patient’s demographic data, comorbidities, and type of ocular manifestations were recorded from the patients’ health records retrospectively.ResultsIn our study, 39 (7.8%) patients presented with ocular manifestations. The majority of COVID-19 patients were male, and 200 (20%) patients had a history of other comorbidities. The majority of our patients had hyperaemia (13 [33.3%]), followed by eye pain (9 [23.1%]), epiphora (8 [20.5%]), burning sensation (4 [10.3%]), and photophobia (2 [5.1%]) patients. There was no statistically significant difference in the occurrence of ocular manifestations and patients’ gender or comorbidities (p > .05).ConclusionThe occurrence of ocular manifestations was lower compared to the present literature. There was no significant association between the occurrence of ocular manifestations and the patient’s gender or comorbidities.     

Neutropenia at the time of subcutaneous port insertion may not be a risk factor for early infectious complications in pediatric oncology patients

Background

The risk of infection associated with subcutaneous port (SQP) placement in patients with neutropenia remains unclear. We reviewed the rate of early infectious complications (< 30?days) following SQP placement in pediatric oncology patients with or without neutropenia [absolute neutrophil count (ANC) < 500/mm³].

Status of Hip Arthroscopy in India: A Short Questionnaire Based Survey and Review of Literature

BackgroundHip arthroscopy is a minimally invasive technology for diagnostic and therapeutic interventions in various hip disorders. Over the past decade or so, the technology and understanding related to this surgery have improved by leaps and bounds; however, in India the overall pace has been limited. The present review highlights the status of hip arthroscopy in the Indian context.MethodologyA small survey with five questions related to practice of hip arthroscopy among Indian orthopaedic surgeons was conducted. Additionally a PubMed database search was conducted to recognise and assess studies pertaining to hip arthroscopy originating from India.ResultsForty-two responses were received for the questionnaire, out of which 38 surgeons performed hip arthroscopy in their practice; the overall numbers were very low with only one respondent performing more than 50 surgeries in a year. For 84.2% of the respondents, the practice was limited to less than ten surgeries per year. 63.2% of the surgeons affirmed that there has been no change in their practice of hip arthroscopies over the past 5 years, signifying the slow growth and limited application of the technique. Only nine studies pertaining to the topic were available in the literature search, out of which five were case reports. The most common indication was removal of intraarticular foreign bodies, followed by joint debridement and lavage, synovial biopsies and femoroacetabular impingement (FAI). The outcomes in all the studies were satisfactory.ConclusionHip arthroscopy is in its nascent stages in India and much is still needed to be done for better implementation of the technique on a wider scale. Adequate training and continued medical education programme, with exposure to the experts in the field, will go a long way in better utilisation of the surgery in India.