Leukemias are the most common cancers in children, with acute lymphoblastic leukemia (ALL) accounting for 73% of cases and acute myeloid leukemia (AML) accounting for 18% of cases. ALL peaks between ages 2-5 years and accounts for 25-30% of all childhood cancers. Treatment involves induction, consolidation/intensification, and continuation phases using chemotherapy protocols over 2-3 years. Supportive care and risk stratification are important for managing treatment and prognosis.
simlpe approach to anemia in children , how to diagnose anemia in kids ,types of anemias ,causes of anemia , iron deficeincy anemia, hemolytic anemias , laboratory tests in anemia ,
Detailed Powerpoint Presentation on Wilms Tumour …. It includes definition with images, causes, sign and symptoms all treatment modalities with nursing responsibilities and recent research related to this...
simlpe approach to anemia in children , how to diagnose anemia in kids ,types of anemias ,causes of anemia , iron deficeincy anemia, hemolytic anemias , laboratory tests in anemia ,
Detailed Powerpoint Presentation on Wilms Tumour …. It includes definition with images, causes, sign and symptoms all treatment modalities with nursing responsibilities and recent research related to this...
Wilms tumor (also called Wilms' tumor or nephroblastoma) is a type of childhood cancer that starts in the kidneys. It is the most common type of kidney cancer in children. About 9 of 10 kidney cancers in children are Wilms tumors.
This presentation was done by Dr. Julius P. Kessy,MD. An intern Doctor at Dodoma Regional Referral Hospital (DRRH) during pediatrics unit clinical meeting and supervised by Dr. Christina K. Galabawa,MD,Mmed2, Pediatrics and Child Health, University of Dodoma (UDOM) in November, 2017.
Wilms tumor (also called Wilms' tumor or nephroblastoma) is a type of childhood cancer that starts in the kidneys. It is the most common type of kidney cancer in children. About 9 of 10 kidney cancers in children are Wilms tumors.
This presentation was done by Dr. Julius P. Kessy,MD. An intern Doctor at Dodoma Regional Referral Hospital (DRRH) during pediatrics unit clinical meeting and supervised by Dr. Christina K. Galabawa,MD,Mmed2, Pediatrics and Child Health, University of Dodoma (UDOM) in November, 2017.
Management of acute lymphoblatic leukemia with light on etiology, clinical features, diagnosis and different aspects of management including chemotherapy and radiation therapy
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
2. Leukemia in Children
Leukemias are the most common cancers
affecting children.
Acute lymphoblastic leukemia (ALL) accounts
for 73%,
Acute myeloid leukemia (AML) accounts for
approximately 18%.
Chronic myeloid leukemia(CML) is rarely seen,
accounting for less than 4%.
3. Epidemiology
ALL: 3–4 cases per 100,000 white children
Peak incidence between 2 and 5 years of age
Accounts for 25–30% of all childhood cancers
In ALL, boys more commonly affected than girls
Incidence of AML is similar for all age groups
5. Pathology
• Acute leukemia
–is characterized by clonal expansion of
immature hematopoietic or lymphoid
precursors.
• Chronic leukemia
–refers to conditions characterized by the
expansion of mature marrow elements
6. CLINICAL FEATURES
General Systemic Effects
1. Fever (60%).
2. Lassitude (50%)
3. Pallor (40%)
Hematologic Effects Arising from Bone Marrow Invasion
1. Anaemia
– pallor, fatigability, tachycardia, dyspnoea & CHF
2. Neutropenia
– fever, ulceration of buccal mucosa and infection.
3. Thrombocytopenia
– petechial, purpura, easy bruisability, bleeding from
mucous membrane and internal bleeding.
7. CLINICAL FEATURES
Clinical Manifestations Arising from Lymphoid
System Infiltration
1. Lymphadenopathy
2. Splenomegaly.
3. Hepatomegaly
8. CLINICAL FEATURES
Clinical Manifestations of Extramedullary Invasion
–CNS‐ ICT symptoms, seizures
–Genitourinary ‐ painless testicular swelling
–Bone joints‐ bone pain
–Skin ‐ bleeds
–Git ‐ bleeds
9. CLINICAL FEATURES – Childhood Cancer
CONTINUOUS FEVER, WEIGHT LOSS
HEADACHES, EARLY MORNING VOMITION
INCREASED SWELLING OR PERSISTENT PAIN IN BONES, JOINTS, BACK OR LEGS
LUMP OR MASS – ABDO, NECK, CHEST, PELVIS, ARMPITS
DEVELOPMENT OF RASH, BLEEDING, BRUISION
CONSTANT / RECURENT INFECTIONS
AWHITISH COLOR BEHIND PUPIL
NAUSEA – PERSISTANT OR VOMITING WITHO OR W/O SEIZURE
CONSTANT TIREDNESS
EYE OR VISON CHANGES
RECURRENT OR PERSISTENT FEVER
11. Cytologic
Features
L1 L2 L3
Cell Size Small cells
predominate
Large,
heterogenous in
size
Large and
heterogenous
Nuclear chromatin Homogenous Variable,
heterogenous
Finely stippled &
homogenous
Nuclear shape Regular, occasional
clefting or
indentation
Irregular, clefting &
indentation
common
Regular, oval to
round
Nucleoli Not visible, or small
& inconspicuous
One or more
present, often large
Prominent, one or
more vesicular
Amount of
cytoplasm
Scanty Variable, often
moderately
abundant
Moderately
abundant
Basophilia of
cytoplasm
Slight or moderate,
rarely intense
Variable, deep in
some
Very deep
Cytoplasmic
vacuolation
Variable Variable Often prominent
12. FAB types of acute lymphoblastic leukemia (ALL).
A) L1 morphology with uniform‐sized blasts.
B) L2 ALL with more blast cell variation. (
C) L3 blasts with more clumped nuclear chromatin, nucleoli,
basophilic cytoplasm, and cytoplasmic vacuoles.
13. Imjunologic
Subtype
% of cases FAB
Subtype
Cytogentetic
abnormalities
Pre B ALL 75 L1, L2 T(9;22),
t(4;11),
t(1;19)
T Cell ALL 20 L1, L2 14q11 or
7q34
Mature B Cell
ALL
(Burkitt
Leukemia)
5 L3 T(8;14)
14. INVESTIGATIONS
• Blood count
• Haemoglobin: Moderate to marked reduction
• Blood smear: Blasts are present on blood
smear. Very few to none (in patients with
leukopenia).
• White blood cell count: Low, normal, or
increased
• Thrombocytopenia: 92% of patients have
platelet counts below normal. Very few to
none (in patients with leukopenia).
15. INVESTIGATIONS – Bone Marrow
• Leukemia must be suspected when the bone
marrow contains more than 5% blasts.
• The hallmark of the diagnosis of acute
leukemia is the blast cell, are relatively
undifferentiated cell with diffusely distributed
nuclear chromatin, one or more nucleoli and
basophilic cytoplasm.
18. INVESTIGATIONS
• Chest radiograph: Mediastinal mass in T‐cell
leukemia.
• Blood chemistry: Electrolytes, blood urea, uric
acid,
• Liver function tests, Immuno globulin levels.
• Coagulation profile: Decreased coagulation
factors that frequently occur with AML are:
hypofibrinogenemia, factors V, IX and X.
19. INVESTIGATIONS - CSF
– CNS1 , < 5 WBCs/mm3 with no blasts;
– CNS2 , < 5 WBCs/mm3, a positive "cytospin" for
blasts;
– CNS3, > 5 WBCs/mm3, blasts on cytocentrifuge
slide
Cerebrospinal fluid: Chemistry and cells.
20. TREATMENT
• Three phases:
1. remission induction,
2. consolidation (or intensification), and
3. continuation (or maintenance).
• Protocol adopted depends on the institution
• Modified BFM or COG protocol is often the
choice
23. MAINTENANCE
• Inj. VCR 1.5 mg/m2 one in a month
• Tab PREDNISOLONE 60 mg/m2 for one wk
• T.6MP 50 mg/m2 p.o daily
• T.MTX 20 mg/m2 p.o wkly
The optimal duration of therapy remains unknown.
Most investigators continue to treat patients for 2
to 3 years, based on results of older studies
24. FOLLOW UP
If the patient completes chemotherapy
for 2 years without relapse-stop chemo
and follow up.
No relapse within 5 years-can be declared
as cured.
25. SUPPORTIVE CARE
• A total of 10 mg/kg/day of allopurinol in
divided doses is given in all cases before the
commencement of antileukemic drugs.
• When the blast cell count is more than
50,000/mm3 or there are large tumour
masses, allopurinol is obligatory, together with
a fluid intake of 2–3 L/m2/day
26. SUPPORTIVE CARE
• use of packed red cells
• When high fever and possible septicemia
occur in the presence of neutropenia,
antibiotic therapy should be started after
taking appropriate blood cultures and a chest
radiograph.(NEUTROPENIA REGIME)
• Platelet transfusions should be administered
to patients with overt bleeding or when the
platelet count is below 10,000/mm3.
27. ALLOGENIC STEM CELL TRANSPLANTATION
• Usually done in second remission.
• Can be done in first remission in high
risk patients
- WBC > 25000,
- philadelphia chromosome positive,
- poor initial response to remission
induction.
29. REMISSION
• Patients with .0.01% leukemic cells after the
end of induction have a worse prognosis and
may require more intensive therapy.
30. RISK STRATIFICATION
FACTOR FAVOURABLE UNFAVOURABLE
Age (yrs) 1 – 9 < 1 OR > 10
WBC count < 10,000 > 2,00,000
Immunophenotype Precursor B Cell T Cell
Genetics Hyoperploidy Hypoploidy
CNS Status CNS 1 CNS 3
MRD (end of induction) < 0.01% 0.5 or 1%
Testicular / CNS
involvement
Absent Present
FAB Type L 1 L 3
Ethnicity White Black
31. DD
• ITP‐
– isolated thrombocytopenia,
– well child with
– no lymph node enlargement or spenomegaly
• Aplastic Anaemia
– Pancytopenia with
– no organ enlargement
• Juvenile Rheumatoid Arthritis
• Infectious mononucleosis
– Atypical lymphocytes
• Metastatic solid tumours
32. RELAPSE
• Despite current intensive front‐line
treatments, 20% of children with ALL
experience bone marrow relapse.
• Relapse may be an isolated event in the bone
marrow or may be combined with relapse in
other sites