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mimirstudies · 2 years
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Been studying for exam season at a new cafe a short walk from my house. Coffee's decent, the atmosphere is peaceful, and it's delightfully small. I've had a hard time keeping still in my own house, so this was a needed change of atmosphere.
Today I passed my immunohematology and clinical chemistry exams (not sure how I managed the last one), and tomorrow I'll do hematology 2 and immunoserology. I'm reviewing white blood cell disorders as of the moment.
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whattolearntoday · 3 years
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September 8th is...
Ampersand Day -  From jotting a shorthand “and” to branding corporate names, this curly, quirky little character is ubiquitously useful.
Iguana Awareness Day - This day is the ideal opportunity to learn about keeping your iguana tame and friendly, how to care for its health and personal grooming, and how to house it comfortably. With the proper care and attention, an iguana can be a wonderful and rewarding pet for many years.
International Literacy Day -  The ability to read and write isn’t only important for individuals, but societies as a whole. Some say literacy is a matter of dignity and human rights. Literacy is also an essential foundation of education. The ability to read and write even increases life expectancy.
Pardon Day -  Forgiveness, the process by which an offended party chooses to change the way they feel about someone who has committed the offense against them.
Pediatric Hematology/Oncology Nurses Day -  Honoring nurses caring for pediatric hematology and oncology patients. These dedicated professionals provide quality nursing care for children, adolescents, and young adults with cancer and blood disorders. Additionally, they provide the highest standard of physical and emotional support to these most precious patients and their families.
Star Trek Day -  To today’s audiences, the original Star Trek series can seem hackneyed, corny, and even incredibly racist when viewed through the modern lens. To view it in this way overlooks the incredible strides that were made during it’s production, and how unthinkable some of the elements found within were.  Star Trek speaks of a hope-filled future where our nationality no longer matters, and yet each of our personal heritages is still something we can be proud of.
World Physical Therapy Day -  When injury or surgery sidetracks a person, they often receive a referral to a physical therapist. Also known as a physiotherapist, this health care professional helps people regain mobility, manage pain, and recover more quickly. Along with helping adults, physical therapists work with children, including babies.
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vtforpedro · 3 years
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health update - long post
hi everyone! I think it's been a month and a half or so since my last update I saw a rheumatologist, had MRIs done, and got my results back from my hematologist SO cancer: still undetectable in my blood, check every 3 months and hope it doesn't show up for a long time lol \o/ I don't think I can say I'm in remission until a certain amount of time has passed but I hope I can say that one day MRIs: actually show some possible improvement with the chiari and spinal fluid flow? and if there IS improvement (like the radiologist who wrote the report had the MRI from a year ago as reference and his findings were all 'normal' compared to april 2020, but it was hard to get an answer out of my neurologist and neurosurgeon if there was solid evidence of physical improvement). but yeah IF there's improvement, that is highly indicative of IIH because my neurosurgeon told me when people with IIH lose weight, the chiari often corrects itself because there's less pressure and more room in the skull for the cerebellar tonsils to be in a normal position. regular chiari that you're born with doesn't do that lol so if there IS improvement with weight loss, then yeah, IIH. even if they don't wanna put in the diagnostic code for it without a lumbar puncture sigh lol I hate typing this because I'm so paranoid it'll all go to shit if I talk about it, but there have been improvements as I've lost weight. I seem to have a couple weeks where my head isn't so severe, mostly manageable with a few awful days. then I'll have a few weeks of it being Really Really bad with a few not-so-awful days. which IIH can do this sort of 'remission' thing but considering it was like 24/7 with no breaks for a year I'd say this is moving in the direction I want it to completely changed my diet a handful of months ago and adjusting it still to be even healthier/more fulfilling. I started using the Noom app (paid sub version) cause it's so focused on psychology instead of 'dieting' and building habits that are sustainable in the long, long-term. I really love it so far. the routine of doing it at the same time every day has already made me feel better mentally about my weight loss journey despite my struggles with losing weight, I am officially down 20lbs \o/ they say for improving/curing IIH, you need to lose 10-20% of your body weight. well, 10% down! time to lose another 20, but I don't find it intimidating and I'm not dreading it. it's hard to have hope, especially on really bad weeks, but I'm taking it one day at a time. definitely not cured but I'm aiming for 40lbs more (so 60 altogether) and by then, maybe, just maybe.... rheumatologist/autoimmune disorder results: so I went to a rheum cause I got that positive autoimmune disorder blood test with the possibility of lupus or scleroderma. she said that she gets so many hematology patients because leukemia and lymphoma have blood antibodies, so it will almost always show up as positive on this antibody test and most people actually won't have an additional autoimmune disorder. I don't have a lot of symptoms of lupus or scleroderma according to her, so she told me don't worry about autoimmune disorders for three months. don't think about them. we'll repeat labs then and see what they say. so that's good news so far and I hope it remains that way 15%+ of the population will test positive on the same test without having any health issues, which I found interesting. and I asked since I already have an autoimmune disorder, tho it's endocrine versus rheumatic, if that would also trigger a positive result and she said yes it would! so yeah... I hope by late July I can still say I don't have an additional autoimmune disorder I see a gastroenterologist tomorrow for the bloating/abdominal pain and other stuff I've been having. I have a feeling I'll be given some antacids (or w/e they're called when it's prescription strength) and that will improve. but jfc I'm up to eight specialists now lol NINE doctors are following my health god it's such a shitty feeling especially when I can barely trust any of them. at
least they all believe me now, but it cost me my quality of life and mental health to even get to this point so I'm still feeling pretty fucking bitter and angry about it all you know what's really hard about completely changing my diet + starting new medications/supplements? for some reason at the beginning of all of this when I was experiencing repeated trauma at the ER, my brain developed a phobia of allergic reactions, despite the fact that I've never had one for food/medicine (I'm talking anaphylactic reactions). so now every single new thing I eat, every new med or supplement, I go through panic attacks for days on end thinking I'm going to die before it starts easing. also, anxiety makes your throat feel like it's closing up and that it's harder to breathe already so lmao fun times. I literally never thought about this in all my life and I never even experienced an allergic reaction to develop this intense fear, so you know. fuck doctors for putting me through this when it was all so unnecessary sigh anyway. still can't watch videos, tv, movies, read, bend over, walk for longer than 5 minutes, and can't talk for long either because it'll trigger a head episode. I'm terrified I won't be able to do these things ever again, but I'm still aiming for my goal weight no matter what and I know I can get there bouncing between misery and hopelessness, and slightly less misery and some hope right now, but I guess that's better than it's been for a year, right? sorry for rambling. I feel like a lot has gone on but I've also had the biggest gaps between doc appts in a while which is a relief just because I can't stand being in medical buildings or around doctors anymore completely vaccinated too, so that's another relief, but I'm wearing masks until americans get their heads out of their asses and we start seeing little to no community spread cause I am still immunocompromised. wouldn't it be nice if people like, idk, cared about each other ok sorry! I hope you're all well and healthy and safe. I love you very much and I'm grateful for your support, forever and always! <3
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techsciresearch · 3 years
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Equipment & Consumables Product Segment to Dominate the United States Biobanks Market | TechSci Research
Rise in demand for affordable drugs and ongoing research and development activities is expected to drive the demand for United States biobanks market for the forecast period.
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According to TechSci Research report, “United States Biobanks Market By Type (Population Based Biobanks v/s Disease Oriented Biobanks) By Ownership (National/regional agency, Non-profit Organization, Universities, and Private Organization) By Product (Equipment & Consumables, Media, Software & Services) By Specimen Type (Blood Products, Solid Tissue, Cell Lines, Nucleic Acid, Others) By Application (Therapeutic v/s Research) By End User (Academic Institutes, and Pharma & Biotech Companies, Others), By Region, Company Forecast & Opportunities, 2026”, the United States biobanks market is expected to witness significant growth for the next five years. Biobanking is a procedure that is used to collect and preserve biological specimens which are used for diagnosis, research activities, and biodiversity studies. The presence of different types of biobanks such as disease-oriented biobanks, tissue banks, blood banks, among others are encouraging consumers to preserve their samples in biobanks which are bolstering the market growth.
The rise in genomic research activities coupled with the expansion of application areas for bio-banked samples is driving the market growth for the forecast period. An increase in the incidence of auto immune diseases such as cancer and blood disorders in addition to the surge in the population suffering from chronic diseases is contributing to boost the market growth. The surge in popularity for personalized medicine and genetic testing is considered the key driver responsible for the market growth. An increase in the number of established stem cell biobanks along with the growing application of stem cells in cell therapy, toxicology, drug development, developmental biology is leading to the rapid rise in the number of stem cell banks, thereby creating lucrative opportunities for the biobank market growth.
The occurrence of COVID-19 outbreak across the world which has been declared as a pandemic by the World Health Organization has affected several countries adversely. Leading authorities in the United States imposed lockdown restrictions and released a set of precautionary measures to contain the spread of novel coronavirus. Coronavirus-affected patients started suffering from shortness of breath along with coughing and sneezing along with the other symptoms.
United States authorities increased the capacity of hospitals as a greater number of patients were getting affected daily and getting admitted into the hospital facilities. To contain the spread of novel coronavirus, high-quality COVID-19 specimens are required for diagnostic and research purposes which can be stored and preserved in biobanks. Biobanks are supporting the drug discovery process to ensure effective treatment along with providing quality samples for the clinical research process which in turn is fueling the growth of the market in this period.
However, the high cost involved in automation may create a hindrance in the growth of the biobanks market.
Browse XX Figures spread through XX Pages and an in-depth TOC on "United States Biobanks Market”.
https://www.techsciresearch.com/report/united-states-biobanks-market/7701.html
United States biobanks market is segmented into type, ownership, product, specimen type, application, end user, regional distribution, and company. Based on specimen type, the market can be divided into blood products, solid tissue, cell lines, nucleic acid, and others. The blood products specimen type segment is expected to account for major market share in the next years as it is the most collected specimen used for diagnostic purposes. The surge in the prevalence of hematological diseases and other blood disorders is leading to accelerating the market demand.
Also, these are the source for DNA and RNA which can provide insight into the lineage and history of the person. Based on application, the market can be bifurcated into therapeutic and research. The therapeutic segment is expected to hold a significant share in the biobanks market in the forecast period. Regenerative medicines are in high demand owing to fueling demand for high-quality biosamples and growing research in regenerative medicine is fostering the market growth.
Thermo Fisher Scientific Inc., Hamilton Company, Brooks Automation, Inc., VWR Corporation, LLC, Promega Corporation, Becton, Dickinson, and Company, RUCDR Infinite Biologics, LabVantage Solutions Inc., US Biolab Corporation, Inc., ProteoGenex, Inc., Cureline, Inc., Bay Biosciences LLC, Geneticist Inc, BioLifeSolutions Inc. are the leading players operating in United States biobanks market. Manufacturers are increasingly focusing on research and development process to fuel higher growth in the market. To meet evolving customer demand with respect to better efficiency and durability, several biobanks service providers are coming up with their technologically advanced offerings.
Download Sample Report @ https://www.techsciresearch.com/sample-report.aspx?cid=7701
Customers can also request for 10% free customization on this report.
“High-end investments by the major players to upgrade the existing infrastructure to advance the platform and tools used in genetic studies are significant factors contributing to the market growth. Technological advancements such as the use of 3-D printing for tissue samples and mini-organ creation are also contributing to propel market growth. Adoption of virtualization, digitalization, and precision medicine to provide effective treatment coupled with the launch of novel products by the major players is boosting the growth of the market in the forecast period till 2026” said Mr. Karan Chechi, Research Director with TechSci Research, a research based global management consulting firm.
“United States Biobanks Market By Type (Population Based Biobanks v/s Disease Oriented Biobanks) By Ownership (National/regional agency, Non-profit Organization, Universities, and Private Organization) By Product (Equipment & Consumables, Media, Software & Services) By Specimen Type (Blood Products, Solid Tissue, Cell Lines, Nucleic Acid, Others) By Application (Therapeutic v/s Research) By End User (Academic Institutes, and Pharma & Biotech Companies, Others), By Region, Company Forecast & Opportunities, 2026” has evaluated the future growth potential of United States biobanks market and provided statistics & information on market size, shares, structure and future market growth. The report intends to provide cutting-edge market intelligence and help decision makers take sound investment decisions. Besides, the report also identifies and analyzes the emerging trends along with essential drivers, challenges, and opportunities in the of United States biobanks market.
Browse Related Reports:
Global Bio Preservation Market By Product (Media, Equipment, Accessories, Alarms & Monitoring System, Incubators, Centrifuges, Other), By Biospecimen (Human Tissue Samples, Stem Cells, Organs, Others), By Cell Providers (CD34+, CD19+, MSC, iPSC, hESC, Tumor Cells), By Application (Therapeutic, Research, Clinical Trials, Others), By End User (Biobanks, Gene Banks, Hospitals, Others), By Region, Forecast & Opportunities, 2025
https://www.techsciresearch.com/report/bio-preservation-market/4711.html
United States Biomedical Refrigerators & Freezers Market By Product (Pass-Through, Explosion Safe, Flammable Storage, Combo/Dual Temperature, Ultra Low Freezers, Plasma Freezers, Others), By Storage (Blood, Vaccines, Plasma, DNA, Flammable Chemicals, Others), By Temperature (RNA & DNA {-70C to -80C}, Vaccines {-30C to -40C} & Others), By Capacity (138L, 169L, 221L, 230L, 426L, 690L, Others), By End-User (Hospitals, Pharmacies, Diagnostic Centers, Research Laboratories, Blood Banks), By Region, Competition Forecast & Opportunities, 2026
https://www.techsciresearch.com/report/united-states-biomedical-refrigerators-and-freezers-market/7502.html
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Eosinophilia and Neutrophilia Associated with Anti- PD-1 use in Metastatic Non-Small Cell Lung Cancer – A Case Report-Iris Publishers
Authored by  Yasir Khan*
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Abstract
The use of immunotherapy has dramatically changed the way many cancers are treated with several studies having looked at the relationship between eosinophils and immunotherapy. This case study reports nivolumab induced eosinophilia and neutrophilia with no other systemic adverse effects in a patient with metastatic non-small cell lung cancer. A 61-year-old woman with Eastern Cooperative Oncology Group performance status 1 was diagnosed with metastatic non-small cell lung cancer without any driver mutations and was commenced on nivolumab after progressing on platinum doublet therapy. She had mild eosinophilia and neutrophilia at baseline in the context of a lower respiratory tract infection which became more pronounced with the introduction of nivolumab. Nivolumab was ceased at week-26 due to significant eosinophilia and reached peak levels at week-35. She developed postural hypotension during the course of her disease and prednisolone was commenced to treat possible adrenal insufficiency from metastasis. The introduction of steroids led to the improvement in eosinophilia and neutrophilia. She had stable disease for 8 months after commencement of immunotherapy before progression of disease leading to clinical deterioration and death. Asymptomatic eosinophilia and neutrophilia is an extremely rare toxicity of immune checkpoint inhibitors. Its significance as prognostic and predictive marker needs to be researched further.
Keywords: Immunotherapy induced eosinophilia; Neutrophilia; Nivolumab.
Introduction
Immune checkpoint inhibitors (ICI) targeting PD-1, PD-L1 and CTLA-4 are routinely used in clinical practice in multiple tumour types. These drugs are very effective especially for solid organ malignancies with high mutational load but carry a wide spectrum of toxicities driven by over stimulation of immune system. Immunerelated adverse events (irAEs) range from low grade toxicities to severe toxicities which can potentially be life threatening in some cases. Among some of the uncommon side effects, immunotherapy induced eosinophilia is a rare toxicity with only a few documented cases and mostly associated with eosinophilia related systemic manifestations or with additional toxicities. There are well established guidelines for treating common irAEs but little is known about the optimal management of rarer toxicities like asymptomatic eosinophilia. This case study reports nivolumab induced eosinophilia and neutrophilia with no other systemic adverse events in a patient with metastatic non-small cell lung cancer.
Case Report
A 61-year-old woman was admitted with the diagnosis of lower respiratory tract infection with investigations leading to a diagnosis of stage IV adenocarcinoma of the lung without targetable mutations. She had a left lung mass, hilar nodes enlargement, malignant ipsilateral pleural effusion and liver metastases. PDL1 status was not obtained as there were no standard treatments based on PD-L1 levels at that time. She was a smoker and had Eastern Cooperative Oncology Group (ECOG) performance status 1.
Due to prescribing restrictions applicable at that time, she was initially commenced on carboplatin and gemcitabine chemotherapy before progression of disease. Second line pemetrexed was given but it failed to provide any clinical benefit. She was then commenced on nivolumab monotherapy. Initial interval scan suggested worsening of disease, however given there was no clinical deterioration, she was given the benefit of doubt and nivolumab was continued on the assumption of pseudo progression. Her baseline neutrophils and eosinophils count were mildly elevated (Table 1). Of note this was in the setting of lower respiratory tract infection. The elevated eosinophil counts were persistent but still mild at the commencement of nivolumab. Both neutrophilia and eosinophilia were more pronounced at 14 weeks post-nivolumab and reached peak levels at 35 weeks (Figure 1) (Table 1).
Table 1:Serial full blood counts (FBC).
Nivolumab was stopped after 13 cycles due to worsening of eosinophilia and neutrophilia in the context of stable disease on imaging. Patient did not have any other systemic features at the time when nivolumab was stopped. Possible differential diagnosis at that stage included paraneoplastic phenomenon, immune mediated toxicity, and myeloproliferative disorder. She started to deteriorate clinically with recurrent falls. Adrenal insufficiency was considered to be the most likely diagnosis based on the clinical features of postural hypotension, hyponatremia, hyperkalemia and finding of left adrenal metastasis on repeat imaging. This diagnosis was further confirmed by inadequate response of adrenal glands to short synacthen test. She was commenced on prednisolone to correct adrenal insufficiency which also led to the improvement in neutrophilia and eosinophilia. Eventually disease progression was recorded soon afterwards along with clinical deterioration predominantly from progression in the lungs causing respiratory failure and death. She had 14 months of survival since diagnosis of the cancer. Progression free survival on immunotherapy was 8 months with stable disease being the best response.
Discussion
A well-known cause of hyper eosinophilia is the DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome. Common features of DRESS include blood eosinophilia, fever, skin changes, facial oedema, visceral involvement, and atypical lymphocytes [1]. DRESS has been reported to be associated with immunotherapy. Mirza et al presented a case of patient who developed DRESS after combination ipilimumab and nivolumab for melanoma and successfully treated with steroids [2]. Voskens et al also presented a case of DRESS syndrome following ipilimumab for melanoma which responded to steroids [3]. Furthermore, there have been other case reports documenting relationship between immunotherapy and eosinophilia with uncommon systemic manifestations. Khoja et al. presented a case of a patient who developed eosinophilic fasciitis and cerebral vasculitis one month after completing an 18-month course of pembrolizumab for metastatic melanoma [4]. Okano et al presented a case of a patient with hypophysitis with associated eosinophilia following nivolumab for metastatic lung cancer [5]. To our knowledge, there are only two case series published in literature in regard to nivolumab induced eosinophilia, however a majority of those patients also experienced other irAEs of various grades [6,7]. In addition to this, there have been five published case reports of nivolumab induced eosinophilia to date [2,8-11]. Our report documents a case with isolated hematological abnormalities including eosinophilia and neutrophilia without systemic features in a patient treated with nivolumab for metastatic non-small cell lung cancer (NSCLC) which is a rare toxicity of anti-PD-1 antibodies.
The role of eosinophils in tissue homeostasis is not fully understood. Nevertheless, certain conditions have a well-known association with eosinophilia such as allergic diseases, infectious diseases (especially parasitic infections), autoimmune diseases (especially adrenal insufficiency) and haematological disorders. Eosinophilia has also been described as a paraneoplastic phenomenon of many solid organ malignancies and is most associated with an advanced stage and poor prognosis [12]. Eosinophils can also play a role in pathogenesis through depositing granules which can have both direct toxic effects and recruit as well as activate other inflammatory cells [13]. A hypereosinophilic syndrome (HES) in which there are symptoms from a high eosinophil count in blood or tissue has been described with the underlying cause often never found despite extensive investigation [12,13]. There are various mechanisms reported in the literature to explain pathophysiology of eosinophilia. Immune proteins and cytokines like interleukin-3 (IL-3) and interleukin-5 (IL-5) have been associated to play a role in elevated eosinophil counts [14,15]. Our patient also had neutrophilia in addition to eosinophilia. Neutrophilia is induced by granulocyte macrophage colony stimulating factor (GM-CSF). Interaction and interplay of immune proteins like GM-CSF, IL-3 and IL-5 leads to activation of multiple cell lines. The role of eosinophils in tumour microenvironment is not well known and may possess anti-tumour effects in some cases while promoting tumorigenesis in others [16]. Its value as prognostic and predictor factor is also unclear. Eosinophilia at diagnosis of the cancer has been linked with poor prognosis in some advanced malignancies [17,18]. On the other hand, some pre-clinical studies indicate immunotherapy induced eosinophilia may be a predictor of response to treatment. In our case, when immunotherapy was stopped after 13 cycles the best response achieved with immunotherapy was stable disease only. As eosinophilia pre-dated the start of immunotherapy, at least in our case, it does not seem to be associated with treatment response or effectiveness.
Conclusion
Asymptomatic eosinophilia and neutrophilia is an extremely rare toxicity of ICI. Development of eosinophilia in the setting of immunotherapy use needs to be studied further to delineate its role as both prognostic and predictive marker.
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fanfansfury · 3 years
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How it started...
My story can be considered a complex one starting from my childhood. For as long as I can remember, I have medical issues that I haven’t ever gotten a real answer for.
As a child in elementary school, I remember being sick way more often than my peers. Stomach bugs, infections, you name it. It felt constant. I also had an amazing ability to pass out unannounced or with very little warning. I’ve always loved being active in sports and working out, but as I have gotten older, I have seemed to build an intolerance to exercise.
My medical history is significant for chronic anemia, low blood pressure, B12 deficiency, anxiety and depression, and a bladder disease named Interstitial Cystitis. My anxiety increased as I understood more that I didn’t’ have control on whether I would pass out unexpectedly or not.
As years went on, I was able to recognize the signs of low blood pressure and could sometimes avoid passing out if I caught it in time. I lived a mostly normal young adulthood full of college and grad school experiences typical of most people my age. I got married to a wonderful man, Sam FanFan, in 2011 and soon had our first daughter, Kyla Maresa, inElla will decrease her sound substitutions in connected speech, with 1-3 prompts or cues from an adult, in 4 out of 5 recorded opportunities. 2012. Kyla was also no stranger to medical issues as a baby, as she gave us a few heart attacks and hospitalizations. Now, as an active 8 year old, she is an accomplished dancer and student, who has seemed to grow out of a lot of issues we used to see with her frequent infections and weak respiratory system. (YAY!)
Fast forward to our second daughter, Kaelani Burke, who was born in 2017. Her birth itself was uneventful. Three hours after she was born, I began hemorrhaging. It was traumatic to say the least, for both me and Sam. To this very day, I am beyond thankful for my labor and delivery nurses who caught the hemorrhaging in time to save my life. 
Kaelani has been through the wringer in her short 4 years of life. She managed to be diagnosed with 12 ear infections by the time she was 20 months old. Oral antibiotics didn’t seem to touch them and we needed to resort to injections almost every time. At 21 months, we knew surgery couldn’t be avoided anymore and she had her adenoids removed and tubes placed in her ears. Neither of which seemed to help avoid recurrent ear infections anyway.
In late 2019/early 2020, Kaelani began having severe nosebleeds. At first, Sam and I chalked it up to dry air and got humidifiers for almost every room in the house. The remedying we tried did not help slow the bleeds down and they were happening multiple times a day, both at home and daycare. By the end of January 2020, Kaelani began to fall asleep after the bleeds. I immediately took her back to her ENT. After about 4 very frustrating appointments and conscious cauterizations, they drew her blood. We were immediately told hemotology/oncolocy was waiting for us upstairs. Though they couldn’t pinpoint the exact disease at that point in time, it was clear to the team Kaelani was suffering from a rare vascular disease and it warranted further investigating.
The next day, Kaelani was brought in for surgery to cauterize the blood vessels that seemed to be causing the problem. This procedure was supposed to be in-and-out to merely stop the bleeding. When Kaelani was in recovery, her surgeon came to talk to Sam and I to report that while she was cauterizing, she saw many telangiectasias (abnormal blood vessels normally found in older adults) in her nasal lining that were quite concerning to her. We were then admitted and by the end of the night, had seen hematology, ENT, and genetics. She was brought in for an ultrasound of her major organs to make sure there wasn’t active bleeding. We were discharged with what seemed like a million appointments ahead of us. Genetics and Hematology are confident she has a very rare blood disorder called HHT (Hereditary Hemorrhagic Telangiectasia), but in order for this diagnosis to be officially on her medical record, a parent needs to be diagnosed. On her medical record now, it states (suspicion of HHT), which may not always get her the help she needs say she were to have a seizure or brain bleed.  Now, let’s cue the blood issues I have had my entire life and assume the connection here. However, since I am currently asymptomatic, this will be no easy feat. Especially since one month after this ordeal, COVID-19 hits and elective appointments are not at the top of anyone’s list.
Since last March, I have seen cardiology, urology, pulmonology, and hematology. As suspected, because I am asymptomatic at this point in my life, not much is being found to help Kaelani’s case.
However, during the pursuit of Kaelani’s diagnosis, my chronic anemia is going strong, so my hematologist decided it was time to do further digging. My anemia is NOT iron related. I am not iron deficient. So, we assumed it was nutritional. I spent a few months on vitamins that should have improved my anemia, even just a little bit. It got worse.
That brings me to this past week. After months of trying to figure out why my anemia continues to get worse, my hematologist decided it was time to do a bone marrow biopsy. In case you were wondering, the biopsy is quite painful. 
Now... we wait. Results are expected by March 4...
Stay tuned.
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Why Is Everyone Talking About Hematology Transcription?
The field of hematology is experiencing exemplary medical breakthroughs. Are you looking forward to hiring the most affordable, prompt, reliable, accurate, and meticulous hematology transcription solutions? If yes, then you need to find out more reasons as to why the medical industry is highly relying on the hematology transcription services.
Meaning of Hematology
The medical specialty comprising of the science of blood, blood-producing organs, a blood disorder, Hematology emphasizes special diagnosis, treatment, and prevention of diseases associated with blood and blood-related disorders. This specialty deals with many disorders related to blood cells, platelets, as well as, coagulation system.
Hematology, the special medical branch that aims to study the diagnosis, problems, functioning, and treatment of elements of human blood, is extremely essential in analyzing etiology. The branch deals with finding out a source of any blood-related disease.
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It involves preventing and treating the diseases that affect the production of blood and its components, such as, platelets, bone marrow, blood vessels, coagulation mechanism, spleen, blood proteins, and hemoglobin. Examples of diseases related to this are blood clots, hemophilia, other bleeding disorders, as well as, blood cancers such as lymphoma, multiple myeloma, and leukemia. The major laboratory work that studies the blood is frequently performed by a well-trained medical laboratory scientist or a medical technologist.
Significance of Hematology Transcription Service
The work of a hematologist involves the generation of voluminous notes along with lab reports to arrive at the most perfect diagnosis. The aim of hematologist is also to deliver the best possible results and care to the affected patients. Hematologists may specialize in the following areas of special interest-
Treating major bleeding disorders such as idiopathic thrombocytopenic purpura and hemophilia
Treating malignancies related to hematology such as leukemia and lymphoma (cancers)
The work associated with blood bank and the science of blood transfusion
Treating hemoglobinopathies
Stem cell and bone marrow transplantation
In addition to this, their duty involves positive interaction with highly-qualified medical professionals such as oncologists, lab technicians, and other medical technologists, so that they are in a position to understand the underlying causes and effects of various blood and blood-related diseases. These are the reasons why Hematologists look forward to partner with the most reliable hematology transcription service providers. These transcription service providers are not only well-versed with the most relevant medical terms but they are also capable of coming up with the most reliable, accurate, and efficient transcripts that ensure quality care and safety of the patient.
Hematology-oncology transcription services are offered in the following areas:
Cancer treatment
chemotherapy
experimental treatments
Biological therapy
ablation therapy
blood transfusions
transplants
blood and bone marrow donations
And more
Hematology transcription process:
The medical client will upload the dictation for the transcription manager
The voice files will be run through an internally developed voice recognition system or engine
A medical hematology transcriptionist will prove the report with voice file word by word
Then the report will be read by a transcriptionist without the assistance of voice file and he/she will re-listen without any doubtful areas if any
A transcriptionist editor will proof-read the report with voice file word by word
The transcriptionist editor will read this report without voice file and re-listen to it without any doubtful areas if any
The final report is then uploaded to the hematology transcription manager or directly to the client’s platform
Feedback from the client is taken for any improvement
What is the specialty of hematology transcription services?
Most of the medical providers look forward to hiring the transcription services of a team full of expert professionals who are having hands-on experience in serving the diverse range of clients in the field of hematology. The highest possible quality services, accuracy, and reliability of the transcriptionists allure the medical providers to try the third-party hematology transcription services.
The best part about hiring a professional hematology transcriptionist for your hospital or clinic is that you will receive assured technological relevance. At the same time, your medical integrity will be maintained. The hematology transcriptionists adopt the most modern tools, methods, and technologies for efficiently and effectively documenting your critical hematology reports. Further, dictation modes are offered very easily according to the choice and preference of the clients.
Hematology transcription services should not only be accurate and dependable but also HIPAA compliant. Further, let us discuss the other benefits of partnering with a well-qualified and experienced Hematology transcription service provider-
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blackkudos · 6 years
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James Edward Bowman
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James Edward Bowman, MD, FASCP, FCAP (February 5, 1923 – September 28, 2011) was an American physician and specialist in pathology, hematology, and genetics. He was a professor of pathology and genetics at the Pritzker School of Medicine at the University of Chicago.
Life and career
James Edward Bowman was born on February 5, 1923, in Washington, D.C., the son of Dorothy (Peterson), a homemaker, and James Edward Bowman, Sr., a dentist. He attended Dunbar High School. He earned his undergraduate and medical degrees from Howard University in 1943 and 1946. He did medical internships at Freedmen's Hospital in Washington D.C. and at Provident Hospital in Chicago, Illinois. His residency in pathology was at St. Luke's Hospital in Chicago where he was the first African American resident.
Following residency, Bowman served as chair of pathology at Provident Hospital. He was drafted again and spent 1953 to 1955 as chief of pathology for the Medical Nutrition Laboratory at Fitzsimons Army Hospital in Aurora, Colorado. After leaving the military Bowman decided to move overseas. “My wife and I decided that we were not going to go back to anything that smacked of segregation,” he recalled. He became chair of pathology at Nemazee Hospital in Shiraz, Iran. “We were recently married, so we took a chance,” he said. “It changed our lives completely.” Their daughter, Valerie, was born in Iran.
In Iran Bowman saw many diseases for the first time. “I saw smallpox, brucellosis, rabies, all sorts of things,” he said. One of the most common diseases among certain ethnic groups in Iran was favism, a metabolic disease caused by an enzyme deficiency in red blood cells. The mutation, which is the most common human enzyme defect, renders those who have it unable to break down a toxin found in fava beans. Favism fit with Bowman’s lifelong focus on inherited blood diseases and led to a series of important discoveries about the genetics of these diseases and the populations they affect, especially in the Middle East, Africa and America. It enabled him to travel all over the world collecting blood samples for DNA testing. It also led to frequent contacts and collaborations with University of Chicago researchers, who had first described the enzyme deficiency (glucose-6-phosphate dehydrogenase deficiency, or G6PD) and its connection with antimalarial medications.
Bowman joined the faculty of the University of Chicago in 1962 as an assistant professor of medicine and pathology and director of the hospital’s blood bank. He was promoted to full professor and director of laboratories in 1971. From 1973 to 1984, he directed the Comprehensive Sickle Cell Center of the University of Chicago, funded by the National Institutes of Health. He was a member of the national advisory group that urged the Nixon administration to initiate the inception of the Comprehensive Sickle Cell Center, which served as a model of patient-centered disease management and research. He also served as assistant dean of students for minority affairs for the Pritzker School of Medicine from 1986 to 1990.
In 1972 Bowman declared that mandatory sickle cell screening laws were “more harmful than beneficial.” These laws could “revive many of the past misadventures and racism of eugenics movements,” he argued at the time, adding that adult screening programs create “inaccurate, misleading, politically motivated propaganda which has left mothers frantic.” In 1973, he was named to two federal review committees designed to oversee sickle cell screening and education and to evaluate laboratory diagnostic techniques.
Bowman was certified by the American Board of Pathology in pathologic anatomy (1951) and clinical pathology (1952).
He was the first tenured African-American professor in the University of Chicago's Biological Sciences Division. He served as the medical school's Assistant Dean of Students for Minority Affairs from 1986 to 1990. He was a fellow of the Hastings Center, a bioethics research institution.
He was married to educator Barbara Bowman and they had one daughter, Valerie Bowman Jarrett, who is a Senior Advisor to President Barack Obama.
Dr. Bowman died of cancer on September 28, 2011, at the University of Chicago Medical Center, at the age of 88.
Selected publications
Bowman published numerous articles and books, including:
Books
Bowman, James E.; Robert F. Murray (1998). Genetic Variation and Disorders in Peoples of African Origin. Hopkins. ISBN 978-0-8018-5884-0. 
Bowman, James E. (1983). Distribution and Evolution of Hemoglobin and Globin Loci. Proceedings of the Fourth Annual Comprehensive Sickle Cell Center Symposium on the Distribution and Evolution of Hemoglobin and Globin Loci at the University of Chicago, Chicago, Illinois, U.S.A., October 10–12, 1982. Elsevier. ISBN 978-0-444-00793-3. 
Journal articles
Bowman, James E.; Robert R. Brubaker; Henri Frischer; Paul E. Carson (September 1967). "Characterization of Enterobacteria by Starch-Gel Electrophoresis of Glucose-6-Phosphate Dehydrogenase and Phosphogluconate Dehydrogenase". Journal of Bacteriology. American Society for Microbiology. 94 (3): 544–551. PMC 251920. PMID 5340676. 
Shaw, Richard F.; Ruth Winter Bloom; James E. Bowman (September 1977). "Hemoglobin and the genetic code: Evolution of Protection against Somatic Mutation". Journal of Molecular Evolution. Springer New York. 9 (3): 225–230. doi:10.1007/BF01796111. PMID 864725. 
Bowman, James E. (May 1989). "Legal and Ethical Issues in Newborn Screening". Pediatrics. 83 (5): 894–896. 
Bowman, James E. (March 1991). "Prenatal screening for hemoglobinopathies". American Journal of Human Genetics. 48 (3): 433–438. PMC 1682982. PMID 1998329. 
Bowman, James E. (1998). "Minority Health Issues and Genetics" (Proceedings of The National Dialogue on Genetics, College Park, Maryland, March 21–22, 1998). Community Genetics — Public Health Genomics. 1 (3): 142–144. doi:10.1159/000016152. PMID 11657303. 
Bowman, James E.; Giselle Corbie-Smith; Peter Lurie; Sidney M. Wolfe; Arthur L. Caplan; George J. Annas; Amy L. Fairchild; Ronald Bayer (2 July 1999). "Tuskegee as a Metaphor". Science. 285 (5424): 47–8; author reply 49–50. doi:10.1126/science.285.5424.47b. PMID 10428701. 
Bowman, James E. (June 2000). "Technical, Genetic, and Ethical Issues in Screening and Testing of African-Americans for Hemochromatosis". Genetic Testing. 4 (2): 207–212. doi:10.1089/10906570050114920. PMID 10953961. 
Bowman, James E. (Autumn 2001). "Genetic Medicine: A Logic of Disease (review)". Perspectives in Biology and Medicine. The Johns Hopkins University Press. 44 (4): 617–618. doi:10.1353/pbm.2001.0061. 
Wikipedia
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karmalkar911 · 2 years
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Dr. Abhishek Karmalkar - General Physician Doctors in Pimpri Chinchwad
Dr. Abhishek Karmalkar - General Physician Doctors in Pimpri Chinchwad
General Physician (MD - General Medicine, MBBS)
Dr. Abhishek Karmalkar’s main objective is to serve INDIA through medicine by making people healthy and excel in profession and serve towards humanity.
Dr. Abhishek Karmalkar is an expert in handling the deadly corona virus, has taken in-charge as chief intensivist and successfully treated more than 2000 critical corona patients and innumerable ward cases.
He is excelled in early recognition and management of diabetes. His speciality includes managing all complication of diabetes including diabetic foot, neuropathy, end organ damage like nephropathy. He has also expertise in management of various infectious diseases and Cardiology, Hepatology, Hematology, Nephrology and Neurology diseases.
Education Details
Dr. Abhishek Karmalkar completed his MD (Medicine) from Grant Government Medical College, Mumbai in 2010 and MBBS from B. J. Medical College, Pune in 2005. Also, he has done Diploma in Critical Care Medicine from ISCCM in 2012. 
Dr. Abhishek Karmalkar is a well-known doctor specialising in General Physician in Pimpri Chinchwad. He has over 9 years of experience practising medicine in various hospitals and clinics. Dr. Abhishek Karmalkar is now working with Sterling Multispeciality Hospital. Dr. Abhishek Karmalkar has previously been associated with B. J. Medical College, Pune, Health Box Polyclinic (Self owned). Dr. Abhishek Karmalkar specialises in Diabetes Management, Thyroid Disorder Treatment, Critical Care Medicine, Hypertension Treatment, Cardiac Care, Dengue Fever Treatment. Apart from hospital affiliations, He has been working actively in various fields. Dr. Abhishek Karmalkar is an alum of Grant Medical College and Sir JJ Hospital, Mumbai where He earned a MD – Medicine. Thereafter, Dr. Abhishek Karmalkar earned Advanced Certificate Course In Diabetes from American Diabetes Association.
What does a general physician do?
A general physician has an extended list of duties due to the fact he/she is the first point of contact for maximum patients. As such, these are some things that physicians do:
Diagnose conditions and injuries
Conduct routine check-ups
Recommend clinical tests for further diagnosis
Assess a affected person`s condition and evaluate clinical history
Prescribe medicine and treatment
Assist in routine surgical operation
Counsel patients on well-being and right self-care
Maintain patient records for ideal preventive care
At Health Box Polyclinic we have we have most of the best general physician in pimpri chinchwad who’re notably professional and expert in diagnosing a host of various clinical conditions. Our state of the art technology and equipment permits for the early detection of diseases, and we’ve a extensive kind of specialists who can take up the case post diagnosis.
Why you choose Dr. Abhishek Karmalkar?
Health Box Polyclinic Clinic is committed to providing the best medical treatment and diagnosis facilities. Physician consultation Including ECG Test, Sugar Check-Up, Full body check-up facility is available in the same clinical premises by expert general physician doctor in pimpri chinchwad. Furthermore, it has a well-facilitated diagnostic centre to provide medical treatment along with the diagnosis facility to the patients. Certainly, Dr. Abhishek Karmalkar is the man behind the establishment of this medical facility center. Most noteworthy this is his effort to provide the best medical facilities including diagnosis facility at the same place, as a result to the residents of the pune.
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sunriselifecare · 2 years
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Oncologist treatment services in dwarka
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Oncologist treatment services in dwarka
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Oncologists are doctors who diagnose and treat cancer. They often act as the main healthcare provider for someone with cancer—designing treatment plans, offering supportive care, and sometimes coordinating treatment with other specialists.
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What Does an Oncologist Do?
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Oncology is the study of cancer. Oncologists specialize in managing and treating patients throughout the course of the disease, which involves:
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Confirming a patient’s initial diagnosis
Explaining the cancer diagnosis and stage
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Providing all possible treatment plans and offering recommendations
Overseeing the course of treatment
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Helping patients manage symptoms and side effects of both the disease and the treatment plan
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Their work isn’t limited to cancer treatment, however. Many oncologists are board-certified to practice hematology as well, treating patients with blood conditions including:
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Anemia, a condition that results from a shortage of red blood cells
Sickle cell disease, an inherited blood disorder that can affect circulation
Different types of thrombosis, which occur when blood clots block blood vessels
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Oncologists typically have a specialty within the field, so they often expand a patient’s team to include the right doctors for a chosen treatment plan.
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Types of oncologists include:
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Medical oncologists who treat cancer with chemotherapy or immunotherapy
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Surgical oncologists who remove tumors in surgery
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Radiation oncologists who treat cancer with radiation therapy
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Other oncology specialists focus on treating cancer in specific areas of the body. For example, gynecologic oncologists treat uterine, ovarian, and cervical cancers, while a hematologist-oncologist focuses on blood cancers. There are also pediatric oncologists who specialize in cancers common in children and teenagers.
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Reasons to See an Oncologist
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Your general practitioner or family doctor may refer you to an oncologist if they want the opinion of an expert in a specific field or can’t determine a cancer diagnosis. This intent is to narrow down—and rule out—potential causes of an issue so that you get the best course of treatment possible.
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Your doctor might refer to you an oncologist to:
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Test an Unusual Growth or Lump
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Doctor’s offices aren’t usually equipped to diagnose a cancerous tumor, so they’ll refer you to an oncologist for further testing. Most suspected tumors are benign, or harmless, but this referral helps the doctor:
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Ensure your peace of mind with a negative test
Rule out cancer as a cause of any symptoms you’re experiencing
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Catch a potentially malignant, or harmful, tumor in its early stages—when treatment options are most successful
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Direct the best possible care in the event of a positive test result
Provide Cancer Treatment
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If you have a confirmed cancer diagnosis, you’ll be referred to an oncologist who will review your case individually, explain all of your treatment options, and offer their recommendation.
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Depending on the cancer, its stage, and any potential health complications, this plan could include:
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Radiation to slow a tumor’s growth without damaging healthy tissue
Surgery to physically remove a tumor
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Targeted therapy to limit a tumor’s spread to other areas of your body
Chemotherapy treatment that destroys cancer cells
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Get a Second Opinion
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Cancer is a complex disease, and its treatments continue to evolve. Asking for another oncologist’s evaluation is common practice, especially that of an expert in a specific cancer or body part.
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This second opinion can help to:
Confirm a diagnosis with a specialist
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Learn additional details about a cancer’s type and stage
Explore more treatment options
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Understand how the cancer affects other parts of your body
Find clinical trials available for you
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Diagnose and Treat Blood Disorders
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Many oncologists also specialize in hematology—the study and treatment of diseases related to the blood.
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Oncologist treatment services in dwarka
Your doctor may refer you to a hematology-certified oncologist for treatment if you have:
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Symptoms of anemia, like brittle nails, a swollen tongue, an enlarged spleen, heart problems, or fatigue
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Symptoms of sickle cell disease, like frequent infections, swollen hands and feet, vision problems, or severe episodes of pain
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Symptoms of thrombosis, like swelling, pain, discoloration, or warmth in the affected area
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Hematology oncologists also treat patients with clotting disorders like hemophilia, von Willebrand disease, and Thalassemia as well as cancers of the blood like lymphoma and leukemia.
Oncologist treatment services in dwarka
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pedsurgerydelhi · 2 years
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Conjoined Twins Surgery In India - Dr. Prashant Jain
Conjoined Twins Surgery In IndiaOn 21st April, 2013, a super speciality team led by Dr Prashant Jain at BLK Super Specialty Hospital made a decision to save two precariously hanging newborn lives.By the night of 12th August, 2013 they had made history.The story behind the rarest of rare separation of conjoined twins at BLK Super Specialty Hospital.
Twin girls Hussaina and Hassana were born conjoined in Nigeria on 28 August, 2012. Celebrations in the family soon turned to shock and sorrow, however. The twins were joined back to back (pygopagus in medical terms). To an extent that they had common urinary and vaginal opening and a common anus.
A clan travels across continents in search of hope
Perplexed by this rare condition, the doctors in Nigeria told the parents that surgical separation of the twins was possible but they would have to lose one of the two girls. Then fate intervened and they were referred to Dr Prashant Jain, Head Pediatric Surgery Department BLK Super Specialty Hospital.
A multi disciplinary team of super specialists
A multi disciplinary team of specialists and super specialists was formed, led by a Pediatric surgeon Dr. Prashant Jain. The team consisted of super specialists from pediatric critical care, anesthesiology, neurology, neurosurgery, plastic surgery, spine surgery, neuro-anesthesia, vascular surgery, hematology, radiology and transfusion medicine.
State-of-the-art technology at BLK
CT angiography, MRI and MCU studies were conducted to investigate and define the complex structural anatomy of the twins through high definition images. MRI and CTScan revealed that girls had a common sacral bone, they shared their lower spinal cords, lower gastrointestinal tract and genitourinary tracts. They also had a common opening for passing stool and urine, and also common genitalia. Fortunately, brain, heart, lungs and kidneys of each twin were normal. The twins tested positive for a sickle cell trait, and hereditary blood disorder that increases the risks and complexity of anesthesia of anesthesia and surgery further.
Logistics and planning
After much brainstorming, the team decided to plan for separation in three stages. In the first stage, tissue expanders will be placed to get adequate skin for covering the raw areas after separation. In the second stage, actual separation of the spinal cords, intestine and genito-urinary tract would be carried out along with reconstruction. In same stage, a temporary opening (colostomy) for passage of stool would be made on the abdominal wall. In the third stage, colostomy would be closed after 6 weeks. The team met regularly during the next two months to put the surgical plan in place. Flowcharts detailing the moves of each and every person involved in the surgery were meticulously prepared and refined. Every surgical step was defined and rehearsed over and over again till it reached precision. The girls were color coded (one pink and the other blue) so that there would be no error at all. This color code was extended to all catheters, wires, tubes and leads that would be connected to the girls during surgery. The team decided to use an advanced technique of neuro-monitoring to avoid any damage to the nerve roots of both spinal cords. The anesthesiologist’s job was made all the more challenging by the fact that whatever drug was given to one twin, the other would receive it inadvertently through a large sharing vein, and dosages were calculated and monitored accordingly. Surgical steps were practiced using dummies procured for the purpose. Reconstruction of high definition images showed that the twins had a shared blood circulation, thereby extending a clue to the anesthesiologists to plan for managing the risk of passing of drugs from one child to another during surgery. Each twin was assigned a separate team of doctors representing each specialty, some of whom were not participate in the surgery but would be on standby if anything went wrong.
May 25, step 1
Tissue expanders were placed on 25th May. These are essentially silicon bags, which were placed under the skin on the buttocks. These were gradually inflated once a week by pumping in saline over a period of 2 month. This helped in expansion of the skin and generation of good tissue cover required during the surgery.
August 12, step 2 (After separation in ICU)
The surgery began at 6 AM on August 12th, 2013. Relay teams of surgeons who were tasked with separating the three involved systems without any compromise, moved in and out of the OT in accordance with the flowcharts prepared earlier. Neurosurgeons used microscopes, while separating the spinal cords. Intensive neuro-monitoring was conducted during the entire surgery. The girls were re-positioned twice during the surgery to enable surgeons to gain access to areas that were to be separated. After 13 nerve-wracking hours later, the girls were moved to separate operation theatres for further reconstruction of genitalia, urethra and anus by Pediatric surgeon.
The recovery
After the surgery, the girls were shifted to the Pediatric ICU where they were electively kept on ventilator support for 24 hrs with close monitoring of blood pressure, blood oxygen and carbon dioxide levels, body temperature and urine output. They were gradually taken off artificial ventilation the next day. Presently, both twins are stable and have shown no signs of any neurological deficit.
Tag =  best pediatric urologist in delhi, best pediatric surgeon in delhi,  best pediatric urologist in india
For more information = http://www.pedsurgerydelhi.com/
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medbooks · 2 years
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(PDF) Yao & Artusio’s Anesthesiology 9th Edition By Fun-Sun F. Yao
This is the PDF eBook version for Yao & Artusio’s Anesthesiology – Problem-Oriented Patient Management 9th Edition by Fun-Sun F. Yao, Hugh C. Hemmings, Vinod Malhotra, Jill Fong. https://booksca.ca/library/pdf-yao-artusios-anesthesiology-9th-edition-by-fun-sun-f-yao/
Table of Contents
vii Contributors xi Preface xix Acknowledgments xx SECTION 1 The Respiratory System 1 1 Asthma and Chronic Obstructive Pulmonary Disease 1 Jaroslav K. Usenko and Fun-Sun F. Yao 2 Bronchoscopy, Mediastinoscopy, and Thoracoscopy 26 Alessia Pedoto, Paul M. Heerdt, and Fun-Sun F. Yao 3 Aspiration and Postoperative Respiratory Failure 47 Kapil Rajwani, Edward J. Schenck, and David A. Berlin 4 Lung Transplantation 72 Choy Lewis, Ryan Hood, and Charles W. Hogue SECTION 2 The Cardiovascular System 90 5 Ischemic Heart Disease and Coronary Artery Bypass Grafting 90 Yasdet Maldonado, Nikolaos J. Skubas, and Fun-Sun F. Yao 6 Mechanical Circulatory Support 137 Lisa Q. Rong, Mudit Kaushal, and Adam D. Lichtman 7 Valvular Heart Disease 151 Meghann M. Fitzgerald and Natalia S. Ivascu 8 Pacemakers, Implantable Cardioverter-Defi brillators, and Cardiac Resynchronization Therapy Devices 180 Alan Cheng and Fun-Sun F. Yao 9 Thoracic and Thoracoabdominal Aortic Aneurysms 201 Yong Zhan, Frederick C. Cobey, Sharon L. McCartney, Madhav Swaminathan, and Jamel Ortoleva 10 Abdominal Aortic Aneurysm Repair 236 Fun-Sun F. Yao and Anup Pamnani 11 Hypertension 259 Christopher W. Tam and Fun-Sun F. Yao 12 Cardiac Tamponade 279 June M. Chan 13 Heart Transplantation and Subsequent Noncardiac Surgery 303 Jeff T. Granton, Ranjana Bairagi, and Davy Cheng 14 Ischemic Heart Disease and Noncardiac Surgery 319 Christopher Szabo and Manuel Fontes Contents Yao9e_FM.indd vii ao9e_FM.indd vii 2/5/20 10:17 PM /5/20 10:17 PM viii CONTENTS SECTION 3 The Gastrointestinal System 340 15 Intestinal Obstruction and Enhanced Recovery after Surgery 340 Leif Ericksen and Tong J Gan 16 Liver Transplantation 366 Christopher H. Choi and Vivek K. Moitra SECTION 4 The Nervous System 386 17 Brain Tumor and Craniotomy 386 June M. Chan, Elena V. Christ, and Kane O. Pryor 18 Carotid Artery Disease 415 Priscilla Nelson and Hugh C. Hemmings Jr. 19 Awake Craniotomy for Mapping and Surgery in the Eloquent Cortex 440 Th omas A. Moore II and Kenneth G. Smithson 20 Head Injury 460 Chris C. Lee, Susan A. Ironstone, and M. Angele Th eard 21 Cerebral Aneurysm 481 Patricia Fogarty Mack SECTION 5 The Endocrine System 499 22 Pheochromocytoma 499 Anup Pamnani and Vinod Malhotra 23 Diabetes Mellitus 510 Mark E. Nunnally and Vinod Malhotra SECTION 6 The Genitourinary System 522 24 Transurethral Resection of the Prostate and Geriatric Anesthesia 522 Anuj Malhotra, Vinod Malhotra, and Fun-Sun F. Yao 25 Kidney Transplant 540 Christine Lennon and Fun-Sun F. Yao 26 Robotic-Assisted Laparoscopic Surgery 556 Judith Weingram SECTION 7 The Reproductive System 580 27 Placenta Previa/Placenta Accreta Spectrum 580 Jill Fong 28 Hypertensive Disorders of Pregnancy 608 Sharon Abramovitz and Jennifer Wagner Yao9e_FM.indd viii ao9e_FM.indd viii 2/5/20 10:17 PM /5/20 10:17 PM CONTENTS ix 29 Breech Presentation, Fetal Distress, and Mitral Stenosis 624 Jill Fong and Jaime Aaronson 30 Appendectomy for a Pregnant Patient 648 Robert S. White and Farida Gadalla SECTION 8 The Hematologic System 661 31 Hemophilia and Disorders of Coagulation 661 Elizabeth M. Staley 32 Sickle Cell Disease 686 Chris R. Edmonds and Vinod Malhotra SECTION 9 Eye, Ear, Nose, and Throat 699 33 Airway Trauma 699 Richard P. Dutton and LaRita Yvette Fouchè-Weber 34 Open-Eye Injury and Cataract Surgery 710 Alaeldin A. Darwich 35 Laser Treatment for Laryngeal Lesions 724 Stephanie Marie Vecino and Hugh C. Hemmings Jr. SECTION 10 Pediatrics 736 36 Tracheoesophageal Fistula 736 Jacques H. Scharoun 37 Congenital Diaphragmatic Hernia 745 Dana L. Gurvitch and Fun-Sun F. Yao 38 Tetralogy of Fallot 753 David Whiting and James A. DiNardo 39 Transposition of the Great Arteries 770 David Whiting and James A. DiNardo 40 Pyloric Stenosis 790 Aarti Sharma and Vinod Malhotra 41 Infl ammatory Airway Disease in Childhood: Laryngotracheobronchitis 800 Miles Dinner and Anthony Longhini 42 Cleft Palate 811 Aarti Sharma 43 Congenital Heart Disease with a Cervical Mass in Infancy 821 Miles Dinner and Elizabeth Q. Starker 44 Patent Ductus Arteriosus and Prematurity 833 Albert C. Yeung and Fun-Sun F. Yao 45 Post-tonsillectomy Hemorrhage 849 Dana L. Gurvitch, Jessica A. Latzman, and Hugh C. Hemmings Jr. Yao9e_FM.indd ix ao9e_FM.indd ix 2/5/20 10:17 PM /5/20 10:17 PM x CONTENTS SECTION 11 Pain Management and Neuraxial Blocks 858 46 Brachial Plexus Block 858 Tiff any Tedore and William Urmey 47 Nerve Blocks of the Lower Extremity 874 Roniel Weinberg, Melvin La, and Danielle M. Gluck 48 Complex Regional Pain Syndromes 894 Mohammad M. Piracha, Neel D. Mehta, Sudhir A. Diwan, and Vinod Malhotra 49 Cancer Pain 906 Shakil Ahmed and Sudhir A. Diwan 50 Low Back Pain and Sciatica 924 David Y. Wang 51 Perioperative Pain Management 945 Anuj Malhotra and Vinod Malhotra 52 Acupuncture 965 Yuan-Chi Lin SECTION 12 Miscellaneous 972 53 Myasthenia Gravis 972 James B. Eisenkraft and Bryan S. Carter 54 Malignant Hyperthermia 982 Henry Rosenberg, Harvey K. Rosenbaum, and Vinod Malhotra 55 Postoperative Residual Neuromuscular Weakness and Prolonged Apnea 997 Mary So, Danielle McCullough, and David J. Kopman 56 Burns 1010 Shreyajit R. Kumar and Anup Pamnani 57 Trauma 1023 Rohan K. Panchamia, Jaideep K. Malhotra, and Ralph L. Slepian 58 Scoliosis 1049 Jordan M. Ruby and Victor M. Zayas 59 Hypoxia and Equipment Failure 1073 James B. Eisenkraft and Garrett W. Burnett 60 Electroconvulsive Therapy 1093 Patricia Fogarty Mack 61 Ambulatory Surgery 1103 Melinda Randall and Hugh C. Hemmings Jr. 62 Magnetic Resonance Imaging 1119 Jayanth Swathirajan, Dana L. Gurvitch, and Hugh C. Hemmings Jr. 63 Morbid Obesity, Obstructive Sleep Apnea, and Bariatric Anesthesia 1132 Jon D. Samuels
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cagrreports21 · 2 years
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readbooko · 2 years
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Lanzkowsky's Manual of Pediatric Hematology and Oncology 7th Edition PDF EBOOK EPUB
Lanzkowsky’s Manual of Pediatric Hematology and Oncology 7th Edition PDF EBOOK EPUB
Lanzkowsky’s Manual of Pediatric Hematology and Oncology 7th Edition PDF EBOOK EPUB Lanzkowsky’s Manual of Pediatric Hematology and Oncology , Seventh Edition remains the go-to clinical manual for the treatment and management of childhood cancers and blood disorders. It is a comprehensive book on patient management, replete with algorithms and flow diagrams, and includes a new section on vascular…
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Global TIGIT Inhibitor Market Trends, Application and Regional Forecast to 2021-2022
Bharat Book Bureau Provides the Trending Market Research Report on “Global TIGIT Inhibitor Drug Opportunity & Clinical Research Insight 2022”under  Life Sciences Market Research Reports Category. The report offers a collection of superior market research, market analysis, competitive intelligence and Market reports.
Global TIGIT Inhibitor Drug Opportunity & Clinical Research Insight 2022 Report Highlights: • Global TIGIT Inhibitor Market Dynamics • Clinical Approaches to Target TIGIT • Role of TIGIT Inhibitors in Cancer, HIV, Autoimmune Disorders • Number of TIGIT Inhibitor Drug In Trials • TIGIT Inhibitors Trials By Phase, Company, Country, Indication • Clinical Trials Adverse Events Scenario • Company Agreement/Partnership/Deals For Ongoing Trials • Global TIGIT Inhibitor Market Future Outlook
T-cell immunoreceptor with Ig and ITIM domains (TIGIT) is one of the most recently identified immune checkpoint inhibitor which is being evaluated as potential immunotherapeutic target. TIGIT is transmembrane glycoprotein receptor with Ig-like V-type domain and an ITIM in its cytoplasmic domain and is expressed on wide range of cells including memory T-cells, NK cells, and Tregs. Apart from this, studies have demonstrated high expression of TIGIT on wide range of solid tumors and hematological malignancies, thus making it potential target in drug development.
Several pharmaceutical companies have developed a robust pipeline of TIGIT inhibitors in their pipeline indicated for the management of several cancers. Current clinical trials are mainly evaluating the role of TIGIT inhibitors in combination with PD-1/PD-L1 inhibitor or CTLA-4 inhibitors. Immunotherapy combinations featuring dual blockade of TIGIT and PD-1/PD-L1 are promising due to their synergistic enhancement of antitumor responses. More recently, Compugen in colloaboration with Bristol Meyer Squibb is evaluating triple combination of Opdivo, BMS-986207 (anti-TIGIT), and COM701 (anti-PVRIG). The preliminary data suggest that the triple combination was safe and well tolerated.
Apart from cancer, researchers are also evaluating the role of novel immune checkpoint in other therapeutic conditions including HIV and autoimmune disorders. TIGIT has emerged out to be attractive target in HIV due to its expression on NK cells and almost all HIV-specific CD8+ T cells. Preclinical studies have favored the co-blockade of TIGIT with PD-1/PD-L1 inhibitor in HIV patients. The encouraging response from preclinical trials is expected to be translated in clinical studies in coming years. Further, researchers have also suggested the relationship between TIGIT expressing Treg cells and different autoimmune diseases including atopic dermatitis, autoimmune thyroiditis, type-1 diabetes, autoimmune uveitis, aplastic anemia, multiple sclerosis, systemic lupus erythematous, arthritis, and colitis. As of now, these studies are mainly confined to in-vivo and preclinical studies.
Currently, the market for TIGIT inhibitor is mainly domination by therapeutic monoclonal antibodies. Several monoclonal antibodies targeting TIGIT have entered the clinical development including Tiragolumab, Ociperlimab, Vibostolimab, ASP-8374, and COM902. Further enhancement in the field of biotechnology and promising results of TIGIT inhibitor in combinational therapies have led to the development of novel bispecific constructs. Currently, a few bispecific antibodies including AGEN1777, IBI321 and HLX301 have entered initial stages of clinical trials. The emergence of bispecific antibody constructs is expected to show enhanced efficacy and will reduce the overall cost of therapy and drug development.
Globally, there are more than 30 clinical trials ongoing which are evaluating novel anti-TIGIT antibodies in wide range of diseases. Some of the major indications which are anticipated to show a better outcome by the launch of these drugs include triple negative breast cancer, non-small cell lung cancer, colorectal cancer, melanoma, gastric cancer, and esophageal cancer. The global market is anticipated to show positive growth due to launch of TIGIT therapies during forthcoming years. Tiragolumab developed by Roche is leading drug candidate which has received priority review by US FDA and is expected to be launched in market by 2022. The emerging trend in TIGIT next generation immunotherapies with continuous headway movement along with the development of new technologies for the development of targeted therapies provides hope for better therapeutic alternatives in coming years.
US will dominate the TIGIT Inhibitor development and commercialization landscape which is mainly attributed to large number of ongoing clinical trials in the region. Further, the high concentration of key players in the region which actively invest in research and development will also propel the growth of market. Beside US, China and South Korea will also emerge as key markets for TIGIT inhibitors drugs driven by increasing research and development activities.
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Lupine Publishers | The Mystery of Ectopia Lentis -A Rare Case Report
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Lupine Publishers | Trends in Ophthalmology Open Access Journal
Abstract
We report a case of a 12-year-old male with hematological, ocular, dermatological, dental and gastrointestinal involvement. To the best of our knowledge and after an extensive internet search, this probably is the first case of subluxation of the natural crystalline lens (NCL) with so many systemic associations described plus the pattern of subluxation itself.
Keywords: Ocular; Systemic; Associations
Case Report
A 12-year-old male (Figure 1) receiving treatment for gastroenteritis from the department of pediatrics (at our institute) presented to us with a history of itching bilateral eyes since his admission to the hospital. Secondly, the department of pediatrics diagnosed the child to be suffering from aplastic anemia and was referring him to a higher center for further management. On the contrary, old records bought by the patient’s father and mother showed that the patient was diagnosed as a case of thalassemia from some other institute and was receiving treatment in the form of regular blood transfusion from that institute. Further, the patient had multiple attacks of diarrhoea in the past few years for which he was admitted in hospital many times. The diarrhoea was not related to any particular meal. He was also receiving treatment from dental department for grade 3 mobility of lower anterior teeth. The positive findings on his general physical and systemic examination were thin sparse hairs on the scalp (Figure 2), facial freckles (Figure 3), and barrel shaped chest (Figure 4). His blood sugar, renal function tests, liver function tests, X ray chest, electrocardiography, vitamin B12 plus folate and zinc levels, C reactive proteins and serum electrolytes which were already carried out were within normal limits. The patient’s parents were farmers by occupation and did not give a history of themselves suffering from any major illness in the past. The patient’s family history revealed that one of the siblings had died at a younger age because of some illness, though no detail or hospital records of the disease were available with the parents. There was no other significant medical, surgical, traumatic or drug usage history.
Ocular examination was carried out. His visual acquity was finger counting at 2 meters bilaterally with no improvement on pinhole and refraction. Slit lamp examination of the right eye (Figure 5) revealed inferonasal subluxation of the NCL with a shallow anterior chamber while the left eye (Figure 6) had subluxation of the NCL into the anterior chamber with a shallow anterior chamber. The intraocular pressure and axial lengths of both the eyes were within normal limits. The patient did allow us to do gonioscopy. Bilateral fundus could not be seen because of media haze, though the NCL bilaterally were not cataractous nor was there any intraocular inflammation. Bilaterally, the ocular movements and pupillary reaction were normal. The itching in his eyes was as a result of allergic conjunctivitis for which we prescribed him antihistaminic eye drops. Clinical features and investigations for diagnosis of homocysteinuria, marfans syndrome and ehler danlos syndrome did not reveal any abnormality. Facility for ultrasound biomicroscopy (UBM), Optical coherence tomography (OCT), B scan ultrasonography and genetic studies were not available at our institute. We could have planned for his NCL removal and a probable intraocular lens implantation under guarded visual prognosis, but the patient wanted all his treatment modalities to be done in single institution, and his referral center had all the facilities.
Discussion
Ectopia lentis is displacement of the lens from its normal position. Ocular causes of lens subluxation include trauma, high myopia, buphthalmos, anterior uveal tumors, pseudoexfoliation syndrome, and hypermature cataracts [1]. Systemic disorders associated with ectopia lentis include Marfan syndrome, homocystinuria, Weill-Marchesani syndrome, and Ehlers-Danlos syndrome [2].
Spontaneous dislocation of the NCL is an extremely rare entity, especially its dislocation to the anterior chamber. This dislocation to the anterior chamber can lead to various complications like corneal edema, pupillary block glaucoma and anterior uveitis which requires urgent removal of the NCL [3]. Surgical procedures such as intracapsular cataract extraction, limbal or pars plana lensectomy and anterior vitrectomy and suturing of the haptics to the sclera have been the surgical modalities in use. Femtosecond laser assisted cataract surgery, glued intraocular lenses, instead of conventional scleral fixation of IOLs with sutures for fixation are another useful advancement in treatment [4].
Conclusion
The presence of ectopia lentis with multisystem involvement in our patient could be a part of a syndrome complex or may be an isolated entity it still remains a mystery for us. Ectopia lentis with hematological involvement has probably not been reported before (to the best of our knowledge)
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