Jawaharlal Nehru Medical College and Hospital, Bhagalpur is a government recognized medical college and hospital in Bhagalpur, Bihar, India.It has an approx area of 209 acres with total constructed area of 1,00,000 (in sq mtr.) approx. It is approved by the Medical Council of India and is affiliated to Aryabhatta Knowledge University, Patna.
Introduction: Systemic autoimmune diseases are known to have a significant impact on renal function, with varying degrees of severity that can influence overall patient outcomes. This study aims to assess the impact of Coronavirus Disease-2019 (COVID-19) on the renal outcomes associated with the spectrum of systemic autoimmune diseases. Material and Methods: This observational study was conducted in Jawaharlal Nehru Medical College, Aligarh, from 1 November 2020 to 31 October 2021, to evaluate outcomes in patients with systemic autoimmune diseases and COVID-19 who developed acute kidney injury (AKI). Results: A total of 129 patients with systemic autoimmune diseases were admitted, out of which 51 patients with AKI were included in the study. Of those, 18 patients were COVID-19 RT-PCR positive. The most common systemic autoimmune disorder observed was systemic lupus nephritis (35.3%) followed by rheumatoid arthritis (RA) (19.6%) and seronegative spondyloarthropathy (SpA) (17.6%). The most common renal manifestation observed was drug-induced kidney injury (37.2%) followed by lupus nephritis (29.4%), thrombotic microangiopathy (7.8%) and renal artery stenosis (7.8%). Patients who were COVID-19 RT-PCR positive ( P <.01), those who required inotropic support ( P <.01), ventilatory support ( P <.01), Intensive Care Unit admission ( P <.01), haemodialysis ( P <.01) and with peripheral oxygen saturation <94% at presentation ( P <.01), were significantly associated with mortality. The need for ventilatory support was observed as an independent predictor of mortality in patients with renal involvement and COVID-19 ( P <.01). Conclusion: The present study sheds light on the outcome of AKI in systemic autoimmune diseases and COVID-19, with the use of ventilatory support significantly contributing to mortality.
BACKGROUND: The management of advanced ovarian cancer includes neoadjuvant chemotherapy (NACT) with platinum agents followed by cytoreductive surgery. Many prognostic and predictive factors have been established in ovarian cancer to date, which significantly affect the treatment outcome and patients’ survival. The objective of this study was to evaluate the predictive value of red cell distribution width (RDW) in patients with advanced ovarian cancer following NACT. MATERIALS AND METHODS: A prospective observational study conducted at a tertiary center in 50 patients with advanced epithelial ovarian cancers. RDW values were noted from the baseline Complete blood count (CBC) counts, all patients received three cycles of NACT with paclitaxel and carboplatin. Patients were divided into two groups based on RDW values: RDW-L with RDW value ≤14.5 and RDW-H with the value >14.5. Treatment response was assessed using contrast-enhanced computed tomography scan conducted after 4–6 weeks of the last chemotherapy. In addition, the percentage change in cancer antigen-125 (CA-125) levels following NACT was evaluated in comparison to the pretreatment RDW value. Statistical analysis was done using SPSS V.20. RESULTS: Among 50 patients, 64% were in the RDW-L group and 36% in the RDW-H group. We observed an overall response rate of 93.75% in the RDW-L group and 77.7% in the RDW-H group, though it was not statistically significant. Furthermore, the RDW-L group showed a higher percentage change in CA-125 following chemotherapy than the RDW-H group, with P = 0.03. CONCLUSION: With our study we found that RDW, a simple, easily available, and affordable marker, can be used as a predictive marker in the management of advanced ovarian cancer using NACT. Further randomized controlled studies are needed to improve the results and integration of these factors into clinical practice.
A BSTRACT Background: Neutrophil-to-lymphocyte ratio (NLR) is the most utilized and easily measurable biomarker for evaluating the inflammatory response in different types of solid tumors. Previous studies have demonstrated the prognostic impact of the pretreatment NLR in various types of solid cancers. The purpose of this study is to evaluate the predictive role of NLR in head-and-neck carcinoma (HNC) receiving definitive chemoradiation. Materials and Methods: This retrospective cohort study included 200 patients with nonmetastatic head-and-neck cancer who received definitive chemoradiotherapy from 2018 to 2023. Pretreatment peripheral complete blood count values were retrieved from the patient records. Treatment response was assessed 6–8 weeks’ posttreatment using contrast-enhanced computed tomography of the face and neck, evaluated by the Response Evaluation Criteria in Solid Tumors 1.1. The association between pretreatment NLR and treatment outcome was analyzed. Results: The normal NLR ranges from 0.78 to 3.53 in the general population. A median value of 2.7 was taken as cutoff in our study to classify the patients as high NLR and low NLR. Among 200 patients evaluated 88 patients (44%) had low NLR and 112 patients (56%) had high NLR. Further analysis showed that in patients with low NLR, 27% had complete response, 38% had partial response, 15% had static disease, and 16% had progressive disease as compared to 23%, 44%, 19%, and 12.5% with high-NLR ratio. Conclusion: The study concluded that high-NLR ratio is associated with poor treatment outcome and can be considered as a predictive marker.
