Hydrogen peroxide (H2O2) is a commonly used antiseptic in surgical practice. However, little is known of its dose-dependent toxicity and benefits. In this study, we bring out the outcome of application of 2

The aim of the study was to evaluate the clinical and laboratory profile of newly diagnosed cases of Multiple myeloma (MM) in a tertiary care hospital in western India. Records of all the patients who were diagnosed as MM was taken out from the archives from September 2013 to February 2021 and analyzed for various parameters. Of the 100 patients studied, 3

Hydrogen peroxide (H2O2) is a commonly used antiseptic in surgical practice. However, little is known of its dose-dependent toxicity and benefits. In this study, we bring out the outcome of application of 2% H2O2 soaks on split skin thickness graft (STSG) post-operatively and discuss the rationale behind using them in daily clinical practice. This is a case series analysis of four patients with similar profile who were admitted and subsequently managed over a period of six to 8 weeks at a zonal hospital. All four patients went through similar pre- and post-STSG regime which includes application of 2% H2O2 soaks on post-operative day (POD) 05. There was negligible graft loss in all operated patients after application of 2% H2O2 soaks on POD 05. This study brings out the differences in outcome in diabetic patients with a different and novel treatment protocol which envisages post-operative application of H2O2 soaks on STSG. It also brings out the concentration-dependent properties of H2O2 which can be applied to clinical practice and further improve the management of chronic non-healing diabetic wounds.

Aims and Objectives In this study the various parameters of acute lymphoblastic leukemia (ALL), including the clinical features, peripheral blood and bone marrow (BM) findings, immunophenotypic and cytogenetic details in ALL cases who had isolated relapse involving the central nervous system (CNS), were studied. Patients/Materials and Methods Duration of the study is from 2015 to 2019 in which 5 ALL cases were presented to this tertiary care center. The presenting symptoms varied from headache, fever, and distension of abdomen. These cases were either on therapy or post completion of chemotherapy. The diagnosis of CNS relapse followed after the examination of cerebrospinal fluid (CSF). Patients also underwent BM examination to rule out systemic relapse. Results Age of patients ranged from 7 months to 42 years. There were three female patients. Two patients had isolated CNS relapse 3.5 years after completing therapy and succumbed to their illness. Two patients had t(9;22) while one patient had t(1;14) cytogenetic abnormality at diagnosis. One patient was diagnosed as T-ALL. Treatment offered was German Multicentre ALL protocol for induction along with 10 cycles of maintenance. Conclusion The most common hematolymphoid malignancy in children namely ALL accounts for 75% of childhood leukemias. Complete remission rates reach up to 70 to 80%. CNS involvement is known to occur in these cases. CNS relapse may occur alone or with systemic relapse. Advances in therapeutic protocols along with CNS prophylaxis have drastically brought down the rates of CNS relapse. It is essential to maintain a high degree of suspicion so that these cases of isolated CNS relapse can be identified at the earliest and definitive therapy can be offered.

Aspergillosis of the breast is very uncommon and associated with various immunosuppressed states. Spectrum of disease extends from cutaneous to disseminated invasive aspergillosis. Only 13 cases of aspergillosis breast have been reported so far with seven of them associated with immunocompromised states. Our case brings out the rare association of aspergillosis of the breast with thymoma and myasthenia gravis (MG) managed successfully and has not been reported in world literature so far. It highlights the importance of understanding the association of autoimmune diseases with aspergillosis.

Background: Chronic myelomonocytic leukemia (CMML) is a clonal hematological neoplasm with features of both myeloproliferation and myelodysplasia with an incidence 0.4 per lakh population.A number of prognostic risks scoring systems have attempted to predict survival and risk of CMML patients, like International Prognostic Scoring System (IPSS), the Spanish Score, the modified Bournemouth Score, the Dusseldorf Score and the MDAP Score.But no prognostic system has been widely accepted.More data from different regions are required to create a widely accepted working prognostic system for CMML.No case series on CMML has been published in literature from India in our knowledge.This article attempts to put to light the various clinicopathological parameters of CMML cases from India and the impact of these parameters on final outcome. Methods:All admitted patients in a tertiary center in western India, with a diagnosis of either a chronic myeloproliferative disease or a myelodysplastic disease over a period of 3 years (2015-2018) were evaluated, out of which nine(n=9) cases fulfilled the diagnostic criteria of CMML.All patients underwent peripheral blood examination, bone marrow aspirate, bone marrow biopsy and cytogenetic studies.Result: All patients (n=9) were between 50 and 80 years and most were males (n=8).Five patients presented with hepatosplenomegaly.Renal and liver function of one patient was deranged who had pleural effusion, ascites.Most patients (n=8) had total leukocyte count above 13000/cumm, while three had low platelet counts.Two out of three patients classified as CMML-II with increased blasts in peripheral blood and bone marrow had fatal outcomes.Patients whose karyotypes were available had normal karyotypes without any additional cytogenetic abnormalities.All were negative for JAK2 and BCR-ABL1. Conclusion:The study concluded that altered biochemical tests (LDH, LFT), blast percentage, CMML II, relative lymphocytosis and transformation to AML were associated with poor outcome.

Primary myoepithelial neoplasms of soft tissue are rare tumors that have only recently been recognized. Due to the presence of varied architectural and cytological features both within a lesion and between different tumors, immunohistochemistry may be required to diagnose these tumors. Herein, we report two cases of myoepithelial carcinoma of soft tissue, one of whom had an aggressive clinical course.