End Of 1st Year Research Articles

Age and growth of gangatic Mystus: Mystus cavasius (Hamilton-Buchanan, 1822) by length-frequency analysis from central Brahmaputra Valley, Assam

The Gangatic catfish Mystus cavasius is a native catfish found in Brahmaputra and Barak valley of Assam which is a very popular food fish with has high market price. Our study provides the first data on age and growth of this species in central Brahmaputra valley of Assam. A total number of 285 specimens comprising of 103 males and 182 females have been studied using von Bertalanffy growth model and computer-based FiSAT programme was used for the estimation of growth parameters. In the FiSAT programme, the direct fit of length–frequency data such as Electronic Length Frequency Analysis-I (ELEFAN)-I technique, Shepherd’s method and Powell–Wetherall plot were employed in the present study. The Asymptotic length (L∞) and growth co-efficient (K) (annual) values of Mystus cavasius estimated by ELEFAN I, Shepherd’s method and Powell and Wetherall method. The value of L∞ and K by ELEFAN I, Shepherd’s method and Powell and Wetherall method are 217.0 mm and 0.8 year-1, 215.25 mm and 0.79 year-1 and 220.73 mm and 0.94 year-1 respectively. The two values of Mystus cavasius estimated about -0.41. The total length attained by this fish is about 135 mm at the end of 1st year, 180 mm at the end of 2nd years, 201 mm at the end of 3rd year and 210 mm at the end of 4th year.

Role of Platelet Rich Plasma in Osteoarthritis of the Knee Joint

Background: Osteoarthritis (OA) is a leading cause of disability and doubles the number of visits to primary care practitioners for those with the condition in comparison to those without. OA affects the knee more often than any other joint, Platelet-rich plasma (PRP) is a concentrate of autologous blood growth factors which has been shown to provide some symptomatic relief in early osteoarthritis (OA) of the knee. Objective: the aim of this prospective study is to demonstrate the effectiveness of prp injection in patients with OA of the knee. Materials and Methods: 60 patients with 74 knees affected by variable grades of OA were enrolled in our study in Alwasity teaching hospital from January 2018 to December 2019 with follow up till December 2021. 49 patients with 62 knees were females and 11 patients with 12 knees were males, all patients received three injections of prp at weekly intervals and were followed up every three months for two years. Results: After one year of follow up 11 knees with KL-G I had decrease in VAS score to 0–2 (73.3%),19 knees with KL-G II had decrease of VAS score to 1–3 (70.3%),10 knees with KL-G III had decrease of VAS score to 4–5 (40%), All 7 knees with KL-G IV didn’t have any response during treatment or at the end of 1st year. All patients had scores similar to that before starting treatment at the end of 2nd year. Conclusion: The present state of knowledge holds promise for PRP of certain specifications for pain management in early OA knee. PRP has consistently been shown by various clinical studies to be useful in OA of the knee. Nevertheless, a lot of grey areas remain in our understanding of PRP and OA, and many more focused clinical and in vitro studies are required. PRP seems to be an evolving future trend.

The study of laparoscopic mini gastric bypass in patients of morbid obesity

Background: Laparoscopic mini gastric bypass (MGB) is considered superior in terms of weight loss, co-morbidity resolution and less complications, thus improve quality of life.Methods: A prospective interventional study using laparoscopic MGB in 52 morbidly obese patient over a period of 2 years.Results: Weight loss with average percentage excess weight loss (%EWL) at the end 6 months is 72.62%, at the end of 1st year 80.55% and at the end of 2nd year it is 85.83%. Out of 15 diabetic patients, 66.66% had complete remission of Diabetes mellitus resulting in discontinuation of medications and 20% of them had partial remission. Out of the 18 hypertensive patients, 88.88% had complete remission and 5.55% of them had partial remission and other 5.55% had decrease in dosage medications. Out of 20 patients of obstructive sleep apnoea syndrome (OSAS), 75% patients had complete remission and 25% of them had partial remission.Conclusions: Laparoscopic MGB is an effective procedure with >50% EWL as early as 3 months. Laparoscopic MGB causes complete or partial remission of the comorbidities like diabetes mellitus, Hypertension and OSAS.

Factors determining cognitive, motor and language scores in low birth weight infants from North India.

Children born with low birth weight (LBW) tend to have lower neurodevelopmental scores compared to term normal birth weight children. It is important to determine factors that influence neurodevelopment in these low birth weight children especially in the first 2-3 years of life that represents a period of substantial brain development. This secondary data analysis was conducted using data from LBW infants enrolled soon after birth in an individually randomized controlled trial (RCT) and followed up till end of 1st year. Neurodevelopmental assessment was done at 12 months of corrected age by trained psychologists using Bayley Scales of Infant and Toddler Development 3rd edition (Bayley-III). Factors influencing cognitive, motor and language scores were determined using multivariable linear regression model. Linear growth (i.e., length for age z score, LAZ) [cognitive: Standardized ẞ-coefficient = 2.19, 95% CI; 1.29, 3.10; motor: 2.41, 95% CI; 1.59, 3.23; language: 1.37, 95% CI; 0.70, 2.04], stimulation at home [cognitive: 0.21, 95% CI; 0.15, 0.27; motor: 0.12, 95% CI; 0.07, 0.17; language: 0.21, 95% CI; 0.16, 0.25] and number of diarrhoeal episodes [cognitive: -2.87, 95% CI; -4.34, -1.39; motor: -2.62, 95% CI; -3.93, -1.29; language: -2.25, 95% CI; -3.32, -1.17] influenced the composite scores in all three domains i.e., cognitive, language and motor. While increase in LAZ score and stimulation led to increase in composite scores; an increase in number of diarrhoeal episodes was associated with decrease in scores. Weight for height z scores (WHZ) were associated with motor and language but not with cognitive scores. Additionally, a negative association of birth order with cognitive and language scores was noted. The findings indicate the possible importance of promoting nutrition and preventing diarrhoea as well as ensuring optimal stimulation and nurturance at home for enhancing child development in LBW infants.

Changes in Body Composition, Energy Expenditure, and Energy Intake during Four Years of University-A Follow-Up Study.

Purpose: The transition to university is often accompanied by the adoption of negative lifestyle habits, which may result in weight and fat gain. While this has been demonstrated during 1st year, little is known about subsequent years. We investigated changes in body composition, energy expenditure, and dietary/energy intake from 1st to 4th year university. Methods: Thirty-eight students (14 males, 24 females) completed a lifestyle questionnaire and had their body mass, fat mass, lean body mass (LBM), and body fat percentage (%BF) measured three times: at the beginning and end of 1st year, and end of 4th year. Results: During 1st year, body mass, fat mass, LBM, and %BF increased (+3.2 ± 3.8 kg, +2.5 ± 3.0 kg, +0.7 ± 2.1 kg, +2.3 ± 4.9%, respectively; p < 0.01), while daily energy intake and expenditure decreased (−359 ± 1019 kcal·d−1 and −434 ± 786 kcal·d−1, respectively; p < 0.01). Between the end of 1st year and end of 4th year, body mass, LBM, and energy expenditure increased (+3.2 ± 3.8 kg, +1.3 ± 2.9 kg, +209 ± 703 kcal·d−1, respectively; p ≤ 0.05), while %BF, fat mass, and energy intake did not change. Conclusions: Although %BF and fat mass remained stable from the end of 1st year to the end of 4th year in this group of university students, the positive increase in energy expenditure was not enough to reverse the weight and fat gained during 1st year.

SO060MONOCYTE-TO-LYMPHOCYTE RATIO, AN INDEPENDENT RISK FACTOR OF SURVIVAL IN HEMODIALYSIS PATIENTS: RESULTS FROM THE INTERNATIONAL MONDO CONSORTIUM

Abstract Background and Aims Patients with end-stage kidney disease have a high prevalence of chronic inflammation and a higher risk of death. Previous work by our group has indicated a positive relationship between neutrophil counts and neutrophil-to-lymphocyte ratio (NLR) and mortality in a large and ethnically diverse dialysis population. Monocytes also have a crucial inflammatory role, but there has been limited study to date, an association between monocyte-to-lymphocyte ration (MLR) was reported in a small Chinese haemodialysis cohort. The aim of this analysis was to study the independent relationship between MLR and all-cause mortality in a large and ethnically diverse haemodialysis population. Method Four cohorts were described by phases of haemodialysis exposure: 1) acute phase cohort- first 90 days on HD as the baseline period with the subsequent 9 months as the follow-up period, 2) early-stable phase cohort- 91 days to the end of 1st year as the baseline followed with 1 year’s follow-up period, 3) mid-stable phase cohort- 2nd year as the baseline and the following 1 year as the follow-up, and 4) late-stable phase cohort- 3rd year as the baseline followed by a 7 year follow-up period. All-cause mortality was recorded during the 4 phases. Kaplan-Meier (KM) curves were applied to explore the association between MLR quartiles with mortality in the 4 cohorts. Cox proportional hazards models with spline terms (adjusted for age, gender, race, body mass index, diabetic (DM) and congestive heart failure (CHF)) were applied to explore the association between MLR levels and all-cause mortality in the cohorts. Results A total of 20,848 patients were included in acute phase cohort; 19,575 in the early-stable phase cohort, 16,515 patients in the mid-stable cohort, and 13,708 patients in the late-stable phase cohort. Notably, patients with higher baseline MLR by quartile tended to be older, male and with a higher percentage of DM and CHF as comorbidities. Lower lymphocyte count and higher neutrophil count, NLR, CRP were associated with higher MLR quartile (Table 1), consistent with the observed association with other markers of inflammation and malnutrition: lower albumin, phosphate and higher ferritin. Adjusted all-cause mortality was observed to be higher in patients with higher MLR quartile both in the KM and spline analyses (Figure 1 a &amp; b) in all phase cohorts (data not shown). Conclusion There is a positive relationship between higher levels of MLR and adjusted all-cause mortality across all phase cohorts, including long-term follow-up in this large and ethnically diverse haemodialysis population. Higher levels of MLR are seen in patients with DM and CHF and are consistently observed with other markers of inflammation and malnutrition. This work supports the findings made previously in a more a restricted cohort and warrants further mechanistic investigation.

Change in the examination pattern in 1st year MDS- boon or bane: A Survey

Introduction: Pursuant to the notification published by Dental Council of India, dated May 17, 2018, no. DE-14-MDS-2018/2131, the committee amended the regulation on postgraduated MDS student and made provision of giving MDS – paper I (basic science paper) at the end of 1st year. Assessment of this survey will provide clear information regarding the response of postgraduate students and teachers. The aim of this article is to report and discuss the characteristics of new-learning processes. Materials and Methods: A total of 400 sample sizes were included, i.e., 300 postgraduate students and 100 postgraduate teachers. Questions were generated using Google form to gain access an establish rapport with participants and to obtain open, honest understanding of the participants “learning experience.” The link was sent to the participants using E-mails or Whatsapp number. Results: Analysis of survey data was done using the Likert scale. Comparison of responses was done using the Chi-square test. [Graph 1], [Graph 2], [Graph 3], [Graph 4], [Graph 5], [Graph 6], [Graph 7], [Graph 8], [Graph 9], [Graph 10] provide responses of participants. Conclusion: Postgraduate students and PG teachers are neutral toward the initial protocol of examination. Participants have positive attitude toward new framework. However, curriculum activity such as library dissertation, dissertation selection, and patient work get disturbed somewhere. It might take time for both students and guide to get familiar with new.

Sleep parameters associated with long-term outcome following subthalamic deep brain stimulation in Parkinson's disease

IntroductionWe aimed to investigate the effects of changes in sleep architecture on long-term clinical outcome in patients with Parkinson's disease (PD) who underwent deep brain stimulation of subthalamic nuclei (STN DBS). MethodsWe followed up eight PD patients before and three years after STN DBS surgery. In addition to clinical assessments, polysomnography (PSG) followed by multiple sleep latency tests was performed before and after STN DBS, while stimulator was ON and OFF. ResultsSubjective sleep latency was significantly decreased (P=0.033) and sleep duration was increased (P=0.041), as measured by Pittsburgh sleep quality index. Latency to REM sleep stage was shortened after surgery with STN DBS ON (P=0.002). Index of central type of abnormal respiratory events was significantly increased while stimulator was ON (P=0.034). Total number of major body movements was found to be increased when stimulator was turned OFF (P=0.012). Among PSG data obtained during STN DBS ON, it was observed that duration of N3 sleep was negatively correlated with UPDRS scores at 1st (P=0.038) and 3rd (P=0.045) post-operative years. Among PSG variables during STN DBS OFF, durations of N3 sleep (P=0.017) and REM sleep (P=0.041) were negatively correlated with UPDRS scores at post-operative 1st year. ConclusionDisturbances in sleep architecture are associated with higher UPDRS scores and worse prognosis at 1st and 3rd post-operative years. Similar results obtained while stimulator was OFF at the end of 1st year support the presence of microlesion effect after STN DBS, which is probably not long lasting.

Outcomes of isokinetic tests and functional assessment of anterior cruciate ligament reconstruction: Transtibial versus single anatomic femoral tunnel technique

ObjectiveThe aim of the study was to compare the outcomes of the transtibial and anatomical femoral single tunnel surgical techniques in ACL reconstruction. MethodsA total of 30 patients, with 16 patients (15 males and 1 female; mean age: 27.2 ± 7.04) with anatomical femoral single-tunnel technique (AFT) and 14 (12 males and 2 females; mean age: 29.4 ± 8.82) with transtibial technique (TT) were included into the study. All patients were evaluated with isokinetic tests at an angular velocity of 60°/s and 180°/s and the IKDC and Lysholm tests were performed preoperatively and in third, sixth, and 12th months postoperatively. The results were compared between the groups. The mean follow-up time was 17.1 ± 6.48 months. ResultsPostoperative third month changes in extension parameters of peak torque (AFT: −93.286, TT: −61.500), peak work (AFT: −77.071, TT: −47.500), peak torque ext/kg (AFT: −1.182, TT: −0.773), peak work ext/kg (AFT: −0.982, TT: −0.604), peak work (AFT: −55.143 TT: −33.063) at an angular velocity of 60°/s and postoperative third month change in extension parameter of peak power (AFT: −86.786 TT: −54.875) at an angular velocity of 180°/s were found to be better in the transtibial group (p < 0.05) and postoperative sixth month peak torque (AFT: 1.429, TT: −5.688) value at an angular velocity of 60°/s was found to be less in the anatomical femoral single-tunnel group (p < 0.05). The IKDC (AFT: 94.671, TT: 90.025) (p < 0.05) and Lysholm (AFT: 96.714, TT: 92.375) (p < 0.05) scores of the anatomical femoral single-tunnel group were better than the transtibial group regarding to the postoperative final follow-up. There are positive intermediate correlations between preoperative IKDC and Lysholm scores with preoperative and postoperative some isokinetic test ratio (r = 0.539; p = 0.031), and preoperative peak power extension (r = 0.541; p = 0.030) at the both angular velocity of 60°/s and 180°/s in the transtibial group. There was no significant difference between the two groups with regards to the Lachman, anterior drawer and pivot shift tests (p < 0.05). ConclusionThere were differences in terms of isokinetic parameters in early outcomes but there was no statistical difference between isokinetic parameters at the end of 1st year between two groups. There were some correlations between IKDC and Lysholm scores with some isokinetic parameters. Level of EvidenceLevel III, Therapeutic Study.

Study of efficacy and functionality of modified technique of proximal arteriovenous fistula as a vascular access for hemodialysis: A retrospective analysis of 171 cases

Background: Vascular access is the lifeline for a patient on hemodialysis. An arteriovenous fistula is the gold standard for hemodialysis access. The order of preference as given by the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative guidelines suggests radiocephalic, brachiocephalic, and brachiobasilic transposition fistulae and then prosthetic grafts as vascular access options. Brachiobasilic transposition fistulae are associated with multiple challenges and complications. By our modified technique of brachiobasilic fistula, we have overcome the challenges posed by the conventional technique. In this study, we have evaluated the results of our modified technique and compared them with conventional technique. Materials and Methods: A retrospective analysis was done, in which all cases of proximal fistula for hemodialysis performed in our institute by the modified technique from January 2010 to December 2014 were included in the study. Result: Of the 171 patients, 136 (79.5%) were successful. The primary failure rate was 20.5%. Maturation time required for the fistula to develop was 46.7 (±4.17) days. Flow rates of more than 250 ml/min could be maintained in 58.8% of patients. Patency rates were 79% at the end of 1st year, 74.2% at the end of 2nd year, 45.7% at the end of 3rd year, and 40.2% at the end of 5th year. Ease of access was determined by a number of pricks required to gain access and development of forearm veins. Of the 136 successful cases, 110 (80%) could be cannulated with ease in the first prick itself. Access over forearm was possible in 117 (86.1%) cases. Conclusion: The modified technique of brachiobasilic fistula overcomes the risk of complications and morbidity of conventional brachiobasilic transposition fistula and is equally effective as vascular access.

Intraocular pressure reduction in neovascular glaucoma using Ex-PRESS implantation

Purpose: evaluation of the role of the Ex-PRESS device implantation in IOP reduction of neovascular glaucoma. Design: non-comparative case series study. Patients and methods: 5 eyes with neovascular glaucoma scheduled to undergo Ex-PRESS glaucoma filtration device. Each study patient underwent a complete ophthalmic examination preoperatively including full clinical history taking, VA measurement, autorefraction examination, slit lamp biomicroscopy of the anterior segment, IOP measurement using Goldmann applanation tonometer, gonioscopic examination to evaluate of the angle of AC, and ophthalmoscopy of the posterior segment using a direct ophthalmoscopy. All patients included were having neovascular OAG (angle grade 3 and 4 on Shaffer classification). Patients were excluded if they were under 18 years old. All eyes underwent Ex-PRESS device implantation performed by the same surgeon for consistency, using the standardized technique for the procedure. A complete ophthalmologic follow-up examination included IOP measurement using Goldmann applanation tonometry, number of drugs required to attain IOP control and any associated complications was carried out postoperatively at the 1st and 3rd days, the end of 1st week, every month till the end of the 6th month and the end of 1st year. Best-corrected visual acuity (BCVA) was tested using Snellen chart, which was converted to LogMAR for statistical analysis. Criteria for success were defined as follows; Absolute success: IOP ≤21 mmHg without any medication, qualified success: IOP ≤21 mmHg with ocular hypotensive medications. Results: all cases (100%) showed qualified success. There is a statistically significant reduction in IOP 1, 3, 6 months and one year postoperatively (P 21 mmHg using anti-glaucoma medications by this time. There is a statistically significant improvement of postoperative BCVA (P=0.002). Moreover, there is a statistically significant reduction of number of anti-glaucoma medications used postoperatively (P<0.001). Conclusion: Ex-PRESS is preferable for neovascular glaucoma.

The role of the Ex-PRESS device implantation in the management of pseudophakic glaucoma

Purpose: evaluation of the role of the Ex-PRESS device implantation in the management of pseudophakic glaucoma. Design: non-comparative case series study. Patients and methods: 6 eyes with pseudophakic glaucoma scheduled to undergo Ex-PRESS glaucoma filtration device. Each study patient underwent a complete ophthalmic examination preoperatively including full clinical history taking, VA measurement, autorefraction examination, slit lamp biomicroscopy of the anterior segment, IOP measurement using Goldmann applanation tonometer, gonioscopic examination to evaluate of the angle of AC, and ophthalmoscopy of the posterior segment using a direct ophthalmoscopy. All the patients were subjected to functional and structural evaluation by SAP (HFA 745i) for central 30-2 threshold test, endothelial cell evaluation by non-contact specular microscopy (Topcon specular microscope; SP-1P Version 1.20) for endothelial cell count and OCT scans (Topcon 3D OCT-2000) for peripapillary RNFL thickness measurements, ONH analysis and GCA. All patients included were having pseudophakic OAG. Patients were excluded if they were under 18 years old. All eyes underwent Ex-PRESS device implantation performed by the same surgeon for consistency, using the standardized technique for the procedure. A complete ophthalmologic follow-up examination included IOP measurement using Goldmann applanation tonometry, number of drugs required to attain IOP control and any associated complications was carried out postoperatively at the 1st and 3rd days, the end of 1st week, every month till the end of the 6th month and the end of 1st year. Best-corrected visual acuity (BCVA) was tested using Snellen chart, which was converted to LogMAR for statistical analysis. Criteria for success were defined as follows; Absolute success: IOP ≤21 mmHg without any medication, qualified success: IOP ≤21 mmHg with ocular hypotensive medications. VF test with SAP, specular microscopy and ONH analysis and GCA assessed with OCT were carried out one year postoperatively. Results: There were 4 eyes (80%) showed complete success (IOP P 21 mmHg using anti-glaucoma medications by this time. There is a statistically significant improvement of postoperative BCVA (P=0.002). Moreover, there is a statistically significant reduction of number of anti-glaucoma medications used postoperatively (P<0.001). For VF indices, there is a statistically significant improvement in both MD and PSD postoperatively (MD; P<0.001) (PSD; P=0.002). However; There is no significant improvement in the staging of glaucoma according to GSS2 (P=327). For OCT parameter, there is a statistically significant increase in the thickness of both RNFL and GCC (P<0.001). Furthermore, endothelial CD shows a statistically significant increase postoperatively (P <0.001). Conclusion: Ex-PRESS is preferable for pseudphakic glaucoma.

Long-Term Safety and Efficacy of Corneal Cross-Linking in thin Corneas with Keratoconus

Objective: To evaluate the long-term safety and efficacy of corneal cross-linking in keratoconus patients with thin corneas. Methods: Forty eyes of 25 subjects having progressive keratoconus with thinnest corneal thickness (TCT) less than 400 µm were evaluated. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), corneal topography, and endothelial cell loss were assessed at baseline and followed at six-month interval till the end of 1st year of follow up and then yearly till the fifth year, de-epithelization of cornea was performed, followed by ultrasound pachymetry to measure TCT. Hypoosmolar riboflavin (0.1%) solution was applied after every 2 minutes for 25 minutes. Ultraviolet A (UVA) irradiation was performed for 30 minutes along with riboflavin for every 2 minutes. Results: Mean TCT was 381.5 ± 13.2 µm (range: 344–396 µm) without corneal epithelium. Following hypotonic riboflavin instillation, mean TCT increased by 97.8 ± 12.1 µm (range: 83–112 µm) for a mean thickness of 478.1 ± 14.9 µm (range: 409–506 µm). The average follow-up period was 61.79 ± 6.19 months (range: 42–68 months). Corrected distance visual acuity, pachymetry values and posterior elevation showed no significant difference before and after CXL at 5 years follow-up. Corneal astigmatism and maximum keratometry reading (Kmax) were significantly reduced. Mean reduction of endothelial cell count was 1.5% at the last follow-up visit. Conclusions: CXL with UVA and hypoosmolar riboflavin was effective in stabilizing keratoconus progression in patients with thin corneas however further studies are required to confirm our results.

Longitudinal assessment of depression, stress, and burnout in medical students.

Background:Medical students can and do suffer from mental disorders is a concept yet to get wide acceptance. There are few studies comprehensively evaluating depression, stress, and burnout in medical students, especially in a longitudinal way in India. The current study aims to assess the impact of medical education on the development of psychological morbidities and the role of personality.Materials and Methods:First-year medical students of a leading medical college of India were enrolled on admission and given anonymized, validated, self-administered questionnaires assessing depression, stress, burnout, and personality. This was repeated at the end of 1st year. Data were analyzed independently as questionnaires were anonymized.Results:We found that 1st year of medical college showed a significantly increasing depression (P < 0.01) and stress (P < 0.01). Overall burnout did not increase significantly. However, only disengagement dimension of burnout increased significantly. Personalities with weak capacity to adjust had a significant positive correlation with depression (r = 0.277, P < 0.001) and stress scores (r = 0.210, P = 0.008). However, burnout did not correlate with any of the personality dimensions.Conclusion:Right from the 1st year of medical education students perceive high-stress levels and have a high risk of depression. Burnout starts to creep in at least in the form of disengagement. This study provides a sound groundwork for planning interventions to reduce student's mental morbidity and avoid burnout.

Analysis of flt3 in Adult AML

FLT3 gene encodes a tyrosine kinase receptor, which is involved in proliferation and differentiation of hematopoietic stem cells. FLT3 mutations are frequently encountered in all AML subgroups specially in AML with t(15;17)- Acute Promyelocytic Leukemia (APL)-, and infers poor prognostic effect. FLT3-ITD mutations represent about 80% of FLT3 mutations. In this study, we aimed to assess frequency and correlation of FLT3-ITD mutation with different AML cytogenetic subgroups, also with MPAL cases and to study the prognostic role of this mutation with focusing on APL.Between 2011 and 2014 in NCI, Cairo University, 212 newly diagnosed acute leukemia patients [198 AML (10 M0, 47 M1, 56 M2, 30 M3, 49 M4, 4 M5, 1 M6 and 1 M7) and 14 MPAL] were included in this study. Thorough Morphological, Immunophenotypic and cytogenetic analysis were done at initial presentation and fixed follow up time points (Day 14, 28, 36) with subsequent monitoring and follow up of patients. FLT3-ITD mutation was detected using RT-PCR.FLT3-ITD mutation was detected in 44/198 AML patients (22.2%) and in 2/14 MPAL patients (14.3%). Correlation with cytogenetic subgroups show significant higher incidence in M3 patients 13/30 (43.3%, P=0.0371) in comparison to other types (20% M0, 20.6% M1, 20.1% M2, 13.4% in Monocytic Leukemia -M4 and M5-). In non-APL patients, favorable cytogenetic changes are more common in FLT3 wild group (19.7%)[27/137 (21 patients with t(8;21) and 6 with inv 16] than in FLT3 mutant group (6.5%) [2 with t(8;21) and none with inv 16]. There were insignificant difference between FLT3 wild and mutant group regarding achieving Compete Remission (CR) by Day 36 (P= 0.261), However Overall Survival (OS) of the wild group was high significantly better than that of mutant group (P=0.002). By the end of the 1st year only 10% of patient with mutant FLT3 were alive versus 30% of those with wild type, with 4 months median survival of mutant group versus 8 months of the wild group.In APL patients, again there was no significance between both groups regarding achieving CR by Day 36 (P=0.06) and still OS of APL patients with wild FLT3 was significantly better than in those with mutant FLT3 (P=0.0182). By the end of 1st year, about 90% of patients with wild group are still alive while only 46% of the mutant group are alive with 2 months median survival.We conclude that FLT3-ITD mutations infers poor prognostic effect even in the presence of favorable cytogenetic changes like t(15;17); which indicate that patient with such mutations should be assigned to aggressive therapy. DisclosuresNo relevant conflicts of interest to declare.

Beginning Readers in Arabic and the Distance between Literary and Spoken Arabic

Two groups of kindergarten children received a battery of phonological awareness, reading, and general abilities tests across a two-year period. One of the groups received phonological training whereas the other (control) group did not. Results indicated that children who received intervention improved in certain phonological awareness skills tested at the end of kindergarten but not in reading skills tested at the end of 1st year. These findings are in contrast to findings compared to those found by Carlisle (1995) and Lyster (2002) in English, but were in line with the findings found by Ibrahim et al. (2007) in Arabic and support the notion that normal Arab child encounters special difficulties in reading acquisition. The psycholinguistic basis and implications of these findings are discussed.

20 Cystic fibrosis newborn screening in Italy: survey for assessment of technical-scientific and organizational issues

Aim: Evaluation of patients with pancreatic sufficiency (PS) and insufficiency (PI) diagnosed in CF NBS. Methods: Groups of 17 PS and PI patients diagnosed in CF NBS with the similar CFTR mutations and confirmed elastaze-1 status were analyzed. Patients with Meconium ileus were excluded. Birth weight and length, age at diagnosis, IRT, sweat test values, evaluation of SD body weight and height at the end of the 1st year of life as well as Pseudomonas aeruginosa (PA) infection were collected. Results: From Sept. 2006 to the end of Dec. 2010 CF was confirmed in 84 newborns screened. In PS group were 41% females and 53% respectively. Both groups consisted of 10 F508del heterozygotes and 7 non-F508del heterozygotes. Average age of diagnosis in PS group was similar to PI patients (55 v 45 days). The mean birth weight (3697.35±472.45 v 3122.12±368.52; p< 0.001) and length (55.82±2.83 v 53.76±2.49; p = 0.031) were significantly higher in PS patients. The mean IRT for the group PS was significantly lower (455.07±342.88 v 676.72±353.22; p = 0.036). At the end of 1st year of life, mean SD body weight and IWH% was in the normal range without differences between group. However, SD height (0.36±0.81 v −0.26±0.89; p = 0.033 were significantly reduced in PI patients. Iontophoresis sweat test was significantly lower in PS group (54.48±20.55 v 81.31±22.77; p = 0.001). 3 patients in both groups had infection with PA in assessed period. Conclusion: CF newborns with PS were characterized by lower sweat test and IRT results but higher birth weight and length than PI children. Although there were no differences in weight at the end of 1st year of life between the groups, children with PI were taller.

High rates of early HBeAg seroconversion and relapse in Indian patients of chronic hepatitis B treated with Lamivudine: results of an open labeled trial

BackgroundThe use of Lamivudine in chronic hepatitis B (CHB) is well known, however the reported rate of HBeAg sero-conversion and its durability post-treatment have varied considerably. We undertook the present study to study the effect of Lamivudine on HBeAg loss and seroconversion rates in Indian patients of CHB in relation to frequency, predictors and durability.MethodsWe treated 60 patients of e antigen positive CHB (with active viral replication and ongoing necro-inflammatory activity) with Lamivudine. They were followed up by monthly aminotransferases, and 3 monthly HBeAg and anti-HBe. Those who attained HBeAg sero-conversion were advised to discontinue Lamivudine after 6 months and followed up every 3 months thereafter, to see for relapse. Treatment was given for maximum of 3 years if not sero-converted.ResultsThe annual incremental loss of HBeAg in patients receiving Lamivudine was 25 (41.6%) at end of 1st year, 33 (55%) at 2nd year and 35 (58.3%) at 3rd year. The corresponding rates for full sero-conversion were 17/60 (28.6%), 22/60 (36.6%) and 24/60 (40%) in the 3 years. HBeAg loss correlated with increased pre-therapy ALT levels (p = 0.002) and decreased pretreatment HBV-DNA levels (p = 0.004). The presence of cirrhosis had no influence on the rate of HBeAg loss. Relapse occurred in 35% (7/20) post-treatment at median time of 6 months.ConclusionIndian patients showed a higher rate of HBeAg sero-conversion in the first year of Lamivudine treatment. This correlated with baseline ALT and inversely with HBV-DNA levels. Relapse rate after treatment was high and occurred soon after stopping treatment.