Response to apheretic platelet transfusion in children of acute lymphoblastic leukemia receiving induction chemotherapy: a cross-sectional study from Bangladesh.

Background: Disease and therapy-related hypoproliferative thrombocytopenia is a significant barrier to managing acute lymphoblastic leukaemia (ALL) patients. To reduce the risk of haemorrhage, apheretic platelet transfusion is a modern, effective, and expensive option. Since most ALL patients in Bangladesh have financial constraints, this study can shed light on the magnitude of benefit regarding the effectiveness of apheretic platelet prophylactically and therapeutically in children of ALL receiving induction chemotherapy. Materials and methods: This observational cross-sectional study was conducted in the department of transfusion medicine and the department of paediatric haematology and oncology at a tertiary level hospital in Bangladesh from June 2020 to June 2021. A total of 33 cases of ALL were enroled in this study according to inclusion and exclusion criteria. After receiving written informed consent, relevant data were collected using a face-to-face interview with the guardian of the patients, thorough clinical examination, and relevant investigation. After the collection of all the required data, analysis was done by Stata (v.16). Results: Mean age of the patients was 7.39±4.46 (SD), ranging from 1 to 18 years. The majority of children were aged younger than or equal to 10 years (69.70%). Male children were slightly predominant (51.5%). Significant post-transfusion platelet increment (Median pre-transfusion count 16×103/µl vs. Median post-transfusion count 133×103/µl, P<0.001) was observed. WHO bleeding grades also improved after apheretic platelet transfusion (P<0.05). Age was a significant factor associated with corrected count increment (CCI) in both univariate and multivariate analysis. In subgroup analysis, age and gender were significant predictors of CCI in therapeutic transfusion group but not in prophylactic transfusion group. Conclusions: Significant improvement in bleeding status and platelet count was observed following apheretic platelet transfusion.

Medical students' career preferences in Bangladesh.

AIM: This study aimed to investigate the career preferences among Bangladeshi medical students, identify the factors that influence their present choices, and additionally report the role of gender and academic year behind their decisions. METHODS: This cross-sectional study conducted in Bangladesh from August 2022 to April 2023 included 801 medical students conveniently selected from medical colleges in eight divisions. Data were collected using a web-based survey and analysed using STATA version 16.0. Statistical tests included the Kolmogorov-Smirnov test, arithmetic mean, standard deviation, frequency, and Kruskal-Wallis H test. The response rate was 94.6%, and the CHERRIES guideline was followed for reporting the results. RESULT: The majority of the participants were female (64.42%) and under the age of 23 years (58.8%). The study revealed that medicine was the preferred career choice for the majority of students (65%), with surgery being the most popular first choice (30.21%) among them. Female medical students showed a significantly higher preference for gynaecology & obstetrics (p < 0.001), while male students had a significantly higher tendency to choose general practice (p = 0.002). There is a significant gender difference (p < 0.05) in the career preference factors, including professional prestige, role model influence, easy money, family time, promotion opportunities, income for lifestyle, and research opportunities. Academic year differences were also observed, with increasing interest in medicine and public health (p < 0.001), a decrease in interest in surgery (p < 0.001), and a decline in preference for non-medical careers as students progressed through their MBBS life (p < 0.05). CONCLUSION: Overall, medicine was the most popular speciality choice, however, male students preferred general practice and female students preferred gynaecology and obstetrics more. Personal passion, opportunities for contribution to society, professional prestige, having a direct dealing with patients, and income will allow an enjoyable lifestyle were the most important factors in the choice of their career.

Lipid profile of Indian children and adolescents.

Dyslipidaemia when diagnosed in childhood predicts the development of clinical atherosclerotic disease in adulthood. Ever since we became aware of the abnormally high incidence of coronary artery disease amongst Indians, there always has been an ever-growing need for study of lipid values amongst Indian children and adolescents. Five hundred and eighty-six children (352 boys and 234 girls) from a public school aged between 8 and 18 years (mean age: 12.86 for boys and 12.15 for girls) were included in the study for assessment of lipid profile during the period from April, 1999 to March, 2000. Fasting venous blood was drawn from each child and total cholesterol and triglyceride levels were measured by enzymatic method, high-density lipoportein (HDL)-cholesterol was measured using specific precipitation method and lipoprotein (a) [Lp (a)] was measured by immunoturbidimetric method. After biochemical estimation was completed reference values and percentiles were calculated for each lipid component. Mean cholesterol and triglyceride values were higher amongst girls compared to boys. HDL-cholesterol values were lower amongst Indian boys compared to girls. Mean Lp (a) values were higher amongst both Indian boys and girls and more so amongst girls compared to boys. Since Lp(a) values remain unchanged through ages, these values should represent corresponding values in adult Indian males and females. It is being expected that data presented in this study should form guidelines with regard to dietary and pharmacological intervention for dyslipidaemia amongst children and adolescents.