RESUMEN
Pediatric acute promyelocytic leukemia (APL) is one of the most curable subtypes of acute myeloid leukemia of childhood. But it may have many early complications, especially in developing countries. This study aims to describe the outcome and complications of pediatric APL patients in Bangladesh. This prospective observational study was conducted in the pediatric hematology and oncology department of Bangabandhu Sheikh Mujib Medical University, Dhaka from September 2017 to March 2019. In this study, PML:RAR-α (Promyelocytic leukemia-retinoic acid receptor-α) positive APL cases were included and observed while being treated with risk-directed ATRA (All-trans-retinoic acid) based chemotherapy. Among twenty PML:RAR-α positive APL cases, 13 children were in the high risk group and hemorrhagic manifestations were present in 95% of patients. Post-induction remission was achieved in 85% of the patients. 3-year overall survival was 70% (45-85% with 95% confidence interval). There was no refractory disease or relapses. Neutropenic sepsis was the most common complication and also the most common cause of mortality. In Bangladesh, the 3-year overall survival of pediatric APL is 70% (45-85% with 95% CI). Post-chemotherapy neutropenic sepsis is the most common complication and also the most common cause of mortality in this potentially curable malignancy in Bangladesh.
Asunto(s)
Leucemia Promielocítica Aguda , Neoplasias , Sepsis , Bangladesh/epidemiología , Niño , Humanos , Leucemia Promielocítica Aguda/complicaciones , Leucemia Promielocítica Aguda/tratamiento farmacológico , Neoplasias/tratamiento farmacológico , Tretinoina/uso terapéuticoRESUMEN
Atomically thin heterostructures and superlattices are promising candidates for various optoelectronic and photonic applications. Different combinations of Al2O3/TiO2 composites are obtained by plasma enhanced atomic layer deposition (PEALD). Their growth, composition, dispersion relation, and optical bandgap are systematically studied by means of UV/VIS spectrophotometry, spectroscopic ellipsometry (SE), x-ray reflectometry (XRR), scanning transmission electron microscopy(STEM) and x-ray photoelectron spectroscopy (XPS). Besides, an effective medium approximation (EMA) approach is applied to model the heterostructures theoretically. The refractive index and the indirect bandgap of the heterostructures depend on the ratio of the two oxides, while the bandgap is very sensitive to the thicknesses of the barrier and quantum well layers. A large blue shift of the absorption edge from 400 nm to 320 nm is obtained by changing the TiO2 (quantum well) thickness from ~2 nm to ~0.1 nm separated by ~2 nm of Al2O3 (barrier) layers. PEALD unfolds the possibility of achieving optical quantizing effects within complex heterostructures enabling control of their structures down to atomic scale. It enables a path towards atomic scale processing of new 'artificial' materials with desired refractive indices and bandgap combinations by precise control of their compositions.
RESUMEN
The presenting features, diagnostic evaluation, seasonal variation and management performed in 110 children with immune thrombocytopenic purpura (ITP) attending at two tertiary level hospitals were evaluated. A peak incidence of children with ITP was observed during the month of June, July and the first step was found in May and lowest in the month of October to December. Mean initial platelet count was 65.5 x 10(9)/L. 35 patients with ITP did not require any treatment who were kept under observation and the rest 75 children who were admitted to hospital given platelet count enhancing treatment- intravenous immunoglobulin in 9, corticosteroids in 60 or both in 6 children with ITP. Intracranial hemorrhages were noticed in two children with ITP. So, this study suggests that ITP had special predilection during summer season and the least in winter along with variable approaches to management of these children.
Asunto(s)
Hospitales de Enseñanza/estadística & datos numéricos , Púrpura Trombocitopénica/epidemiología , Adolescente , Corticoesteroides/uso terapéutico , Distribución por Edad , Bangladesh/epidemiología , Niño , Preescolar , Femenino , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Incidencia , Lactante , Masculino , Recuento de Plaquetas , Estudios Prospectivos , Púrpura Trombocitopénica/diagnóstico , Púrpura Trombocitopénica/tratamiento farmacológico , Púrpura Trombocitopénica/inmunología , Factores de Riesgo , Estaciones del Año , Encuestas y CuestionariosRESUMEN
Serum lactate dehydrogenase (LDH) level was estimated in 44 childhood (age range 1-15 years) acute lymphoblastic leukemia (ALL) on admission, day 14 and day 29 of induction. Another 25 children without ALL were included as control. On admission, the level of serum LDH was significantly high in ALL cases than control (p < 0.001). Total WBC count was significantly decreased along with serum LDH level at day 14 and day 29 of induction (p < 0.001). A significant rise of platelet count was observed at day 29 of induction in relation to significant decrease of serum LDH level (p < 0.001). A significant decrease of peripheral and bone marrow blast cell percentages were also observed at day 29 of induction along with significant decrease level of serum LDH (p < 0.001). So, the measurement of serum LDH level can be accepted as an enzymatic tool for presumption of childhood ALL and the response to chemotherapy during induction of remission.