Infantile T-cell Acute Lymphoblastic Leukaemia: A Case Report.

Introduction: Acute lymphoblastic leukaemia (ALL) is the most common malignancy in children, with a male predominance. Paediatric ALL is usually of B-cell lineage; T-cell leukaemia is uncommon and extremely rare under 1 year of age. Mixed-lineage leukaemia gene rearrangement is the best-known hallmark of infantile leukaemia and is a poor prognostic indicator. While multiagent high-dose chemotherapy remains the first line of treatment for paediatric T-cell lineage ALL (T-ALL), there are numerous side effects of these regimens, and most patients undergo relapse. Due to the rarity of the disease, treatment protocols for infantile T-ALL have not been established to date. Clinical Description: We present a case of a 7-month-old Pakistani male that presented with fever and cough and was subsequently diagnosed with T-cell ALL. T-ALL was diagnosed on flow cytometry. Due to poor prognosis, the patient was assigned palliative care. Practical Implications: Management of infantile leukaemia has yet to be studied in-depth. With a lack of clear treatment guidelines, the approach toward these patients remains challenging. Further research and clinical trials in this area of study are paramount to improving clinical outcomes for these young patients.

Associations of endogenous markers of kidney function with outcomes: more and less than glomerular filtration rate.

PURPOSE OF REVIEW: As alternative markers of kidney function are investigated for clinical and research use, understanding their specific associations with outcomes, independent of glomerular filtration rate (GFR), becomes critical. RECENT FINDINGS: Recent large meta-analyses have defined the relationship between GFR estimated by serum creatinine and a variety of outcomes, and numerous studies have found that cystatin C predicts outcomes more strongly than does serum creatinine. Similarly improved prediction has been found recently for novel markers, beta trace protein and beta-2 microglobulin. Only a few studies of individuals with chronic kidney disease have compared these associations between markers of kidney function to directly measured GFR. These studies have found associations between these markers and mortality, cardiovascular outcomes and kidney failure that are independent of directly measured GFR. SUMMARY: Novel markers of kidney function may help in diagnosis, clinical management and research in chronic kidney disease (CKD). Understanding the non-GFR determinants of specific markers and relationships of markers to risk of outcomes is necessary to make these advances.

Knowledge attitude and practices of undergraduate students regarding first aid measures.

OBJECTIVES: To assess knowledge, attitude and practices of first aid measures in undergraduate students of Karachi. METHODS: A cross-sectional study was carried out at six colleges of Karachi, three of which were medical colleges and three non-medical colleges. Knowledge was assessed regarding various emergency situations with the help of a questionnaire. The target population size was 460, based on 50% prevalence and 95% confidence interval. The eventual sample size achieved was 446. RESULTS: A total of 446 students were interviewed. Seventy eight students (17.5%) had formal First Aid (FA) training. The mean number of correct answers of students with FA training was 10.3 (+/- 3.5) as opposed to 8.58 (+/- 4.0) in those without FA training (p < 0.001, 95% CI) with a mean difference of 7.84%. The mean number of correct answers by medical students with FA training was 11.2 (+/- 2.9) as opposed to 7.2 (+/- 3.43) by non-medical students (p < 0.001, 95% CI) with a mean difference of 18.14%. Students having received formal first aid training scored better than those who had not (p < 0.001). CONCLUSION: First aid training programmes should be introduced at school and college level in developing countries to decrease the early mortality and morbidity of accidents and emergencies.