Leishman and Giemsa stain: a new reliable staining technique for blood/bone marrow smears.

INTRODUCTION: Peripheral blood and bone marrow smear examination is an important basic tool for the diagnosis of different haematological conditions including haematological malignancies. We created a newer modification of the conventional Leishman and Giemsa stains as Leishman and Giemsa (L&G) stain and compared the efficacy and reliability of this stain with conventional stains. The study was performed to evaluate the staining efficacy, feasibility, time and cost of L&G stain over the conventional Leishman and Giemsa stains. METHODS: A pilot study was carried out in the Department of Haematology of our hospital from October 2013 to December 2013. Hundred selected cases, each with peripheral blood and bone marrow smears were taken, and three sets of the smears were prepared from each sample--one for L&G stain and other two--one each for conventional Leishman and Giemsa stains. This staining is further incorporated in our routine standard operating protocols for staining of all the peripheral blood smears in automated stainer, Sysmex SP10. RESULT: The average grading score from each staining methods from all the three experts was compiled. The average grading score of L&G staining method was noted to be significantly higher than the other two methods (analysis of variance test, P value < 0.05). When modified L&G stain (C) was compared with stain conventional stains (A and B), a P value of <0.001 was noted in all parameters except between Leishman stain and L&G stain in mature RBC and WBC nucleus and RBC inclusions (P value between 0.05 and 0.001). CONCLUSION: L&G staining is a newer staining technique of immense help in high-throughput haematology laboratories by offering a time-saving, cost-effective and better staining option to conventional staining methods. It gives a better nuclear and cytoplasmic differential staining and can also be used in automated blood counters/stainer.

Hyperbaric oxygen therapy in parenchymal liver disease.

Use and efficacy of hyperbaric oxygen therapy (HOT) in liver disease has not been established. A prospective control study of HOT in liver diseases was undertaken. Sixty cases were selected for this study (30 with HOT and 30 with conventional therapy only). Almost equal number of Hepatitis B virus surface antigen (HbsAg) positive cases were included in both groups. All patients were male. Only cases with serum bilirubin over 10 mg/dl were included in this study. It was found that study cases recovered faster, gained appetite and had an earlier sense of well-being. There was faster disappearance of pruritus, earlier achievement of normal liver function, HbsAg negativity and overall shorter duration of hospital stay and convalescence. Short term adverse effects were unremarkable.

Hyperbaric oxygen therapy: current trends and applications.

Hyperbaric medicine is the fascinating use of barometric pressure for delivering increased oxygen dissolved in plasma to body tissues. Hyperbaric oxygen therapy (HOT) or hyperbaric oxygen (HBO) involves intermittent inhalation of 100% oxygen under a pressure exceeding that of the atmosphere, that is greater than 1 atmosphere absolute (ATA). Therapy is given in special therapeutic chambers which were earlier used primarily to treat illnesses of deep sea divers. There is recently a renewed interest in this field all over the world. Acute traumatic wounds, crush injuries, burns, gas gangrene and compartment syndrome are indications where addition of hyperbaric oxygen may be life and limb saving. Patients who are suffering with non-healing ulcers, decubitus ulcers (bed sores) and all late sequelae of radiation therapy are also benefited with HBO therapy. Acute hearing loss and many neurological illnesses are also now known to possibly benefit from hyperbaric oxygen therapy. This article aims to give a brief overview of the rationale, existing trends and applications of this therapy.

GAS POISONING WITH FREON-12 (A Report of Three Cases).

Three pauents of accidental gas poisoning with Freon-12 are reported. Presenting features were transient loss of consciousness, bradycardia, hypotension and anaesthesia. All patients made a rapid and uneventful recovery without any residual effects.

RENAL TRANSPLANTATION - AN EARLY EXPERIENCE.

Renal transplant (RT) is now a therapy of choice for end stage renal disease (ESRD). The Nephrology Unit, Asvini started functioning in Dec 90 and to date 1298 sittings of hemodialysis have been given to 45 patients. Of these, 35 were in ESRD and 11 patients underwent renal transplantation at this hospital during the period Jan 91 - Dec 93. One patient expired after 18 months of transplantation due to infection. Early experience in screening patients for RT, use of immunosuppression, management of rejection episodes and protocol are presented with special emphasis on its relevance to the Armed Forces.

High altitude dives from 7000 to 14,200 feet in the Himalayas.

Indian Navy divers carried out no-decompression dives at altitudes of 7000 to 14,200 ft (2134-4328 m) in the Nilgiris and Himalayas from May to July 1988. Seventy-eight dives on air and 22 dives on oxygen were carried out at various altitudes. The final dives were at Lake Pangong Tso (4328 m) in Ladakh, Himalayas, to a maximum of 140 feet of sea water (fsw) [42.6 meters of sea water (msw)] equivalent ocean depth in minimum water temperature of 2 degrees C. Oxygen diving at 14,200 ft (4328 m) was not successful. Aspects considered were altitude adaptation, diminished air pressure diving, hypothermia, and remote area survival. Depths at altitude were converted to depths at sea level and were applied to the Royal Navy air tables. Altitude-related manifestations, hypoxia, hypothermia, suspected oxygen toxicity, and equipment failure were observed. It is concluded that stress is due to effects of altitude and cold on man and equipment, as well as changes in diving procedures when diving at high altitudes. Equivalent air depths when applied to Royal Navy tables could be considered a safe method for diving at altitudes.