Use of central venous access devices and its complications in neonates

Background: Intravenous therapy is a major component in the health care and appropriate research-based knowledge is essential to ensure positive patient outcomes. Objective: The objective of the study was to study the use of Central Venous Access Devices (CVADs) and their complications in neonates in routine practice. Methods: A prospective observational study was conducted at a tertiary care neonatal intensive care unit (NICU) on 40 newborns. CVADs were inserted in neonates, who had been anticipated to have intravenous access for >7 days. CVADs used in the study included Peripherally Inserted Central Catheters (PICCs) and umbilical venous catheters. CVADs were inserted under strict aseptic precautions as per international guidelines, and maintenance protocols followed. Monitoring for complications was done daily. Central Line Associated Blood Stream Infection (CLABSI) was established by a combination of suggestive clinical signs and blood culture reports as per Centre for Disease Control and prevention definition. Results: Extremely low birth weight neonates contributed 40% of the patients. PICC insertions formed the 85% of the devices used. Basilic vein was the preferred site of the insertion in almost one-half of the patients. 80% of the PICCs in neonates were used to administer total parenteral nutrition. CLABSI was the most common complication occurring at a rate of 7.5/1000 catheter days. Other complications were occlusion, suspected infection, accidental displacement, and thromboembolism. Conclusion: Central venous catheterization is a safe and efficient procedure with minimal complication in neonates. This study emphasizes its use whenever prolonged intravenous access requirement is expected

Effect of Electromagnetic Field on Antimicrobial Activity and Novel Antimicrobial Compounds

The objective of this study is to determine the antimicrobial activity of the essential oils and effect of electromagnetic field on the activity. To find out antimicrobial activity of essential oils (Thyme, Clove, Lavender), against test organisms disc diffusion assay was performed. MIC of all essential oils were determined under electromagnetic field and non-electromagnetic field. Both studies confirmed the antimicrobial activity of oils and effect of electromagnetic field. However, time killing experiment was conducted to calculate rate of inhibition for essential oils, lavender oil and thyme oil showed higher rate as compared to that of clove oil. This study provides evidence to antimicrobial activity of essential oils, and also confirmed the effect of electromagnetic field on the activity. The proposed mechanism for antimicrobial activity is inhibition of metabolic enzymes which has supported with Analytical Profile Identification (API 20NE)

MOLECULAR HETEROGENEITY IN ACUTE PROMYELOCYTIC LEUKEMIA - A SINGLE CENTRE EXPERIENCE FROM INDIA

Atypical breakpoints and variant APL cases involving alternative chromosomal aberrations are seen in a small subset of acute promyelocytic leukemia (APL) patients. Over 7 different partner genes for RARA have been described. Although rare, these variants prove to be a diagnostic challenge and require combination of advanced cytogenetic and molecular techniques for accurate characterization. Heterogeneity occurs not only at the molecular level but also at clinico-pathological level influencing treatment response and outcome. In this case series we describe the molecular heterogeneity of APL seen in a single tertiary referral centre with a focus on seven variant APL cases from a single tertiary cancer center in India over a period of two and a half years. We discuss five cases with PLZF-RARA fusion and two novel PML-RARA variants, including a Bcr3 variant involving fusion of PML exon4 and RARA exon3 with an additional 40 nucleotides originating from RARA intron2, another involving exon 6 of PML and exon 3 of RARA with addition of 126 nucleotides, which mapped to the central portion of RARA intron 2  To the best of our knowledge this is the first of kind case series from India</jats:p

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection