BackgroundEosinophilia in children is commonly caused by or parasitic, allergic and immunologic problems.
ObjectivesTo study clinical and laboratory profile of patients with eosinophilia and to identify possible causes.
MethodA prospective and descriptive study was conducted from January 2009-December 2011. All the cases of eosinophilia with symptoms and signs of single or multiple organ were included. The known caused of eosinophilia like allergy, asthma and drugs were excluded.
ResultsDuring three years period, 84(2.41%) cases had eosinophilia with single or multiple organ involment. 14.3%, 39.3% and 46.4% had mild, moderate and severe eosinophilia respectively, with cases of hypereosinophilia comprising 85.7%. Eosinophilia is seen predominantly in tamang caste with overall age ranging from 1-14 years. Most common symptoms and signs are abdominal pain (67.9%) hepatomegaly (59.5%) respectively. Gastrointestinal system was most commonly involved organ followed by respiratory system. Nineteen percent had polyserositis involving pleural, pericardial effusion and ascites at presentation. Out of 84 patients only nine serum samples were able to be sent for parasitological analysis. sixteen had identifiable and/ or possible causes. Serum sample for parasitological analysis revealed fascilosis, filariasis, strongylosis stercoralis and toxocariasis.
ConclusionEosinophilia is more common among tamang poulation in our study. Most common symptoms and signs are abdominal pain and hepatomegaly respectively. Parasitic infection seems to be the most common cause however further study has to be done to reach final conclusion.
BackgroundOcular melanoma (OM) comprises <5% of all melanomas. Uveal melanoma (UM) is the most common subtype of OM, while conjunctival melanoma (CM) is rare and differs significantly from UM. The purpose of this study is to evaluate a large cohort of OM patients to differentiate demographic, pathologic, and clinical factors between these two neoplasms, which may affect treatment and outcomes.MethodsThe Surveillance, Epidemiology, and End Results database (1973–2012) was used to extract demographic and clinical data on 8,165 OM patients (92.1% UM and 7.9% CM).ResultsBoth CM and UM were most prevalent among Caucasian males in the seventh decade of life. UM patients presented more often with localized disease (90.9% vs 81.2, P<0.01). Surgery (42.8%), radiation (43.0%), or combined surgery and radiation (7.0%) were used in the treatment of UM, while CM was treated almost exclusively with surgery (88.7%). Mean overall survival was longer (15.4 vs 14.6 years; P<0.01) and mortality rates were lower in patients (38.8% vs 46.1%; P<0.01) with CM.ConclusionDespite presenting with more advanced disease than UM, CM is associated with an increased overall survival. Surgery is the primary therapy for CM, whereas radiotherapy is the primary therapy for UM and is associated with prolonged survival.
PurposeThe patient believes in adherence to medication rather than to self-care adherence and lifestyle changes for the management of diabetes. This study was carried out to establish the association of self-care adherence and their barriers in poor glycemic control in our diabetic population.Patients and methodsThis cross-sectional study was conducted among 480 already diagnosed diabetes outpatients attended in our two hospitals. Glycaemic control was defined by levels of HbA1c. Socio-demographic data, lifestyle variables and anthropometric measurements were recorded using a standard questionnaire. Fasting blood glucose, HbA1c and lipid profiles were estimated using the manufacturer’s guideline. Student’s t-test and one-way ANOVA were used for comparison between different groups and the correlation was established by Spearman correlation. Risk factors associated with poor glycaemic control were verified by logistic regression analysis.ResultsThe mean HbA1c of the study population was 7.4±1.3% and 65.4% had poor glycaemic control with mean 8.0±1.1%. Higher HbA1c levels were significantly associated with duration of diabetes, a number of drugs used, patient–physician relationship and knowledge about diabetes. The poor glycaemic control was significantly associated with low adherence of following the meal plan, regular medication and regular exercising (p<0.001). Among all the barriers, a too busy schedule for following the meal plan, taking medications and exercising regularly was significantly correlated with HbA1c levels. Multivariable logistic regression analysis showed irregular meal plan (OR=5.27), irregular exercise (OR=2.25), number of medication used (OR= 0.19) and lesser extent patient–physician relationship (OR=2.68) were independent risk factors for poor glycaemic control.ConclusionThe poor glycaemic control was associated with poor adherence to self-care adherence and their barriers in our diabetic population. Integrated knowledge on diabetes management should be targeted to improve glycaemic control in our communities.
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