Background Marrow damage from chemo- and radiation therapies has been suggested to affect quality and quantity of Hematopoietic stem cell (HSC) products. We tested the hypothesis that CD34+ cells (HSC) from low mobilizers are qualitatively inferior to HSC from high mobilizers. Materials and Methods HSC quality was defined by proportion of primitive HSC subsets (CD34+CD38−, CD34+HLA-DR− and CD34+ in G0 stage of cell cycle), the proportion of HSCs that express CXCR4 and CD26 homing proteins and days, to neutrophil and platelet engraftments post transplant. HSC content and CD34 subsets analyses were performed using flow cytometry following ISHAGE protocol. We evaluated the HSC quantity and quality of 139 autologous filgrastim mobilized HSC products. Patients were categorized into low, moderate and high mobilizers if their total HSC collection was <3 ×106/kg, ≥3 ×106/kg and <5 ×106/kg, and ≥5 × 106/Kg respectively. Results The median number of primitive CD34 subsets increases with increasing HSC numbers and this association was statistically significant (p = 0.001). However, when the ratios of the primitive CD34 subsets to total HSC counts were compared among the mobilization groups, the ratios were not significantly different. Co-expression of neither CD26 nor CXCR4 with CD34 antigen correlated with HSC mobilization. Evaluation of days to neutrophil engraftment among the mobilization groups did not show a statistically significant difference (p = 0.1). However, days to platelet engraftment among the mobilization groups was statistically significantly different (p = 0.05). Conclusion The quality of HSCs from low mobilizers was comparable to HSCs from high mobilizers.

No abstract

No abstract

Background:The transverse abdominis plane (TAP) block, provides effective analgesia after lower abdominal surgeries if used as part of multimodal analgesia. In this prospective, randomized double-blind study, we proposed to determine the optimal volume of local anaesthetic to be used in ultrasound guided TAP (transversus abdominis plane) block for post Caesarean section analgesia. Subjects and Methods: Total 90 parturients were randomly allocated to group A, group B and group C to receive after routine spinal anaesthesia, bilateral TAP blocks with 15ml, 20ml and 30 ml of 0.2% Ropivacaine in addition to standard analgesic comprising intravenous(IV) Acetaminophen, 1 gram 8 hourly and IV patient-controlled analgesia (PCA) with fentanyl. Each patient was assessed at 0.5, 2, 4, 6, 8, 10, 12, and 24 hours after surgery by an independent observer for pain at rest and on movement using visual analog scale, time of 1st demand for fentanyl, total consumption of PCA fentanyl, satisfaction with pain management and side effects(nausea , vomitng and sedation). Results: Use of fentanyl was significantly reduced in group B and C compared to Group A during 24 h after surgery (P < 0.001). Pain scores were lower both on rest and activity at each time point for 24 h in groups B and C (P < 0.001), time of first analgesia was significantly longer, satisfaction was higher, and side effects were less in group B and C compared to group A. The difference was not significant between group B and C. Conclusion: We concluded that though increasing the volume of local anaesthetic from 15 ml bilaterally to 20 ml bilaterally resulted in increased duration and quality of analgesia, further increase to 30 ml bilaterally offered no significant advantage in terms of reduction in VAS scores or opioid consumption.

Elbow Arthritis is a rare condition characterized by loss of articular cartilage in the ulnotrochlear and radiocapitellar articulations. The symptoms include pain, stiffness and loss of motion while radiographic manifestations may include osteophytes, loss of joint space and subchondral cysts. Recently it has been suggested that there is chronic low grade systemic inflammation in osteoarthritis occurring as a part of greater inflammatory metabolic syndrome. Primary OA mainly affects weight bearing joints of the lower extremity. The common assertion that the elbow is not a weight-bearing joint should not suggest that the elbow does not bear load. Elbow osteoarthritis commonly affects middle aged men who indulge in strenuous activity. We present a case report of a middle aged Indian Woman having primary elbow osteoarthritis with metabolic syndrome.