Clinicoepidemiological features of adult leukemias in Pakistan

A total of 113 patients of leukemia, over 15 years of age, were seen in three different institutions from July, 1992 to June, 1994. There was an almost equal distribution of acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) (44 vs 43 cases respectively). Chronic lymphocytic leukemia (CLL) was the least common, accounting for 5% of all cases. Mean age in CLL was 59 years. Chronic myeloid leukemia (CML) was three times commoner than CLL with a younger age distribution (median age was 34 years). We conclude that the clinicoepidemiological features of adult leukemias differ considerably from that seen in the developed world. However, recruitment of patients needs to continue in order to define these features based on a larger patient population.

Treatment of acute and transient psychotic disorders with low and high doses of oral haloperidol

The apparent rationale for the popular use of high doses of neuroleptics in psychotic patients is to increase the degree and speed of therapeutic response .However, several recent reports have questioned these claims. The present study was undertaken with the aim to compare the efficacy of high and low oral doses of haloperidol in the treatment of acute and transient psychotic disorders. The sample comprised of forty patients of both sexes diagnosed as acute and transient psychotic disorder who were randomly assigned to high dose (20 mg/day) and low dose (5 mg /day) haloperidol groups with equal number of subjects (n=20) in both groups. Weekly assessment was done on Brief Psychiatric Rating Scale and Haloperidol Side-effects Check List (day 7, 14, 21, 28, 35 & 42). Both groups showed significant improvement in BPRS from baseline scores on all assessments. Comparison of the improvement rate in both study groups revealed no significant difference.

Mania in twins : a case report

A 19 year old patient presented with a first episode of mania. A year ago his twin brother had developed a similar illness. In the family, there was no other history of psychiatric disorders.

Acute leukemias of childhood: a retrospective analysis of 62 cases

Acute leukemia is reported to be less common in developing countries compared to non-Hodgkins lymphomas which is the most common childhood malignancy. A retrospective analysis was performed to identify the clinicopathological features of acute leukemias of childhood at the Oncology Department of Allama Iqbal Medical College, Lahore. The commonest malignancy in the under 15 years age group was leukemias (54%) followed by non-Hodgkins lymphomas (16%). Acute lymphocytic leukemia (ALL) was the commonest subtype (82%) followed by acute myeloid leukemia (16%). Peak incidence occurred in the 2.5-5 years age. The median duration of symptoms prior to diagnosis was 5 months. We conclude from our study that the incidence and clinicopathologic paediatric ALL is similar to that reported in the Western literature, unlike reports from other developing countries. Various environmental, viral and dietary carcinogens may play a major role in the etiology of leukemias.

Effects of indomethacin on follicular structure, vascularity, and function over the periovulatory period in women

OBJECTIVE

To assess the effect of indomethacin (taken at defined times) on follicular rupture, indexes of intrafollicular blood flow, and steroidogenesis.

PARTICIPANTS

Six healthy volunteers awaiting treatment for infertility by IVF-ET during subsequent natural cycles.

INTERVENTIONS

All women were examined (at least every 8 hours) by transvaginal ultrasonography with color Doppler imaging and had samples of blood taken for hormone analysis. A self-test for urinary LH was performed before each scan. Indomethacin was first taken (50 mg three times per day) according to the maximum follicular diameter (first four women) or when the LH dipstick gave a positive result; the drug was taken for > or = 3 days.

RESULTS

Follicular rupture was delayed in five of six cases (by 2 to 12 days). There was a reduction in intrafollicular peak systolic velocity before and after the positive urinary LH test compared with historical controls. Three follicles (50% of women) with the highest peak systolic velocity had an hemorrhagic appearance and persisted longer. There was no significant effect on menstrual cycle length or the levels of circulating FSH, E2, LH, or P.

CONCLUSION

Indomethacin administered at the time of a positive self-test for urinary LH can delay follicular rupture with an associated reduction in intrafollicular blood flow but with no apparent effects on hormonal or menstrual status.