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author:("malta, yanshu")
1.  Overview of the coagulation system 
Indian Journal of Anaesthesia  2014;58(5):515-523.
Coagulation is a dynamic process and the understanding of the blood coagulation system has evolved over the recent years in anaesthetic practice. Although the traditional classification of the coagulation system into extrinsic and intrinsic pathway is still valid, the newer insights into coagulation provide more authentic description of the same. Normal coagulation pathway represents a balance between the pro coagulant pathway that is responsible for clot formation and the mechanisms that inhibit the same beyond the injury site. Imbalance of the coagulation system may occur in the perioperative period or during critical illness, which may be secondary to numerous factors leading to a tendency of either thrombosis or bleeding. A systematic search of literature on PubMed with MeSH terms ‘coagulation system, haemostasis and anaesthesia revealed twenty eight related clinical trials and review articles in last 10 years. Since the balance of the coagulation system may tilt towards bleeding and thrombosis in many situations, it is mandatory for the clinicians to understand physiologic basis of haemostasis in order to diagnose and manage the abnormalities of the coagulation process and to interpret the diagnostic tests done for the same.
doi:10.4103/0019-5049.144643
PMCID: PMC4260295  PMID: 25535411
Anaesthesia; Coagulation system; haemostasis
2.  Body iron stores in middle-aged North Indian patients with type 2 diabetes and obesity 
Journal of Mid-Life Health  2014;5(2):72-77.
Introduction:
Evidence from various epidemiological and clinical studies suggests that iron overload is proinflammatory and proatherosclerotic. Excess body iron has been positively associated with insulin resistance, type 2 diabetes and obesity.
Aim of the Study:
To study the relationship of body iron stores with type 2 diabetes and obesity in middle aged North Indian population.
Materials and Methods:
The participant population consisted of four groups of randomly selected participants (between 40 and 65 years of age and postmenopausal women); Group A: Normal individuals (controls), Group B: Obese nondiabetic individuals, Group C: Lean diabetic patients, Group D: Obese diabetic patients. Blood was examined for hematological, biochemical estimations, C-reactive protein, and serum ferritin (SF).
Observation and Results:
A total of 197 participants were enrolled. The mean SF levels (ng/ml) among males were: Group A (n = 18) 148.56 ± 119.90; Group B (n = 25) 129.11 ± 94.77; Group C (n = 27) 127.96 ± 109.65 and Group D (n = 22) 148.36 ± 104.94. The mean SF levels (ng/ml) among females were: Group A (n = 23) 67.44 ± 37.59; Group B (n = 25) 59.62 ± 43.56; Group C (n = 24) 77.97 ± 91.46 and Group D (n = 33) 66.46 ± 86.05. No statistical difference was found among the groups in both the sexes.
Conclusions:
Our observation is in sharp contrast to the earlier studies published from the West stressing that iron stores are increased in obesity and diabetes. We conclude that SF may not be a strong risk factor in the pathogenesis of obesity and diabetes in middle aged North Indians.
doi:10.4103/0976-7800.133991
PMCID: PMC4071648  PMID: 24970985
Diabetes; obesity; serum ferritin
3.  ZBTB16-RARα variant of acute promyelocytic leukemia with tuberculosis: a case report and review of literature 
The Korean Journal of Hematology  2012;47(3):229-232.
A 23-year-old male presented with pulmonary tuberculosis and swelling of both lower limbs. He was put on antitubercular treatment. Hemogram showed mild anemia and Pseudo Pelger-huet cells. The bone marrow (BM) examination showed 52% promyelocytes with regular round to oval nuclei, few granules and were positive for CD13 and CD33, and negative for HLA-DR. Cytogenetic analysis of the BM aspirate revealed an apparently balanced t(11;17)(q23;q21). Final diagnosis rendered was acute promyelocytic leukemia (APL) with t(11;17)(q23;q21); ZBTB16/RARA. APL is a distinct subtype of acute myeloid leukemia. The variant APL with t(11;17)(q23;q21) cases that are associated with the ZBTB16/RARA fusion gene have been reported as being resistant to all-trans-retinoic acid (ATRA). Therefore, differential diagnosis of variant APL with t(11;17)(q23;q12) from classical APL with t(15;17)(q22;q12); PML-RARA is very important. Here we have discussed the importance of distinct morphology of variant APL and also significance of rare presentation with tuberculosis.
doi:10.5045/kjh.2012.47.3.229
PMCID: PMC3464342  PMID: 23071480
ZBTB16-RARα variant; Tuberculosis; Promyelocytes
4.  Simultaneous Presence of Two Hematological Malignancies: Chronic Lymphocytic Leukemia and Myelofibrosis in a Patient 
Coexistence of chronic lymphocytic leukemia (CLL) with myelofibrosis is a rare association with only isolated case reports in the literature. We report an unusual case of CLL in which the cause of anemia was coexistent myelofibrosis. In a case of CLL presenting with refractory anemia, besides common causes like autoimmune hemolytic anemia and marrow infiltration, other causes like myelofibrosis should be searched for.
doi:10.1007/s12288-010-0020-8
PMCID: PMC3102507  PMID: 22379292
CLL; Myelofibrosis

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