Instagram and WhatsApp are two social media and networking services introduced in 2010. They are currently subsidiaries of Facebook, Inc., California, USA. Using evidence from the published literature and case reports indexed in PubMed and other sources, we present an overview of the various applications of Instagram and WhatsApp in health and healthcare. We also briefly describe the main issues surrounding the uses of these two apps in health and medicine.

Instagram and WhatsApp in Health and Healthcare: An Overview

Background: The advent of telemedicine has allowed physicians to deliver medical treatment to patients from a distance. Mobile apps such as WhatsApp Messenger, an instant messaging service, came as a novel concept in all fields of social life, including medicine. The use of instant messaging services has been shown to improve communication within medical teams by providing means for quick teleconsultation, information sharing, and starting treatment as soon as possible. Objective: The aim of this study was to perform a comprehensive systematic review of present literature on the use of the WhatsApp Messenger app as an adjunctive health care tool for medical doctors. Methods: Searches were performed in PubMed, EMBASE, and the Cochrane Library using the term “whatsapp*” in articles published before January 2016. A bibliography of all relevant original articles that used the WhatsApp Messenger app was created. The level of evidence of each study was determined according to the Oxford Levels of Evidence ranking system produced by the Oxford Centre for Evidence-Based Medicine. The impact and the indications of WhatsApp Messenger are discussed in order to understand the extent to which this app currently functions as an adjunctive tool for telemedicine. Results: The database search identified a total of 30 studies in which the term “whatsapp*” was used. Each article’s list of references was evaluated item-by-item. After literature reviews, letters to the editor, and low-quality studies were excluded, a total of 10 studies were found to be eligible for inclusion. Of these studies, 9 had been published in the English language and 1 had been published in Spanish. Five were published by medical doctors. Conclusions: The pooled data presents compelling evidence that the WhatsApp Messenger app is a promising system, whether used as a communication tool between health care professionals, as a means of communication between health care professionals and the general public, or as a learning tool for providing health care information to professionals or to the general population. However, high-quality and properly evaluated research is needed, as are improvements in descriptions of the methodology and the study processes. These improvements will allow WhatsApp Messenger to be categorically defined as an effective telemedicine tool in many different fields of health care.

WhatsApp Messenger as an Adjunctive Tool for Telemedicine: An Overview

The aim of this study was to evaluate WhatsApp messenger usage for communication between consulting and emergency physicians. A retrospective, observational study was conducted in the emergency department (ED) of a tertiary care university hospital between January 2014 and June 2014. A total of 614 consultations requested by using the WhatsApp application were evaluated, and 519 eligible consultations were included in the study. The WhatsApp messages that were transferred to consultant physicians consisted of 510 (98.3 %) photographic images, 517 (99.6 %) text messages, 59 (11.3 %) videos, and 10 (1.9 %) voice messages. Consultation was most frequently requested from the orthopedics clinic (n?=?160, 30.8 %). The majority of requested consultations were terminated only by evaluation via WhatsApp messages. (n?=?311, 59.9 %). Most of the consulting physicians were outside of the hospital or were mobile at the time of the consultation (n?=?292, 56.3 %). The outside consultation request rate was significantly higher for night shifts than for day shifts (p?=?.004), and the majority of outside consultation request were concluded by only WhatsApp application (p?<?.001). WhatsApp is useful a communication tool between physicians, especially for ED consultants who are outside the hospital, because of the ability to transfer large amounts of clinical and radiological data during a short period of time.

An Analysis of WhatsApp Usage for Communication Between Consulting and Emergency Physicians

Iron, an indispensable element for life, is involved in all kinds of important physiological activities. Iron promotes cell growth and proliferation, but it also causes oxidative stress damage. The body has a strict regulation mechanism of iron metabolism due to its potential toxicity. As a cancer of the bone marrow and blood cells, leukemia threatens human health seriously. Current studies suggest that dysregulation of iron metabolism and subsequent accumulation of excess iron are closely associated with the occurrence and progress of leukemia. Specifically, excess iron promotes the development of leukemia due to the pro-oxidative nature of iron and its damaging effects on DNA. On the other hand, leukemia cells acquire large amounts of iron to maintain rapid growth and proliferation. Therefore, targeting iron metabolism may provide new insights for approaches to the treatment of leukemia. This review summarizes physiologic iron metabolism, alternations of iron metabolism in leukemia and therapeutic opportunities of targeting the altered iron metabolism in leukemia, with a focus on acute leukemia.

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Iron and leukemia: new insights for future treatments.

Objectives: The 2015 Workshop of the Society for Hematopathology/European Association for Haematopathology aimed to review immunodeficiency-related lymphoproliferative disorders with plasmablastic and plasma cell differentiation.

Methods: The workshop panel reviewed human herpes virus 8 (HHV8)/Kaposi sarcoma herpesvirus (KSHV)–associated lesions and other lesions exhibiting plasma cell differentiation, including plasmablastic proliferations with features of myeloma/plasmacytoma, plasmablastic neoplasms presenting in extranodal sites and effusion-based lymphomas, and rendered a consensus diagnosis.

Results: The spectrum of HHV8/KSHV-associated proliferations ranged from multicentric Castleman disease (MCD) to MCD with plasmablastic aggregates to HHV8+ diffuse large B-cell lymphoma and germinotrophic lymphoproliferative disorder. Comparisons across effusion-based lymphomas with and without HHV8/KSHV and plasmablastic lymphomas in immunodeficient and immunocompetent patients were discussed.

Conclusions: The presence or absence of HHV8/KSHV is a defining feature in disorders associated with Castleman disease, although their differential diagnosis and recognition of progression may be challenging. Plasmablastic proliferations overlap with myeloma/plasmacytoma as well as extranodal and effusion-based lymphomas. The involvement of Epstein-Barr virus is typically variable.

/pdf/hhv8-kshv-positive-lymphoproliferative-disorders-and-the-4f41p8zclx.pdf

HHV8/KSHV-positive lymphoproliferative disorders and the spectrum of plasmablastic and plasma cell neoplasms: 2015 SH/EAHP Workshop Report - Part 3.

The revolution of internet and specifically mobile internet has occurred at a blinding pace over the last decade. With the advent of smart phones, the hand held device has become much more than a medium of voice calling. Healthcare has been catching up with the digital revolution in the form of Hospital Information System and Laboratory Information System. However, the advent of instant messaging services, which are abundantly used by the youth, can be used to improve communication and coordination among the various stake holders in the healthcare sector. We have tried to look at the impact of using the WhatsApp messenger service in the laboratory management system, by forming multiple groups of the various subsections of the laboratory. A total of 35 members used this service for a period of 3 months and their response was taken on a scale of 1 to 10. There was significant improvement in the communication in the form of sharing photographic evidence, information about accidents, critical alerts, duty rosters, academic activities and getting directives from seniors. There was also some increase in the load of adding information to the application and disturbance in the routine activities; but the benefits far outweighed the minor hassles. We thereby suggest and foresee another communication revolution which will change the way information is shared in a healthcare sector, with hospital specific dedicated apps.

Role of WhatsApp Messenger in the Laboratory Management System: A Boon to Communication

Objective

The aberrant expression of CD5 in both HCL and HCL-v is a very rare event. Although a number of CD5 positive HCL and HCL-v cases have been reported, but these are far and few in between. We aimed to review the reported cases of CD5 positive HCL and its variant.



Method

We hereby report a case of CD5 positive HCL, with variations in PIK3CA and PDGFRA gene, along with a brief review of literature of the cases of CD5 positive HCL and its variant.



Results and Conclusion

The current case was positive for CD103, CD11c, CD25, and CD123 which has led the diagnosis to be of typical HCL. With the extensive literature review we found that only 26 cases of hairy cell leukemia [HCL and HCL-v] bearing CD5 expression have been reported so far. The positivity of CD5 is more common in HCL-v as compared to HCL. Additional prospective studies of CD5+ HCL and its variants are required to show whether they are a clinically significant subgroup of lymphoid malignancies. © 2016 International Clinical Cytometry Society

https://onlinelibrary.wiley.com/doi/pdf/10.1002/cyto.b.21365

CD5 positive hairy cell leukemia: A rare case report with brief review of literature

Karyotyping was done in 100 children suspected of having chromosomal abnormalities of genetically uncertain syndromes, multiple congenital anomalies, short stature, dysmorphic features, unclassified mental retardation, and Down syndrome. A total of 56 patients had an abnormal karyotype: ring chromosome of 13 was seen in 1 patient (1.78%), and trisomy 21 was seen in 29 patients (51.78%) who were diagnosed as Down syndrome patients. Among them, 9 were male patients (31.03%) (47,XY+21) and 18 were female patients (47,XX+21) (62.06%); 2 patients showed 47,XY+21/46,XY (mosaicism) (6.89%). Chromosomal rearrangements involving chromosome numbers 13, 14, and 21 were seen in three patients. Among them, one patient had t(13;21) [45,XX,t(13;21)] and two patients had 45,XY,t(14;21). Trisomy 22 was seen in three patients (5.3%), marker chromosome was seen in two patients (3.57%), 46,XY,16qh variant was seen in one patient (1.78%), 46,XX,der(2) was seen in one patient (1.78%), 46,XX,14ps+ was seen in two patients (3.57...

Increasing role of cytogenetics in pediatric practice.

Background: CD71 is a marker that has been usually used for identifying dysplasia in the erythroid series. We have tried to evaluate the expression of CD71 in various types of acute leukemias. Materials and Methods: We studied 48 patients of acute leukemia, of which 25 were acute myeloid leukemia (AML), 13 were precursor B-acute lymphoblastic leukemia (B-ALL), 8 were T-ALL, and 2 were mixed phenotype acute leukemia (T/myeloid) as per the WHO classification. Results: We found that the expression of CD71 was most prevalent in AMLs (84%), followed by T-ALL (50%) and least in B-ALL (30%). Conclusion: This finding clearly shows the higher expression of CD71 in AMLs compared to other common type of leukemias, such as B- and T-ALL. We suggest that the high expression of CD71 in AMLs could be used as a diagnostic marker and may also be used for minimal residual disease analysis after further studies in posttreatment scenario. This study is the first of its kind in the South Asian population.

Expression of CD71 by flow cytometry in acute leukemias: More often seen in acute myeloid leukemia

The disease man agement of a plastic anemia patien ts is, to an extent, based on the etiology i.e., constitutional or acquired. Chromosomal breakage study using Mitomycin-C is widely used for this differential diagnosis in India. The present study was undertaken to find out the frequency of constitutional aplastic anemia. This prospective study was carried out at Immunology and Molecular biology Lab of Apollo hospital during July, 2007 to June, 2009. Clinico-hematologically classified 300 aplastic anemic patients that have been catered to the hospital for their differential dia gnosis of aplastic anemia and their res pective age and sex matched healthy controls were processed f or chromosomal breakage study. Patient's habitat, clini cal symptoms, differential blood count and history of dr ug exposure and post vir al devel opment of t he disease were documented. The survival rate was documented after 2 years of diagnosis. Relative risk was estimated by odds ratio (OR) with 95% confidence interval (CI) in m atched cas es an d con trols. A significant inc rease of chromosomal breakages seen in 9.40% patients. 8 of 83 (9.64%) patients of > 21 yrs of age and 19 of 204 (9.31%) of ≤21 years of age showed increased breaks. The sex ratio was 3.2:1. Moderate, severe and very- severe levels of diseas e w ere seen in 27.6, 69.8 and 2.6% of the patients respectively. The su rvival data documented for 100 patients suggest 60% mortality. 9.40% had evidence of constitutional aplastic anemia in contrast to previously published data from India where the proportion ranges from 11-42%. The skewed sex ratio in our study probably reflects the gender bias in our society. No significant difference (p 21 yrs age grou ps (28 .9%). Patien ts with constitutional disease could not be differentiated on the basis severity. The high mortality rate raise a need to analyze these patients on a molecular platform to dig out the genetic factors involved, if any.

Dharmendra Jain

Papers

Role of WhatsApp Messenger in the Laboratory Management System: A Boon to Communication

CD5 positive hairy cell leukemia: A rare case report with brief review of literature

Increasing role of cytogenetics in pediatric practice.

Expression of CD71 by flow cytometry in acute leukemias: More often seen in acute myeloid leukemia

Chromosomal Breakage Study in Aplastic Anemia Patients in India