Etude des performances de l'analyseur de biochimie le i-smart 30 au laboratoire de biochimie du Centre Hospitalier Universitaire Pédiatrique Charles De Gaulle (CHU-P/CDG)

De façon générale il s'est agi de l'évaluation du niveau de performances du i-Smart 30 pour l'analyse des électrolytes (Na+, K+ et Cl-) et de comparer le i smart 30 versus Micros 60 pour la mesure de l'hématocrite.Nous avons fait une étude analytique et descriptive qui s'est déroulée sur 06 mois au laboratoire du CHU-P/CDG. Pour l'analyse de la performance dans le dosage des électrolytes nous avons utilisé trois sérums de contrôles de niveau différent (bas, moyen et élevé) et la pour l'hématocrite nous avons utilisé du sang de patients en faisant un passage en parallèle sur le i-Smart 30 et le Micros 60 l'automate de référence.Pour les tests de comparaison nous avons eu une bonne concordance entre les résultats fournis par i-Smart30 et le Micros60 avec un biais de Bland-Altman à 1,96. Pour la justesse tous les points des électrolytes se situaient dans les intervalles requis par le fabricant. En ce qui concerne les tests de précision, la répétabilité et la fidélité intermédiaire, la plupart des niveaux de contrôle avaient des CV qui sont conformes aux normes maximales d'acceptabilité établis par la SFBC témoignant d'une bonne précision du i-Smart 30 pour le dosage des ions. Le i-Smart30 a été donc qualifié pour être utilisé lors des gardes et des permanences. La satisfaction a été confirmée par les résultats des contrôles de qualité externes

Epidemiology of soil-transmitted helminths, schistosoma mansoni, and haematocrit values among school children in Ethiopia

Introduction: This study aimed to determine the prevalence of intestinal helminths; risk factors and haematocrit values among primary schoolchildren. Methodology: Across-sectional study was conducted in 12 primary schools in March 2011. Stool samples were randomly selected from 778 children and were microscopically examined using Kato-Katz and formal-ether concentration methods. Haematocrit values were measured using heparinized capillary tubes. Results: The overall prevalence of intestinal helminths was 51.5 (rural = 68.3; urban = 36.2). Hookworm spp.; Schistosoma mansoni and Schistosoma stercoralis were more prevalent in rural schools; whereas Hymenolepis nana was higher in urban schools (p = 0.0001). With regard to haematocrit; 34 of rural and 21.7 of urban schoolchildren had haematocrit values below the median (40.5) (p=0.001). Hookworm spp. and S. mansoni infected children had lower haematocrit values than non-infected children (p = 0.001). Lack of footwear was positively associated with intestinal helminths infection in rural schools [OR = 2.5 (95 CI: 1.5-4.1)]; and having dirty fingernails and untrimmed fingernails were positively associated with the prevalence of intestinal helminths in urban samples [OR = 1.58 (95 CI: 1.03-2.5)]. Conclusion: The prevalence of soil-transmitted helminths and S. mansoni differs by geographical area of the schools and social determinants. Primary school de-worming and health education on proper hygiene are recommended

Accuracy in Diagnosis of Postpartum Haemorrhage Using Visual Estimation of Blood Loss versus Change in Haematocrit in a Tertiary Teaching Hospital in Tanzania

Abstract:Postpartum haemorrhage is the leading cause of maternal death in the developing country and yet is poorly diagnosed due to inaccurate measurement of blood loss following delivery. A study was carried out at Muhimbili National Hospital (MNH) Tanzania between October 2005 and January 2006 to determine the accuracy of visual estimation of blood loss (VEBL) in comparison to laboratory measurement of blood loss in diagnosis of primary postpartum haemorrhage (PPH). A total of 426 pregnant women who were in active phase of labour were recruited and their venous blood was drawn for estimation of haematocrit before delivery and 12 hours thereafter. Active management of third stage of labour was conducted by giving 10IU of oxytocin (intramuscularly or intravenously) and this was followed by visual estimation of blood loss. The proportion of patients who developed PPH was then determined by both methods. The mean duration of third stage of labour was 8.3 minutes and mean blood loss was 164.9ml. The prevalence of PPH was 8.9 and 16.2 by VEBL and changes in haematocrit; respectively. Change in haematocrit in diagnosis of PPH was found to be more accurate; specific with high positive predictive values compared to VEBL. The need for additional uterotonics was 5.8 and the commonest labour complications associated with PPH were second degree tear; retained placenta and EUA for continued bleeding. In conclusion; VEBL using calibrated vessel will increase accuracy where conventional method using non calibrated method is used for diagnosis of PPH. Service providers working in labour wards need to be trained on how to estimate blood loss using simulated methods so as to increase their long term memory and accuracy in diagnosis of post-partum haemorrhage; hence provision of immediate intervention

Assessment of Clinical Features and Haematocrit Levels in Detection of Hypoxaemia in Sick Children

This cross-sectional study was to determine the prevalence of hypoxaemia among sick children in EnuguState University Teaching Hospital, Enugu, Nigeria and correlate it with clinical features and haematocrit levels.Ninety-two (92) sick children aged 2­48 months hospitalised at the teaching hospital were recruited after obtaining consent from their carers.The prevalence of hypoxaemia in this study, defined by oxygen saturation of less than 90%, was 13%, and was not dependent on age or sex. A higher proportion of subjects with hypoxaemia had tachypnoea (81.8%),compared with those without (18.2%) (χ² = 1.69; p=0.19).The sensitivity of using tachypnoea alone to predict hypoxaemia was 18.4% while the specificity was 92.3%.The presence of hypoxaemia predicted poor outcome 66.7% of those that died had hypoxaemia. The difference was statistically significant (χ2= 17.9; p=0.00).Tachypnoea had a poor sensitivity although good specificity in predicting hypoxaemia. Presence of hypoxaemia connotes poor prognosis. We recommend that finger pulse oximeters, which are cost effective,should be routinely available at hospitals in developing countries, so that hypoxaemia can be detected earlier and more intensive management instituted

Certain Red Blood Cell Indices of Maternal and Umbilical Cord Blood in Owerri; Nigeria: A Preliminary Report

BACKGROUND: Umbilical cord blood analysis may give a clue to the state of health of both pregnant mothers and their neonates. However, there is paucity of literature on some of these indices from our area.OBJECTIVES:This present study determined the red blood indices of maternal and umbilical cord blood in Owerri, Nigeria.METHODS:Pregnant mothers aged 18 - 42 years who booked and received antenatal care until vaginal delivery at the antenatal clinics of two tertiary health care centres in Owerri, Nigeria were divided into five age groups I - V. Maternal blood samples were obtained immediately after delivery of the baby. The umbilical blood samples were collected from the umbilical cord of the baby at the end of the second stage of labour. The haemoglobin (Hb) concentration and packed cell volume (PCV) were determined using standard procedures. The mean corpuscular haemoglobin concentration (MCHC) was calculated mathematically.RESULTS:The result of the cord blood haemoglobin concentration and packed cell volume were significantly higher than the maternal values (14.22 ± 1.25 g/dl versus 11.20 ± 0.92g/d and 42.6 9± 3.80% versus 33.67 ± 2.71% respectively; (P < 0.0001).However, there was no significant differences between cord blood and maternal mean corpuscular haemoglobin concentration (33.24 ±0.23% versus 33.29 ± 0.45 % ;P = 0.310). Furthermore, a positive linear Pearson's correlation was observed between the mean Hb and PCV of cord blood and maternal blood (r=1.11 and r=1.15 respectively <0.0001).CONCLUSION:This result provides a baseline data for further studies on establishing a reference value for maternal and umbilical cord packed cell volume and haemoglobin concentration in our locality

Effets theoriques et evolution bioclinique de l'hematocrite au cours de l'hemodulition normovolemique

L'enorme reduction du nombre des patients causee par le taux seuil d'hematocrite fixe a 34;nous a pousse a initier cette etude;tandis que dans les pays developpes plusieurs etudes menees avec un taux d'hematocrite au voisinage de 30se passent sans probleme majeure. Les arguments theoriques et biocliniques de notre etude nous permettent aujourd'hui d'affirmer qu'en ce qui concerne les noirs et pour nos pays en voie de developpement un hematocrite a 32peut s'averer satisfaisant et benefique pour nos patients. La mesure de l'hematocrite reste une variable sure; et satisfaisante pour l'evaluation de cette technique d'epargne sanguine. Il permet d'evaluer les pertes sanguines et de surveiller l'evolution des patients hemodilues. Il fait partie integrante de l'hemogramme au meme titre que l'hemoglobine tel que defini par la nomenclature des actes de biologie

Evaluation of clinical signs to diagnose anaemia in Uganda and Bangladesh, in areas with and without malaria

The object of this study was to assess the ability of pallor and other clinical signs, including those in the Integrated Management of Childhood Illness (IMCI) guidelines developed by WHO and UNICEF, to identify severe anaemia and some anaemia in developing country settings with and without malaria. A total of 1226 and 668 children aged 2 months to 5 years were prospectively sampled from patients presenting at, respectively, a district hospital in rural Uganda and a children's hospital in Dhaka, Bangladesh. The study physicians obtained a standardized history and carried out a physical examination that included pallor, signs of respiratory distress, and the remaining IMCI referral signs. The haematocrit or haemoglobin level was determined in all children with conjunctival or palmar pallor, and in a sample of the rest. Children with a blood level measurement and assessment of pallor at both sites were included in the anaemia analysis. Using the haematocrit or haemoglobin level as the reference standard, the correctness of assessments using severe and some pallor and other clinical signs in classifying severe and some anaemia was determined. While the full IMCI process would have referred most of the children in Uganda and nearly all the children in Bangladesh with severe anaemia to hospital, few would have received a diagnosis of severe anaemia. Severe palmar and conjunctival pallor, individually and together, had 10-50% sensitivity and 99% specificity for severe anaemia; the addition of grunting increased the sensitivity to 37-80% while maintaining a reasonable positive predictive value. Palmar pallor did not work as well as conjunctival pallor in Bangladesh for the detection for severe or some anaemia. Combining "conjunctival or palmar pallor" detected 71-87% of moderate anaemia and half or more of mild anaemia. About half the children with no anaemia were incorrectly classified as having "moderate or mild" anaemia. Anaemia was more easily diagnosed in Uganda in children with malaria. Our results show that simple clinical signs can correctly classify the anaemia status of most children. Grunting may serve as a useful adjunct to pallor in the diagnosis of severe anaemia. Conjunctival pallor should be added to the IMCI anaemia box, or the guidelines need to be adapted in regions where palmar pallor may not readily be detected

Haematological indices and serum lead level in welders working in automobile industry in a Nigerian city

Forty-four welders working in car maintenance industry in Jos; Nigeria had their haemoglobin; haematocrit; leucocyte; platelet and serum lead level determined; while their urine were screened for haem synthetic products. The serum lead level in welders was 28.5 plus 11.2/ng/dl which was significantly higher than the value of 20.8 plus 9/ng/dl recorded for the control group. Though 24 welders who had worked over 10 years had higher serum levels than 20 welders who had worked for less than 10 years this was not statistically significant; also urine examination did not reveal the presence of porphyrinogen or porphyrin in the welders