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SUMMARY OBJECTIVES: This study aimed to develop artificial intelligence and machine learning-based models to predict alterations in liver enzymes from the exposure of low annual average effective doses in radiology and nuclear medicine personnel of Institute of Nuclear Medicine and Oncology Hospital. METHODS: Ninety workers from the Radiology and Nuclear Medicine departments were included. A high-capacity thermoluminescent was used for annual average effective radiation dose measurements. The liver function tests were conducted for all subjects and controls. Three supervised learning models (multilayer precentron; logistic regression; and random forest) were applied and cross-validated to predict any alteration in liver enzymes. The t-test was applied to see if subjects and controls were significantly different in liver function tests. RESULTS: The annual average effective doses were in the range of 0.07-1.15 mSv. Alanine transaminase was 50% high and aspartate transaminase was 20% high in radiation workers. There existed a significant difference (p=0.0008) in Alanine-aminotransferase between radiation-exposed and radiation-unexposed workers. Random forest model achieved 90-96.6% accuracies in Alanine-aminotransferase and Aspartate-aminotransferase predictions. The second best classifier model was the Multilayer perceptron (65.5-80% accuracies). CONCLUSION: As there is a need of regular monitoring of hepatic function in radiation-exposed people, our artificial intelligence-based predicting model random forest is proved accurate in prediagnosing alterations in liver enzymes.
Subject(s)
Humans , Artificial Intelligence , Occupational Exposure/adverse effects , Radiation Dosage , Algorithms , LiverABSTRACT
Introduction: Globally, breast cancer is leading to cancer found among women. It is well known that cancer is an age-relateddisease and this holds true in breast cancer as well. Breast cancer is the most frequently diagnosed cancer in women, and itwas estimated that there will be 252,710 new cases of invasive breast cancer and 63,410 new cases of in situ breast cancersamong women in the United States in 2017.Purpose: The aim of the present study was to analyze the demographic spectrum of breast cancers in the Kashmir valley.Materials and Methods: This was an observational chart based study on breast cancer patients aged above 18 years of agewho were diagnosed with either invasive or in situ breast cancer at Government Medical College Hospital, Srinagar, Kashmir.The duration of the study was from June 2015 to December 2018. A retrospective study was conducted to find the informationregarding age, sex, clinical presentation, anatomical site, histopathological type, and stage of the disease.Results: A total of 151 patients with histopathologically confirmed breast cancers formed the study population. The majority of thepatients (46%) among females were <45 years of age and among males >45 years in age, with males and females constituting4% and 96% of patients in their respective groups. The upper outer quadrant was involved in 81 (54%) patients followed byupper inner 14% and central quadrant involvement in 25 (16%) patients. Among 151 patients, 42 women (28%) presented inStage IIA, 32 patients (21%) presented with Stage IIB disease, 19 patients (12%) in Stage IIIA, and 20 patients (13%) in StageIIIC; however, 17 patients (11%) presented with Stage IV disease. G2 was the most common histological grade. On the whole,liver was the most common presenting site for distant metastasis followed by lung and brain metastases.Conclusion: Early age, female sex, and residence within an endemic geographical region seem to be the prime determinantsaffecting breast cancer prevalence in a given population. A significant number of breast cancer patients in Kashmir presentwith early stage of disease and major clinical presentation were breast swelling. The majority of the cases reported in StagesII and III. Furthermore, there was significant number of patients presenting with metastasis, i.e., Stage IV.
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Introduction: Multidrug resistant bacteria is causing a veryserious problem in the proper treatment and management ofsick patients in ICU’s. Study aimed to find out antimicrobialsusceptibility pattern of bacterial isolates from trachealculture.Material and methods: This study was carried over a periodof 6 months from July to December 2017 in the departmentof microbiology. Total of 470 tracheal aspirates were studied.Each specimen was streaked on 5% sheep blood agar andMacConkey agar. After isolation and identification, sensitivityof selected organisms against different antibiotics was studiedResults: Out of 470 tracheal aspirates, 328 samples showedsingle bacterial growth, 76 were sterile; contaminants weregrown in 58 samples and in remaining 8 samples yeast weregrown. The incidence of positivity in our study was 83.8%,with gram negative bacteria outnumbering the gram positiveones. Of the 328 samples which showed bacterial growth,Acinetobacter spp 159(40.3) was the most common organismfollowed by Klebsiella pneumoniae 72(18.2), Pseudomonasspp 46(11.6), Escherichia coli 27(6.8), Staphylococcus aureus13(3.2), Klebsiella oxytoca 5(1.26), Enterococcus spp 3(0.76),Proteus spp, Citrobacter spp, Providencia stuartii 1(0.25)each. Also XDR (extensively drug resistant) bacteria wereisolated at a high frequency (67%) with Acinetobacter spp.being the most common 128(56.6)) followed by Klebsiellaspp. 39(17.2) Pseudomonas spp. 38(16.8), and E.coli 12(5.3).Conclusion: Gram negative were main organisms responsiblefor lower respiratory tract infections in hospitalized patientsand the majority of the isolates belong to XDR and MDRcategory.
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Introduction: Organophosphorus compounds are widelyused as insecticides. Organophosphorus poisoning hasa significant morbidity and mortality and is a commonoccurrence due to their easy accessibility. Study aimed toassess clinicoepidemiological profile of organophosphoruspoisoning.Material and methods: Our study was a hospital basedprospective study conducted over a period of two yearsinvolving all the patients of organophosphorus (OP)poisoning, admitted in the medical emergency of the hospital.These patients were evaluated for demographic and clinicalprofile and followed till the time of discharge or death.Results: 102 cases of OP poisoning were admitted, majoritybelonged to the age group of 15-25 years (54.9%) and were ofrural origin (84.3%). Females (67.64%) outnumbered males.97 cases had taken it with suicidal intent. Miosis was themost consistent clinical feature (93.13%). 64 patients (62.7%)needed admission in ICU. Respiratory failure was the mostcommon complication. Mortality rate of 14.7% was observed.Conclusion: OP compounds are ingested mostly with suicidalintent due to their easy availability mostly by young andproductive population. Initial management and resuscitationin periphery is invaluable
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Synthetic drugs have widely been helpful in management of diabetes mellitus type 2. However, side effects associated with synthetic drugs serve as an impetus to explore plants as alternate mode of treatment. The hydroethanolic leaf extracts of Conocarpus erectus were evaluated for phenolic contents, flavonoid distribution, antioxidant activity and antidiabetic potential. The maximum extract yield, total phenolic and flavonoid contents were exposed by 60% ethanolic extract. The Antioxidant and anti alpha-glucosidase tendency of 60% ethanolic extract was the most promising and complemented by in-vivo antihyperglycemic impact on mice. The findings were substantial regarding suppression of blood glucose levels in alloxan induced diabetic mice establishing the Conocarpus erectus as proficient pool of nutraceuticals for diabetes mellitus type 2 management
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Infection due to hepatitis C virus (HCV) is a major cause of fibrosis and hepatocellular carcinoma in Pakistan. In the current review, pattern of HCV genotypes and subtypes in Khyber Pakhtunkhwa province was ascertained in light of the available literature. After thorough analysis, genotype 3 (58.27%) was determined to be the leading HCV genotype, followed by genotypes 2 (12.39%), 1 (9.54%) and 4 (0.86%). The proportions of genotypes 5 and 6 were recorded as 0.09% and 0.22% respectively. Subtype wise, 3a accounted for 48.67%, followed by subtype 2a (10.91%), 3b (9.43%), 1a (5.84%), 1b (3.66%), 2b (1.45%) and genotype 4 with its undefined subtypes contributed a portion of 0.86%. The cumulative share of subtypes 1c, 2c, 3c, 5a and 6a was less than 1%. In 11.51% cases, the subtype was untypeable while in 7.17% cases mixed subtypes were recorded. Gender wise, proportions of most HCV subtypes were marginally higher among males as compared to females. On the basis of studied groups, 3a was pervasive among all groups except in intravenous drug users where 2a was the major HCV subtype. Similarly, based on various geographical locations (provincial divisions), subtype 3a revealed a ubiquitous distribution. Conclusively, HCV 3a persists to be the principal subtype across the province of Khyber Pakhtunkhwa. The considerable number of untypeable subtypes in most studies urges for an improved genotyping system on the basis of local sequence data and practice of sequencing for determination of underlying subtype in untypeable cases. Further, studies on identification of subtypes transmission pattern are imperative for assessment of transmission origin and reinforcement of efficient control strategies. In addition, the current review emphasizes the need of attention toward HCV risk groups and ignored southern side of Khyber Pakhtunkhwa province for better holistic understanding of HCV genotype distribution pattern in the province.
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Infection due to hepatitis C virus (HCV) is a major cause of fibrosis and hepatocellular carcinoma in Pakistan. In the current review, pattern of HCV genotypes and subtypes in Khyber Pakhtunkhwa province was ascertained in light of the available literature. After thorough analysis, genotype 3 (58.27%) was determined to be the leading HCV genotype, followed by genotypes 2 (12.39%), 1 (9.54%) and 4 (0.86%). The proportions of genotypes 5 and 6 were recorded as 0.09% and 0.22% respectively. Subtype wise, 3a accounted for 48.67%, followed by subtype 2a (10.91%), 3b (9.43%), 1a (5.84%), 1b (3.66%), 2b (1.45%) and genotype 4 with its undefined subtypes contributed a portion of 0.86%. The cumulative share of subtypes 1c, 2c, 3c, 5a and 6a was less than 1%. In 11.51% cases, the subtype was untypeable while in 7.17% cases mixed subtypes were recorded. Gender wise, proportions of most HCV subtypes were marginally higher among males as compared to females. On the basis of studied groups, 3a was pervasive among all groups except in intravenous drug users where 2a was the major HCV subtype. Similarly, based on various geographical locations (provincial divisions), subtype 3a revealed a ubiquitous distribution. Conclusively, HCV 3a persists to be the principal subtype across the province of Khyber Pakhtunkhwa. The considerable number of untypeable subtypes in most studies urges for an improved genotyping system on the basis of local sequence data and practice of sequencing for determination of underlying subtype in untypeable cases. Further, studies on identification of subtypes transmission pattern are imperative for assessment of transmission origin and reinforcement of efficient control strategies. In addition, the current review emphasizes the need of attention toward HCV risk groups and ignored southern side of Khyber Pakhtunkhwa province for better holistic understanding of HCV genotype distribution pattern in the province.
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The present study aimed to explore antioxidant, antimicrobial and anti-diabetic properties of the fern Adiantum venustum. The TPC [total phenolic content] of methanolic extract of the plant was 247.95+/-0.0007micro g of Gallic acid equivalents per gram of dried extract [mg GAE/g]. The highest TPC was in n-butanolic fraction, which was 981.45+/-0.1562mg GAE/g. Hexane fraction showed lowest TPC [256.95+/-0.0420mg GAE/g]. Ethyl acetate fraction exhibited highest total flavonoid content [TFC], i.e., 62.0+/-0.050mg of Rutin equivalents per gram of sample. DPPH [1,1- diphenyl-2- picryl hydrazyl] radical scavenging activity of the plant was significant. n-Butanolic fraction was most potent with IC[50]being 1.06mg/mL. The IC[50]of methanolic extract was 1.50mg/mL, that of aqueous fraction was 2.51 mg/mL, and that of chloroform fraction was 2.65mg/mL. Antibacterial potential of the fern was tested against two Grampositive bacterial strains, Pseudomonas aeruginosa and Escherichia coli and two Gram-negative bacterial strains, Bacillus subtilis and Staphylococcus aureus. n-Butanolic fraction showed highest zone of inhibition [ZOI, 25.13+/-1.237 mm] against P. aeruginosa. Ethyl acetate fraction was most active [ZOI, 15.75+/-1.060 mm] against S. aureus. Against E. coli, aqueous and n-butanolic fractions were most active [ZOI, 14.75+/-0.353 and 14.50+/-0.707mm, respectively]. Minimum inhibitory concentration [MIC] of methanolic extract against B. subtilis was as low as 1.98mg/mL. The hexane fraction was least toxic against all the fractions. The plant displayed significant alpha-amylase inhibitory activity. Chloroform fraction was most effective with lowest IC[50][1.10mg/mL] followed by ethyl acetate fraction [1.92mg/mL]. A. venustum is rich in phenolics and has substantial antioxidant, antimicrobial and alpha-amylase inhibitory potential
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Objective: To compare the mean post-operative analgesic requirement in non-closure and closure of peritoneum during open appendectomy
Study Design: Randomized controlled trial
Place and Duration of Study: Department of General Surgery Combined Military Hospital Quetta, from 1[st] August 2014 to 30[th] April 2015
Material and Methods: A total of 60 patients were included in this study and were divided into two groups of 30 each. Patients in group A underwent open appendectomy with closure of peritoneum while patients in group B had non-closure of peritoneum during the same procedure. Post-operatively, pain severity was assessed on visual analogue scale [VAS] numeric pain distress scale. On presence of VAS numeric pain distress scale between 5 to 7, intramuscular [IM] diclofenac sodium was given and on score >7, intravascular [IV] tramadol was given. The final outcome was measured at day 0 and day 1
Results: Pain score and analgesic requirements were significantly less in non-closure group than closure group on day 0 and day 1, showing statistically significant difference between the two groups
Conclusion: Mean post-operative analgesic requirement is significantly less in non-closure group as compared to closure group during open appendectomy
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Skin wound closure occurs when keratinocytes migrate from the edge of the wound and re-epithelialize the epidermis. Their migration takes place primarily before any vascularization is established, that is, under hypoxia, but relatively little is known regarding the factors that stimulate this migration. Hypoxia and an acidic environment are well-established stimuli for cancer cell migration. The carbonic anhydrases (CAs) contribute to tumor cell migration by generating an acidic environment through the conversion of carbon dioxide to bicarbonate and a proton. On this basis, we explored the possible role of CAs in tissue regeneration using mouse skin wound models. We show that the expression of mRNAs encoding CA isoforms IV and IX are increased (~25 × and 4 ×, respectively) during the wound hypoxic period (days 2–5) and that cells expressing CAs form a band-like structure beneath the migrating epidermis. RNA-Seq analysis suggested that the CA IV-specific signal in the wound is mainly derived from neutrophils. Due to the high level of induction of CA IV in the wound, we treated skin wounds locally with recombinant human CA IV enzyme. Recombinant CA IV significantly accelerated wound re-epithelialization. Thus, CA IV could contribute to wound healing by providing an acidic environment in which the migrating epidermis and neutrophils can survive and may offer novel opportunities to accelerate wound healing under compromised conditions.
Subject(s)
Animals , Humans , Mice , Hypoxia , Carbon Dioxide , Carbon , Carbonic Anhydrases , Cell Movement , Epidermis , Keratinocytes , Neutrophils , Protein Isoforms , Protons , Re-Epithelialization , Regeneration , RNA, Messenger , Skin , Wound Healing , Wounds and InjuriesABSTRACT
Background: Present research aimed to determine molecular genotype of kappa-casein gene in female Red Sindhi cattle. This gene has great influence on the technologically advanced milk properties. Methods: Blood specimens (n=50) from females of this cattle breed at a well-managed farm in Sindh-Pakistan were collected and commercial kit was employed for DNA extraction. Genotype determination of κ-casein gene and alleles was done through PCR-RFLP technique by using primer; PCR products were digested upon HINFI restriction enzyme. The digested fragments were analyzed by electrophoresis on agarose gel using ethidium bromide to increase visibility. The bands were examined under ultra violet-light to study polymorphic locus on DNA fragments. Results: Digestion upon HINFI restriction enzyme of 350bp fragment indicated three patterns. The 1st (homozygote genotype BB), 2nd (homozygote genotype AA) and 3rd (heterozygote genotype AB) patterns yielded major fragment(s) of 1) 266bp, 2) 134bp and 132bp and 3) 134bp, 132bp and 266bp, respectively. Each of the three patterns yielded one minor fragment of 84bp. The genotype frequency for homozygote AA and the allelic frequency of allele A were higher than the same for homozygote genotype BB and the allelic frequency of allele B, respectively. Conclusions: An accurate profile of genetic make-up and alternate forms of κ-casein genes in Sindhi cattle is likely to help researchers, policy makers, immunologists, dietitians, neonatologists, community physicians and managerial as well as production level officials to exploit it to full potential.
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Various tests to help in the clinical diagnosis of distal biceps tendon ruptures have been described. In our experience these tests are painful in the acute setting. We suggest a simple alternative test wherein the biceps muscle belly is held by the examiner and translated medially and laterally. This is done with the forearm flexed to 90 degrees. It is first performed with the biceps relaxed and subsequently performed with the forearm flexed against resistance. In the relaxed forearm the biceps easily translates over 50% of its width. When placed under tension (by flexing against resistance) this translation is significantly reduced. In cases of complete distal biceps tendon rupture, the biceps still translates, even under resisted flexion of the forearm. This simple test is less painful than other described tests, is easy to perform, and aids in clinical diagnosis of distal biceps tendon ruptures.
Subject(s)
Diagnosis , Forearm , Physical Examination , Rupture , Tendon Injuries , TendonsABSTRACT
Background. The central role of males in female reproductive health issues in patriarchal societies makes them an important group in the eradication of female genital mutilation/cutting (FGM/C).Objective. To determine knowledge about and attitudes to FGM/C among male adolescents; and their preparedness to protect their future daughters from it.Methods. A cross-sectional survey among male adolescent students in Ilorin; Nigeria. Participants completed a self-administered questionnaire after consent had been obtained from them or their parents. Statistical analysis was with SPSS version 20.0 (IBM; USA). A p-value of 0.05 was taken as significant.Results. Of 1 536 male adolescents (mean age 15.09 (standard deviation 1.84) years; range 14 - 19); 1 184 (77.1%) were aware of FGM/C; 514 (33.5%) supported female circumcision; 362 (23.6%) would circumcise their future daughters; 420 (27.3%) were of the opinion that FGM/C had benefits; mostly as a necessity for womanhood (109; 7.1%); and 627 (40.8%) perceived it as wickedness against females; 546 (35.5%) were aware of efforts to eradicate FGM/C; and 42.2% recommended education as the most important intervention to achieve thisConclusion. Education and involvement in advocacy may transform male adolescents into agents for eradication of FGM/C
Subject(s)
Circumcision, Female , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Reproductive HealthABSTRACT
Background: Isolated gastric varices [IGV] are one of the major causes of upper gastro intestinal bleeding in cases with liver cirrhosis. They are difficult to manage and N butryl cyanoacrylate is one of the options
Objective: To determine the efficacy of N butryl cyanoacrylate in cases with isolated gastric varices due to liver cirrhosis
Methodology: This cross-sectional study was conducted at Endoscopy unit of Hamza Medicare Hospital, Rahim Yar Khan from 1st January 2015 to 31 th July 2016. The cases presenting with upper GI bleedy and history of liver cirrhosis [documented by presence of jaundice, ascites, hepatic encephalopathy, deranged LFTs, i.e. serum bilirubin, PT, albumin] irrespective of etiology and the child pugh class were included. The endoscopy was done by Olympus GIF-XQ140 and the site of bleeding varices were documented. The cases of isolated gastric varices of any type or severity were considered. Then glue comprising N butryl cyanoacrylate with lipoid solution in a ratio of 5:8 was injected into the varices in a dose of 2.5 to 5 cc and were then followed for next 5 days for any re bleeding episode and control of homeostasis. The cases, in which no such event was noted, were labeled as with positive efficacy. The data was entered and analyzed by using SPSS version 21
Results: In this study out of total 54 cases of IGV, there were 34 [62.96%] males and 20 [37%] females. The mean age was 58.50 +/- 15.54 years. There were 47 cases with hepatitis C and 7 has hepatitis B. Efficacy was seen in 52 [96.30%] out of 54 cases. Thirty-three out of 34 males and 19 out of 20 females has shown efficacy with p value of 0.80. The efficacy was better seen with age group of 15 to 35 years with cure in 5 [100%] out of 5 cases as compared to lower rate in others with p= 0.27. The cases with Child pugh class C contained the both failure cases with significant p= 0.04. There were one case each with hepatitis B and C with failure with p= 0.39
Conclusion: N butryl cyanoacrylate has a high efficacy rate in shortterm relief for bleeding and Child pugh class C is significantly associated with lower success rate
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Background: Liver cirrhosis, associated with upper gastrointestinal [GI] bleed, is one of the leading cause of morbidity and mortality. Esophageal and isolated gastric varices, both are common but the later is the more difficult to treat
Objective: to determine the frequency of isolated gastric varices in cases with liver cirrhosis presenting with upper gastrointestinal bleeding
Methodology: This cross sectional study was conducted at Hamza Medicare Hospital, Rahim Yar Khan from 1 January 2015 to 31 July 2016. The cases with upper GI bleeding due to liver cirrhosis [assessed by presence of ascites, splenomegaly and deranged liver functions like LFTs, PT] were included in this study. Sociodemographic data was collected like age, gender and other data like type of viral hepatitis and other examination to label for their child pugh class. The cases then underwent upper GI endoscopy with Olympus GIF-XQ140 and were assessed for presence of ulcers or varices from esophagus to stomach. The cases with varices of any size or type only in the gastric area were labeled as isolated gastric varices [IGV]. The data was entered and analyzed by SPSS version 21
Results: In this study there were total 662 cases of liver cirrhosis out of which 180 [27.19%] were females and 482 [72.81%] males. The mean age was 58.50+/- 15.51years. There were 495 [74.77%] cases with hepatitis C and 167 [25.23%] with hepatitis B virus. Isolated gastric varices. [IGV] were seen in 54 [8.17%] cases. All the cases were in GV1 class and all has size of more than 10 mm. IGV were seen in 34 [7.05%] males as compared to 20 [11.11%] females [p value= 0.53]. There was no significant association of GV with any age group with p= 0.17. There was significant association of IGV with child pugh class C [p=0.03]. There was no significant association with type of hepatitis with IGV [p=0.21]
Conclusion; Isolated gastric varices are common entity and every twelfth case of liver cirrhosis develops this. Child pugh class C is significantly associated with isolated gastric avarices
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Various tests to help in the clinical diagnosis of distal biceps tendon ruptures have been described. In our experience these tests are painful in the acute setting. We suggest a simple alternative test wherein the biceps muscle belly is held by the examiner and translated medially and laterally. This is done with the forearm flexed to 90 degrees. It is first performed with the biceps relaxed and subsequently performed with the forearm flexed against resistance. In the relaxed forearm the biceps easily translates over 50% of its width. When placed under tension (by flexing against resistance) this translation is significantly reduced. In cases of complete distal biceps tendon rupture, the biceps still translates, even under resisted flexion of the forearm. This simple test is less painful than other described tests, is easy to perform, and aids in clinical diagnosis of distal biceps tendon ruptures.
Subject(s)
Diagnosis , Forearm , Physical Examination , Rupture , Tendon Injuries , TendonsABSTRACT
Acute promyelocytic leukemia (APML) is considered to be sensitive to all-trans-retinoic acid (ATRA) which acts as a differentiating agent. ATRA is considered to be a well-tolerated agent and is known to achieve complete remission in acute promyelocytic leukemia. However, a few cases on long term all-trans-retinoic acid (ATRA) use can develop pseudotumor cerebri. Out of 32 patients with APML who were treated in our Centre over a 4-year-period, we encountered 6 patients who developed ATRA-related pseudotumor cerebri while on maintenance treatment. The patients ranged from 12 to 40 years of age. 3 patients complained of unbearable headache, 2 of diplopia and 1 of gross reduction in visual acuity. CT scans and MRI did not reveal any intracranial lesions. Cerebrospinal fluid (CSF) examination was normal with CSF manometry revealing a high CSF pressure (average of 345mmH2O). Fundoscopy revealed papilledema in 5 patients and optic atrophy in 1 patient. The patients were successfully managed with decrease dose/discontinuation of ATRA, use of acetazolamide, corticosteroids and therapeutic CSF drainage.
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Fracture neck of femur is a devastating injury. One of its main complications is avascular necrosis [AVN] of the femoral head. For the fixation of femoral neck fractures, cannulated screws are now universally used. The aim of the study was to determine the frequency of avascular necrosis in fracture neck of femur fixed with cannulated screws. Descriptive cross sectional study. Orthopedic unit of Ayub Teaching Hospital Abbottabad. 7[th] March, 2011 to 6[th] September, 2011. Recruiting 113 patients of either gender between 15 to 60 years of age with fracture neck of femur who were fixed with cannulated screws. The data was entered and analyzed with the help of SPSS 10. There were 113 patients with an overall mean age of 43.51 years +/- 11.94SD. Maximum number of patients was 56 [49.50%] from the age group of 46 to 60 years. Avascular necrosis was noted in 23 [20.35%] cases. The maximum number of patients with avascular necrosis was 13 [56.52%] belonging to the age group of 15 to 25. Avascular necrosis was high in younger ages in displaced fractures of neck of femur treated with cannulated screws
Subject(s)
Humans , Female , Male , Middle Aged , Adult , Femur Head Necrosis/epidemiology , Bone Screws , Cross-Sectional StudiesABSTRACT
To determine frequency of thrombocytopenia and thrombocytosis, the MPV [mean platelet volume] and PDW [platelet distribution width] in patients with probable and culture proven neonatal sepsis and determine any association between platelet counts and mortality rate. Descriptive analytical study. NICU, Fazle Omar Hospital, from January 2011 to December 2012. Cases of culture proven and probable neonatal sepsis, admitted in Fazle Omar Hospital, Rabwah, were included in the study. Platelet counts, MPV and PDW of the cases were recorded. Mortality was documented. Frequencies of thrombocytopenia [< 150000/mm[3]] and thrombocytosis [> 450000/mm[3] were ascertained. Mortality rates in different groups according to platelet counts were calculated and compared by chi-square test to check association. Four hundred and sixty nine patients were included; 68 [14.5%] of them died. One hundred and thirty six [29%] had culture proven sepsis, and 333 [71%] were categorized as probable sepsis. Thrombocytopenia was present in 116 [24.7%], and thrombocytosis was present in 36 [7.7%] cases. Median platelet count was 213.0/mm[3]. Twenty eight [27.7%] patients with thrombocytopenia, and 40 [12.1%] cases with normal or raised platelet counts died [p < 0.001]. Median MPV was 9.30, and median PDW was 12.30. MPV and PDW of the patients who died and who were discharged were not significantly different from each other. Thrombocytopenia is a common complication of neonatal sepsis. Those with thrombocytopenia have higher mortality rate. No significant difference was present between PDW and MPV of the cases who survived and died