Platelet function tests: A 5-year audit of platelet function tests done for bleeding disorders in a tertiary care center of a developing country

Introduction: The platelet function disorders remain largely undiagnosed or incompletely diagnosed in developing nations due to lack of availability of tests like lumiaggregometry, granule release assay or molecular testing. We performed a retrospective analysis of all the platelet function test (PFT) carried out in past 5 years by Light transmission aggregometery (LTA) using a panel of agonist. The indications and the test results were analyzed by two hematopathologist with the aim to look into the present diagnostic facilities or lack of it for correct diagnosis. This is essential for better management and genetic counselling. Materials and Methods: The PFT was performed both on patients and healthy unrelated age specific controls by light transmission aggregometry on Chronolog platelet aggregometer using platelet rich plasma. The panel of agonists included ADP (10?m/l and 2.0 ?m/l), epinephrine (10.0 ?m/l), collagen (2?g/ml), arachidonic acid (0.75 mM) and ristocetin (1.25 mg/ml & 0.25 mg/l). Results: The 5 years records of 110 cases were audited, 101 of these were tested for clinical bleeding , 35 adults and 66 children. The adults included 29 women and 6 men, 17 to 82 years of age. The children were 16 years to 3 months of age, 30 girls and 36 boys. Platelet function test abnormality was found in 31.6% (32/101) cases ,a majority remained undiagnosed of these about 21% had clinically significant bleeding.The cases diagnosed included Glanzmann Thromboasthenia-11 , von Willebrand Disease-6, Bernard Soulier'syndrome-1, storage pool disorder-6, mild defect of Epinephrine-3, isolated defect with collagen in1. Conclusion: An epidemiologically large proportion of platelet function disorders amongst people living in developing nations remain undiagnosed. This lacunae needs to be highlighted and addressed on larger scale. The options available are to increase the available armamentarium of tests or international collaboration with a specialized laboratory to aid in complete diagnosis.

Pattern of computer and internet use among medical students in Coastal South India.

Background: The use of computers is increasing among medical students, therefore we carried out a cross sectional study in Mangalore, India, with the objective of assessing the pattern of computer and Internet use among both undergraduate and postgraduate medical students. Methods: A total of 500 medical students from 4 different medical colleges in Mangalore participated in the study. 400 were undergraduates and 100 were postgraduates / interns. A pre-tested semi-structured questionnaire was used to collect data and data analysis was done using SPSS Version 11. Results: The majority of students who participated in the study were from the age group 19-21years constituting 34.6%. The computer was used for entertainment mainly by the 1st and 2nd year medical students (69.5%) whereas 40% PG / Interns use it for general information and 31% for research activities. Majority of the PG/Interns (77%) were satisfied with computer assisted teaching while 20% 1st and 2nd year students were not. Majority of 1st and 2nd year medical students (50.5%) use Internet most often to communicate socially while 21% Pre final and final year students use Internet most often to engage in work for classes. The use of E-mail was the most popular of Internet services used by 87% PG/Interns. Conclusion: A significant relationship was demonstrated between the year of study and the purpose of computer/Internet use. As the students progress through their curriculum the use of computer for entertainment is declining and use for general information and thesis / research work is rising.

Trends in neonatal outcome with low Apgar scores.

Trends in incidence and neonatal outcome following low Apgar scores (1 min Apgar score < 6) were prospectively studied during the years (1981, 1983, 1986 and 1988. The incidence of birth asphyxia was 7.6% of live births during the study period; it was 5.8% in 1981, increased to highest of 8.9% in 1986 with slight reduction to 7.2% in 1988. Birth weight distribution of asphyxiated babies and 1 min Apgar score < 3 (severe asphyxia) remained unchanged. A significant decline in neonatal mortality with asphyxia was noted from 46.0% to 28.4% during 1981 and 1988 respectively. Aetiological factors for asphyxia could be identified in nearly 90% of infants during 1988, and all but 2 of 12 factors studied registered significant differences from control non-asphyxiated group.