impact of mean corpuscular volume in identifying thalassemia trait through the premarital screening program in northern Jordan

To study the significance of Mean Corpuscular Volume [MCV] measurement in the identification of thalassemia trait during a premarital screening program in Irbid in north of Jordan. All couples applied for marriage procedures in Irbid city were screened over a one year period. When MCV results were less than 80 fL in both of them, then hemoglobin electrophoresis was performed to both to confirm the diagnosis of thalassemia trait. The subjects were considered to have the beta-thalassaemia trait if they had a hemoglobin A2 level of more than 3.2% or a hemoglobin F level of more than 2%. During the study period, premarital screening of hemoglobinopathies was evaluated retrospectively in 1752 subjects [876 couples]. MCV less than 80 fL was detected in 568 [32.4%] subjects [284 couples] for whom Hb electrophoresis was further measured. HbA2 higher than 3.2%was found in 110 of them, 47 [16.4%] female subjects and 63 [22.3%] male subjects. The percentage of high HbA2 from the total accounts of subjects evaluated in premarital screening was calculated to be [0.062] and for those with low MCV was [19.4%] with a 95% confidence interval value 0.736 [o.449-1.034]. Fourteen couples both of them have high HbA2. HbF was found to be high in another 26 [4.5%] subjects from both sexes, 5 couples both of them have high HbF, and that HbS and HbC were 8 [1.4%] and 2[0.4%], respectively. From this study, we concluded that the measurement of MCV alone is an effective preliminary premarital screening tool to identify possible thalassemia trait. For those with possible thalassemia trait, Hb electrophoresis will identify definite cases of thalassemia trait

effect of neonatal sepsis on platelet count and their indices

To study the effect of neonatal sepsis on the platelets' counts and sizes. Also, our study aims to verify if there are significant differences in the platelet's indices between gram-positive or gram-negative sepsis or being full term or premature. This study was conducted prospectively over a one year period starting from January 2006 at Princess Rahmah Teaching Hospital. The study included all neonates who were admitted to neonatal intensive care units with a clinical diagnosis of sepsis. Only neonates who had positive blood culture results were included in the study, else were excluded from the study. All neonates included in the study had full septic work up including the platelet's number and size. Other serological and radiological investigations were selectively done when needed. Neonatal sepsis was diagnosed in 105 cases. Sepsis caused by gram-positive microorganisms was seen in 50 [47.6%] with Staphylococcus coagulase negative microorganism being the commonest accounting for 44 [41.9%]. Gram-negative microorganism was seen in 55 [52.4%], with klebsiella pneumonia accounting for 42 [40%]. Full term babies' account for 59 [56.1%] while premature babies account for 46 [43.9%]. Thrombocytopenia was present in 45[42.8%] of the all cases of neonatal sepsis, of which 27 [60%] were found among gram negative sepsis. The remaining 18 [40%] cases were due to gram-positive microorganisms. 19 [42.2%] of the cases of thrombocytopenia are premature babies and 26 [57.8%] are full term babies. The mean platelet volume was found to be high in 29 [27.6%] of all cases. Nineteen [65.5%] were found to be attributed to gram negative sepsis and the remaining 10 [34.4] of cases were gram positive microorganism. Low platelets count and high mean platelets volume was present in nearly quarter of children with neonatal sepsis. There is no statistical significance difference in these indices and gram negative or positive sepsis, neither being premature or full term baby. [MPV] Mean Platelet Volume, [PWD] Platelet Distribution Width, [PRTH] Princess Rahmah Teaching Hospital, [SCBU] Special Care Baby Unit