Résumé
Background: Mild microcytic hypochromic anaemias due to iron deficiency (IDA) and beta thalassemia trait(β-TT) continue to be a cause of significant burden to the society, particularly in the poorer developing countries. The objective of the present study was to study the RBC based indices in patients of marked anisopoikilocytosis in determining the etiology of it, to standardize few automated red cell parameters, and also objective grading of RBC morphology on peripheral smear and interpreting its utility in indicating a diagnosis. Also, to establish a relation between value of RBC indices with that of degree of anisocytosis.Methods: A total of 500 patients diagnosed with mild microcytic hypochromic anaemia on complete blood count and peripheral blood film were included in the study. Hb, RBC count, MCV, MCH and RDW obtained from the electronic cell counter were used to calculate discrimination indices by various mathematical formulae. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden’s index (YI) were calculated.Results: Green and King index demonstrated the lowest sensitivity of 70.51%. Mentzer index demonstrated the highest specificity of 96.80%. The highest and lowest PPV were found for Mentzer index (97.09%) and Sehgal index (92.81%) respectively. Sehgal’s index demonstrated the highest NPV of 95.96% and lowest NPV was exhibited by G and K (87.9%). The highest and the lowest values for Youden’s index were shown by Sehgal’s index (87.82%) and G and K index (68.47%).Conclusions: Sehgal’s index followed by Mentzer index are highly sensitive and reasonably specific in differentiating β-TT from IDA and none of the indices is 100% sensitive and specific. Though HbA2 estimation is the gold standard for diagnosing β-TT, in developing countries, Sehgal index followed by Mentzer et al, index can be used to screen mild microcytic hypochromic anaemia cases to eliminate as many false positive cases as possible to reduce the financial cost.
Résumé
Anemia, reduced red cell mass below normal range, results in reduction of oxygen carrying capacity of bloodthat results in tissue hypoxia. MCV, MCH, MCH and RDW represent a sensitive indicator to study erythrocytemorphology. Mentzer Index recommended MI<13 to be suggestive of â-TT and MI>13 for Iron deficiencyanemia. 100 cases were analyzed prospectively over a span of 1 year at MMIMSR, Mullana. The studyrevealed 34% of patients to be in age group of 21-30 years with (59%) female predominance out of whichmajority of cases were of moderate anemia (73%). Erythrocyte indices revealed pattern with majority ofsamples having MCV, MCH and MCHC to be in normal range while RDW showed increased values. Mentzerindex came out to be >14 in 96% of samples. To conclude evaluation of erythrocyte indices and Mentzerindex aids in quatitative assessment of anemia and also to distinguish between iron deficiency anemia andthalassemia trait.
Résumé
Background: The association between anaemia and iron deficiency anaemia with febrile seizures is still not very well understood. The purpose of this study was to describe the occurrence of anaemia in children admitted with first episode of febrile seizures.Methods: This was a hospital based prospective study conducted at Central Referral Hospital, Gangtok, Sikkim, India from December 2012 to May 2014 on 50 children in the age group of 6 to 60 months admitted with first episode of febrile seizures. Detailed history and physical examination were performed and findings recorded and complete blood count, serum electrolytes and random blood sugar were done in all children. Mentzer Index was calculated from the haematological data.Results: The mean age in this study was 24.88'13.22 months. 74% of the cases were males. Twenty-eight children (56%) had anaemia out of which twenty-seven had Iron deficiency anaemia. The statistical analysis of qualitative data using Chi-square test with Yate's correction revealed no statistically significant difference between number of children with anaemia and no anaemia (p value=0.1493) and also between number of children with Iron deficiency anaemia and children with no Iron deficiency anaemia (p value=0.4478).Conclusions: This study did not reveal a higher occurrence of anaemia as well as iron deficiency anaemia in children admitted with first episode of febrile seizures.