Diagnostic importance of mean platelet volume, platelet distribution width and platelet large cell ratio as screening tool in immune thrombocytopenia.

OBJECTIVE: To determine diagnostic importance of mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (PLCR) in diagnosing cases of immune thrombocytopenia. METHODOLOGY: The study was done in Khyber Teaching hospital from January 2017 to May 2018. Cases with low platelet count of all the ages and both the genders were included in the study by non probability purposive sampling technique and were subjected to bone marrow aspiration to rule out other causes of thrombocytopenia and thus confirm the diagnosis of immune thrombocytopenia. The platelet indices were noted and their sensitivity, specificity and accuracy were determined for immune thrombocytopenia. Mean and standard deviation were used for quantitative data. Percentage and frequency were used to measure qualitative data. Data was analysed by SPSS. RESULTS: 84 cases with thrombocytopenia of mean age 23.4 ±â€Š12.1 years (range 7-81 years) were included in the study. There were 38 (45.2%) males and 46 (54.8%) females. There were 40 cases of immune thrombocytopenia. The sensitivity and specificity for PDW (59.1% and 43.1%, respectively), MPV (59.1% and 52.9%, respectively), and PLCR (50% and 52.9%, respectively) were found low to be used as screening tool for immune thrombocytopenia. CONCLUSION: The MPV, PDW and PLCR has low sensitivity and specificity and therefore should not be used as reliable screening tool in giving preliminary diagnosis of the immune thrombocytopenia.

Pathological fracture of femoral neck in a middle-aged woman: a rare presentation of primary hydatid cyst disease in humans.

Hydatid disease in humans is caused by Echinococcus granulosus. It most commonly involves the liver and, to a lesser extent, the lungs and spleen; however, it is known to involve other areas, too. Involvement of bone by hydatid cyst is rare. Here, we describe the case of a 37-year-old woman who presented with pain in the left groin and swelling in the left thigh. The radiological imaging showed a fracture of the femoral neck and cysts in the shaft of the femur. Diagnosis of hydatid cyst was confirmed on the basis of histopathology of biopsy specimens. The patient recovered after surgical excision of the cyst. This case illustrates the various sites and presentations of hydatid cyst disease, and the need to investigate for it if cystic bony lesions are encountered especially in endemic regions, as a delay in diagnosis can lead to long-term morbidity and even death.