Online ISSN: 2515-8260

Keywords : Platelet count


CORRELATION BETWEEN SEVERITY OF THROMBOCYTOPENIA AND PORTAL HYPERTENSIVE GASTROPATHY IN PATIENTS WITH CHRONIC LIVER DISEASE

Srinivasa Guptha L.R , Sachin K. Dhande , Rajalakshmi K.V ,Dayanandan Y, Jagadeesan M

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2711-2717

Background: Portal hypertensive gastropathy (PHG) is known but under detected complication of cirrhosis of liver. Patients with stable liver disease are more prone to internal bleeding due to portal hypertension. Thrombocytopenia is a common complication associated with chronic liver disease and it is associated with poor prognosis.
Aim: The aim of this study is to find out the association between correlation between severity of thrombocytopenia and portal hypertensive gastropathy in patients with chronic liver disease.
Materials and Methods: This cross-sectional analytical study was conducted in a tertiary care centre at Saveetha Medical College Hospital and Research Centre. A total of 80 consecutive subjects were included in this study. All adult patients admitted with diagnosis chronic liver disease underwent upper GI endoscopy; those with portal hypertensive gastropathy(PHG) were included. Platelet count was estimated and severity of gastropathy was classified. Correlation of thrombocytopenia and severity of gastropathy was studied. Statistical analysis was done using SPSS 21. Statistical analysis was done by t test and chi-square test.
Results: Patients withmild PHG category had normal platelet count between 1.5-4.5 lakhs/mm3. But in patients with severe PHG, almost 80% of patients had thrombocytopenia, in which 8% had severe thrombocytopenia <50,000 cells/mm3. The inverse relationship between the platelet count and the severity of PHG was statistically significant.
Conclusion: The severity of thrombocytopenia increased with the increasing grade of portal hypertensive gastropathy. Hence platelet count can serve as the prognostic marker of chronic liver disease induced portal hypertensive gastropathy.

STUDY OF ROLE OF PLATELET COUNT AND MEAN PLATELET VOLUME IN EVALUATING THE DISEASE SEVERITY IN COVID 19 INFECTION-OUR EXPERIENCE AT TERITARY CARE HOSPITAL

A.Smitha Reddy, B.V. Anuradha Devi, Swarupa Ravuri, B. Nageshwar Rao, Danda Samyukta Reddy, Anunayi Jestadi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 185-192

INTRODUCTION: Patients Infected with CORONA VIRUS- 2019 (COVID-19) showed changes in their platelet counts and Mean platelet volume (MPV). The present study was aimed to observe any association between lowered platelet counts with mean platelet volume (MPV) from the corana positive individuals.
METHODS: It is a prospective study from 1-8-2020 to 30-9-2020 .Patients  who presented with complaints of Fever, sore throat, body pains, cough, breathlessness, diarrhoea were evaluated at the triage area of the Hospital. Throat swab was taken and RT-PCR was done and only 200 confirmed cases were included in the study. Patient blood samples were collected and processed in SYSMAX 5 -part Haematology analyser in the Hospital Central Laboratory. The patients CBP, Platelet count and MPV were tabulated.
RESULTS: Out of 200 COVID-19 confirmed cases, the numbers of males were 145 (72.5%) and females 55 (27.5%). Most of the patients belonged to age group 50 years (25.5%), 60yrs age group (21%).  The Maximum age in our study group was 80 years, minimum age was 19 years and mean age was 50 years. In our study it was noticed that Severe thrombocytopenia was seen in one patient with platelet count 38,000/μL,(0.5%), Moderate thrombocytopenia was seen in two patients(1%) and mild thrombocytopenia  was seen in 12 (6%) cases. In our study only fifteen cases (7.5%) showed thrombocytopenia. The MPV for all fifteen cases were studied and MPV was in Range of 9.6- 11.8 fl.
CONCLUSION: Low platelet count and high MPV are associated with disease severity. Platelet count is one of easy cheap method for the assessing the disease severity along with other parameters 

PLATELET COUNT IN WOMEN WITH PREGNANCY INDUCED HYPERTENSION

Mrs. K. Ayesha Siddikhakhatoon, Dr. Macherla Bikshapathy

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2672-2679

Objective:  One of the most common and potential life threatening complications of pregnancy is pregnancy induced hypertension. This cross-sectional study aimed to investigate the relationship between platelet count and pregnancy induced hypertension.
Materials and Methods: This is a present cross-sectional study was carried out in the Department of Medicine and Obstetrics and Gynecology, Maheshwara Medical College & Hospital over a period of 1 year among 60 subjects. The subjects for this cross-sectional study included consecutively - recruited Normotensive (n = 130) serve as a control, Non-Sever Pre-eclamptic (N = 35) and Severe pre-eclamptic (n = 35). All consenting, adult (≥ 18 years) pregnant women who were confirmed to have pregnancy induced hypertension by an Obstetrician constituted the subjects for these subjects.
Results: A total of 200 pregnant women were included in the study. Platelet count and platelet crit levels tend to decrease as pre-eclampsia becomes more severe. In this study, no statistically significant differences were observed between the three groups in age, residence, number of pregnancies (gravidity), number of deliveries (parity), gestational age, and BMI, but there was a significant difference between the three studied groups with regards to SBP, DBP and MAP which increased with severity of preeclampsia (P<0.001). The value of PLT accounts 180(97–352) ×103/μl for pre-eclamptic women and 260(139–445) ×103/μl for normotensive pregnant women (p<0.001).
Conclusion: Platelet indices, including platelet count, mean platelet volume, platelet distribution width, and Platelet crit, have been identified as promising candidate markers for predicting preeclampsia in pregnant women. In the future, a serial examination of these indicators during several trimesters of pregnancy should be conducted.

Study of Coagulation Profile in Liver Disease Patients at A Tertiary Care Hospital

Almas Sahir Chopdar; Sneha Suryaji Sangrame; Savita Sanjay Patil; Leena Ashok Nakate

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 595-603

Background: The study of coagulation can be traced back to about 400 BC and to the father of Medicine, Hippocrates. The liver is the cornerstone of the coagulation system. The liver is the site of synthesis of fibrinogen and factors Ⅱ, Ⅴ, Ⅶ, Ⅸ, Ⅹ, Ⅺ and Ⅻ. Von Willebrand factor (VWF) is synthetized by the endothelium. When both cellular and plasmatic coagulation are defective, represents a hallmark of advanced liver disease. There is substantial overlap in the hemostatic abnormalities observed in the patients with acute infectious or toxic hepatitis, chronic hepatitis, and cirrhosis, the severity of hepatocellular dysfunction is typically more informative than the etiology.
Aim & Objective:
1. To determine the coagulative abnormalities among liver disease patients admitted in medicine wards.
2. To study the association of coagulation abnormalities with the extent or severity of liver disease.
Methods: Study design: A Cross sectional study. Study setting: Department of pathology. Study duration: June 2019 to June 2020.
Study population: All patients of acute and chronic liver disease admitted to medicine wards in tertiary care hospital such cases included in the study.
Sample size: 200
Results: most common age group was between 31-40yrs of age, i.e., 32% of total patients. 174 (87%) were male population and 26 (13%) were female population.78(39%) cases of cirrhosis, 46(23%) cases of hepatitis, 44(22%) cases of Alcoholic liver disease, and 32(16%) cases of other liver diseases. patients showed coagulation abnormalities considering different parameters i.e., PT, APTT, Platelet count individually or in combinations, and 11(5.5%) patients showed normal test results. About 87% (174/200) had prolonged PT. Mean PT in present study was 28.33±22.29. P value was <0.05 i.e., 0.013 which was statistically significant
Conclusions: Cirrhosis was the most common pathology amongst the study subjects. The PT was most abnormal test among all tests performed. The platelet count and APTT were the least frequently abnormal test. Hence PT was most significant coagulation test among other tests. The proportion of raised PT was highest in alcoholic liver disease and lowest in case of other liver diseases. Coagulation abnormalities were significantly associated with the extent of liver diseases.

Study the Proportion of Coagulative Abnormalities Among Liver Disease Patients and To Predict Severity in Cirrhosis Patients by Using Child-Pugh-Turcotte Score at Tertiary Care Center

Sneha Suryaji Sangrame; Almas Sahir Chopdar; Savita Sanjay Patil; Leena Ashok Nakate

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 2072-2080

Background: The study of coagulation can be traced back to about 400 BC and to the father of Medicine, Hippocrates. Liver is an important organ of the body having functions of synthesis of plasma proteins and a range of blood clotting factors being produced, some of them exclusively in the organ. All of them are deranged in various liver disorders .Liver plays a predominant role in the regulation of haemostasis. Both cellular and plasmatic coagulation are defective, representing a hallmark of advanced liver disease. Laboratory tests, coagulation tests and liver function tests are useful in the evaluation, management and assessment of prognosis. They provide a sensitive, noninvasive method of screening for the presence of liver dysfunction.
Aim & Objective: 1.To study the proportion of coagulative abnormalities among liver disease patients admitted in medicine wards.2.To study the association of coagulation abnormalities with the extent or severity of liver disease. 3. To predict severity in cirrhosis patients by using Child-Pugh-Turcotte score.
Methods: Study design: Prospective Cross sectional study. Study setting: Department of pathology of tertiary care center. Study duration: April 2021 to April 2022.
Study population: All patients of acute and chronic liver disease admitted to medicine wards in tertiary care hospital such cases included in the study.
Sample size: 200
Results: Majority of cases found in age group of 31-40yrs of age, i.e., 32% of total patients. 174 (87%) were male population and 26 (13%) were female population.78(39%) cases of cirrhosis, 46(23%) cases of hepatitis, 44(22%) cases of Alcoholic liver disease, and 32(16%) cases of other liver diseases. patients showed coagulation abnormalities considering different parameters i.e., PT, APTT, Platelet count individually or in combinations, and 11(5.5%) patients showed normal test results. About 87% (174/200) had prolonged PT. Mean PT in present study was 28.33±22.29. P value was <0.05 i.e., 0.013 which was statistically significant
Conclusions: Majority of cases presented with cirrhosis. The PT was most abnormal test among all tests performed. The platelet count and APTT was the least frequently abnormal test. Hence PT was most significant coagulation test among other tests. The proportion of raised PT was highest in alcoholic liver disease and lowest in case of other liver diseases. Coagulation abnormalities were significantly associated with the extent of liver diseases.

PLATELET INDICES AS USEFUL INDICATORS OF NEONATAL SEPSIS

Venkata Sri Laxmi, Pravallika Mallipeddi, Varun Kanakam

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1479-1484

Background:Neonatal septicemia is a clinical syndrome characterized by signs and symptoms of infection with accompanying bacteremia in the first month of life. Despite continuing advances in diagnosis and treatment, it remains one of the important causes of higher mortality and morbidity.Aim of our study is to evaluate the changes of platelet count and indices (MPV, PDW) in neonatal sepsis.
Materials and Methods: It is a prospective crossectional study conducted in Tertiary health center (PRATHIMA INSTITUTE OF MEDICAL SCIENCES) in the DEPARTMENT OF PATHOLOGY in colloboration with neonatology section over a time period of 7 months from January to August 2019.Using convenient sampling method, 100 neonates with sepsis and 100 normal neonates without any medical problems, as the control group were selected. Weight and gestational age matched healthy neonates without any infectious disease served as control. The groups were compared for age, WBC count, neutrophil count, platelet count, PDW AND MPV.
Results: In our study out of 100 cases, early onset sepsis was present in 30 cases, while late onset neonatal sepsis was present in 70 cases.40 neonates showed culture positivity and the remaining 60 showed culture negative sepsis. Statistically significant correlation of MPV with platelet count(high MPV in thrombocytopenic neonates) and outcome. Significant difference in PDW in thrombocytopenic neonates and non-thrombocytopenic neonates. Neonates with sepsis have significantly increased MPV, PDW compared to healthy neonates.
Conclusion: Platelet count and indices can be used as early diagnostic markers in neonatal sepsis. Neonates with sepsis have significantly increased MPV, PDW compared to healthy neonates. Platelet indices are inexpensive and easily available tests can be routinely performed for all neonates suspected to be in sepsis.

DENGUE AND CHIKUNGUNYA OUTBREAKS IN TERTIARY CARE HOSPITALS A RETROSPECTIVE STUDY

G Ratna Prabha, S Rajeshwar Rao

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 687-695

Dengue and chikungunya are two arboviral infections that are common in tropical countries and are spread by aedes mosquitoes. A retrospective study was conducted from June 21 to June 22 to determine the prevalence of these diseases at Gandhi Hospital Secunderabad, Telangana. NIV's IgM antibody capture ELISA kits were used to test for chikungunya.SDdiagnostics performed dengue NS1 antigen testing using ELISA. There were 2981 samples for dengue NS1 antigen, of which 114 (3.8 percent) were positive, and 4822 samples for IgM, of which 618 (12.8 percent) were positive.The number of chikungunya samples received was 4711, with 376 (7.9%) being positive. The age group most commonly affected by dengue was 40–60 years old (37.7 percent) and for chikungunya, 21–40 years (58.7 percent). In terms of gender distribution, males accounted for 58.7 percent of dengue infections and females for 55.7 percent of chikungunya infections, respectively. Dengue infectivity increased the most in September (17.4%) and October (17.11%), while chikungunya infectivity increased the most in September (9.5%) and November (10%). But early detection and treatment, as well as controlling vectors toprevent  the spread of disease, would be good for the community and society as a whole.

THROMBOCYTOPENIA AND DISEASE SEVERITY AMONG COVID 19 PATIENTS

Dr. Divyarani M N , Dr. Manoranjan U D , Mr. Jagadish

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3052-3057

Background: Thrombocytopenia in covid 19 patients were important for treatment and management of the disease. Main objective of the study was to assess thrombocytopenia and its association with disease severity among covid 19 patients. Methods: A cross-sectional study was conducted among 160 patients from April 2020 to December 2020.Sociodemographic and clinical data were collected. Thrombocytopenia has been implicated in patients infected with SARS Cov 2. Results: Among 160 patients, majority were males with mild severity. Platelet count were decreased in severe cases when compared to mild and moderate severity cases and found to be statistically significant(p<0.05).Conclusion: platelet count was an independent risk factor for COVID 19 patients.

Clinical study of dengue fever in children of 1-12 years age group at a tertiary hospital

Dr. Asadkhan S Pathan, Dr. Shivprasad K Mundada,Dr. Asadkhan S Pathan .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1353-1359

Background: Dengue infections vary in severity, ranging from influenza like self-limiting illness to life threatening dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Present study was aimed to study dengue fever in 1-12 years age group at a tertiary hospital.

Analysis of the Dengue Infection, Occurrence and Hematological Profile of Dengue Patients in Dhaka City

Mohammad Zakerin Abedin; Md. Sifat Uz Zaman; Tasnim Ahmad; Md. Abdullah Al Maruf; Md Babul Aktar; Md. Fayez Ahmed; Md. Abu Sayeed Imran; Rubait Hasan; Pinki Akter; Md. Ekhlas Uddin

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1572-1578

In the tropical and subtropical area, dengue virus is mostly found. To the determination of the occur-rence of dengue viral infection and hematological profile of dengue infected peoples in the Dhaka city. A sum of 255 samples of blood from both sex and different age groups were collected in this research. Dengue nonstructural protein 1 (NS1) and complete blood count (CBC) test were performed for the study. During this study period, total 255 samples were tested. Among these, 67samples were diagnosed as positive. Seroprevalence of dengue was 26.30%. Out of 67 positive dengue patients, 41 (61.2 %) were male and 26 (38.8 %) were female. Dengue infection was observed more in 21 to 30years age group followed by above 40years and 16 to 20years but observed less in of 1st day to 5years followed by 11 -15years, then 6 -10years and 31 - 40years. It was seen that the >40years of age group had the maximum unit of cases having low platelet count followed by 21-30years and it was also seen that 21-30years of age group had the maximum range of cases having low WBC count followed by above 40years of age group. In our research, we showed thrombocytopenia (100000 - 150,000/μl) with leucopenia (White Blood Cells, WBC <5000/μl) in 8(26.6%) cases and thrombocytopenia (100000-150,000/μl) without leucopenia in 9 (24.3%) cases but thrombocytopenia (<100000/μl) with leucopenia (White Blood Cells (WBC) < 5000/μl) in 5(16.7%) cases and thrombocytopenia (<100000/μl) without leucopenia in 6 (16.2%) cases. Among 67 positive cases, we found that (26.6%) had DF and (16.7%) had DHF according to WHO classification. For validating more reliability, this research needs further work.