Online ISSN: 2515-8260

Keywords : thrombocytopenia


STUDY OF CLINICAL OUTCOME IN ADULT PATIENTS WITH SEROLOGICALLY PROVEN DENGUE SYNDROME AT A TERTIARY HOSPITAL.

Panuganti Raveen, Panuganti Ratnachary, K. Sudharani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 755-762

Background: Dengue fever is an acute febrile illness (AFI) caused by one or more dengue viruses belonging to genus Flavivirus and transmitted by Aedes aegypti mosquito. The exact clinical and laboratory profile is crucial for early diagnosis and management of patients. Present study was aimed to study clinical outcome in adult patients with serologically proven dengue syndrome at a tertiary hospital.
Material and Methods: Present study was hospital based, observational study, conducted in patients of age > 18 years, of either gender, with acute febrile illness, with serologically proven dengue syndrome admitted in wards & ICUs.
Results: We studied 210 serologically proven dengue patients in present study. Majority of patients were from 31-40 years age group (29.05%), were male (60.48%), NS 1 Positive (81.90%). In present study, non-severe dengue (83.81%) cases were more as compared to severe Dengue fever(DHF) (16.19%). Laboratory findings such as hematocrit < 36%, leukopenia, thrombocytopenia, reactive lymphocytes, prolonged PT, prolonged APPT, SGOT>40 IU/L & SGPT >40 IU/L were common in severe dengue group as compared to non-severe dengue group & difference was statistically significant (p

CORRELATION OF SEROLOGICAL MARKERS AND PLATELET COUNT IN DENGUE PATIENTS

Dr. Srividya Yeruva,Dr. Sowjanya Rakam,Dr.Pravallika Mallipeddi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1546-1553

Introduction: Dengue virus infection has emerged as a notable public health problem in recent decades . Laboratory evaluation of  dengue  Serological markers and  platelet count help in early diagnosis and can be used as predictor to reduce the morbidity and mortality of dengue disease.
Aim: Aim of  this  study is  to evaluate  Dengue  serological  markers for early diagnosis of cases  and to study  the correlation between  serological markers  and  platelet count  in dengue positive cases .
Materials and Methods: This was a cross-sectional prospective study  conducted  in  the Tertiary  health care centre , Hyderabad..  All clinically suspected cases of dengue, reported  to various outpatient departments, emergency services and admitted patients in the Hospital were included for this study,  from  July to   September   2018 . The Chi-Square test and statistical software Epi info and MS excel was used to find out the statistical significance of the estimate.
Results:   Among  700 blood  samples were  received from clinically suspected case of dengue , 125 (17.85%)  cases  were detected dengue positive  out of which  65 (52%) cases showed platelet count less than 1 lakh. . In confirmed dengue cases, thrombocytopenia is more consistently found in  dengue  positive cases  with only IgM  and only NS1 positive cases compared to other serological groups.
Conclusion: Detection of  dengue specific serological markers along with platelet count  in the diagnosis of dengue, increases the early diagnosis so as to avoid complications significantly and can be used as prognostic marker to reduce the morbidity and moratlity of dengue disease.

ESTIMATION OF HEMATOLOGICAL PROFILE OF HIV PATIENTS ON ARTIN VINDHYA REGION WITH SPECIAL EMPHASIS ON CD4 COUNT

Dr Hariom Gupta, Dr Ravi Prakash Pandey,Dr Ram Chandra Patel, Dr P. K. Baghel .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2597-2604

BACKGROUND
            Clinically significant hematologic abnormalities are common in HIV infection. Early identification of the hematologic abnormalities would lead to appropriate planning of treatment strategies and prevent further complication. This study was conducted in order to know the pattern of these hematologic abnormalities and its correlation with CD4 count among HIV patients of Vindhya region who were on ART.
METHODOLOGY
            This was a cross sectional, analytic study conducted in the Department of Medicine, SSMCRewa, M.P. between January 2020 to June 2021. The study group included a total number of 200 patients with HIV infection on ART. Patients were investigated for Hb%, total count, differential count and platelet count. CD4 count was obtained by flow cytometric analysis.
AIMS AND OBJECTIVES:
To analyse the hematological profile of people living with HIV/AIDS and To identify the possible correlation between CD4 count and hematological abnormalities.
RESULTS
            Among 200 patients,52.0%were males and 48.0% were females.90.5% were from rural area.The maximum no. of cases had heterosexual mode of transmission, i.e. 179 (89.5%).Out of 145 anemic cases, maximum no. i.e. 68 (46.89%) cases had normocytic anemia followed by 42 (28.97%) cases of macrocytic anemia.Among patients who had ≤200 CD4 counts, 21.27% cases had severe anemia whereas among patients who had >500 CD4 counts none had severe anemia.11.0%ofpatients hadthrombocytopenia. Among patients who have ≤200 CD4 counts, 23.40% have thrombocytopenia whereas among patients who had>500 CD4 counts only 4.87% had thrombocytopenia.   
CONCLUSIONS
            Hematologic manifestations of HIV infection are common and frequent with progression of disease.
            The Present Study revealed a significant increase in the number and severity of cases of anemia with decreasing CD4 cell count.
            We have to provide proper awareness and education about the HIV safety measures, especially in young adolescents and adults, emphasizing to rural population.
            It is important to simultaneously treat HIV patients for hematologic manifestations to reduce morbidity.

Dengue detection and serotyping using multiplex real time polymerase chain reaction: Study from a tertiary care centre in Eastern India

Dr. Manish Ranjan, Dr. Shveta, Dr. Sakshi Kawatra, Dr. Saumya Singh, Dr. Abhishek Agrawal, Dr. Anupama Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1475-1481

Introduction: Dengue is an arboviral infection transmitted through the bite of Aedes mosquitoes having four distinct serotypes DENV 1-4. Secondary infections often lead to increased disease severity. The study was carried out with an aim to analyze dominant serotype in circulation and to find an association between serotype and hematological parameters.
Material & Methods: A total of 163 Dengue Positive samples were subjected to serotype-specific Real-time Polymerase chain reaction to identify the serotype. Hematological parameters viz; WBC counts, Hematocrit value, platelets, lymphocyte % were also studied concurrently for these patients.
Results: The mean age of the participants was 27.2 years with male preponderance.NS1 antigen positive (74.8%), IgM (38%) and both NS1 & IgM positives (12.8%) were detected. The predominant serotype identified was DENV-2(48.4%), DENV-4(43.5%), and DENV-3 (7.9%). Statistically significant difference in platelet counts was observed in DENV-2 & DENV-4.White blood cell counts showed statistically significant differences within DENV-2 and DENV-3 serotypes.
Conclusion: Cocirculation of multiple serotypes of DENV was observed in our study. The application of molecular testing will increase DENV diagnostics, especially in secondary infections which carry more chances of adverse outcomes. We recommend the inclusion of serotype testing in the Dengue diagnostic algorithm to be able to reduce morbidity and mortality.

A Study on Observation of Paltelate Status in Malaria

Yerraguntla Shashidhar,Golla Vahini

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 925-934

The present study was conducted in the Department of medicine,Gandhi Hospital,
Secunderabad. 100 malarial fever cases were taken up for the study, which consisted of
79(79%) males and 21% females. Among this, 55% cases were of p.vivax and 45%
p.falciparum. The maximum number of cases fell in the age group of 15-35 years (62%).
100% cases presented with fever, chills and rigors. Other presenting symptoms were
headache (25%)and vomiting (33%). Splenomegaly was seen in 32% cases, while
hepatomegaly in 22%, 15% showed pallor and 8%cases had icterus. Complete
hematological tests were done on cases taken for study and analyzed. Anemia ranged
from 6.0 to 15.6gm/dl, leukocyte count varied from 1.8 to 17.7cu/mm. Platelet count was
done on every patient on day 1, 2, and 3.Thrombocytopenia was seen in 31% (31) cases
of p.vivax, 24% of p.falciparum patients. Association of thrombocytopenia and effect of
treatment was completely analyzed in both p.falciparum and p.vivax the effect of
antimalarial drugs on platelet count was observed. On Day 1 platelet count varied
from 15,000 to 1,94,000. On Day 2 platelet count varied from 14,000 to 1,84,000. On Day
3 platelet count varied from 26,000 to 1,98,000.

A prospective study of coagulation profile in patients of pregnancy induced hypertension

Dr. Manoj Kumar, Dr. Ramesh Kumar Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11030-11035

Introduction: The most common disorders that are associated with pregnancy are
Eclampsia. Hypertensive disorders of pregnancy affect about 10% of all pregnant
women globally. The prevalence of Pregnancy Induced Hypertension in India ranges
from 5 - 8%. Hypertensive disorders of pregnancy are the frequent cause of severe
acute morbidity, long term disability and death among pregnant mothers and
babies.Abnormal coagulation of blood can be a cause of frequent haemorrhages in
women. There is a strong association between the two most important causes of
maternal mortality and morbidity globally such as Preeclampsia and Postpartum
haemorrhage. Recently, there is no observable screening test that would help in
identifying which pregnancy will be affected with PIH or assess its
severity.Hypertension prior to 20 weeks gestation is almost always is due to chronic
hypertension; preeclampsia is rare prior to the third trimester.5 Hence this study was
done to study the platelet and coagulation abnormalities occurring in patients of PIH
including platelet count, PT and APTT parameters.

Correlation of D-dimer levels with severity of dengue fever

Dr Jilla Naganna, Dr Gadiga Srikanth Goud, Dr Sneha, Dr Vasanth Kumar Suram

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10239-10247

Introduction: Thrombocytopenia and bleeding are common complications of dengue
fever. Platelet count is a poor predictor of bleeding manifestations. A surrogate marker
of bleeding can be D-Dimer assay which is often used to describe coagulation activity in
a patient. This project aims to study the correlation of D-dimer level with coagulation
parameters so that d-dimer assay can be considered as an important predictor and
prognostic marker for development of hemorrhage or shock in dengue.
Methodology: This was a cross sectional study done on dengue patients attending
Gandhi hospital from 2019 to 2021. Patients were grouped in to 2 groups – group1
having no bleeding manifestations and group 2 having bleeding manifestations. D-dimer
levels in both groups were compared with platelet count, aPTT, PT and INR. Means of
both groups were compared using student’s unpaired t-test. p value of <0.05 was taken
as significant. Correlation of d-dimer with thrombocytopenia and coagulation
parameters was done using Pearson’s correlation
Results: 100 patients were recruited in this study. Of these 100, 57 patients did not have
any bleeding manifestation and 43 had bleeding manifestations. Mean age in group 1
was 40.60±16.14 and in group 2 was 38.95±15.60. Group 1 had 23 (40.35%) females and
group 2 had 17 (39.53%) females. Mean platelet count in group 1 was
72,263.16±26,340.85 /ul while in group 2 was 54,813.95±16,844.18 /ul. Mean APTT in
group 1 was 36.65±2.02 seconds while in group 2 was 37.67±2.22 seconds. Mean APTT
in group 1 was 36.65±2.02 seconds while in group 2 was 37.67±2.22 seconds. Mean PT in
group 1 was 15.46±1.49 seconds while in group 2 was 16.16±1.79 seconds. Mean INR in
group 1 was 1.41±0.14 while in group 2 was 1.80±0.20. Mean D-Dimer in group 1 was
929.74±268.46 ng/ml while in group 2 was 5034.53±2024.85 ng/ml. All parameters were
significantly higher in group with bleeding compared to non-bleeding (p>0.05). D dimer
had positive correlation with thrombocytopenia, APTT, PT and INR. Association of d
dimer with APTT, PT and INR was higher in bleeding group.
Conclusion: D-dimer levels were raised in dengue patients with bleeding. Strong
association of d-dimer levels with thrombocytopenia, APTT, PT and INR was seen in
both groups. Hence it can be concluded that detection of D dimer in febrile stage of
dengue infection may be beneficial for predicting the clinical course of the disease

DIAGNOSTIC SIGNIFICANCE OF THROMBOCYTOPENIA IN MALARIA AND ITS CORRELATION WITH TYPE AND SEVERITY OF MALARIA

Dr. Amita Patel, Dr. Shetal Chauhan, Dr. Bimal Chauhan, Dr. Vandana Patel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1413-1417

Introduction: Malaria remains today one of the major health hazards in the tropics having
increased morbidity and mortality. It is one of the most common hematological parasites in
tropical and subtropical countries particularly in the continents of Africa and Asia. More than
40% of the world population reside in malaria-endemic area and it is accountable than 300-
500 million cases and 1.5-2.7 million deaths will occur in each approaching year.Among
these manifestations, thrombocytopenia is the most common complication presented in both
the species of malaria, viz-P. falciparum and P.vivax. The clinical diagnosis of malaria is
always challenging as signs and symptoms overlap with other febrile illnesses. The gold
standard technique for diagnosis is smear positivity. Among the hematological abnormality
thrombocytopenia is the most common but its correlation with the type of malaria and its
prognostic implications have not been evaluated in many of the studies.