scholarly journals Association between haematological parameters and sickle cell genotypes in children with Plasmodium falciparum malaria resident in Kisumu County in Western Kenya

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Paul Kosiyo ◽  
Walter Otieno ◽  
Jesse Gitaka ◽  
Elly O. Munde ◽  
Collins Ouma

Abstract Background Sickle cell disease (SCD) is a monogenic disorder due to point mutation in the β-globin gene resulting in substitution of Valine for Glutamic acid. The SCD is prevalent in P. falciparum endemic regions such as western Kenya. Carriage of different sickle cell genotypes may influence haematological parameter during malaria. Children resident in malaria holoendemic regions suffer more from malaria-related complications and this is moderated by the presence of the SCD. In the current study, we determined the association between sickle cell genotypes and haematological parameters in children with P. falciparum malaria resident in Kisumu County in Western Kenya. Methodology Children (n = 217, aged 1–192 months) with acute febrile condition were recruited at Jaramogi Oginga Odinga Teaching and Referral Hospital. Chi-square (χ2) analysis was used to determine differences between proportions. Differences in haematological parameters were compared across groups using Kruskal Wallis test and between groups using Mann Whitney U test. Multivariate logistic regression analysis controlling for infection status was used to determine the association between sickle cell genotypes and haematological parameters. Results Using HbAA as the reference group, multivariate logistic regression analysis revealed that carriage of HbSS was associated with reduced haemoglobin [OR = 0.310, 95% CI = 0.101–0.956, P = 0.041], reduced haematocrit [OR = 0.318, 95% CI = 0.128–0.793, P = 0.014], reduced RBC count [OR = 0.124, 95% CI = 0.045–0.337, P = 0.001], reduced MCHC [OR = 0.325, 95% CI = 0.118–0.892, P = 0.029], increased leucocytosis [OR = 9.283, 95% CI = 3.167–27.210, P = 0.001] and reduced monocytosis [OR = 0.319, 95% CI = 0.123–0.830, P = 0.019]. However, carriage of HbAS was only associated with increased micro-platelets [OR = 3.629, 95% CI = 1.291–8.276, P = 0.012]. Conclusion Results show that carriage of HbSS in children influence the levels of haemoglobin, haematocrit, RBC, MCHC, WBC and Monocytes. Therefore prior knowledge of HbSS should be considered to improve clinical management of haematological alterations during malaria in children.

2020 ◽  
Author(s):  
Paul Kosiyo ◽  
Walter Otieno ◽  
Jesse Gitaka ◽  
Elly O. Munde ◽  
Collins Ouma

Abstract Background: Sickle cell disease (SCD) is a monogenic disorder due to point mutation in the β-globin gene resulting in substitution of Valine for Glutamic acid. The SCD is prevalent in P. falciparum endemic regions such as western Kenya. Carriage of different sickle cell genotypes may influence haematological parameter during malaria. Children resident in malaria holoendemic regions suffer more from malaria-related complications and this is moderated by the presence of the SCD. In the current study, we determined the association between sickle cell genotypes and haematological parameters in children with P. falciparum malaria resident in Kisumu County in Western Kenya.Methodology: Children (n=217, aged 1-192 months) with acute febrile condition were recruited at Jaramogi Oginga Odinga Teaching and Referral Hospital. Chi-square (c2) analysis was used to determine differences between proportions. Differences in haematological parameters were compared across groups using Kruskal Wallis test and between groups using Mann Whitney U test. Multivariate logistic regression analysis controlling for infection status was used to determine the association between sickle cell genotypes and haematological parameters. Results: Using HbAA as the reference group, multivariate logistic regression analysis revealed that carriage of HbSS was associated with reduced haemoglobin [OR=0.310, 95% CI=0.101-0.956, P=0.041], reduced haematocrit [OR=0.318, 95% CI=0.128-0.793, P=0.014], reduced RBC count [OR=0.124, 95% CI=0.045-0.337, P=0.001], reduced MCHC [OR=0.325, 95% CI=0.118-0.892, P=0.029], increased leucocytosis [OR=9.283, 95% CI=3.167-27.210, P=0.001] and reduced monocytosis [OR=0.319, 95% CI=0.123-0.830, P=0.019]. However, carriage of HbAS was only associated with increased micro-platelets [OR=3.629, 95% CI=1.291-8.276, P=0.012]. Conclusion: Results show that carriage of HbSS in children influence the levels of haemoglobin, haematocrit, RBC, MCHC, WBC and Monocytes. Therefore prior knowledge of HbSS should be considered to improve clinical management of haematological alterations during malaria in children.


2020 ◽  
Author(s):  
Paul Kosiyo ◽  
Walter Otieno ◽  
Jesse Gitaka ◽  
Elly O. Munde ◽  
Collins Ouma

Abstract Background: Sickle cell disease (SCD) is a monogenic disorder due to point mutation in the β-globin gene resulting in substitution of Valine for Glutamic acid. The SCD is prevalent in P. falciparum endemic regions such as western Kenya. Carriage of different sickle cell genotypes may influence haematological parameter during malaria. Children resident in malaria holoendemic regions suffer more from malaria-related complications and this is moderated by the presence of the SCD. In the current study, we determined the association between sickle cell genotypes and haematological parameters in children with P. falciparum malaria resident in Kisumu County in Western Kenya.Methodology: Children (n=217, aged 1-192 months) with acute febrile condition were recruited at Jaramogi Oginga Odinga Teaching and Referral Hospital. Chi-square (c2) analysis was used to determine differences between proportions. Differences in haematological parameters were compared across groups using Kruskal Wallis test and between groups using Mann Whitney U test. Multivariate logistic regression analysis controlling for infection status was used to determine the association between sickle cell genotypes and haematological parameters.Results: Using HbAA as the reference group, multivariate logistic regression analysis revealed that carriage of HbSS was associated with reduced haemoglobin [OR=0.310, 95% CI=0.101-0.956, P=0.041], reduced haematocrit [OR=0.318, 95% CI=0.128-0.793, P=0.014], reduced RBC count [OR=0.124, 95% CI=0.045-0.337, P=0.001], reduced MCHC [OR=0.325, 95% CI=0.118-0.892, P=0.029], increased leucocytosis [OR=9.283, 95% CI=3.167-27.210, P=0.001] and reduced monocytosis [OR=0.319, 95% CI=0.123-0.830, P=0.019]. However, carriage of HbAS was only associated with increased micro-platelets [OR=3.629, 95% CI=1.291-8.276, P=0.012].Conclusion: Results show that carriage of HbSS in children influence the levels of haemoglobin, haematocrit, RBC, MCHC, WBC and Monocytes. Therefore prior knowledge of HbSS should be considered to improve clinical management of haematological alterations during malaria in children.


2020 ◽  
Author(s):  
Paul Kosiyo ◽  
Walter Otieno ◽  
Jesse Gitaka ◽  
Elly O. Munde ◽  
Collins Ouma

Abstract Background: Sickle cell disease (SCD) is a monogenic disorder due to point mutation in the β-globin gene resulting in substitution of Valine for Glutamic acid. The SCD is prevalent in P. falciparum endemic regions such as western Kenya. Carriage of different sickle cell genotypes may influence haematological parameter during malaria. Children resident in malaria holoendemic regions suffer more from malaria-related complications and this is moderated by the presence of the SCD. In the current study, we determined the association between sickle cell genotypes and haematological parameters in children with P. falciparum malaria resident in Kisumu County in Western Kenya.Methodology: Children (n=217, aged 1-192 months) with acute febrile condition were recruited at Jaramogi Oginga Odinga Teaching and Referral Hospital. Chi-square (2) analysis was used to determine differences between proportions. Differences in haematological parameters were compared across groups using Kruskal Wallis test and between groups using Mann Whitney U test. Multivariate logistic regression analysis controlling for infection status was used to determine the association between sickle cell genotypes and haematological parameters. Results: Using HbAA as the reference group, multivariate logistic regression analysis revealed that carriage of HbSS was associated with reduced haemoglobin [OR=0.310, 95% CI=0.101-0.956, P=0.041], reduced haematocrit [OR=0.318, 95% CI=0.128-0.793, P=0.014], reduced RBC count [OR=0.124, 95% CI=0.045-0.337, P=0.001], reduced MCHC [OR=0.325, 95% CI=0.118-0.892, P=0.029], increased leucocytosis [OR=9.283, 95% CI=3.167-27.210, P=0.001] and reduced monocytosis [OR=0.319, 95% CI=0.123-0.830, P=0.019]. However, carriage of HbAS was only associated with increased micro-platelets [OR=3.629, 95% CI=1.291-8.276, P=0.012]. Conclusion: Results show that carriage of HbSS in children influence the levels of haemoglobin, haematocrit, RBC, MCHC, WBC and Monocytes. Therefore prior knowledge of HbSS should be considered to improve clinical management of haematological alterations during malaria in children.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Atsushi Kotera

Abstract Background Postanesthetic shivering is an unpleasant adverse event in surgical patients. A nonsteroidal anti-inflammatory drug has been reported to be useful in preventing postanesthetic shivering in several previous studies. The aim of this study was to evaluate the efficacy of flurbiprofen axetil being a prodrug of a nonsteroidal anti-inflammatory drug for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries. Method This study is a retrospective observational study. I collected data from patients undergoing gynecologic laparotomy surgeries performed between October 1, 2019, and September 30, 2020, at Kumamoto City Hospital. All the patients were managed with general anesthesia with or without epidural analgesia. The administration of intravenous 50 mg flurbiprofen axetil for postoperative pain control at the end of the surgery was left to the individual anesthesiologist. The patients were divided into two groups: those who had received intravenous flurbiprofen axetil (flurbiprofen group) and those who had not received intravenous flurbiprofen axetil (non-flurbiprofen group), and I compared the frequency of postanesthetic shivering between the two groups. Additionally, the factors presumably associated with postanesthetic shivering were collected from the medical charts. Intergroup differences were assessed with the χ2 test with Yates’ correlation for continuity category variables. The Student’s t test was used to test for differences in continuous variables. Furthermore, a multivariate logistic regression analysis was performed to elucidate the relationship between the administration of flurbiprofen axetil and the incidence of PAS. Results I retrospectively examined the cases of 141 patients aged 49 ± 13 (range 21-84) years old. The overall postanesthetic shivering rate was 21.3% (30 of the 141 patients). The frequency of postanesthetic shivering in the flurbiprofen group (n = 31) was 6.5%, which was significantly lower than that in the non-flurbiprofen group (n = 110), 25.5% (p value = 0.022). A multivariate logistic regression analysis showed that administration of flurbiprofen axetil was independently associated with a reduced incidence of postanesthetic shivering (odds ratio 0.12; 95% confidence interval, 0.02-0.66, p value = 0.015). Conclusions My result suggests that intraoperative 50 mg flurbiprofen axetil administration for postoperative pain control is useful to prevent postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries.


2020 ◽  
Vol 8 ◽  
Author(s):  
Chen Dong ◽  
Minhui Zhu ◽  
Luguang Huang ◽  
Wei Liu ◽  
Hengxin Liu ◽  
...  

Abstract Background Tissue expansion is used for scar reconstruction owing to its excellent clinical outcomes; however, the complications that emerge from tissue expansion hinder repair. Infection is considered a major complication of tissue expansion. This study aimed to analyze the perioperative risk factors for expander infection. Methods A large, retrospective, single-institution observational study was carried out over a 10-year period. The study enrolled consecutive patients who had undergone tissue expansion for scar reconstruction. Demographics, etiological data, expander-related characteristics and postoperative infection were assessed. Univariate and multivariate logistic regression analysis were performed to identify risk factors for expander infection. In addition, we conducted a sensitivity analysis for treatment failure caused by infection as an outcome. Results A total of 2374 expanders and 148 cases of expander infection were assessed. Treatment failure caused by infection occurred in 14 expanders. Multivariate logistic regression analysis identified that disease duration of ≤1 year (odds ratio (OR), 2.07; p < 0.001), larger volume of expander (200–400 ml vs <200 ml; OR, 1.74; p = 0.032; >400 ml vs <200 ml; OR, 1.76; p = 0.049), limb location (OR, 2.22; p = 0.023) and hematoma evacuation (OR, 2.17; p = 0.049) were associated with a high likelihood of expander infection. Disease duration of ≤1 year (OR, 3.88; p = 0.015) and hematoma evacuation (OR, 10.35; p = 0.001) were so related to high risk of treatment failure. Conclusions The rate of expander infection in patients undergoing scar reconstruction was 6.2%. Disease duration of <1 year, expander volume of >200 ml, limb location and postoperative hematoma evacuation were independent risk factors for expander infection.


2021 ◽  
Author(s):  
Yoshihiro Nakamura ◽  
Shin Yokoya ◽  
Yuki Matsubara ◽  
Yohei Harada ◽  
Nobuo Adachi

Abstract Background The purpose of this study was to identify differences in the morphology of the scapula according to the presence or absence of a rotator cuff tear (RCT). Methods One hundred and three shoulders with and 87 shoulders without RCTs were included in this study. The critical shoulder angle (CSA) and lateral acromion angle in the frontal view and the acromial coverage angle (ACA) and coracoid and scapular spine angle (CSSA) in the lateral view were evaluated using three-dimensional computed tomography. The glenoid anterior tilt, anterior acromial projection angle (AAPA), coracoid process angle, scapular spine angle (SSA) and inferior angle angle (IAA) with respect to the scapular plane were measured in the lateral view. The morphological parameters of the scapula associated with RCT were statistically analysed using a multivariate logistic regression analysis. Results In univariate logistic regression analysis, CSA, ACA, CSSA, AAPA, SSA and IAA were significantly different between shoulders with and without RCTs. In multivariate logistic regression analysis, CSA and IAA were greater in shoulders with RCT and were significantly associated with this condition. Conclusion To the best of our knowledge, this is the first study to focus on the relationship between RCT and the scapular body. RCT cases were characterised by a greater curvature of the scapular body in addition to CSA.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e22524-e22524
Author(s):  
Tomohiro Kondo ◽  
Takahiro Yamada ◽  
Masahiro Yoshioka ◽  
Masakazu Nishigaki ◽  
Yoshihiro Yamamoto ◽  
...  

e22524 Background: Presumed germline pathogenic variants (PGPVs) can be detected in tumor tissues using comprehensive genomic profiling. Clinicians and patients can decide whether to conduct confirmatory germline testing or not. However, the promoting and obstructive factors for confirmatory germline testing are unclear. Methods: This single institutional retrospective study aimed to identify factors related to confirmatory germline testing in patients with PGPVs. Between April 2015 and April 2019, 270 consecutive patients with cancers of unknown primary site, rare tumors, or solid tumors refractory to standard chemotherapy, who underwent tumor-only comprehensive genomic profiling were reviewed. PGPVs were proposed to be disclosed as variants to the patients by our institutional molecular tumor board. Univariate logistic regression analysis was conducted to investigate the relationship between each patient’s characteristics and confirmatory germline testing. Factors showing a statistical relationship (p < 0.10 in univariate analyses) were included in multivariate logistic regression analysis with a backward selection of variables. Statistical significance was set at p < 0.05. Results: Of the 270 patients who underwent tumor-only comprehensive genomic profiling, 77 possessed PGPVs. The most common PGPVs were TP53 (n = 56), APC (n = 9), PTEN (n = 7), RB1 (n = 6), and BRCA2 (n = 6). Among the 77 patients, only 11 (14.3%) chose to undergo confirmatory germline testing. Multivariate logistic regression analysis revealed that the person disclosing the results (experienced oncologists with knowledge of cancer genome medicine vs. others, odds ratio [OR]: 27.7, 95% confidence interval [CI]: 4.60–167) and study period (OR: 0.110, 95% CI: 0.015–0.787) were independently and significantly associated with confirmatory germline testing. Conclusions: These findings indicate that fostering genomic competency in oncologists and collaborating with genetic experts would facilitate cancer patients and their families to receive genetic medical services in the process of cancer genomic profiling.


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