scholarly journals A STUDY ON PLATELET COUNT AND PLATELET INDICES IN NEONATAL SEPSIS IN A TERTIARY CARE CENTER

Author(s):  
Neha Sharma ◽  
G S Senger ◽  
Seema Meena ◽  
Priyanka Sharma

Background: The present study is undertaken to evaluate Platelet count and platelet indices in diagnosis of neonatal sepsis. Methods: This prospective observational study was conducted on 100 consecutive neonates (both inborn and out born), with clinical signs and symptoms of sepsis along with either positive culture (confirmed neonatal sepsis ) or other laboratory findings suggestive of bacterial and fungal infection in absence of positive cultures (probable sepsis), were included after written informed consent from parents. Results: 71 (71.00%) out of 100 cases had increased values of Platelet Distribution Width. In Proven sepsis group 31(86.11%) cases had increased values of PDW, in Probable sepsis 31(63.27%) and in No sepsis group 9(60.00%) cases were having increased values of PDW. This difference was statistically not significant (P value is 0.08). Conclusion: Platelet count and platelet indices, which are easily available hematological parameters in remote & resource poor areas of our country, should be taken into consideration for suspected cases of neonatal sepsis so that prompt treatment can be given, and morbidity and mortality can be reduced. Keywords: Sepsis, TPC, MPV, PDW.

Author(s):  
Anita Devi ◽  
Rakesh Kumar Sharma ◽  
Kapil Kumar

Background: Changes in Platelet parameters like Mean Platelet Volume and Platelet Distribution Width are helpful in diagnosis of neonatal sepsis but these indices have not been extensively studied in neonatal sepsis. Hence, the present study is undertaken to evaluate Platelet count and platelet indices in diagnosis of neonatal sepsis. Methods: This prospective observational study was conducted over a period of 4 months i.e from December 2019 to March 2020 in neonatal intensive care unit of Jhalawar Medical College & Attached Hospitals, Jhalawar. During the study period 154 consecutive neonates (both inborn and out born), with clinical signs and symptoms of sepsis along with either positive culture (confirmed neonatal sepsis ) or other laboratory findings suggestive of bacterial and fungal infection in absence of positive cultures (probable sepsis), were included after written informed consent from parents. Results: Out of total (154), 81.8%, 76% and 67.5% of cases had thrombocytopenia, raised MPV (>10.8) and raised PDW respectively. As compared to Non-sepsis group, MPV values were raised in more cases of Sepsis proven group (88%) and the difference was statistically significant with P value of 0.011. PDW values were also more increased in Sepsis proven group compared to Non-sepsis group. Conclusion: Platelet count and platelet indices, which are easily available hematological parameters in remote & resource poor areas of our country, should be taken into consideration for suspected cases of neonatal sepsis so that prompt treatment can be given, and morbidity and mortality can be reduced. Keywords: Sepsis, CRP, MPV, PDW.


Author(s):  
Rashim Passi ◽  
B. P. Baviskar ◽  
R. R. Karle

<p class="abstract"><strong>Background:</strong> Dengue is an endemic in tropical and sub-tropical regions of the world and also in various parts of India. Recent evidence indicates that platelet indices can be used to assess the severity and prognosis of dengue. This study aimed to assess the role of the platelet indices-mean platelet volume (MPV), platelet distribution width (PDW), platelet to large cell ratio (P-LCR), plateletcrit (Pct) and hematological parameters like hemoglobin (Hb), hematocrit (Hct) with the platelet count in dengue NS1 antigen positive cases.</p><p class="abstract"><strong>Methods:</strong> An observational cross-sectional study conducted on cases of dengue over a period of 3 months admitted with serological positivity (NS1 antigen) in a tertiary care hospital, Loni. The platelet indices like MPV, PDW, Pct, P-LCR and hematological parameters like Hb, Hct were noted using Sysmex XN-3100 Automated hematology analyzer and compared with platelet count.</p><p class="abstract"><strong>Results:</strong> Relationship between various platelet indices like MPV, PDW, P-LCR and PCT and hematological parameters like Hb, TLC and Hct were related with platelet count. Dengue positive cases were inversely related to MPV, PDW, P-LCR, Hb and Hct and directly related to Pct. In the present study Pct, P-LCR, Hb and Hct were statistically significant in correlation with platelet count.</p><p class="abstract"><strong>Conclusions:</strong> Pct, P-LCR, Hb and Hct along with platelet count can be used to assess the predictive outcomes in case of dengue infection.</p><p>.</p>


Author(s):  
Kirtirekha Mohapatra ◽  
Pranati Mohanty ◽  
Nahida Nigar Sultana

Background: Preeclampsia (PE) is a major cause of maternal and foetal morbidity and mortality in pregnancy. A decreased platelet count is observed during the progression of preeclampsia, and is considered a marker of the severity of preeclampsia. Considering the role of the PDW, PCT and platelet indices during the disease, the aim of this study was to evaluate the feasibility of using platelet indices as a severity marker for PE.Methods: This was a prospective, observational study, hospital-based study, from 2017-19 with 400 pregnant women being included on the basis of a predefined inclusion and exclusion criteria, through antenatal clinic, and labour room of the department of obstetrics and gynecology, S. C. B. Medical College, Cuttack, Odisha, India.Results: Study found that platelet count and plateletcrit showed a significant negative correlation with MAP whereas platelet distribution width showed a maximum positive correlation. In the preeclampsia group, subjects with PCT <0.22% were at risk of developing severe disease with a sensitivity of 53.5% and a high specificity of 85.5%. The AUC of 0.75 showed that it has a good predictability. In the eclampsia group, subjects with PCT <0.16% had a risk of developing severe disease with a sensitivity of 89.5% and specificity of 73.7%. The AUC 0.9 shows PCT to be a good predictor for assessing severity of eclampsia.Conclusions: This study suggests that platelet distribution width and plateletcrit are useful in risk evaluation of preeclampsia. These are a valid measurement tool to predict the severe progression of PE even when normal platelet counts are observed.


2020 ◽  
Vol 7 (4) ◽  
pp. 820
Author(s):  
Anupama Deka ◽  
Aravind P.

Background: The early diagnosis of neonatal sepsis, a significant cause of neonatal morbidity and mortality still remains a challenge. Red-cell Distribution Width (RDW) vary significantly in conditions associated with inflammation and infection like sepsis. The study aims to find the normal range of RDW in healthy newborns and investigate the role of RDW in the early diagnosis of neonatal sepsis.Methods: This is a prospective observational study, 50 normal and 50 sepsis neonates were considered for the study. The neonatal sepsis group consisted of neonates with (i) Positive sepsis screen with/without clinical features of neonatal sepsis and/or (ii) Blood, urine or CSF culture positive or signs of pneumonia on chest x-ray. The mean RDW and the relationship between RDW and neonatal sepsis were analysed using appropriate statistical methods in SPSS-25 software.Results: Mean RDW (%) was significantly higher in sepsis neonates (18.59±1.28) than in normal newborns (16.21±1.35). RDW had statistical significance with CRP (C-Reactive Protein) in the sepsis group. RDW had significant relationship with the diagnosis of neonatal sepsis with a p value of 0.000. An RDW cut-off level of 17.25% had 86% sensitivity, 87% specificity, and 93.5% accuracy in diagnosing neonatal sepsis.Conclusions: RDW helps as a diagnostic test in the early diagnosis of neonatal sepsis. 


Author(s):  
. Varshashree ◽  
Subhashis Das ◽  
K Prabhakar

Introduction: One of the most important responsibility of Blood Bank is to ensure uninterrupted supply of quality blood products, namely Platelet Concentrate (PC), which are in high demand particularly during pandemic. In India, PCs are of three types prepared by different methods like Platelet Rich Plasma-Platelet Concentrate (PRP-PC), Buffy Coat Platelet Concentrates (BC- PC), and Single Donor Platelets (SDP) units. Hence, establishing optimum quality standards across all the three types of PC remains a challenge in order to maximum benefit to recipients. Aim: To assess and compare the quality parameters of platelet concentrate prepared by PRP-PC, BC-PC and apheresis methods (SDP). Materials and Methods: This laboratory based observational study was conducted at rural, tertiary care, postgraduate, teaching hospital located at South India from December 2018 to November 2019. A total of 156 PCs were studied with 52 units belonging to PRP method, 52 units BC-PC method and the remaining were 52 units of SDP prepared by apheresis method. Quality parameters include volume, pH, swirling, White Blood Cell (WBC) count/bag, platelet count/bag and platelet indices. Platelet indices include Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), and Platelet Large Cell Ratio (PLCR). Arterial Blood Gas (ABG) analysis was also done to assess (pH, partial pressure of Carbon Dioxide (pCO2), plasma bicarbonate (pHCO3-)). The p-value less than 0.05 were considered statistically significant. Statistical Package for the Social Sciences (SPSS) software version 23.0 used for statistical analysis. Results: All the 156 PC units were analysed as per the Director General of Health Services (DGHS) India, criteria. Among the 156 platelet concentrates scored as per DGHS criteria, a score of 5 was obtained for 34.61% [18/52], 30.76 [16/52] and 11.5% [6/52] SDP, BC-PC and PRP-PC units, respectively. All the PC units were sterile and Red Blood Cell (RBC) contamination was within acceptable limits. Conclusion: In this study, quality parameters of SDP was better than BC-PC and PRP-PC but with improvement and more standardisation of procedures and storage, BC-PC units can give a yield similar to that of SDP units.


2013 ◽  
Vol 5 (1) ◽  
pp. e2013009 ◽  
Author(s):  
Smita Chandra ◽  
Harish Chandra

BackgroundMalaria may be associated with complications which may be avoided by early diagnosis and treatment. Microscopic diagnosis showing presence of malarial parasites is needed for confirmation which at times may be unreliable and requires technical expertise. The present study was conducted to statistically analyze the haematological parameters including platelet indices which can give initial hint for malarial infection and therefore prompt the laboratory physician for active search of the parasite microscopically. MethodsA retrospective study was conducted which included 334 cases of acute malaria caused by Plasmodium vivax, falciparum and dual infection along with 100 cases of control. Routine haematological parameters along with platelet indices (MPV and PDW) which are easily available on automated cell counter were statistically analyzed to assess their role as indicators for malaria.ResultsLeukocyte count and platelet count were significantly lower in cases of acute malaria in comparison to controls (p value <0.001). Platelet count<150x109/l showed 87.2% sensitivity, 65% specificity, 89.3% positive predictive value and 2.49 likelihood ratio for the infection. PDW of 6-10 and MPV>8 fl had 71.9% and 61.5% sensitivity and 78.2% and 77.7% positive predictive value respectively for infection. Platelet count <150x109/l and MPV>8 fl was comparatively more sensitive indicator for vivax (88% and 70.8% respectively) than falciparum (84.8% and 50.4% respectively) and PDW 6-10 was more sensitive indicator for falciparum (82.6%) than vivax (69.5%) infection.ConclusionThrombocytopenia (<150x109/l) and low leukocyte count (<4x109/l) may be used as probable indicator for malaria. Higher MPV (>8 fl) and PDW of 6-10 also show considerable sensitivity for malarial infection. In addition, thrombocytopenia (<150x109/l) and higher MPV (>8 fl) was more sensitive for vivax infection while PDW 6-10 was more sensitive for falciparum infection.


2020 ◽  
Vol 11 (SPL2) ◽  
pp. 284-289
Author(s):  
Dhanya Menon ◽  
Ganthimathy Sekhar ◽  
Siddharth A R ◽  
Sridevi M

Dengue is a global arboviral disease of growing public health concern. Several parameters have been used to detect the infection and severity of dengue. Recent evidence suggests that platelet indices can be used to assess the severity and prognosis of dengue infection. This retrospective study aims at assessing the role of the platelet indices – Mean Platelet Volume (MPV), Platelet Distribution Width, (PDW), P-LCR (Platelet Large Cell Ratio) and Plateletcrit (PCT) and its correlation with the platelet count in 50 Dengue NS1 antigen positive cases and to find the sex ratio and the age-wise distribution of the dengue cases. The indices were obtained using an Automated Hematology analyzer and were compared with the platelet count, considering p-value <0.05 as statistically significant. Thrombocytopenia was found in a majority of the cases and PDW and PLCR were found to be inversely proportional to the platelet count. MPV was found to have no correlation with the platelet count. Hence, we conclude that Platelet count, PDW, and P-LCR can be used as predictors of Dengue infection and severity, whereas MPV cannot be used as a predictor of Dengue infection or severity.


Author(s):  
Payal Mukker ◽  
Smitha Kiran

Background: Platelet indices (PIs)-Platecrit, mean platelet volume (MPV) and platelet distribution width (PDW)-are a group of platelet parameters obtained as a part of complete blood count using automated hematology analyzers. Evidence suggests that PIs may have diagnostic and prognostic value in febrile thrombocytopenia. This study aims to understand the profile of PIs in dengue fever. Aims and objectives was to study the platelet indices in patients with dengue fever.Methods: The present study is a retrospective observational study conducted in a tertiary hospital in Kerala. Platelet count, mean platelet volume (MPV), platecrit and Platelet distribution width (PDW) along with routine blood parameters hemoglobin(Hb), hematocrit, WBC, Platelet count, serum bilirubin, liver enzymes (AST, ALT) of 123 patients were collected. These 123 patients were grouped into three according to the platelet count (<20000,20000-100000, >100000). All the test results are available in hospital database. This was accessed using inpatient numbers obtained from medical records department of our institution. All analysis was done using free to use software R and values were rounded off to the nearest decimal point. Non normally distributed parameters were expressed as median (IQR). Parameters which did not follow normal distribution were analyzed with Kruskall Wallis test and the values are expressed as mean (SD) and a p value <0.05 was considered statistically significant.Results: Platelet indices PDW (57±13.8 vs. 55.4±6.9, p value 0.001) and MPV (9.2±0.09 vs. 13.8±1.3fL, p value <0.001) values were significantly altered in dengue fever with platelet counts below 20,000 compared to platelet count more than one lakh group. Similarly, the Platelet index (MPVxPDW\PLCxPCT), MPV\PLC, MPV\Platecrit, PDW\PLC and PDW\Platecrit ratio showed statistically significant difference between the different platelet groups.Conclusions: Platelet indices are useful parameters in dengue infection. Other than platelet count, PDW, MPV, platecrit are useful to monitor dengue fever.


Author(s):  
HV Shubha ◽  
Archana Shetty ◽  
TG Vivek ◽  
Vijaya Chowdappa

Introduction: Thrombocytopenia (TCP) is defined as a platelet count below 1,50,000 per microliter. This fall can be attributed to increased destruction, decreased production in bone marrow and pooling of platelets. A good knowledge of the cause and clinical course of the underlying pathology as reflected by the platelet indices contributes to the better management of TCP. With the advent of automation in haematology, these indices are now available from the routinely used blood cell counters in the laboratory. Aim: To determine if studying the variation in platelet indices helps to identify the aetiology of TCP. Materials and Methods: The prospective study was conducted in the haematology wing of central diagnostics attached to a medical college in Bangalore, Karnataka, India over a period of three months from June 2019 to August 2019. A total of 598 cases of adult TCPs were encountered, out of which 505 cases met the inclusion criteria and were categorised into three groups, namely- Hyperdestructive (Group 1), Hypoproductive (Group 2) and Abnormal pooling (Group 3). Variation of platelet indices {Platelet count, Plateletcrit (PCT), Mean Platelet Volume (MPV), Platelet Distribution Width (PDW)} were studied not only between the groups but also with the severity of TCPs. Data was analysed using the software Statistical Package for Social Sciences (SPSS) program version 20 and tested for statistical significance using one-way Analysis of Variance (ANOVA) test. A p-value of <0.05 was considered as statistically significant. Results: Of the 505 cases a majority fell under Group 1- 420 cases (83%). A higher value of MPV (11.870±1.3) and PDW (15.63±3.4) were seen in Group 1 compared to Groups 2 and 3. There was also significant variation among the platelet indices (PCT, MPV, PDW) with the severity of TCPs. Conclusion: Platelet counts along with a good knowledge on interpretation of platelet parameters obtained by automated analysers play a pivotal role in determining the aetiology of TCPs, thereby, providing better initial patient management.


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