Clinical and hematological features of childhood immune thrombocytopenia at Pediatric Center of Hue Central Hospital

Background: Immune thrombocytopenia (ITP) is the most common of the hemorrhagic diseases caused by thrombocytopenia in children. It usually occurs between the ages of 5 and 7 years old and at both sexes. It is difficult to predict ITP basing on bleeding because some severe thrombocytopenia cases have slight purpura or ecchymoses. This study aims to describe the clinical and hematological features of childhood immune thrombocytopenia Methods: This was a cross - sectional study. Patients were stratified according to age (0 to 15 years) and diagnosed ITP at the Pediatric Center of Hue central Hospital. Results: From May 2020 to March 2021, we identified 42 children diagnosed with idiopathic thrombocytopenia. Newly diagnosed ITP was the most common (66.7%) followed by chronic ITP (26.2%) and persistent ITP (7.1%). There was a slight predominance of boys to girls with the male - to - female ratio was 2:1. However, this ratio was dependent on ITP phases. The highest prevalence of immune thrombocytopenia was found under 6 years old. Children in this study usually had a history of preceding infection or vaccination. Natural hemorrhage was 83.3% (skin 95.2%). The most common type of cutaneous bleeding was petechiae (83.3%). Mild to moderate hemorrhages were dominant. Newly diagnosed ITP had less severity of hemorrhage than persistent and chronic ITP. Most children did not have a fever, hepatomegaly, splenomegaly, and lymphadenopathy. The majority of children seem to have severe thrombopenia (66.7%), but the number of platelets was not related to the severity of bleeding. Mean platelet volume was normal. Conclusions: Newly diagnosed ITP was the most common. There was a little clinical and hematological features difference between the ITP phases.

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4653-4653
Author(s):  
Tubagus Djumhana Atmakusuma ◽  
Lugyanti Sukrisman ◽  
Fransiska Hardi

Abstract Background: Platelet destruction in immune thrombocytopenia (ITP) is mediated by autoantibodies against platelet antigens. Anti-GPIIb/IIIa and anti-GPIb/IX antibodies are two major antibodies spesific for platelets and megakaryocytes. The diversity of clinical characteristics and therapeutic responses have been thought to be influenced by heterogeneity of spesific glycoprotein complexes. However, there has been no published data regarding either antiplatelet antibodies profile or response rates to corticosteroid, in adult patients with primary ITP. Objectives: To determine antiplatelet glycoprotein antibodies profile in adult patients with primary ITP and to compare the response rate to corticosteroid referring to the profile. Methods: This study is a cross sectional study in adult patients with primary ITP who visited Hematology Clinics in Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia, in a period of March to October 2013. The tests to determine the auto antibodies against the platelet GPIIb/IIIa and GPIb/IX surface antigens were performed by a direct MAIPA technique. Results: A total of 40 patients who were diagnosed as primary ITP have been enrolled into the study. The subjects of the study were divided in two groups, 10 subjects with newly diagnosed ITP, and 30 subjects with persistent or chronic ITP. Most of the subjects were female (82.5 %) with the median age was 24,5 (17-55) years old.. Seventy (??) subjects had ITP Bleeding Score (IBLS) 2.. In a persistent/chronic ITP group (n= 30), the proportion of anti-GPIIb/IIIa was 20 / 30 (66,67 %) with the median optical density (OD) was 0,461 (0,093-2,116) and the proportion of anti-GPIb/IX was 25/30 (83.33%) with the median OD was 0,507 (0,190-1,924). Meanwhile, in a newly diagnosed ITP group (n=10) the proportion of anti-GPIIb/IIIa was 7/10 (70%) with the mean OD was 0,802 ± 0,71 and the proportion of anti-GPIb/IX was 8/10 (80%) with the mean OD 0,82 ± 0,57. The response rates to corticosteroid were as follows: 42.5 % of the subjects achieved complete response, 45 % achieved response, and 12.5 % achieved no response. Comparison between the subjects with and without anti-GPIIb/IIIa and anti-GPIb/IX antibodies showed similarity response rates to prednisone. Conclusion: Sincemost of patients with primary ITP had anti GPIIb/IIIa and anti GPIb/IX antibodies, those antibodies may support a diagnosis of primary ITP. Since no differences in terms of the response rates to corticosteroid between subjects with and without anti-GPIIb/IIIa and anti-GPIb/IX antibodies, those antibodies can not be used as a predictor of the treatment Disclosures Sukrisman: Division of Hematology Medical Oncology: Other: Colleague.


2021 ◽  
Vol 29 (01) ◽  
pp. 2-5
Author(s):  
Mehwish Waris ◽  
Sajjad Ahmad ◽  
Muhammad Mumtaz Khan ◽  
Sabeen Nasir ◽  
Qurat-ul-ain Mushtaq ◽  
...  

Objective: Patients with oral potentially malignant disorders (OPMDs) are at risk for development of malignancy and tobacco use contributes in its transformation. This study was designed to assess exfoliative cytological findings in OPMD cases using tobacco and healthy controls with no history of tobacco use. The aim was to screen OPMD cases for biopsy with the help of brush cytology. Materials and Methods: This comparative cross-sectional study was conducted at Histopathology Laboratory of Peshawar Medical College, Peshawar for which samples were collected from two dental hospitals and private dental clinics of Peshawar. The study included 20 cases of clinically diagnosed Oral Potentially Malignant Disorders (OPMDs) with history of tobacco use; including 10 cases of leukoplakia and 10 cases of oral lichen planus (OLP), and 20 age and gender matched healthy controls with no history of tobacco use, after observing a strict inclusion and exclusion criteria. A pre-designed proforma was used to collect the data, which was later analyzed in SPSS version 21. Results:  A total of 40 participants had a mean age of 48.25±10.01 years with gender distribution of 32(80%) males and 8(20%) females, giving a male to female ratio of 4:1. The duration of tobacco use in cases had a mean of 22.95 ± 9.17 years, while duration of lesion had a mean of 2.3±4.4 years. As per Oral Bethesda Criteria, 18 (90%) OPMD cases were Negative for Intraepithelial Lesion/Malignancy (NILM). Buccal mucosa 12(60%) was the most common site of lesions. On Oral Exfoliative Cytology (OEC), OPMDs showed mild to moderate cytological changes as compared to healthy controls. Conclusion: This study concluded that most of the OPMD cases show mild to moderate cytological changes as compared to healthy controls. Dysplastic changes were seen only in 10% of OPMD cases that needed further assessment through biopsy. 


2022 ◽  
Vol 8 (1) ◽  
pp. 16-20
Author(s):  
Yusak Mangara Tua Siahaan ◽  
Pricilla Yani Gunawan ◽  
Jeffry Foraldy Haryanto ◽  
Veli Sungono

Background: Plantar fasciitis is a common problem caused by thickening of the plantar fascia. The normal plantar fascia thickness ranged between 2-3 mm and it was generally accepted that value more than 4mm was considered pathologic. Objective: to identify normal plantar fascia thickness in adults using ultrasonography. Methods: This is a cross sectional study measuring the thickness of plantar fascia in 145 subjects with no history of heel pain. Plantar fascia thickness was measured in both feet using an ultrasound. Age, height and weight were recorded and analysed. Results: As much as 145 subjects were included in this study. Male to female ratio was 0.7. Mean age was 44 and body mass index (BMI) was mostly within normal range. Plantar fascia thickness in male was 2.71 ± 0.48 mm in right foot, and 2.74 ± 0.47 mm in left foot. Fascia thickness in female was 2.55 ± 0.50 mm in right foot, and 2.57 ± 0.45 mm in left foot. There was a significant plantar fascia thickness difference between male and female (p = 0.035 in right foot, and p=0.04 in left foot). Age, weight and BMI had a significant correlation towards plantar fascia thickness. In multivariate analysis, age and BMI revealed to have a linear correlation to plantar fascia thickness Conclusion: Age and BMI were found to be the best predictive factor of plantar fascia thickness.


2014 ◽  
Vol 15 (1) ◽  
pp. 03-08
Author(s):  
Makhan Lal Paul ◽  
Rezaul Karim Khan ◽  
Md. Zulfiqar Hossain Khan ◽  
Md. Mahabubur Rahman ◽  
Monoj Sinha ◽  
...  

A cross sectional study was carried out in the department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka to explore the different clinical pattern of polyneuropathy. A total of 60 subjects were included in this study and mean age of the entire patient was 42.25 year and male and female ratio was 3:1. Out of all patients 26.7% were service holder, 20.0% were student, 20.0% were housewife, 11.7% were unemployed and 33.3% were engaged in some other professions. Maximum 41.7% patients were educated up to graduate and above level followed by 20.0% secondary, 18.3% primary, 16.7% higher secondary and 3.3% were illiterate. Out of all patients 31.7% were smoker, 48.3% were non smoker and 20.0% past smoker. About 35.0% patients had history of betel leaf; nut chewing and no patient had history of alcohol intake. Out of all patients of polyneuropathy 33.3% had diabetic neuropathy, 11.7% had Guillain-Barré syndrome (GBS), 10.0% had chronic inflammatory demyelinating polyneuropathy, similar number had unknown etiology, 6.7% had renal failure, 5.0% had leprosy, Vitamin B 12 deficiency and chronic liver disease(CLD) of each, 3.3% had history of INH drug intake and similar had systemic lupus erythematosus (SLE). Regarding clinical presentation, out of all respondents 83.3% had muscle weakness, similar number had problems with object handling, 66.3% had muscle cramp, 63.3% had impaired standing or gait, 55.0% had distal paresthesia, 41.7% had burning feet, 8.3% had restless legs and 5.0% had stiffness. In the light of this study we conclude that polyneuropathy has wide variety of clinical pattern. The study will enrich our current knowledge and will improve the quality of management of polyneuropathy among the Bangladeshi population.DOI: http://dx.doi.org/10.3329/jom.v15i1.19851 J Medicine 2014; 15: 3-8


2017 ◽  
Vol 4 (4) ◽  
pp. 1305
Author(s):  
Ragesh Kalikottu Valappil ◽  
Sheena Krishnan ◽  
Siddharth Matad ◽  
Shameej Kinakool Vayalipath

Background: Diabetes mellitus is a chronic disorder affecting large segment of population and is a major public health problem.Methods: A prospective cross sectional study of 150 patients conducted in the Department of Surgery at Government Medical College, Kozhikode, Kerala, IndiaResults: Maximum numbers of patients were in the age group of 60-69. Male to female ratio is 3.04:1.50% had duration of diabetes <10 years and 50% had duration ≥10. years. 81 (54%) patients had neuropathy, 53 (35.3%) had PVD, 41 (27.3%) had history of prior foot ulcer, 70 (46.7%) had poor glycemic control (RBS >200 mg/dl) at the time of admission and 44 (29.3%) had history of smoking.Conclusions: Most important risk factors for diabetic foot ulcers were neuropathy (54%), poor glycemic control (46.7%) and PVD (35.3%), diabetic foot requires a comprehensive management.


2015 ◽  
Vol 12 (1) ◽  
pp. 3-10
Author(s):  
Ananda Kumar Sharma ◽  
D N Shah ◽  
M P Upadhyay ◽  
M Thapa ◽  
G. S. Shrestha

Background: Congenital Cataract is the most important cause of treatable childhood blindness. Rubella is one of the major causes of preventable disease in many countries. There are scanty reports on congenital cataract in Nepal. Objective: To find out the demographic and etiological factors of congenital cataract in children. Method: In a hospital based cross sectional study, 46 children with congenital cataract were evaluated to find out morphology of cataract, laterality, associated ocular and systemic abnormality, visual status and etiology of cataract. Assessment included antenatal, birth and neonatal history, a detailed eye examination in slit lamp or the operating microscope under general anaesthesia, serum serology for TORCH infections, random blood sugar, urine reducing substance and thyroid profile. Result: Among 46 children with congenital cataract, 76.1% children presented before 5 years of age and 78.2% had bilateral onset. Male to female ratio was 1.3:1. Most of the children were legally blind (79.3%) in cataractous eye. Family history of congenital cataract was present in 15.2% cases. The most common mode of presentation was leukocoria in 91.3%. Microcornea (28.3%), resolved uveitis (13.0%), and iris atrophy (8.7%) were the most common ocular associations. Delayed developmental milestone (21.7%) and cardiac anomalies (10.9%) were the most common systemic anomalies. Lamellar cataract (51.3%) was the most common morphology of cataracts observed. The maternal infection was the major cause of congenital cataract in 17.4% cases with predominantly rubella infection in 13% cases. Conclusion: Most of the children with cataract are legally blind. Maternal infection in the antenatal period is the major cause of congenital cataract.DOI: http://dx.doi.org/10.3126/hren.v12i1.11975  Health Renaissance 2014;12(1):3-10


2017 ◽  
Vol 33 (1) ◽  
pp. 24-29
Author(s):  
Sharif Uddin Khan ◽  
Kazi Mohibur Rahman ◽  
ATM Hasibul Hasan ◽  
Sirajee Shafiqul Islam ◽  
Rajib Nayan Chowdhury ◽  
...  

Background: Moyamoya disease is rare but not uncommon throughout the world. Clinical profile of childhood moyamoya (MMD) disease is not well delineated in Bangladesh. Methods: We conducted this cross sectional study in pediatrics and neurology department of Dhaka Medical College Hospital that involved 20 patients of MMD over a period of one year. Result: Among the cases about 2/3rd(65%) of the patients were within 8 years age at onset with mean age of the patients being 7.24(±3.34) years at onset with a male: female ratio of 1.2:1. Almost half of the patients had past history of intermittent episodes TIA which precipitated by hyperventilation and crying (p <0.05). Important history related to prothombotic conditions (Family History of stroke, MI, Hyperlipidemia, Obesity, Coagulation disorders) were also statistically significant (p<0.05). Sixteen patients in our series exhibited hemiparesis and out of them 4(25%) were alternating (p<0.05), followed by dysarthria at onest 13(65%). Convulsions and visual impairment were seen in 5 (25%) different patients, 3(15%) different patients had altered consciousness, involuntary movements, ataxia, headache and cognitive impairment at onset. We observed intellectual impairment in and psycho–motor retardation in two different patients. MRA abnormalities were found in 19 cases out of 20. Among 19 cases bilateral ICA stenosis with collaterals seen in 18 cases (90%), MCA stenosis along with bilateral ICA stenosis were seen in 16(80%) cases, ACA stenosis along with bilateral ICA stenosis were seen in 07(35%) cases, PCA stenosis along with bilateral ICA stenosis were observed in 05(25%) cases. No collaterals and without typical “puff of smoke” appearance was seen in 01(5%) and unilateral ICA stenosis with collaterals was seen in 01(5%) cases (probable MMD). Diagnostic Cerebral DSA was done in 07 (35%) patients and typical angiographic findings of Moyamoya disease were present in all of them. Conclusion: C-MMD may have various presentations. Stroke and TIA are most common presentation. MRA may well delineate the characteristics angrographic abnormality. Bangladesh Journal of Neuroscience 2017; Vol.  33 (1): 24-29


2020 ◽  
Vol 8 (1) ◽  
pp. 49-49
Author(s):  
Mahsa Esmaeillou ◽  
Jalil Houshyar ◽  
Fariborz Akbarzadeh ◽  
Akbar Aliasgarzadeh

Abstract Introduction: Diabetic autonomic neuropathy is one of the most important complications of diabetes mellitus (DM) that ultimately occurs in most patients. The purpose of this study was to screen and diagnose latent cases of autonomic neuropathy between patients who have a history of over 10 years DM and recently diagnosed diabetic patients. Methods: This cross-sectional study was performed on 104 patients (52 type 2 DM patients diagnosed in the last 6 months; and 52 type 2 DM patients with more than 10 years history) referred to outpatient Endocrine Clinic of Imam Reza Medical Center in Tabriz University of Medical Sciences between 2015-2016. Blood pressure, resting heart rate and corrected QT interval were evaluated according to standard methods. The history of gastrointestinal and urinary tract neuropathy was extracted from patients’ history and physical exam. Results: Of the 104 patients studied, 54 were male and 50 were female. Standing heart rate (p=0.02), resting (p<0.0002) and standing (p<0.0001) systolic blood pressure, and resting diastolic blood pressure (p=0.03) were significantly higher in chronic diabetic patients compared to newly diagnosed group. Additionally, blood glucose levels (p=0.03) and body mass index (BMI) (p<0.0001) were significantly higher in patients with neuropathy. Conclusion: Overall, the results of this study showed that in patients with type 2 DM, cardiac autonomic dysfunction is more common in patients with a longer history of DM.


2022 ◽  
Author(s):  
Trushna Rahangdale ◽  
Tushar Phulambrikar ◽  
Tanvi Dosi ◽  
Vihang Naphade ◽  
Gauri Barkalle ◽  
...  

Abstract Introduction India is one of the leading producers and consumer of tobacco. Additionally, India has one of the highest global prevalence of oral leukoplakia (OL). However, large epidemiological studies from Madhya Pradesh (Central India), the state with maximum consumers of tobacco products in India, are lacking. Objective Thus, we assessed the prevalence of OL among individuals residing in Central India and evaluated its association with age, gender, and history of adverse habits. Methods This was a prospective, cross-sectional study involving 9954 patients visiting the out-patient Department of Oral Medicine and Radiology over a period of 15 months (January 2019 to March 2020). The clinical diagnosis of OL was arrived by exclusion of all the lesions mimicking OL. Univariate and multivariate analyses were performed to assess the association between OL and age, sex, and history of adverse habits. Results The prevalence of OL was 5.6% (557/9954). It was predominant in males (male-to-female ratio=3.9:1) and increased with advancing age. The odds of developing OL was higher among patients aged ≥50 years (OR=1.08; 95%CI: 1.07–1.08, p-value<0.0001), those with history of smoking tobacco (OR=1.32; 95%CI: 1.05–1.68, p-value=0.02), consuming smokeless tobacco (OR=318.60; 95%CI: 101.68–998.30, p-value<0.0001), and alcohol (OR=1.15; 95%CI: 9.0–1.49, p-value=0.269). Females had lower odds of developing OL (OR=0.77; 95%CI: 0.60–0.99, p-value=0.042). Conclusion We observed high prevalence of OL (5.6%). OL was significantly associated with older age, male sex, and tobacco-related adverse habits. While, alcohol consumption may possibly be a risk factor, no statistically significant relation was observed.


Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 392
Author(s):  
Enoch Odame Anto ◽  
Christian Obirikorang ◽  
Max Efui Annani-Akollor ◽  
Eric Adua ◽  
Sampson Donkor ◽  
...  

Background and Objectives: Dyslipidaemia and its associated complications have been reported to increase mortality among type 2 diabetes mellitus (T2DM) patients. However, there is a dearth of data on the incidence of dyslipidemia among Ghanaian patients with T2DM. This study evaluated dyslipidemia among newly diagnosed T2DM patients at Dormaa Presbyterian Hospital, Ghana. Materials and Methods: This cross-sectional study recruited a total of 215 participants at the Presbyterian Hospital, Dormaa-Ghana. A well-structured questionnaire was administered to collect demographic data. Predisposing factors of dyslipidemia such as BMI, hypertension, and family history of diabetes were also obtained. Lipid profile was performed on the serum obtained from each respondent. Dyslipidaemia was defined as total cholesterol (TC) >200 mg/dL, triglyceride (TG) >150 mg/dL, low density lipoprotein cholesterol (LDL-c) >100 mg/dL, and high-density lipoprotein cholesterol (HDL-c) <40 in males and <50 mg/dL in females. Combinations of the individual parameters of dyslipidaemia were further evaluated. Results: Of the total (215) participants, 86 (40%) were males and 129 (60%) were females, representing a ratio of 1:1.5. High total cholesterol was more prevalent in females (69.0%) than males (53.5%). Generally, dyslipidaemia was predominant among those aged >40 years, with the exception of increased LDL-c (25.1%), which was higher among the 20–40 years age group. The male participants exhibited significantly (p < 0.001) higher percentages of all combined measures of dyslipidaemia—such as high TG and reduced HDL-c (77.9%), high TG and elevated LDL-c (75.6%) and high LDL and low HDL (65.1%). BMI was significantly associated with HDL levels (p = 0.02), whereas family history of diabetes was associated with TC (p = 0.004) and TG levels (p = 0.019). Conclusion: Combined dyslipidaemia is relatively high among newly diagnosed T2DM patients in Ghana, and in those >40 years. Gender is significantly associated with combined dyslipidaemia in T2DM, and males may be at a higher risk than females. BMI and family history of diabetes are potential risk factors of dyslipidaemia in T2DM.


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