Combined Diagnostic Accuracy of Total Leukocyte Count, Neutrophil Count, and Ultrasonography for the Diagnosis of Acute Appendicitis

Objective: To determine the frequency of bacterial infection in children less than five years of age presenting with respiratory wheeze to Tertiary care centre. Study Design: Descriptive Case Series study. Setting: Department of Pediatrics, The Children’s Hospital and The Institute of Child Health, Multan. Period: November 2019 to April 2020. Material & Methods: A total of 130 children, presenting with respiratory symptoms were examined for presence of respiratory wheeze. After confirmation of chest auscultation, patients were enrolled. Information regarding duration of wheeze, axillary temperature, presence of chest in drawing and respiratory rate were recorded. Appropriate blood sample were drawn for total leukocyte count and differential leukocyte count from which absolute neutrophils count was calculated. Children were evaluated for the presence of bacterial infection as per operational definition. Results: There were 38 (29.23%) female and 92 (70.76%) male patients. Overall, mean age was13.17±5.49 with age range of 1-57 months. Bacterial infection was noted in 33 (25.38%) patients. Out of 130 patients presenting with wheeze, 50 patients (38.46%) had temperature range of 98.1-990F. Absolute neutrophil count was more than 5000/dl in 42(32.30%) patients, out of these 33(78.6%) had bacterial infection. Chest X-rays were showing infiltrates in 110 (84.6%) patients. Conclusion: Children suffering from wheeze have bacterial infection if age is less than five years and there is fever, crepitations, elevated absolute neutrophil count and radiographic evidence of pneumonia.

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Immunometabolic response in Egyptian water buffalo cows during the transition period

Veterinary World ◽

10.14202/vetworld.2021.2678-2685 ◽

2021 ◽

pp. 2678-2685

Author(s):

Naglaa A. Gomaa ◽

Samy A. Darwish ◽

Mahmoud A. Aly

Keyword(s):

Neutrophil Count ◽

Water Buffalo ◽

Transition Period ◽

Complete Blood Count ◽

Leukocyte Count ◽

Density Lipoprotein ◽

Physiological Adaptation ◽

Total Leukocyte Count ◽

Gamma Glutamyl Transferase ◽

Glutamyl Transferase

Background and Aim: The transition period is extremely critical for pregnant producing animals. However, there is very limited research on the metabolic and immunological changes in Egyptian water buffalo cows during the transition period. Therefore, this study was conducted to investigate the immunometabolic changes occurring during the transition period in Egyptian water buffalo cows. Materials and Methods: A total of 50 multiparous pregnant Egyptian water buffalo cows were subjected to weekly blood sampling 3 weeks before calving and 3 weeks after calving and on the day of parturition to determine the complete blood count, including red blood cell count, total leukocyte count (TLC), differential leukocyte count, hemoglobin level, and packed cell volume (PCV). Some selected serum biochemical and immunological parameters were analyzed, including serum glucose, beta-hydroxybutyric acid (BHBA), non-esterified fatty acids, triglycerides, high-density lipoprotein, low-density lipoprotein (LDL), very LDL (VLDL), cholesterol, total protein, albumin, globulin, creatinine, blood urea nitrogen (BUN), aspartate aminotransferase, alkaline phosphatase, alanine transaminase, gamma-glutamyl transferase, Haptoglobin, and C-reactive protein and the pro-inflammatory cytokines interleukin β1, interleukin 6 (IL-6), and tumor necrosis factor-alpha. All data were statistically analyzed using the IBM Statistical Package for the Social Sciences statistics software. Results: The neutrophil count showed a statistically significant increase at 2 weeks preparturition. There was also a significant increase in PCV, TLC, neutrophil count, and IL-6 and TNF-α level at the time of parturition and even at 2 weeks post parturition, except PCV that returned to normal levels in the 1st week post parturition. BHBA and BUN levels were increased significantly in the 2nd and 3rd weeks postcalving. Serum creatinine and VLDL levels were decreased significantly at the time of parturition, and VLDL levels showed a significant decrease even till the 3rd week postcalving, whereas creatinine levels gradually returned to the pre-calving levels in the 3rd week postcalving. Other parameters showed no significant changes. Conclusion: The most important immunometabolic changes occur in the first 2 weeks post parturition in Egyptian water buffalo cows, which exhibit a potent, remarkable physiological adaptation achieved by their functional liver, which can help the animal overcome the stressful conditions during the transition period.

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Role of Total Leukocyte Count in Diagnosis of Acute Appendicitis

International Journal of Health and Medical Sciences ◽

10.20469/ijhms.3.30004-2 ◽

2017 ◽

Vol 3 (2) ◽

Keyword(s):

Acute Appendicitis ◽

Leukocyte Count ◽

Total Leukocyte Count

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Diagnostic Accuracy of Increased Mean Platelet Volume as Inflammatory Marker in Diagnosis of Acute Appendicitis Taking Histopathology as Gold Standard

10.53350/pjmhs2115102790 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2790-2792

Author(s):

Hina Rehman Siddiqui ◽

Tahira Tariq ◽

Samar Babiker Awadallah Omer ◽

Nadia Rizvi

Keyword(s):

Acute Appendicitis ◽

Diagnostic Accuracy ◽

Gold Standard ◽

Mean Platelet Volume ◽

Inflammatory Marker ◽

Total Leukocyte Count ◽

Platelet Volume ◽

Duration Of Symptoms ◽

Predictive Values ◽

Sensitivity Specificity

Objective: To determine diagnostic accuracy of increased mean platelet volume as inflammatory marker in diagnosis of acute appendicitis taking histopathology as gold standard. Study Design: Cross Sectional Study. Setting: Department of Surgery, Abbasi Shaheed Hospital, Karachi. Duration: From 28th October 2016 To 27thApril 2017. Material and Methods: Total 229patients suffered from acute appendicitis were included. Venous blood (<20 ml) for complete blood count was sent to lab before surgery. MPV >11fl was taken as increased value. Post-appendicectomy appendix was sent for histopathology. Sensitivity, specificity, positive and negative predictive values were calculated. Stratification was done. Chi-square test was applied post stratification and p-value ≤0.05 was considered as significant. Results: There were 128 male and 101 female. Mean age was 34.09±6.63 years. Mean duration of symptoms was 28.97±11.89 hours. 107 patients were observed with total leukocyte count >10X103µL. Mean platelets volume was more than 11 fl in 47.2% patients. Sensitivity, Specificity, PPV, NPV and accuracy were 74.6%, 91.6%, 92.5%, 71.9%, and 81.6% respectively. Conclusion: In conclusion in patients with temporary diagnosis of acute appendicitis, high MPV “≥ 11fl” can assist in the identification of acute appendicitis hence negative rate of appendectomy can be decreased.. Keywords: Diagnostic Accuracy, Increased Mean Platelet Volume, Acute Appendicitis, Histopathology

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Treatment of Neuroleptic-Induced Leukopenia with Lithium Carbonate

The Canadian Journal of Psychiatry ◽

10.1177/070674378102600710 ◽

1981 ◽

Vol 26 (7) ◽

pp. 487-489 ◽

Cited By ~ 10

Author(s):

R. Yassa ◽

J. Ananth

Keyword(s):

Neutrophil Count ◽

Leukocyte Count ◽

Lithium Carbonate ◽

Lithium Therapy ◽

The Other ◽

Total Leukocyte Count ◽

Drug Induced ◽

Other Hand ◽

Wbc Count

Based on the finding that lithium carbonate administration can stimulate leukocyte production, six patients were treated with neuroleptic and other drug-induced granulocytopenia with lithium carbonate. The average total leukocyte count of 2500/mm3 increased to 4566/mm3. Similarly the average neutrophil count of 1028/mm3 increased to 2893/mm3 after lithium therapy. In all six patients, neutrophils decreased upon discontinuation of lithium. On the other hand, total WBC count of 4566/mm3 decreased to 2650/mm3, and the total neutrophil count of 2893/mm3 decreased to 966/mm3 after four weeks without lithium. The results suggest that lithium carbonate is effective in the treatment of drug-induced leukopenia.

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Accuracy of Ultrasound in the Diagnosis of Acute Appendicitis and Correlation with Histopathology

Nepalese Journal of Radiology ◽

10.3126/njr.v8i2.22975 ◽

2018 ◽

Vol 8 (2) ◽

pp. 13-19

Author(s):

Aimandu Shrestha ◽

Hensan Khadka ◽

Baburam Poudel ◽

Ranga Bahadur Basnet ◽

Siv Bahadur Basnet

Keyword(s):

Acute Appendicitis ◽

Leukocyte Count ◽

Total Leukocyte Count ◽

Radiology Department ◽

Clinical Impression ◽

Negative Appendectomy ◽

Differential Leukocyte Count ◽

Diagnostic Modality ◽

Predictive Values ◽

Negative Appendectomy Rate

Introduction: Acute appendicitis is a common surgical condition; yet its diagnosis can be elusive at times and missed diagnosis can lead to attendant complications of perforation and its sequelae. On the contrary, negative appendectomy subjects one to unnecessary surgery and its physiological and psychological consequences. Among the various available modalities of diagnosis of appendicitis, Ultrasonography(USG) is easily accessible, non invasive, less time consuming, low cost investigation no radiation hazards. So, USG is appropriate diagnostic modality in our country.Methods: This prospective observational study was carried out from January 2011 to June 2011, in the radiology department of Bir hospital. Total of 80 cases with clinical impression of acute appendicitis were enrolled. These patients underwent surgery for suspected acute appendicitis. Details of signs and symptoms, lab findings including Total Leukocyte count (TLC), Differential Leukocyte Count (DLC) and USG findings were recorded. Intra-operative and histopathology findings were also recorded. The findings were analyzed to assess accuracy of ultrasonography in acute appendicitis. Histopathological report was considered the goal standard.Results: A total of 93 cases clinically diagnosed as acute appendicitis were subjected for USG. Out of 93 cases, 80 cases underwent surgery. Among 80 cases, sonography showed acute appendicitis in 56 cases out of which 54 was proved by histopathology as well. However, ultrasonography was not able to detect appendicitis in 9 cases. The sensitivity and specificity of USG for acute appendicitis were 87.7% and 88.2% respectively. The positive and negative predictive values were 96.4% and 62.5% respectively. Overall negative appendectomy rate of 21.2% had been used a basis for decision making, the rate of error being 13.7%.Conclusion: Ultrasonography is a fairly accurate and safe modality in acute appendicitis. It can be useful in reducing negative appendectomy rate.

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