ROLE OF ABSOLUTE EOSINOPHIL COUNT AS A MODALITY OF INVESTIGATION IN SUSPECTED CASES OF HELMINTHIC INFESTATION IN CHILDREN AGED BETWEEN 5 TO 15 YEARS WITH COMPARISON TO STOOL ROUTINE AND MICROSCOPY

Introduction: Eosinophilia is a well-known host immune response in helminthic infestation. This study was carried out to investigate whether a correlation exists between absolute eosinophil count in children with stool specimen positive for helminthic infestation. Aim And Objective: To determine average raised absolute eosinophil count in children who were having various helminthic infestation with stool specimen positive. Materials And Methods: A hospital based cross sectional study done at Navodaya medical college hospital and research centre during 2019 October to 2020 September for a period of 12 months. Both blood and stool samples were obtained from a total of 69 suspected children after examined, categorised into 2 groups. Among them 24 cases were positive of helminthic infestation and 45 cases were negative. T-test and descriptive statistics were used to analyse the data. Results: The study revealed that children infested with helminths found to have higher absolute eosinophil count (mean 4644/µl (95%CI; 3474-4212) than not infested (mean 801/µl (95%CI; 616-945) with p value <0.001. In this helminth's family; nematodes, trematodes, cestodes showed mean values of absolute eosinophil count were 5206/µl (4806-7151/µl), 4930/µl (4500-5382/µl) and 2179/µl (2500-1669/µl) respectively. Conclusions: Raised absolute eosinophil count has been observed in stool specimen positive cases of helminths, especially more in nematodes. Therefore, should be considered for a single dose of albendazole.

Correlation of absolute eosinophil count, nasal smear eosinophilia and serum IgE levels in allergic rhinitis

Allergic rhinitis (AR) is one of the most common disease in India. The association between eosinophils and allergic diseases has been known since many years. To correlate Nasal smear eosinophilia (NSE), blood absolute eosinophil count (AEC) and total serum IgE levels with severity of the clinical score in patients with allergic rhinitis. This is one-year prospective study in patients (n=60) presented with allergic rhinitis to our institute. After taking consent, all the study participants were subjected for blood AEC, IgE levels and nasal smears for eosinophils. Among the samples, 81.7% were males. The mean age of patients was 35.2 years. AEC &#62; 440 cells/cu.mm was seen in 46.6%, NSE&#62;10% in 81.6% and total serum IgE was elevated &#62; 100 IU/ml in 95.0%. There was a good correlation of NSE and serum IgE with the severity of disease. There was no correlation of blood AEC with the severity of clinical score. Data was analysed using SPSS software.rn NSE and IgE both correlated well with severity of the disease. Nasal smear cytology is a simple procedure having good correlation with severity of clinical score should be used routinely. Testing for serum IgE levels will increase the accuracy with a better diagnostic utility.

Study of Eosinophil Count in Nasal and Peripheral Blood Smear Compare with Serum IgE Level in Children with Allergic Rhinitis

Introduction: Allergic rhinitis is one of the most common respiratory diseases. Patient with allergic rhinitis may have elevated level of serum IgE and eosinophil than normal person. Nasal smear eosinophil count is a simple test as well as noninvasive, can be repeated and inexpensive method for diagnosis of allergic rhinitis. Objective: To assess the eosinophil count in nasal smear as an alternative diagnostic test for children with allergic rhinitis. Methods: This cross-sectional study was conducted at the Department of Laboratory medicine and Paediatrics, BSMMU, Dhaka from September 2019 to August 2020 in 120 children (Age up to 18 years both sex). Diagnosed patients of allergic rhinitis according to ARIA-WHO guideline with history and clinical feature who fulfilled the inclusion criteria were selected as study population. After taking informed written consent blood and nasal secretion of allergic patient were drawn for serum IgE and eosinophil count. Nasal smears for eosinophil were stained using Giemsa stain and observed eosinophil under light microscope. Peripheral blood eosinophil count was estimated by hematology auto-analyzer (SYSMEX-XN 2000) and rechecked manually. The serum total IgE level was performed based on sandwich principle of ELISA. Results: The serum IgE level, nasal smear eosinophil count and blood eosinophil count were found increased with severity of allergic rhinitis, which was statistically significant (p<0.001). Pearson’s correlation coefficient test revealed significant positive correlation between nasal smear eosinophil count with serum IgE (r= +.656, p<0.001) and blood absolute eosinophil count (r= +.415, p<0.001). Conclusion: Nasal smear eosinophil count was significantly raised alone with absolute eosinophil count and serum IgE level with the severity of allergic rhinitis in children.

A Descriptive Study on Serum IgE and Absolute Eosinophil Count in Children with Bronchial Asthma Attending the Paediatric Department of a Medical College in Central Kerala

BACKGROUND Bronchial asthma is a major public health concern especially in the paediatric population. An elevated immunoglobulin E (IgE) level is considered as an objective marker of allergy. Because IgE is a mediator of allergic response, quantitative measurement of IgE together with other clinical markers, can provide useful information for the differentiation between atopic and non-atopic diseases. In this study, we wanted to determine serum IgE and absolute eosinophil count (AEC) levels and correlate both levels with severity of asthma in children in the age group of 2 - 15 years admitted in the paediatric department. METHODS This is a descriptive cross-sectional study. After taking the informed consent from the parent or guardian, relevant information on asthmatic symptoms and severity, other associated manifestations, precipitating factors, and family history of asthma were recorded in a pre-designed proforma. A total of 65 children (age group 2 – 15 years old) with bronchial asthma were studied. Investigations such as hemogram and serum IgE levels were determined. Asthma severity was assessed according to global initiative for asthma (GINA) guidelines. RESULTS Among 65 children, 69.2 % were boys. Receiver operating characteristic curve (ROC) analysis showed that total IgE cut-off concentration of 168 IU/ml, distinguishes children with intermittent asthma from those with mild persistent disease. IgE cut-off concentration of 989 IU/ml distinguishes mild persistent from those with moderate persistent asthma. Both showed adequate or good diagnostic efficacy. Cut off value of 168 IU/ml may prove useful in practice, indicating that 75 % of children in intermittent group will have serum concentration of total IgE < 168 IU/ml. No association was observed between AEC and increasing severity of asthma. Only atopic dermatitis with asthma showed increasing trend of IgE levels. CONCLUSIONS Asthmatic children with higher asthma severity have a higher serum total IgE concentration (168 IU/ml and 989 IU/ml are the cut off values for differentiating intermittent from mild persistent and mild persistent from moderate persistent). KEYWORDS Serum IgE, Absolute Eosinophil Count, Childhood Asthma, Asthma Severity

Eosinopenia as a Marker of Sepsis in Intensive Care Unit Patients

Sepsis is one of the most common cases of mortality and morbidity in the intensive care unit (ICU). This study was done to evaluate eonsinopenia as a marker of sepsis in intensive care unit patients. This cross sectional study was carried out in the Department of Clinical Pathology, Bangabandhu Sheikh Mujib Medical University, Dhaka from March 2012 to February 2013. Absolute Eosinophil Count (AEC) was done by automated cell counter and rechecked manually microscopically. In this study 74 suspected case of sepsis were enrolled from intensive care unit, BSMMU, Dhaka. Out of these patients 34 were included in the infection group and 40 in the non-infection group depending on blood culture report. The area under ROCcurve was 0.765 in current study. At the cutoff valve of AEC< 40 cell/cumm, the sensitivity and specificity of AEC for diagnosis of sepsis was 72.5% and 61.8% respectively. This present data revealed that decreased absolute eosinophil count was significantly associated with sepsis. So eosinopenia may be a reliable marker for early diagnosis of sepsis.

Low Eosinophil Count : A Predictor of Inhospital Mortality in a Cohort of Cirrhosis Patients With Sepsis

Background and Aims:Eosinopenia has recently been associated with sepsis. Thus, eosinopenia can be used as a marker of the severity of sepsis and high mortality, which helps in early identification of high risk patients, so better management can be offered to such patients. Aim of the study was to assess whether Absolute Esoinophil Count (AEC) at the time of ICU admission can be used as a predictor of inhospital mortality in cirrhotics.Materials and Methods:This study was a retrospective cohort study. The study population included cirrhosis patients admitted in ICU and High Dependency Unit with sepsis and their absolute eosinophil counts were assessed on the day of hospital admission.Results: A total of 105 patients were enrolled in the study. Among the various parameters analyzed, MELD score, CTP score, Albumin levels, Total count, CRP, ESR, ALT, Bilirubin, Creatinine, Urea, SIRS and Absolute Eosinophil Count(AEC) were statistically significant in predicting the mortality. AUROC of AEC for predicting mortality was 0.881. Cutoff of AEC by Youden’s index was 110 cells/cumm (sensitivity 91.3%, specificity 89%, positive predictive value 87.5% and negative predictive value 93%) in predicting inhospital mortality. MELD AUROC was 0.78 with cut off of > 24 (sensitivity 89%, specificity 74.6%, positive predictive value 73% and negative predictive value 89%) to predict mortality. Conclusion:In critically ill cirrhosis patients, absolute eosinophil count less than 110 cells/cumm can predict inhospital mortality.