Granulocyte Colony Stimulating Factor (G-CSF) Quantitative Analysis In Plasmodium Vivax Infected Malaria Patients Experiencing Trombocytopenia

Introduction : P. Vivax has been refered as pathological factor underlying increasing prevalences of haematological abnormality including anemia and thrombocytopenia. Through the day, exact mechanism of thrombocytopenia in malaria infection has yet come to a conclusion, several hypothesis are still in considered, phagocytosis and platelets aggregation remain the major disscussion topics. G-CSF, cytocine with elevated serum quantity in P. Vivax infections, were responsible in increasing phagoctytosis and conducting direct effect on platelets aggregation using adequate ADP. Increasing number of ADP in malaria cases were correlated with erythrocyte haemolitic, leading to increasing platelets aggregation. Although numerous hypothesis has been compelled, only a-few research publication has been made corresponding to G-CSF serum level on malaria P. Vivax infection and its correlations to thrombocytopenic events. Aim of study : To analyze the relations between G-CSF serum levels and parasite numbers towards platelets profile in infected malaria P. Vivax patients. Methods : Study design using Prospective analysis. Thirty six patients with single infection of Malaria Vivax in Puskesmas Sukamaju (Primary Heath Care Centre) and Puskesmas Kota Karang were assessed for G-CSF plasma levels, platelet counts, and MPV. Data analysis were conducted using Spearman correlation methods with SPSS. Results : Study results showing significant correlation between G-CSF serum levels towards Platelet conts (R = -0,397(p = 0,016)), without significant correlation between G-CSF and MPV value (p = 0,874) Conclusion : G-CSF serum levels were related with thrombocytopenia, with no correlation towards MPV. Keyword: G-CSF, P. vivax, Thrombocytopenia, MPV.

UJI HEMATOLOGI PASIEN TERDUGA DEMAM BERDARAH DENGUE INDIKASI RAWAT INAP

Indonesia is an endemic area of Dengue Hemorrhagic Fever (DHF). The clinical symptoms of this disease varies; it can beasymptomatic or atypical fever. Therefore, the early detection of Dengue virus is important to reduce the incidence of new victims fromhis infection. The aim of this study was to find out the haematological features of DHF suspected patients indicated for hospitalization. Aross-sectional study was done on DHF suspected patients indicated for hospitalization. The data were obtained from the Medical Recordat Wahidin Sudirohusodo Hospital from January-July 2009. The data were presented in the form of table. The results showed that themean leukocyte counts was 5.138 103/µL ranging from 2.10–16.70 103/µL, the mean erythrocyte count was 5.136 106/µL rangingrom 3.2–6.40 106/µL, the mean platelet count was 111.27 103/µL ranging from 11.40–260 103/µL. The DHF patients at admissionwho had leucositopenia, thrombocytopenia, and monocytosis were 54.30%, 71.40%, and 51.40%, respectively. Based on the result itan be concluded, that the most common haematological abnormality in DHF suspected patients whom indicated for hospitalizationwere thrombo cytopenia, leucocytopenia and monocytosis.

Investigation of outpatients referred to a chemical pathologist with potential pseudohyperkalaemia

Background:Pseudohyperkalaemia is when the in vitro blood potassium concentration is artefactually raised while the in vivo concentration is normal. With unexplained hyperkalaemia, pseudohyperkalaemia needs to be excluded to avoid unnecessary and potentially detrimental therapy. There are numerous causes, but no systematic approach for the investigation of outpatients with potential pseudohyperkalaemia exists in the literature.Aims:To evaluate the in-house protocol.Methods:Patients referred for investigation of potential pseudohyperkalaemia underwent an outpatient based protocol which is designed to determine whether the cause was due to delayed blood separation, clotting, centrifugation or a haematological abnormality.Results:32 patients with serum potassium of 5.5–7.1 mmol/l were referred. All patients had pseudohyperkalaemia; the most frequent causes were full blood count (FBC) abnormalities (28%), time >4 hours from sampling to centrifugation (28%) and sample clotting (25%). Anaemia was more likely to be found in male patients.Conclusion:Before a problem can be treated, it must be confirmed and its aetiology identified. A systematic approach to investigate potential pseudohyperkalaemia has been presented. This confirmed the clinician’s suspicion of pseudohyperkalaemia and in the majority of patients the aetiology was also identified. The use of serum and plasma potassium with an FBC in the initial investigation will identify whether clotting or a haematological abnormality is the cause in about half of the cases. Assay of whole-blood potassium is less important as centrifugation is a rare cause. Time to centrifugation is likely to play a major part in the majority of the remaining cases.

Retrospective study of snake envenomation in 155 dogs from the Onderstepoort area of South Africa

A retrospective study was undertaken to evaluate the incidence, signalment, haematological and biochemical changes, therapy, and outcome of dogs presented to the Outpatients section of the Onderstepoort Veterinary Academic Hospital for confirmed snake envenomation. Three hundred and seventy-six records of dogs presented for snake envenomation from 1998 to 2002 were reviewed and 155 were selected on the basis of there being a positively identified snake. The 2 most commonly encountered snake envenomations in dogs were puff-adders (Bitis arietans) and snouted cobras (Naja annulifera annulifera). The majority of cases (56 %) occurred in the autumn (March to May), with most being bitten by puff-adders. Dogs were 3 to 168 months old with a median of 36 months.No sex predilection was identified. Ten per cent of cases died because of the snake envenomation. Fifty-seven per cent and 43 % of snakebites were puff-adders and cobras, respectively. There was no difference in mortality between the 2 groups of snakes. Of the cobras 60%were the snouted cobra, 14 % Mozambique spitting cobra, and 24 % rhinkals. Swelling in the area of the bite, usually the face and forequarters, was the primary clinical abnormality. Significant haematological findings were leukocytosis (median 17.3 × 109/ℓ ; range 0.4-44), neutrophilia (median 13.6×109/ℓ ; range 0.3-39.9), band neutrophilia (median 0.4×109/ℓ ; range 0-5.32), and thrombocytopaenia (median 124 × 109/ℓ ; range 3-555). Dogs envenomated by a puff-adder and Mozambique spitting cobra had a greater degree of thrombocytopaenia: median of 68 and 66, respectively, versus 243 for the cobra group. The most commonly used treatments were intravenous fluids, antibiotics and glucocorticoids. Thirty-eight dogs were treated with polyvalent antiserum: 9 for puff-adder envenomation and 29 for cobra envenomation. Only 2 of the dogs that received antisera died, both of them of cobra envenomation. The study concluded that snake envenomation in dogs is associated with high morbidity but moderate mortality rate and that the most significant haematological abnormality is thrombocytopaenia.

Physical Complications in Anorexia Nervosa

Of twelve patients consecutively admitted to the Maudsley Hospital Eating Disorders Unit, four had neuromuscular abnormality, eight haematological abnormality, and four no abnormality. All those having neuromuscular signs had concomitant haematological dysfunction. Vomiting, and food restriction with vegetarianism, appeared more likely to lead to complications than either food restriction alone or laxative abuse. The physical status of severely underweight patients admitted for refeeding needs to be carefully monitored.