Platelet Index in Patients with Confirmed Coronavirus Disease 2019 Cases

BACKGROUND: Changes found on hematological examination are a helpful modality for assessing coronavirus disease 2019 (COVID-19). In addition, platelet index is a parameter that can help in assessing the COVID-19 disease prognosis. AIM: Objective of the study is to determine the difference in platelet index in nucleid acid amplification test (NAAT) confirmed COVID-19 patients, suspected COVID-19 with negative NAAT results, and non-COVID-19 controls. METHODS: This is an analytical observational study with 96 subjects; 48 subjects with confirmed COVID-19, 23 subjects suspected COVID-19 with negative NAAT results, and 24 non-COVID-19 control subjects. First, NAAT examination was carried out using the GeneXpert tool with the target genes of the E and N2 genes. Then, the platelet index was compared between the three groups by the Kruskal-Wallis test. RESULTS: There was no significant difference in the number of platelet (PLT), mean PLT volume (MPV), and PLT crit (PCT) between the three groups with p = 0.732, 0.741 and 0.483, respectively. In general, the number of PLT, MPV, and PCT in the three groups was within the normal reference value. CONCLUSIONS: There were no significant differences observed in the number of PLT, MPV, and PCT between COVID-19 patients with positive NAAT, COVID-19 suspects with negative NAAT, and non-COVID-19 controls. Therefore, detecting the severe acute respiratory syndrome coronavirus 2 virus by NAAT examination in COVID-19 patients has not altered the PLT index changes.

Chronometric vs. Structural Hypercoagulability

Prolonged tourniquet stasis induced by venepuncture can lead to the release of the plasma of cell lysis products, as well as tissue factor (TF), impairing the quality of coagulation test results. The accidental presence of TF in vitro can trigger the coagulation mechanism, generating a false decrease in prothrombin time (PT). Background and Objectives: Identification of short PT tests below the normal reference value that could suggest a situation of hypercoagulability. The study aimed to compare the results of the shortened PT tests at their first determination with the eventual correction following duplication of the analysis from the same sample. Materials and methods: Identification of the shortened PT tests has been carried out for a period of 4 months, upon 544 coagulation samples referred to the Hematology department of Sf. Spiridon County Clinical Emergency Hospital from Iasi, Romania. Results: Out of the 544 samples of which the results indicated a state of hypercoagulability, by repeating the determination from the same sample, for 200 (36.76%) PT tests (p = 0.001) the value was corrected, falling within the normal reference range. For 344 (63.24%) tests, the results suggested a situation of hypercoagulability. Conclusions: In order to guarantee the highest quality of the laboratory services, a proper interpretation and report of the patients’ results must be congruent and harmoniously associated to the actual clinical condition of the patient. Duplication of the PT determination from the same sample would exclude situations of false hypercoagulability and would provide significant improvement for the patient’s safety.

Ultrasound assessment of the external occipital protuberance in young adults. Clinical implications

Introduction The current lifestyle, related to the indiscriminate use of screens from early ages with sustained postures, can cause structural changes (osteophytes) to the upper trapezius enthesis on the external occipital protuberance. Such findings in the skull are rare and usually asymptomatic, especially in young adults. Therefore, it is important to analyze, evaluate and correlate these findings with the patient's symptoms. Musculoskeletal ultrasound is an ideal tool to enable the evaluation of these structural alterations. Description of the Exam Prone position avoiding cranio-cervical hyperextension. A linear probe is used with a low frequency range (8–10 Mhz) The scan used as a reference is the transverse exam of the bone prominence. Subsequently, this is confirmed with a longitudinal exam, which is used to measure the osteophyte. The normal reference value is <10 mm. Discussion The ultrasound exam described above enables the easily reproducible assessment and measurement of osteophytes and insertional soft tissue at this level to enhance treatment planning.

Ultrasound Measurement of Thyroid Isthmus Thickness in Clinically Euthyroid Subjects

Introduction: The purpose of this study was to establish the reference value of normal thickness of thyroid isthmus among clinically euthyroid Nepalese individuals using Ultrasonography and correlate this with thyroid volume, sex, individual’s built and geographic location.Methods: This was a prospective cross sectional study involving 485 clinically euthyroid individuals. B -mode Ultrasonography was used to measure the thickness of thyroid isthmus in transverse plane. Mean thickness of isthmus for male and female was obtained and Pearson correlation test was used to see the relationship with various factors.Results: Among 485 individuals between 1 to 83 years of age, 221 were males and 264 were females. Maximum individuals (72.99%) were from hilly region and minimum (3.30%) were from Himalayan region. Mean thickness of isthmus was 3.097 ± 1.009 mm (range 1.0 to 6.8 mm). It was 3.114 ± 0.9513 mm for male and 3.083 ± 1.056 mm for female. Isthmus thickness best correlated with total thyroid volume (r=0.373, p=0.0001). Isthmus thickness also positively correlated with body mass index (r=0.355, p =0.0001), body surface area (r= 0.296, p=0.0001), weight (r =0.334, p=0.0001) and height (r =0.130, p =0.004) of the individuals.Conclusion: This study estimated the normal reference value of thyroid isthmus thickness. As isthmus thickness correlated well with total thyroid volume, it can roughly guide the thyroid volume and help assessment of thyroid size in diffuse thyroid disease.

Effect of weight and age based split weaning on growth performances and welfare of Large White Yorkshire piglets

With an objective to minimize the weaning stress and to maximize the welfare, early weaning was combined with split weaning in 41 piglets of Large White Yorkshire (LWY). Weaning method was either “Weight Based Early or Split Weaning” i.e. TES or “Conventional Weaning” i.e. TC and treated as control. The weaning age in TC was 56 days. In TES, heavier (> 1.5 kg) medium weighing (1.0-1.5 kg) and lighter (> 1.0 kg) piglets were weaned at 30 (TESH), 37 days (TESM) and 42 days (TESL), respectively. Different records pertaining to body weight, feed consumption, haematological profiles etc. were collected up to 120 days. At the end of the study period, body weight of piglets was almost equal in both groups. The overall ADG at the end of study period was almost equal in all three sub-groups and in control. FCR of piglets under split and conventional weaning groups was significantly better (P>0.05) in TESH than Tc group, both during pre- and post-weaning period. The PCV (%) and TLC value under different sub-groups of split-weaned piglets were almost similar to different sub-groups of conventionally weaned piglets and were within normal range. There were significant differences among haemoglobin level among different sub-group of TES and Tc and it was within the range of normal reference value. From the present study it can be concluded that split weaned piglets performed almost equally to conventionally weaned piglets.

Testosterone and Gonadotropins in Infertile Men with Sertoli Cell Only Syndrome from Gaza Strip

Aim: To assess serum testosterone and gonadotropins in Sertoli cell only syndrome patients from Gaza Strip.Methods: Based on testicular biopsy, a cross section of 74 Sertoli cell only syndrome patients were enrolled in the study. Age matched 44 fertile men were served as controls. Patients and controls were questioned for their medical history. Blood samples were drawn and serum testosterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH) were determined by enzyme-linked immunosorbent assay. Data were computer analyzed using SPSS/PC, version 18.0.Results: Varicocele and hormonal problems were significantly more frequent among patients than controls (P<0.05). Serum testosterone was significantly lower in patients compared to controls (1.7±1.3 versus 5.0±2.2 ng/ml, P=0.000). In contrast, LH and FSH were significantly higher in patients than controls (12.8±9.7 and 20.8±14.8 mlU/ml versus 6.3±3.1 and 7.7±3.9 mlU/ml, P=0.000, respectively). Hypergonadotrophic hypogonadism and hypogonadotrophic hypogonadism patients showed lower levels of testosterone compared to the normal reference value (0.9±0.5 and 0.5±0.4 ng/ml versus 2.0-7.0 ng/ml). Higher levels of LH and FSH were recorded in hypergonadotrophic hypogonadism (24.5±2.6 and 37.4±6.7 mlU/ml) compared to the reference values of 2.0-13.0 and 2.5-10.0 mlU/ml, respectively whereas LH and FSH levels were lower in hypogonadotrophic hypogonadism (0.6±0.4 and 0.6±0.5 mlU/ml, respectively). In this context, all hypergonadotrophic hypogonadism and hypogonadotrophic hypogonadism patients showed abnormal levels of testosterone, LH and FSH.Conclusions: Abnormal levels of serum testosterone, LH and FSH, particularly in hypergonadotrophic hypogonadism and hypogonadotrophic hypogonadism were identified in infertile men with Sertoli cell only syndrome from Gaza Strip.J MEDICINE January 2017; 18 (1) : 21-26

Gestational Gigantomastia Complicating Pregnancy: A Case Report and Review of the Literature

Background. Gestational gigantomastia is a rare disorder without clear etiology or well-established risk factors. Several pathogenic mechanisms contributing to the disease process have been proposed, all of which can lead to a similar phenotype of breast hypertrophy.Case. A 28-year-old Guinean woman presented at 37 weeks of gestation with bilateral gigantomastia, mastalgia, peau d’orange, and back pain. Prolactin levels were 103.3 μg/L (with a normal reference value for prolactin in pregnancy being 36–372 μg/L). The patient was treated with bromocriptine (2.5 mg twice daily), scheduled for a repeat cesarean, and referred to surgery for bilateral mammoplasty.Conclusion. Gestational gigantomastia is a rare disorder, characterized by enlargement and hypertrophy of breast tissue. Our patient presented with no endocrine or hematological abnormalities, adding to a review of the literature for differential diagnoses, workup, and management of cases of gestational gigantomastia with normal hormone levels.

Prostate Specific Antigen (PSA): Normal Reference Value in Bangladeshi Male, a Retrospective PSA Analysis of 765 Male

Prostate specific antigen (PSA) is an important tool for the diagnosis, prognosis and follow up of prostatic cancer, the most common malignancy of the male throughout the world. It is safe, reliable, specific, noninvasive test if done properly. However there are many benign, inflammatory and other prostatic conditions which can also give rise to elevated PSA value and thus limits its use. Different methods of estimation may also give rise to variable PSA level. More over the normal reference range may be variable depending on the age, geographic situation, environmental conditions and other factors. The normal reference range mentioned in the texts is based on findings in the developed countries. No effort was made before to see the normal reference PSA value among Bangladeshi male population. With this background the present study was undertaken to determine the normal reference value of PSA in Bangladeshi population. It is evident form the present study that the normal reference PSA value for Bangladeshi male in different age groups are lower in comparison to that of upper limit of normal reference value mentioned in the text. DOI: http://dx.doi.org/10.3329/akmmcj.v5i1.18766 Anwer Khan Modern Medical College Journal Vol. 5, No. 1: January 2014, Pages 19-22