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Zainab Mohammedi Golwala Hardik Shah Neeraj Gupta V Sreenivas Jacob M Puliyel 《African health sciences》2016,16(2):356-362
BackgroundThrombocytopenia has been shown to predict mortality. We hypothesize that platelet indices may be more useful prognostic indicators. Our study subjects were children one month to 14 years old admitted to our hospital.AimTo determine whether platelet count, plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) and their ratios can predict mortality in hospitalised children.MethodsChildren who died during hospital stay were the cases. Controls were age matched children admitted contemporaneously. The first blood sample after admission was used for analysis. Receiver operating characteristic (ROC) curve was used to identify the best threshold for measured variables and the ratios studied. Multiple regression analysis was done to identify independent predictors of mortality.ResultsForty cases and forty controls were studied. Platelet count, PCT and the ratios of MPV/Platelet count, MPV/PCT, PDW/Platelet count, PDW/PCT and MPV × PDW/Platelet count × PCT were significantly different among children who survived compared to those who died. On multiple regression analysis the ratio of MPV/PCT, PDW/Platelet count and MPV/Platelet count were risk factors for mortality with an odds ratio of 4.31(95% CI, 1.69–10.99), 3.86 (95% CI, 1.53–9.75), 3.45 (95% CI, 1.38–8.64) respectively. In 67% of the patients who died MPV/PCT ratio was above 41.8 and PDW/Platelet count was above 3.86. In 65% of patients who died MPV/Platelet count was above 3.45.ConclusionThe MPV/PCT, PDW/Platelet count and MPV/Platelet count, in the first sample after admission in this case control study were predictors of mortality and could predict 65% to 67% of deaths accurately. 相似文献
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Amit Kavimandan Meenakshi Sharma Anil K. Verma Prasenjit Das Prabhash Mishra Sanjeev Sinha Anant Mohan V. Sreenivas Siddhartha Datta Gupta Govind K. Makharia 《Indian journal of gastroenterology》2014,33(2):114-118
Background
While anemia occurs in 80 % to 90 % of patients with celiac disease (CD), it may be the sole manifestation of CD. The prevalence of CD in Indian patients with nutritional anemia is not known.Patients and Methods
Adolescent and adult patients presenting with nutritional anemia were prospectively screened for CD using IgA anti-tissue transglutaminase antibody (anti-tTG Ab) followed, if positive, by upper gastrointestinal endoscopy and duodenal biopsy.Results
Ninety-six patients [mean?±?SD age 32.1?±?13.1 years and median duration of anemia 11 months (range 1 to 144 months)] were screened. Of these patients, 80 had iron deficiency anemia, 11 had megaloblastic anemia, and 5 had dimorphic anemia. Seventy-three patients were on hematinics and 36.4 % had received blood transfusions. Nineteen had a history of chronic diarrhea and the mean?±?SD duration of diarrhea in them was 9.7?±?35.8 months. IgA anti-tTG Ab was positive in 13 patients, of whom 12 agreed to undergo duodenal biopsy. Ten patients had villous atrophy (Marsh grade 3a in three, 3b in one, and 3c in six) and two did not. Thus, 10 patients with nutritional anemia (iron deficiency 9, vitamin B12 deficiency 1) were diagnosed to have CD. On multivariate logistic regression, age, duration of symptoms, and presence of diarrhea were found to be the predictors of CD. All the patients with CD were put on gluten-free diet and with iron and vitamin supplementations and showed a significant improvement in hemoglobin concentration.Conclusions
CD screening should be included in the work up of otherwise unexplained nutritional anemia. 相似文献15.
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We report a case of acute disseminated staphylococcal disease in an 11-year-old boy who had septic arthritis of the left hip, left iliac vein thrombosis and pulmonary embolism. Rapid deterioration was seen in this patient due to the development of disseminated intravascular coagulation. This was further complicated by chicken pox and slipping of the capital femoral epiphysis on the left side following attempted reduction of hip dislocation during follow-up. Closed reduction and percutaneous pinning were performed which failed, resulting in disability. Aggressive management by means of team approach and timely interventions are essential to prevent long-term complications in this life-threatening condition. 相似文献
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BACKGROUND/AIMS: Cervical web is predominantly a disease of middle-aged females. Sixteen patients with cervical web of esophagus were studied. Dysphagia is mostly for solids, intermittent, non-progressive and was present for many months before they presented. METHODOLOGY: Treatment consisted of forceful dilatation with Savary-Gilliard bougies of 15 or 17 mm diameter after initial rupture of the web by endoscope or 11 mm dilator. RESULTS: Single session of dilatation was adequate in all patients (100%) and there was no recurrence of web during follow-up of 22.8 +/- 18.9 months. CONCLUSIONS: Endoscopic dilatation is a simple outpatient procedure having least morbidity and is suggested as the treatment modality of choice in the management of cervical web of the esophagus. 相似文献
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