scholarly journals Abnormal WBC Scattergrams by Sysmex XN550, A Supplementary Diagnostic Tool for Malaria to the Conventional Methods

2021 ◽  
Vol 8 (1) ◽  
pp. A14-19
Author(s):  
Rajeshwar Suresh Bute ◽  
Bhavana Madhukar Bharambe ◽  
Ravikiran Pawar ◽  
Asawari Bharat Jadhav

Background: In India, malaria has a major impact on health system. It is usually diagnosed based on symptomatology, parasite detection in the peripheral smear (PS) or rapid diagnostic tests (RDT) such as malaria antigen test (MAT). Detection of malaria by MAT is considered as the gold standard. A rapid, cost effective screening of malaria can be done with the automated analyzers. The present study was undertaken to assess the efficacy of WBC scattergram generated by Sysmex XN 550 hematology analyzer to diagnose malaria. Methods: A prospective study was conducted over a period of 4 months from August to November 2019, after obtaining institutional ethical clearance. All cases diagnosed as Plasmodium vivax / Plasmodium falciparum infections on malaria antigen test (MAT) were included. Their hemogram and WBC scattergrams obtained from Sysmex XN 550 were studied. Thick & thin Smears were made and stained with Leishman’s stain for microscopy. Results: A total of 101 cases were diagnosed as malaria positive by MAT and thick smear. Ninety-seven were positive by Leishman’s stain. Abnormal scattergrams were 81 out of 101 malaria positive cases. The commonest pattern was double neutrophil zone (n=22) followed by double neutrophil with less space between neutrophil and eosinophil (n=17). An abnormal event on X axis was observed in 16 patients. Gray zone and double eosinophil areas were observed in 11 and 4 cases respectively. The sensitivity of the analyzer was found to be 80.19%. Conclusion: Scattergram of automated haematology analyser (Sysmex XN 550) has good sensitivity, which can be increased to a better level if combined with thrombocytopenia and symptomatology of the patients.

2020 ◽  
Vol 14 (11) ◽  
pp. 1327-1331
Author(s):  
Chandan Kumar Kedarisetty ◽  
B Laksminarayana Samaga ◽  
Sudha Vidyasagar ◽  
Jayanthi Venkataraman

Introduction: Malaria is a growing global threat and a major cause of mortality in the tropics. The gold standard diagnosis is peripheral blood smear examination. It has been demonstrated that melatonin acts as messenger molecule in malaria pathophysiology. This concept was used to evolve a clinical study wherein use of exogenous melatonin could improve the chance of detection of the parasite. Methodology: In a prospective study, 80 consecutive patients seen in the Department of Medicine at Kasturba Hospital, Manipal, suspected to have malarial fever were enrolled with proper informed consent, and randomly assigned to the groups given oral melatonin 3mg (melatonin group, n = 40) or placebo (control group, n = 40). Blood samples were collected for peripheral smear examination at baseline and then at two, three, four and five hours after drug administration. The primary end point was the parasite detection index. Results: Baseline characteristics of patients were comparable. In the melatonin group, there was a significant increase of 0.0943 ± 0.22 in the mean parasite index from 0.217 ± 0.42 pre-melatonin to 0.3114 ± 0.5 post-melatonin (p = 0.001), compared to a difference of 0.0025 ± 0.22 in mean parasite index before and after placebo in the control group (p = 0.95). The maximum rise in parasite detection was seen at five hours after melatonin. Conclusions: In a single centre study, for the first time, it has been shown that a significantly higher proportion of patients was diagnosed with malaria on peripheral smear after oral melatonin administration, maximal at five hours after administration of melatonin.


Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 189-192 ◽  
Author(s):  
Anis Dosani ◽  
Sameer K. Khan ◽  
Sheila Gray ◽  
Steve Joseph ◽  
Ian A. Whittaker

This prospective non-randomised two-cohort study compares the use of an absorbable suture (Poliglecrapone [Monocryl]: Group A) and a non-absorbable suture (Polyamide [Ethilon]: Group B) in wound closure after elective carpal tunnel decompression. The primary outcome was scar cosmesis as assessed by the Stonybrook Scar Evaluation Scale (SBSES); the financial cost of wound closure was compared as a secondary outocome. All fifty patients completed follow-up. At six weeks, there was no significant difference in the two groups regarding scar tenderness (p = 0.5), although residual swelling was more evident in the absorbable group (p = 0.2). The mean SBSES score at six weeks was 4.72 in Group A, and 4.8 in Group B (p = 0.3). The unit cost per closed wound of Monocryl was three times than Ethilon (p < 0.05). Ethilon is thus cost-effective without compromising the cosmetic outcome, and we recommend using this as the preferred suture for closure of carpal tunnel wounds.


Author(s):  
M Sobrino-García

Background: The prevalence of hypersensitivity reactions to radiological contrast media (RCM) is increasing due to the greater performance of diagnostic and therapeutic tests that require RCMs. Objective: We carried out a year-long real-life observational study to prospectively evaluate the patients referred to the Allergy Service from Primary Care, Emergency Room, and other Services with suspected moderate to severe RCM hypersensitivity. Methods: To study the costs of RCM hypersensitivity evaluation, we systematically recorded direct and indirect costs. Results: Sixty-nine patients with previous reactions to RCM were evaluated in the Allergy Service from June 1st, 2017, to May 31st, 2018. Total direct health care costs were € 10715.84, with a mean cost per patient of € 155.30 ± 77.08. Specifically, direct non-health costs reached € 1605.42 (mean € 23.27 ± 41.14), and indirect costs were € 6490.85 (mean € 94.07 ± 110.61). In summary, the total cost was € 18812.11, which means a mean cost of € 272.64 ± 164.77. Conclusions: Our study reflects that the costs of an elective evaluation of hypersensitivity to RCM are low. This fact reaffirms that correct and safe management of these patients could be cost-effective, so our efforts should be directed to implement the necessary logistics.


2021 ◽  
Vol 62 (4) ◽  
pp. 99-103
Author(s):  
Waleed Saadi Ahmed ◽  
Salah M. Tajer ◽  
Hend M. Sayaly

Background:  Acute appendicitis is the commonest non traumatic cause of acute abdominal pain that needs surgical management .Alvarado score and ultrasonographies are the most cost effective, easy and available aids for diagnosis. The aim of the study was determining   the reliability of Alvarado score and ultrasound in the diagnosis of acute appendicitis. Results: The study was applied with 100 cases with different types of abdominal pain at presentation with 51 males and 49 females .The sensitivity was97.3% ,specificity 90%, and accuracy  89 of combined usage of Alvarado score and U/S findings preoperatively. Patients and method:  A prospective non-interventional study including patients admitted with suggestive history with signs and symptoms of acute appendicitis to the surgical emergency ward of Baghdad teaching hospital from July 1st 2017 to Feb 10th 2018, Alvarado score calculated and ultrasonography done for each patient enrolled in this study, then to be followed for intraoperative findings. Conclusions: Combined application of Alvarado score and U/S has sensitivity 94.1% ,specificity 90% and accuracy 89% . In our medical facility and emergency ward, acute appendicitis remains as one of the top acute abdominal emergencies needing surgery in patients presenting with atypical clinical finding. So diagnosis becomes difficult. So Alvarado score along with ultrasound findings are useful for increasing the reliability in emergency department for  accurate diagnosis of acute appendicitis therefore there should be training for the use of U/S by emergency physician and general surgeon in the diagnosis of acute appendicitis in order to decrease the rate of negative appendectomies .  


2021 ◽  
Author(s):  
Stéphane Chevaliez ◽  
Françoise Roudot-Thoraval ◽  
Christophe Hézode ◽  
Jean-Michel Pawlotsky ◽  
Richard Njouom

Aim: HCV diagnosis will become the bottleneck in eliminating hepatitis C. Simple, accurate and cost-effective testing strategies are urgently needed to improve hepatitis C screening and diagnosis. Materials & methods: Performance of seven rapid diagnostic tests (RDT) have been assessed in a large series (n = 498) of serum or plasma specimens collected in France and in Cameroon. Results: Specificity varied from 96.1 to 100%. The clinical sensitivity, compared with immunoassays as the reference, was high for all seven RDT (97.2–100%). The Multisure HCV antibody assay and OraQuick HCV rapid antibody test reached sensitivity ≥99%. Conclusion: A number of RDT may be suitable for WHO prequalification and may be implemented in the framework of large-scale low-cost treatment programs to achieve the WHO viral hepatitis objectives by 2030.


Biomedicine ◽  
2021 ◽  
Vol 41 (4) ◽  
pp. 811-814
Author(s):  
Senthil Loganathan ◽  
Sradha Murali ◽  
U. Thiyagarajan ◽  
D. Gokulraj

Introduction and Aim: Masquelet’s technique is a 2-staged procedure, for treatment of infected segmental bone defect. 1st stage involves radical debridement with antibiotic-induced cement spacer. During second stage, the spacer is removed and the autologous bone graft is applied into the biomembrane formed. In this study, we evaluate the Masquelet’s technique for the management of infective non-union of long bones.   Materials and Methods: 15 patients with infective non-union of long bones- tibia, femur and a case of congenital pseudoarthrosis of tibia, were treated with Masquelet’s technique. They underwent 2 stages of procedures 6-8 weeks apart and was followed up for about 9 months and radiological and clinical outcomes were assessed.   Results: Out of 15 patients with infective non-union, 8 patients attained union. Out of the 7 patients with failure of the technique, higher failure rates were attributed to Pseudomonas infection.   Conclusion: Masquelet’s technique is a cost-effective method for treating infective segmental non-unions, not requiring special training or sophisticated instruments. This method shows good results with Gram positive infections. Although, the outcome with Pseudomonas aeruginosa infection, have not shown satisfactory results.


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