Detection Of Thrombocytopenia Research Articles

Detection of Thrombocytopenia, Anemia and Leukocytosis by Using Ensemble Learning

Blood disorders are conditions that impact the blood’s ability to function correctly. There is a range of different symptoms depending on the type. There are several different types of blood disorders such as Leukemia, chronic myelocytic leukemia, lymphoma, myelofibrosis, polycythemia, Thrombocytopenia, anemia and Leukocytosis. Some resolve completely with therapy, or do not cause symptoms and do not affect overall lifespan Some are chronic and lifelong but do not affect how long you live. Other blood disorders, like sickle cell disease and blood cancers, can be fatal. Thereneeds to capture of hidden information in the medical data for detecting diseases in the early stage. In this study, we apply the Ensemble Learning technique for classification. We compared our result with other classification methods. The results show that Ensemble Learning methods can predict the Tumor of blood disease better than the other classifiers.

Диференційна діагностика тромбоцитопенії під час вагітності: клінічні і діагностичні алгоритми

Purpose — to create an algorithm for early diagnosis and differential diagnosis of conditions accompanied by thrombocytopenia (TP) during pregnancy, as well as an algorithm for the treatment of immune thrombocytopenia during pregnancy based on analysis of clinical, laboratory data and obstetric and perinatal results of such pregnant women. Materials and methods. We analyzed 155 histories of pregnancy and childbirth of women with TP, who underwent inpatient treatment and/or gave childbirth in the obstetric clinic of the State Institution «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova NAMS of Ukraine» from January 2008 to August 2018. According to the inclusion criteria, 111 histories were selected for further analysis. Pregnant women are divided according to the etiological principle of TP into three groups: with gestational thrombocytopenia, immune thrombocytopenia, secondary thrombocytopenia. The first group included 32 women (28.8%), the second — 65 (55.6%), the third — 14 (12.6%). During the selected period of time there were 99 births, 100 babies were born, 1 twin birth. Results and conclusions. The number of platelets progressively decreases during pregnancy with a minimum in childbirth. The algorithm of examination, the decision on the initiation or intensification of treatment, the choice of monitoring tactics for TP during pregnancy, the calculation of obstetric and perinatal risks, preparation for childbirth and the choice of method depend on the cause of TP and differ significantly. Developed «Algorithm for diagnosis and differential diagnosis in the detection of thrombocytopenia during pregnancy» and «Algorithm for the treatment of immune thrombocytopenia during pregnancy» are aimed at the prevention of obstetric and perinatal complications in pregnant women with thrombocytopenia. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: thrombocytopenia, pregnancy, diagnostic algorithm, treatment algorithm.

Severity of thrombocytopenia and its outcome in preterm and term neonates admitted in neonatal intensive care unit in a rural tertiary care hospital

Background: Detection of thrombocytopenia is a useful initial assessment for sick neonates, and it is considered as one of the complications of the disease process.Methods: The present study was a prospective hospital based observational study done in 60 neonates in the department of Paediatrics, KIMS, Narketpally during the period of October 2016 to September 2018.Results: The proportion of babies with thrombocytopenia admitted to the NICU was 10.9%. out of the sixty newborns with thrombocytopenia, 31(51.7%) were term babies and 29(48.3%) babies were preterm. Out of 29 preterm babies 3 (5%) were extremely preterm, 5 (8.3%) were very preterm and 21(35%) babies were moderate to late preterm. 32 babies (53.3%) had mild thrombocytopenia, 14 babies (23.3%) babies had moderate thrombo cytopenia and 14 babies (23.3%) had severe thrombocytopenia. The most common etiologic association with thrombocytopenia was septicemia (60%) followed by birth asphyxia (23.3%), maternal Pregnancy induced Hypertension (18.3%), both Disseminated intravascular coagulation and Meconium aspiration syndrome were 6.6% and Necrotizing enterocolitis was 3%. Among the 60 babies admitted with thrombocytopenia, the most frequently seen symptom was not feeding well (35%) and lethargy (33.3%) in all three groups that is babies with mild, moderate, and severe thrombocytopenia. Mortality rate among severely thrombocytopenic neonates was significantly higher (57.14%).Conclusions: Low platelet count was an independent risk factor for poor outcome in our study. Hence it could be used as a prognostic indicator in thrombo- cytopenic neonates.

Upregulation of SCUBE1 in Dengue Virus Infection.

BACKGROUND:Dengue is a major communicable disease in tropical areas, with an increasing prevalence every year. Thrombocytopenia is one of the commonly used laboratory parameters for predicting the severity of the disease. It is detected on day 6 or day 7 after the febrile stage, and its presence indicates that the disease has become potentially fatal. Therefore, it is necessary to identify a marker for the early recognition of dengue virus infection during the febrile stage before the detection of thrombocytopenia on day 6 to prevent severe disease outcomes. Signal peptide-CUB- (complement C1r/C1s)-EGF (epidermal growth factor)-like domain-containing protein 1 (SCUBE1) is secreted in activated platelets under inflammatory conditions and enhances platelet-platelet adhesion and agglutination. This gene was first identified in human vascular endothelium, but its biological role in platelets remains unknown.AIM:This study aims to identify SCUBE1 expression during the febrile stage of dengue virus infection and examine the correlation of its expression with thrombocytopenia occurrence on day 6.MATERIAL AND METHODS:Blood samples were collected from 17 patients infected with dengue virus on day-3 fever and from 16 healthy controls who met the inclusion and exclusion criteria for dengue virus infection according to the World Health Organization (WHO) classification for dengue virus infection. All samples were subjected to SCUBE1 gene analysis using real-time reverse transcription quantitative PCR (RT-PCR).RESULTS:The results showed that upregulation of SCUBE1 gene in infected patients (8.9 ± 3.1-fold) compared to that in healthy controls, indicating SCUBE1 involvement in dengue virus infection. Furthermore, we analysed the laboratory parameters of infected patients on day 3 and day 6, when thrombocytopenia is usually detected. Platelet count was found to be significantly decreased from day 3 until day 6 in the infected patients. Unfortunately, our results showed no correlation between SCUBE1 expression in the febrile stage and the occurrence of thrombocytopenia on day 6.CONCLUSION:The conclusion of this study is SCUBE1 might play a role in dengue virus infection but does not correlate with thrombocytopenia on day-6 fever.

Antiphospholipid Syndrome: primary or secondary to Systemic Lupus Erythematosus? Description of a clinical case of avitaminosis D in premenopausal woman with pseudo-Cushing syndrome

Low vitamin D levels have been described in obese individuals and in some autoimmune diseases, such as Systemic Lupus Erythematosus (SLE) and primary antiphospholipid syndrome (pAPS). In particular, more than 50% of premenopausal women with pAPS have hypovitaminosis D. In this issue we report a case of an obese, premenopausal, and hypertensive woman with pseudo-Cushing syndrome, affected by deep venous thrombosis associated with pulmonary embolism after rib fracture who presented hypovitaminosis D. 7 years before, diagnosis of pAPS had been made after the detection of thrombocytopenia (present at a young age) and arterial ischemia of a lower limb. For seven years she was treated with acetylsalicylic acid without complications. We found positive anti-dsDNA antibodies, a triple antiphospholipid antibodies (aPL) positivity and levels of vitamin D < 4 µg/l. The case report arises some questions: is vitamin D deficiency due to obesity or APS? Is the positivity of anti-dsDNA indicative of progression to SLE? Is preventive therapy with hydroxychloroquine indicated? Does the high-risk aPL profile justify a high-intensity and life-long anticoagulation regimen?

PREGNANCY INDUCED HYPERTENSION;

Objective: To assess the early detection of thrombocytopenia in womenpresenting with varying degree of pregnancy induced hypertension (PIH). Study Design: A casecontrol study. Place of Study: Hematology laboratory Isra University Hospital Hyderabad.Duration of Study: From July 2009 to December 2010. Materials and Methods: Total 130pregnant women were included in this study. The subjects were divided into three groups asGroup 1 with pre-eclampsia, Group 2 with eclampsia and Group 3 with normotensive pregnantwomen as control group. The Group 1 was further divided into two sub groups such as Subgroup1a with mild preeclampsia and Sub-group 2b with severe pre-eclampsia. Results:Anticoagulated whole blood samples (5cc) from all subjects were analyzed for the detection ofthrombocytopenia for the possible involvement of pregnancy induced hypertension. It was notedthat out of total subjects, 33(25.39%) had mild pre-eclampsia, 17(13.07%) had severe preeclampsia,15(11.54%) had eclampsia and 65 (50.0%) were normotensive pregnant women.Based on the comparative findings, the results showed significant differences between group 3and group 1a (p-value 0.001), group 3 and group 1b (p-value 0.001), group 2 and group 3 alsoshowed same results (p-value 0.001) but the subjects of group 1a and 1b when compared,showed non-significant findings (p value 0.955). Conclusion: The results suggested that earlydetection of platelet count provide significant role for the assessment of severity of disease inwomen with pregnancy induced hypertension when compared with normotensive pregnantwomen.

THROMBOCYTOPENIA IN NEONATAL SEPSIS: TIME RELATIONSHIP BETWEEN CLINICAL SIGNS, DETECTION OF THROMBOCYTOPENIA AND POSITIVE BLOOD CULTURE

Thrombocytopenia is a common manifestation of bacterial sepsis in children. A prospective study was designed to investigate the time relationship between the clinical manifestations of sepsis, detection of thrombocytopenia and the confirmation of a positive blood culture. Three groups of neonates admitted to special care were studied. Group I (16 pts) had sepsis confirmed by positive blood cultures. Group II (63 pts) were suspected to be septic but blood cultures were negative. Group III (28 pts) were randomly selected sick neonates without suspected or confirmed sepsis. Platelet counts by phase microscopy were done at the time of septic work-up and at 12, 24, 48 and 72 hours in Groups I and II and at similar intervals in Group III. Thrombocytopenia, platelets < 100,000/mm3, were found in 63% of Group I, none in Group II and in 18% of Group III. At the above time intervals comparisons of platelet counts between Groups I and II, and I and III showed statistically significant differences at all times (p < 0.05). In Group I thrombocytopenia was detected at 8 ± 12 hours while the positive blood cultures were confirmed at 43 ± 27 hours with p<0.005. This study confirms that thrombocytopenia is frequently associated with bacterial sepsis in neonates, although less frequently it may be present in clinical entities other than sepsis. The rapid appearance of thrombocytopenia, long before the confirmation of a positive blood culture, makes this test a valuable adjunct to management of septic neonates.

LACK OF THROMBOCYTOPENIA IN NEWBORN INFANTS TREATED WITH PHOTOTHERAPY

Recent investigations in animals and in low birthweight infants showed that conventional phototherapy increases the rate of platelet turnover. A prospective study was designed to investigate the time relationship between clinical signs of neonatal sepsis, detection of thrombocytopenia and positive blood culture. As part of the same study we investigated the effect of conventional phototherapy on platelet counts. Sixty newborn infants who had septic work-up but without positive blood culture and without a clinical condition known to cause thrombocytopenia were included in this study. Platelet counts by phase microscopy were done at the time of septic work-up and repeated at 12, 24, 48 and 72 hours. Twenty-four infants received phototherapy during the study period (mean 48 ± 25 S.D. hours) and 36 served as controls.None of the infants of phototherapy or control group developed thrombocytopenia (platelets <100,000/mm3)neither statistical comparisons between the two groups, at the above time intervals, showed any significant differences. Contrary to previous reports this study does not show any thrombocytopenia associated with conventional phototherapy although the platelet turnover may be increased. In the presence of thrombocytopenia, etiology other than phototherapy should be considered.