Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Count and Plateletcrit (PCT) as predictors of in-hospital paediatric mortality: a case-control Study.

Background: Thrombocytopenia 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. Aim: To determine whether platelet count, plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) and their ratios can predict mortality in hospitalised children. Methods: Children 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. Results: Forty 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 x PDW/Platelet count x 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. Conclusion: The 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.

Hardpan and maize root distribution under conservation and conventional tillage in Agro-Ecological Zone IIA, Zambia

Hardpans (plough/hoe pans) are commonly believed to restrict plant root growth and crop yields under conventional small-scale agriculture in sub-Saharan Africa. This study questions the notion of widespread hardpans in Zambia and their remedy under conservation tillage. Soil penetration resistance was measured in 8x12 grids, covering 80 cm wide and 60 cm deep profiles in 32 soil pits. Large and fine maize roots were counted in 8x6 grids. Soil samples from mid-rows were analysed for pH, exchangeable H+, exchangeable Al3+, cation exchange capacity, total N and extractable P (Bray 1) at six depths from 0-10 to 50-60 cm. Cultivation-induced hardpans were not detected. Soils under conservation tillage were more compact at 5 cm depth than soils under conventional tillage. No differences in root distributions between conservation and conventional tillage were found. Maize ( Zea mays L. ) roots were largely confined to a relatively small soil volume of about 30 cm x 30 cm x 30 cm. Root growth appeared to be restricted by a combination of low concentrations of N and P. Soil acidity and Al saturation appeared to play a minor role in root distribution. L-shaped taproots in soils under manual tillage reported earlier were not necessarily due to hardpans, but may rather be caused by temporarily dry, impenetrable subsoils early in the rain season. There is no scientific basis for the recommendation given to farmers by agricultural extension workers to “break the hardpan” in fields under manual or animal tillage in the study areas.

Aortic Intima-Media Thickness and Mean Platelet Volume in Children With Type 1 Diabetes Mellitus

Background: Diabetes mellitus type 1 is the most common endocrine metabolic disorder occurring in childhood and adolescence due to the autoimmune destruction of pancreatic beta cells as a result of various environmental factors interacting with an underlying genetic predisposition. Diabetes is a risk factor for early onset atherosclerosis, and the high mortality rate seen in these patients is partially related to cardiovascular diseases. Objectives: This study was conducted to compare mean platelet volume as a marker of early atherosclerosis with aortic intima-media thickness in children with type 1 diabetes and to identify its correlation with known cardiovascular risk factors. Patients and Methods: The study included 27 patients between age range of 6 and 17 years that were diagnosed with type 1 diabetes and 30 healthy children of the same age range who did not have any chronic disease. In both groups, we used the color Doppler ultrasound to measure children’s aortic intima-media thickness and identify their mean platelet volumes. Results: There was no significant difference between the groups regarding gender distribution, age, High-Density Lipoprotein (HDL) and Low-Density Lipoprotein (LDL) cholesterol levels (P > 0.05). Also no significant difference could be documented between the patient and control groups regarding the aortic intima-media thickness and mean platelet volume (P > 0.05). However, there was a significant correlation between aortic intima-media thickness and mean platelet volume (r = 0.351; P < 0.05). Conclusions: In the present study, there was no evidence of early atherosclerosis in children with type 1 diabetes. However, mean platelet volume having a significant correlation with aortic intima-media thickness may be useful as an early marker of atherosclerosis.