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.

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.

Hematobiochemical changes of lead Poisoning and amelioration with Coconut ( Cocos nucifera L.) Water in wistar albino rats

To determine the ameliorative effect of coconut water on haematobiochemical changes due to lead poisoning in wistar albino rats for six weeks, sixty rats were assigned to four groups. 0.10g/l of lead and 75ml coconut ( cocus nucifera l.) water were given orally for six weeks. The mean values of red blood cells, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red blood cell distribution width and platelets (8.10±0.63(×106μl), 52.7±0.87(μm3), 17.9±0.56(pg), 34.73±0.65(g/dl), 17.90±0.67(%) and 670.00±42.22(×103μl) respectively) reduced in lead treated rats when compared with control mean values (8.41 ± 0.90(×106μl), 56.60 ± 1.55(μm3), 19.33 ± 0.82(pg), 34.93 ± 0.90(g/dl), 18.27 ± 0.73(%) and 818.33± 123.68(×103μl) respectively ) and these values increased in75ml coconut water only group and the group of 0.10g/l lead + 75ml coconut water except mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, and red blood cell distribution width of the 75ml coconut water only. The mean values of white blood cells, lymphocytes, total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, low density lipoprotein-cholesterol/high density lipoproteincholesterol and total cholesterol/high density lipoprotein-cholesterol increased (12.23±0.57(×103μl), 79.83±3.87(%), 64.66±6.01(mg/dl), 89.00±7.94(mg/dl), 22.67±6.93(mg/dl), 21.00±4.58(mg/dl), 1.29±0.62 and 3.36±0.83 respectively ) in the lead group when compared with mean values of control group (5.83±0.74(×103μl), 69.07±10.57(%), 54.00±4.04(mg/dl), 97.33±11.34(mg/dl), 20.00±3.06(mg/dl), 17.00±6.51(mg/dl), 0.97±0.41 and 2.87±0.55 respectively) but the mean values decreased when compared with the mean values of group of 75ml coconut water only and group of 0.10g/l lead + 75ml coconut water, except the mean values of high density lipoprotein-cholesterol. These results indicate that coconut water could ameliorate effects of lead toxicity