Relationship between serum IgE and frequent relapse idiopathic nephrotic syndrome.

This prospective case control study was carried out in Renal and Dialysis Unit of Dhaka Shishu Hospital, Bangladesh from January 2004 to December 2004 to determine serum IgE level in frequent relapse Idiopathic nephrotic syndrome and to evaluate any role of IgE in the rate of relapse. Thirty cases of frequent relapse (FR) Idiopathic nephrotic syndrome (INS) were considered as cases and thirty cases of infrequent relapse nephrotic syndrome (IRNS) were considered as control. Serum IgE level was measured in all patients at the time of relapse and again four weeks after steroid treatment when patient was in remission. The test statistics used to analyses the data were descriptive statistics, Chi-square probability test, Student's "t"-Test, Mann Whitney test and Wilcoxon Signed Rank test. Majority of the patients' age in both the groups was between 2-6 years. The male female ratio in FR group was 2:1, while that in IR group was 3:2. Forty percent of the frequent relapsers and 30% of infrequent relapsers were found to possess the history of atopy. However, the difference between the two groups was not statistically significant (p>0.05). The mean serum albumin in FR was observed to be significantly lower (13.73±0.59 gm/L) than that in IR (15.73±0.67 gm/L) (p<0.05). Mean serum IgE at the time of relapse in FR (1791±95 IU/mL) was found to be more than 3 times higher than that in IR (560±50 IU/mL) (p<0.001). Serum IgE level at the time of remission has decreased to almost normal in IR group (204±21 IU/mL) but it was still found 5 times higher in FR group (1086±79 IU/mL) (p<0.001). Serum IgE level is high in both FR and IR groups of nephrotic syndrome at the time of relapse. It reverts back to normal in IRNS but persistently and significantly high in FR group in both relapse and remission. Level of the serum IgE can be used as a predictor of FRNS.

Evaluation of simple hematological screen for early diagnosis of neonatal sepsis.

This prospective study was undertaken in Dhaka Shishu Hospital from 15th March 2005 to 15th October 2006 to evaluate the role of simple hematological test for early diagnosis of neonatal sepsis. Eighty suspected cases of septicaemia admitted in neonatal ward of Dhaka Shishu Hospital were included in this study. Patients those who had history of perinatal asphyxia, infant of diabetic mother, congenital cyanotic heart disease etc. were excluded from the study. Thirty neonates without sign symptoms of septicaemia admitted for other causes like jaundice, feeding problems etc. were taken as a control group. After taking informed consent data were collected in structured questionnaire. Following laboratory investigations like total WBC count, differential count, absolute neutrophil count, band cell count, platelet count, CRP, blood culture were done. Micro-ESR was done as bed side test. Immature and total neutrophil ratio (I/T ratio) detected from total neutrophil and band form count. Patients with positive blood culture were categorized as definite sepsis. Patients with negative blood culture but abnormal hematological report suggestive of sepsis were categorized as probable sepsis. Those who had no signs of sepsis were categorized as control group. Absolute neutrophil count (ANC) had low sensitivity (13%) but Micro-ESR, CRP, I/T ratio, platelet count had moderately high sensitivity and specificity. These simple hematological screen are useful marker for early diagnosis of neonatal sepsis.