Role of Red Cell Distribution Width to Platelet Ratio in Predicting Hepatic Fibrosis in Chronic Hepatitis B.

Hepatitis B virus (HBV) infection is a serious global health problem. Globally more than 2 (Two) billion people are infected with Hepatitis B virus and about 400 million people are chronic carriers who are at risk of death from liver cirrhosis and liver cancer that kill more than one million people globally each year. Prevalence of HBV infection in Bangladesh is 2.3 to 9.7% and approximately 10 million people are harboring the virus as carrier. HBV infection is increasing at an alarming rate in Bangladesh due to lack of health education, poverty, illiteracy and lack of hepatitis B vaccination. This cross sectional study was carried out in the Department of Clinical Pathology, in collaboration with Department of Hepatology and Department of Pathology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2013 to August 2014 to assess the role of Red cell distribution width to platelet ratio (RPR) as a non invasive marker in predicting hepatic fibrosis in chronic hepatitis B patients. Total 40 patients with chronic hepatitis B virus infection who fulfilled the criteria of chronic hepatitis B were included in this study. In this study, majority of the patients belonged to 20-29 years, most of the patients were male and HBeAg negative .Histopathology was gold standard to identify the stages of hepatic fibrosis. We also measured RDW and Platelet count by automated haematology analyzer when platelet count was rechecked manually; RDW to platelet ratio was calculated to see the correlation between RPR with different stages of hepatic fibrosis. In chronic hepatitis B patients a positive and significant correlation was found between RPR and stages of hepatic fibrosis and Spearman's correlation coefficient for RPR was 0.749 which was positive and highly significant (p<0.001). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of RDW to Platelet ratio (RPR) was 62.86%, 80%, 95.65%, 23.53% and 65% respectively. To assess the diagnostic performance of RPR we also used receiver-operating curve (ROC). The area under ROC was 0.889 for identification of hepatic fibrosis. This data revealed that RPR is strongly associated with stages of hepatic fibrosis in chronic hepatitis B patients. As such RPR may be a useful diagnostic tool for assessing the hepatic fibrosis in chronic hepatitis B patients.

Serum zinc and magnesium level in newly diagnosed type-2 diabetic subjects.

This cross sectional study aimed to determine serum levels of zinc and magnesium in 80 newly diagnosed type 2 diabetic (Group I) and 80 healthy non-diabetic subjects (Group II). Diabetic patients without any complications were studied. It was carried out in the Department of Biochemistry, Mymensingh Medical College in cooperation with the out patient Department of Endocrinology of Mymensingh Medical College, Bangabandhu Sheikh Mujib Medical University and BIRDEM Hospital, Dhaka during the period from July 2008 to June 2009. A total of 160 subjects aged 55-65 years were enrolled for this study. Of them 80 were newly diagnosed type 2 diabetic (Group I) and 80 were apparently healthy non-diabetic (Group II) subjects. For both case and control, persons having no current medication, intercurrent illness, macro or microvascular complications and history of renal failure were selected. Atomic Absorption Spectrophotometer (AAS) was used to estimate the serum levels of zinc and magnesium. The Plasma zinc (72.07±6.84µg/dl) and magnesium (1.86±0.17mg/dl) significantly decreased in type 2 diabetic patients when compared with control (76.59±6.10µg/dl, 1.99±0.17mg/dl). It is concluded that type 2 diabetes mellitus can result in changes in zinc and magnesium levels. As the present study sample was small so it is difficult to draw any definite conclusion. However, the estimation and supplementation of both zinc and magnesium may be suggested in those cases.