Performance of Haematological Parameters in Early Diagnosis of Clinically Suspected Neonatal Sepsis.

Neonatal sepsis is one of the major health problems throughout the world and major cause of morbidity and mortality in developing countries. Positive blood culture considers the gold standard for confirmation of neonatal sepsis, but it does not provide rapid diagnosis. So this study was designed to find out the performance of haematological parameters in early diagnosis of neonatal sepsis. The objective of the study was to evaluate the performance of haematological parameters individually and in combination in early diagnosis of neonatal sepsis. It was a cross-sectional study conducted at neonatal ward, SCANU and obstetric ward of Rangpur Medical College Hospital from January 2014 to December 2015. A total of 70 neonates clinically suspected to have features of sepsis were included in this study. Another 70 healthy term neonates were included in the study as reference group. Blood sample were obtained to estimate TLC, ANC, immature neutrophil count, degenerative changes in PMNs, platelet count, I/T and I/M ratio. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the individual test and tests combination were calculated. Among the haematological parameters, performance of combined tests had high sensitivity, specificity, with PPV and NPV. Among the individual tests I/T and I/M ratio had high sensitivity (95%), specificity (85%, 90%), PPV (90%, 75%) and NPV (90%). There were 22 out of 70 neonates (31.42%) who had culture proven sepsis. Among 22 culture proven sepsis most commonly found organism were Escherichia Coli 12(54.5%) followed by Klebsiella 3(13.63%), Proteus 3(13.63%), Staphylococcus aureus 2(9.9%) and Salmonella 2(9.9%). There is no ideal test for diagnosis of early diagnosis of neonatal sepsis haematological parameters is useful adjunct test in identifying clinically suspected neonatal sepsis.

Dipstick Method versus Spot Urinary Protein Creatinine Ratio for Evaluation of Massive Proteinuria in Childhood Nephrotic Syndrome.

Measurement of massive proteinuria is vital for diagnosis of childhood Nephrotic syndrome. Quantification of 24 hours urinary protein is the gold standard test. Dipstick method of urinary protein measurement gives instant result for massive proteinuria. Spot urinary protein creatinine ratio measurement is variable. This was a hospital based prospective cross sectional study done at Department of Paediatric Nephrology, Rangpur Medical College Hospital from January 2014 to December 2015 to evaluate accuracy of dipstick method versus spot urinary protein-creatinine ratio in estimation of massive proteinuria in childhood nephrotic syndrome. Total 100 children diagnosed as Nephrotic syndrome fulfilling the inclusion and exclusion criteria were enrolled into the study. After collection of spot urine sample, proteinuria was estimated by dipstick method and same sample was sent to laboratory for measuring protein creatinine ratio. All data were collected in individual predetermined case record form and analyzed by SPSS version 17.Dipstick had sensitivity 97%, specificity 70%, positive predictive value 96.7%, negative predictive value 77% and efficacy 95%. There was a significant correlation between spot urinary protein creatinine ratio and dipstick testing of Nephrotic range of proteinuria (p<0.05).The dipstick result of proteinuria significantly correlates with spot urinary protein creatinine ratio. Dipstick method of urinary protein measurement yields accurate result instantly.