Introduction. Primary thrombocytosis is very rare in children; reactive thrombocytosis is frequently observed in children with infections, anemia, and many other causes. Aims and Objectives. To identify the etiology of thrombocytosis in children and to analyze platelet indices (MPV, PDW, and PCT) in children with thrombocytosis. Study Design. A prospective observational study. Material and Methods. A total of 1000 patients with thrombocytosis (platelet > 400 × 109/L) were studied over a period of 2 years. Platelet distribution width (PDW), mean platelet volume (MPV), and plateletcrit (PCT) were noted. Results. Of 1000 patients, 99.8% had secondary thrombocytosis and only two children had primary thrombocytosis (chronic myeloid leukemia and acute myelogenous leukemia, M7). The majority of the children belonged to the age group of 1month to 2 years (39.7%) and male to female ratio was 1.6 : 1. Infection with anemia (48.3%) was the most common cause of secondary thrombocytosis followed by iron deficiency alone (17.2%) and infection alone (16.2%). Respiratory infection (28.3%) was the predominant infectious cause observed. Thrombocytosis was commonly associated with IDA among all causes of anemia and severity of thrombocytosis increased with severity of anemia (P = 0.021). With increasing platelet count, there was a decrease in MPV (<0.001). Platelet count and mean PDW among children with infection and anemia were significantly higher than those among children with infection alone and anemia alone. None were observed to have thromboembolic manifestations. Conclusions. Primary thrombocytosis is extremely rare in children than secondary thrombocytosis. Infections in association with anemia are most commonly associated with reactive thrombocytosis and severity of thrombocytosis increases with severity of anemia.
Background: Cerebral palsy is the most common aetiology for motor dysfunction among children worldwide. It is associated with range of co-morbid conditions that affects the quality of life. Cerebral palsy has been studied extensively in western countries and there are only few articles available on epidemiological information in developing countries and low resource settings. This study focuses on the aetiology, risk factors, types and co-morbidities in cerebral palsy.Methods: Cerebral palsy children attending tertiary care hospital were prospectively recruited into the study. The study was conducted during January 2017 to July 2018. The cross-sectional study included complete prenatal, natal and postnatal history of the participants, BERA and Ophthalmological examinations were done.Results: One hundred and fifty children with cerebral palsy were enrolled. The mean age of participants were 36±30 months. Male to female ratio was 2.19:1. The most common maternal risk factor among study participants was consanguinity in marriage (23.33%). 16% had prolonged labour and 10% had toxaemia during pregnancy. 47% of the children were born by institutional normal vaginal delivery. The most common neonatal risk factor was Birth Asphyxia (23%), low birth weight (20%) and neonatal sepsis (21%). 122 had spastic type of cerebral palsy. The most common morbidity associated with cerebral palsy was Gastro intestinal disturbances in 61% of the participants.Conclusions: History of prolonged labour and birth asphyxia were risk factors for cerebral palsy. Spastic CP is the most common type. Malnutrition, Gross Motor delay, Seizures, Mental retardation were the most common morbidities associated with CP.
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