Loganathan, K (2018) Noninvasive index using complete blood counts (P2/MS) for detecting oesophageal varices in cirrhosis. Masters thesis, Madurai Medical College, Madurai.
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Abstract
BACKGROUND: The diagnosis of EV is required for patients with liver cirrhosis to detect those who will benefit from variceal bleeding primary prophylaxis. Currently, esophago-gastro-duodenoscopy (EGD) remains the gold standard test for such diagnosis. However, EGD is limited by its invasiveness and high cost. A simple non-invasive widely available and cheap test would be ideal if proved to have sufficient specificity and sensitivity. Therefore, aim of this study is the diagnostic value of an index derived from the patients' complete blood count; namely the P2/MS ratio as a predictive tool for the presence of varices and if they are at high risk of bleeding. AIMS & OBJECTIVES: 1. To evaluate the predictive value of P2/MS index (platelet count)2/[monocyte fraction (%) × segmented neutrophil fraction (%)] derived from the patient's complete blood count for detecting oesophageal varices in cirrhosis. 2. To compare the P2/MS index in cirrhosis patients with portal hypertension and patients without portal hypertension STUDY POPULATION: This study was conducted in 50 patients with liver cirrhosis attending the Department of Medicine and Department of Medical gastroenterology, Govt. Rajaji Hospital, Madurai METHODS: 50 liver cirrhosis patients with no previous variceal bleeding and not on beta blocker prophylaxis were subjected to do complete blood count test. P2/MS index were calculated using platelet count, monocyte fraction and neutrophil fraction. They were subjected to esophagogastroduodenoscopy for detecting esophageal varices and comparing p2/ms index in cirrhosis patients with portal hypertension and patients without portal hypertension RESULTS: Out of 50 patients ogd findings were normal in 22 patients with median p2/ms index of 147,grade I varices in 9 patients with median p2/ms index of 42,grade II varices in 12 patients with median p2/ms index of 35.5,and grade III varices in 7 patients with median p2/ms index of 21 In patients with portal hypertension the median p2/ms index was 36 where as in patients without portal hypertension the median p2/ms index was 138. Among 50 cirrhosis patients ogd findings were normal in 22 patients with median p2/ms index of 147. In this study. above a cut-off value for P2/MS of 30.5, high risk esophageal varices could be excluded, with a negative predictive value [NPV] of 91.6%. CONCLUSION: In patients with low p2/ms index esophageal varices are more likely present and it has emerged as significant predictors for the presence of esophageal varices in cirrhosis patient. P2/ms index was low in patients with portal hypertension when compared to patients without portal hypertension
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Noninvasive index ; complete blood counts (P2/MS) ; detecting oesophageal varices ; cirrhosis. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 27 Aug 2018 16:22 |
| Last Modified: | 27 Aug 2018 16:22 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/9373 |
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