The clinical implications of thrombocytopenia in adults with severe falciparum malaria: a retrospective analysis

BackgroundThrombocytopenia is a common finding in adults with severe falciparum malaria, but its clinical and prognostic utility is incompletely defined.MethodsClinical and laboratory data from 647 adults with severe falciparum malaria were analysed retrospectively to determine the relationship between a patient’s platelet count on admission to hospital and their subsequent clinical course.ResultsOn admission, 614 patients (94.9%) were thrombocytopenic (platelet count <150 × 109/L) and 328 (50.7%) had a platelet count <50 × 109/L. The admission platelet count was inversely correlated with parasite biomass (estimated from plasma PfHRP2 concentrations, rs = −0.28, P = 0.003), the degree of microvascular sequestration (measured with orthogonal polarizing spectral imaging, rs = −0.31, P = 0.001) and disease severity (the number of World Health Organization severity criteria satisfied by the patient, rs = −0.21, P <0.001). Platelet counts were lower on admission in the patients who died (median: 30 (interquartile range 22 to 52) × 109/L versus 50 (34 to 78) × 109/L in survivors; P <0.001), but did not predict outcome independently from other established laboratory and clinical prognostic indices. The 39 patients (6%) with profound thrombocytopenia (platelet count <20 × 109/L) were more likely to die (odds ratio: 5.00, 95% confidence interval: 2.56 to 9.75) than patients with higher platelet counts, but these high-risk patients could be identified more rapidly with simple bedside clinical assessment. The admission platelet count did not reliably identify the 50 patients (7.7%) with major bleeding during the study.ConclusionsThrombocytopenia is a marker of disease severity in adults with falciparum malaria, but has limited utility in prognostication, triage and management

Analysis of charge transport resistance of ZnO-based DSSCs because of the effect of different compression temperatures

This article represents a research study about the effect of compression temperature on the performance of Zinc Oxide (ZnO)-based dye-sensitized solar cell (DSSC). To find the optimum compression temperature, the electrodeposited photoanodes are subjected to compression at 60 MP with various compression temperatures ranging from room temperature to 80 °C. The performance analysis involved the analysis of Electrochemical Impedance Spectroscopy (EIS) and photocurrent-voltage (I-V) data under dark and illuminated conditions. The EIS data are examined to gain insights into the electron transport mechanism and validate the cell's performance under optimum compression temperature. The findings of this study demonstrate that cells prepared at 60 MP with a compression temperature of 70 °C show the most favorable photovoltaic performance compared to cells prepared at other compression temperatures. Thickness measurement confirms that increasing the compression temperature ensures a compact layer of photoelectrode. A compression temperature greater than 70 °C causes several defects on the photoelectrode surface, as confirmed by the Scanning Electron Microscopy Image. EIS and I-V data confirm that the cell prepared at 60 MP and 70 °C heating gives comparatively lower series resistance and higher shunt resistance.  Though the series and shunt resistance exhibited different values under dark and illumination conditions, their trends remained consistent. Under this optimized compression temperature the cells achieved a maximum efficiency (η) of 2.78%, accompanied by an open circuit voltage (Voc) of 0.58 V, a photocurrent density (Jsc) of 8.87 mA/cm2, and a fill factor of 0.54