Evaluation of Neutrophil to Lymphocyte Ratio and Mean Platelet Volume in Inactive Hepatitis B Carriers

Aim: The aim of this study was to investigate the neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) levels in children with inactive hepatitis B virus (HBV) carriers and to evaluate the possible association between NLR, MPV and inflammation status in HBV infection.Material and Method: Thirty inactive HBV carrier children and 32 age and gender matched healthy controls were enrolled as study group. Complete blood count parameters including white blood count, absolute neutrophil count and lymphocyte count, neutrophil to lymphocyte ratio and mean platelet volume were assessed in both study and the control groups.Results: There was no significant difference in the mean age of inactive HBV carriers (11.9±3.4 years) and the control subjects (11.0±2.7 years) (p=0.25).  No significant differences were found in NLR (2.90±3.24 and 1.74±0.87, respectively, p=0.82) and MPV levels (7.9±1.0fL and 8.0±1.2fL, respectively, p=0.86) between inactive HBV carriers and the controls. MPV was found to be inversely correlated with platelet count in both patients and the control groups (r=-0.44, p=0.01; r=-0.36, p=0.04, respectively). A positive correlation was found between NLR and MPV (r=0.41, p=0.03) in patient group.Conclusion: NLR and MPV levels were not different in inactive HBV carrier children compared to the controls. Our results suggest that NLR and MPV values may not be appropriate for determining of chronicity and inflammation status in chronic HBV infection.Key words: Hepatitis B, chronic, neutrophil to lymphocyte ratio, mean platelet volum

Bacterial Agents Causing Meningitis During 2013-2014 in Turkey: A Multi-Center Hospital-Based Prospective Surveillance Study

This is an observational epidemiological study to describe causes of bacterial meningitis among persons between 1 month and 18 y of age who are hospitalized with suspected bacterial meningitis in 7 Turkish regions. covering 32% of the entire population of Turkey. We present here the results from 2013 and 2014. A clinical case with meningitis was defined according to followings: any sign of meningitis including fever, vomiting, headache, and meningeal irritation in children above one year of age and fever without any documented source, impaired consciousness, prostration and seizures in those < 1 y of age. Single tube multiplex PCR assay was performed for the simultaneous identification of bacterial agents. The specific gene targets were ctrA, bex, and ply for N. meningitidis, Hib, and S. pneumoniae, respectively. PCR positive samples were recorded as laboratory-confirmed acute bacterial meningitis. A total of 665 children were hospitalized for suspected acute meningitis. The annual incidences of acute laboratory-confirmed bacterial meningitis were 0.3 cases / 100,000 population in 2013 and 0.9 cases/100,000 in 2014. Of the 94 diagnosed cases of bacterial meningitis by PCR, 85 (90.4%) were meningococcal and 9 (9.6%) were pneumococcal. Hib was not detected in any of the patients. Among meningococcal meningitis, cases of serogroup Y, A, B and W-135 were 2.4% (n = 2), 3.5% (n = 3), 32.9% (n = 28), and 42.4% (n = 36). No serogroup C was detected among meningococcal cases. Successful vaccination policies for protection from bacterial meningitis are dependent on accurate determination of the etiology of bacterial meningitis. Additionally, the epidemiology of meningococcal disease is dynamic and close monitoring of serogroup distribution is comprehensively needed to assess the benefit of adding meningococcal vaccines to the routine immunization program.Wo