Predictive Value of Complete Blood Count and Inflammation Marker on Risk of Recurrence in Children with Henoch-Schönlein Purpura / 中国实验血液学杂志

OBJECTIVE@#To investigate the predictive value of complete blood count (CBC) and inflammation marker on the recurrence risk in children with Henoch-Schönlein purpura (HSP).@*METHODS@#One hundred and thirty-three children with HSP admitted to Cangzhou Central Hospital from February 2017 to March 2019 were enrolled. The clinical data of the children were collected, at the time of admission CBC and C-reactive protein (CRP) were detected. After discharge, the children were followed up for 1 year, the clinical data of children with and without recurrence were compared, and multivariate logistic regression was used to analyze the risk factors affecting HSP recurrence. Receiver operating characteristic (ROC) curve should be drawn and the predictive value of CBC and CRP on HSP recurrence should be analyzed.@*RESULTS@#In the follow-up of 133 children, 8 cases were lost and 39 cases recurred, with a recurrence rate of 31.20% (39/125). The age, skin rash duration, proportion of renal damage at the initial onset, percentage of neutrophils, percentage of lymphocytes, platelet count (PLT), mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), MPV/PLT ratio (MPR), and CRP level of patients with recurrence were statistically different from those without recurrence (P <0.05). Multivariate logistic regression analysis showed that long skin rash duration, renal damage at the initial onset, increased PLR, high PLT, increased MPV and elevated CRP level were independent risk factors for recurrence in children with HSP (P <0.05). The ROC curve analysis showed that the area under the curve (AUC) of the combination of the four blood and inflammation marker (PLT, MPV, PLR and CPR) in the early prediction of HSP recurrence was 0.898, which was higher than the initial renal damage (AUC=0.687) and persistent skin rash time (AUC=0.708), with a sensitivity of 84.62% and a specificity of 83.72%.@*CONCLUSION@#Observation of CBC and CPR can predict the risk of HSP recurrence early and guide early clinical intervention.

Alteraciones hematológicas en sangre periférica de pacientes con COVID-19 / Molecular study of leukemias: essential tool for the hematologist

Introducción: Los primeros casos con neumonía atípica de etiología desconocida fueron reportados en Wuhan, China en diciembre de 2019. En enero 2020 se describió como agente causal un nuevo tipo de virus de la familia Coronaviridae, denominado SARS-CoV-2. Objetivo: Evaluar la significación clínica de los cambios hematológicos y morfológicos en la sangre periférica de pacientes con COVID-19. Métodos: Se realizó un estudio descriptivo, observacional, transversal que incluyó a los pacientes con COVID-19 que ingresaron en el Hospital Clínico Quirúrgico Docente Freyre de Andrade desde el 1ro de junio hasta 31 de septiembre de 2021. Los pacientes fueron asignados a dos grupos según fueron admitidos, en las unidades de vigilancia intensiva o en la unidad de cuidados intensivos. Se les realizó hemograma completo y lámina periférica el día del ingreso para evaluar la significación clínica de estas variables en la evolución de estos pacientes. Resultados: El sexo femenino predominó en los pacientes ingresados en unidades de vigilancia intensiva (67,36 %) y el masculino en los ingresados en unidades de cuidados intensivos (63,26 %). La media de edad fue mayor en el grupo de pacientes en cuidados intensivos (65,83 años). La leucocitosis y el menor recuento de plaquetas predominaron en los pacientes ingresados en cuidados intensivos, seguido de linfopenia. Las macroplaquetas, las vacuolas citoplasmáticas y las granulaciones tóxicas fueron más frecuentes en el grupo de cuidados intensivos. Conclusiones: El hemograma y el frotis de sangre periférica son útiles para diagnosticar y predecir la evolución de los pacientes y permiten un mejor manejo de la infección.

Introduction: The first cases of atypical pneumonia of unknown etiology were reported in Wuhan, China in December 2019. In January 2020 a new virus from Coronaviridae family was described as causal agent and was named SARS-COV-2. Objectives: To evaluate the clinical significance of numerical values of complete blood count (CBC) and morphologic changes on peripheral blood on patients with COVID-19. Methods: A descriptive, observational, transversal study included patients with diagnosis of COVID-19 admitted in Freyre de Andrade Hospital in Havana, between June 1st and September 31st of 2022 was carried out. Patients were assigned to two groups according to their admission in intensive vigilance ward or intensive care unit. CBC test and peripheral blood smear were performed on admission day to evaluate the significance on clinical evolution. Results: Female sex predominated on intensive vigilance group (67,36 %) and male in intensive care group (63,26 %). Media of age was superior in intensive care group (67,83 years). Leukocytosis and low level of platelets count were significantly more common in more severe group followed by lymphopenia. The presence of big platelets, cytoplasmic vacuoles and toxic granules were more common in intensive care unit group. Conclusions: The CBC and peripheral blood smear are useful tools to diagnose and predict clinical evolution and allow a better management of infection.

Predictive value of baseline CRP, NLR, and LER for aspiration pneumonia in patients with acute cerebral infarction / 中华急诊医学杂志

Objective:To investigate the predictive value of C-reactive protein (CRP), neutrophils-lymphocytes ratio (NLR) and leukocyte-erythrocyte ratio (LER) for aspiration pneumonia (AP) in patients with acute cerebral infarction (ACI).Methods:Retrospective analysis was performed on 989 consecutive hospitalized ACI patients in 2021 who were free of infection within 48 h after ACI onset. General information, past medical history, CRP and complete blood count within 24 h after admission were collected. NLR and LER were calculated based on neutrophil, lymphocyte, leukocyte and erythrocyte count. ACI patients were divided into two groups: non-AP group ( n = 883) and AP group ( n = 106) according to whether they had AP 48 h after admission. Spearman correlations of CRP, NLR and LER with AP were analyzed. The receiver operator characteristic (ROC) curves were plotted to evaluate the predictive values of CRP, NLR and LER for the occurrence of AP in ACI patients, and the sensitivity and specificity at the optimal cut-off value were also calculated. Logistic regression analysis was used for further verification. Results:Compared with the non-AP group, CRP, NLR and LER were significantly higher in the AP group ( P<0.05). Spearman correlation analysis showed that AP was positively correlated with CRP, NLR and LER ( r = 0.42, 0.36 and 0.35, P<0.01). ROC curve analysis showed that CRP, NLR and LER had certain predictive value for AP in ACI patients ( P<0.05), and the area under the curve (AUC) was 0.8917, 0.8349 and 0.8269, respectively. The optimal cutoff values of CRP, NLR and LER were 12.70 mg/L, 4.40 and 1.89 ×10 -3, respectively, with the sensitivity and specificity of 79.25% and 86.41%, 71.70% and 84.94%, and 75.47% and 79.95%, respectively. Multivariate Logistic regression analysis showed that CRP ( OR=6.65, 95% CI: 3.70-11.98, β=1.90, P<0.001), NLR ( OR=2.84,95% CI: 1.60-5.03, β=1.04, P<0.001) and LER ( OR=3.51, 95% CI: 2.00-6.16, β=1.26, P<0.001) were independent risk factors for AP in ACI patients. Conclusions:CRP, NLR and LER at baseline show certain predictive value for the occurrence of AP in ACI patients, and CRP has the strongest predictive power.

Hematology and blood biochemistry profile of the freshwater stingray Potamotrygon magdalenae as a tool for population assessment in artificial environments / Perfil hematológico e bioquímico do sangue da arraia de água doce Potamotrygon magdalenae como ferramenta para avaliação da população em ambientes artificiais

Hematological and blood biochemical reference information is important to establish physiological status of freshwater stingray populations and improve care and management protocols in artificial environments. Here, we used a commercial freshwater stingray with high mortality rates in the market (Potamotrygon magdalenae), as an example to understand how artificial environments and handling protocols influence physiological status of captive freshwater stingrays. To this purpose, blood from five adult males and six adult females was collected to perform complete blood counts and blood chemistry analyses. All sampled animals showed good body condition with no differences between sexes. Differences between sexes were only found for the differential count of lymphocytes. Red blood results were consistent with previously studied potamotrygonids while white blood results showed higher values of leukocytes, thrombocytes, heterophils and lymphocytes in P. magdalenae compared to other Potamotrygonids. All types of leukocytes described for elasmobranchs were found except neutrophils and basophils. Blood metabolites showed an influence of ex situ diet in total protein, triglycerides and cholesterol. Glucose results were consistent while urea showed lower levels than those recorded for other freshwater stingrays. These results highlight the importance of physical, physiological and health analysis in freshwater stingrays as a part of welfare assessment to improve monitoring protocols and survival rates in public or private aquaria.

A informação de referência hematológica e bioquímica do sangue é importante para estabelecer o estado fisiológico das populações de arraias de água doce e melhorar os protocolos de cuidado e manejo em ambientes artificiais. Aqui, usamos uma espécie comercial de arraia de água doce com elevadas taxas de mortalidade no mercado (Potamotrygon magdalenae) como espécie exemplo para compreender de que modo os ambientes artificiais e os protocolos de manipulação influenciam o estado fisiológico das arraias de água doce em cativeiro. Para este fim, foi coletado sangue de cinco machos adultos e seis fêmeas adultas para realizar contagens completas de células sanguíneas e análises bioquímicas de sangue. Todos os animais amostrados mostraram boa condição corpórea, sem diferenças entre os sexos. Diferenças entre os sexos foram encontradas só na contagem diferencial de linfócitos. Os resultados de células sanguíneas vermelhas foram consistentes com potamotrigonídeos previamente estudados, enquanto o leucograma revelou valores mais elevados de leucócitos, trombócitos, heterófilos e linfócitos em P. magdalenae, em comparação com outros potamotrigonídeos. Todos os tipos de leucócitos descritos para elasmobrânquios foram encontrados, exceto para neutrófilos e basófilos. Todos os tipos de leucócitos descritos para elasmobrânquios foram encontrados, exceto para neutrófilos e basófilos. Os metabólitos do sangue mostraram influência da dieta ex situ nas proteínas totais, triglicerídeos e colesterol. Os resultados da glicose foram consistentes, enquanto a ureia mostrou níveis mais baixos do que os registrados para outras espécies de arraias de água doce. Os resultados da glicose foram consistentes, enquanto a ureia mostrou níveis mais baixos em P. magdalenae. Estes resultados enfatizam a importância da análise física, fisiológica e de saúde em arraias de água doce como parte da avaliação do bem-estar para melhorar os protocolos de monitoramento e as taxas de sobrevivência em aquários públicos ou privados.

Hematology and blood biochemistry profile of the freshwater stingray Potamotrygon magdalenae as a tool for population assessment in artificial environments / Perfil hematológico e bioquímico do sangue da arraia de água doce Potamotrygon magdalenae como ferramenta para avaliação da população em ambientes artificiais

Hematological and blood biochemical reference information is important to establish physiological status of freshwater stingray populations and improve care and management protocols in artificial environments. Here, we used a commercial freshwater stingray with high mortality rates in the market (Potamotrygon magdalenae), as an example to understand how artificial environments and handling protocols influence physiological status of captive freshwater stingrays. To this purpose, blood from five adult males and six adult females was collected to perform complete blood counts and blood chemistry analyses. All sampled animals showed good body condition with no differences between sexes. Differences between sexes were only found for the differential count of lymphocytes. Red blood results were consistent with previously studied potamotrygonids while white blood results showed higher values of leukocytes, thrombocytes, heterophils and lymphocytes in P. magdalenae compared to other Potamotrygonids. All types of leukocytes described for elasmobranchs were found except neutrophils and basophils. Blood metabolites showed an influence of ex situ diet in total protein, triglycerides and cholesterol. Glucose results were consistent while urea showed lower levels than those recorded for other freshwater stingrays. These results highlight the importance of physical, physiological and health analysis in freshwater stingrays as a part of welfare assessment to improve monitoring protocols and survival rates in public or private aquaria.

A informação de referência hematológica e bioquímica do sangue é importante para estabelecer o estado fisiológico das populações de arraias de água doce e melhorar os protocolos de cuidado e manejo em ambientes artificiais. Aqui, usamos uma espécie comercial de arraia de água doce com elevadas taxas de mortalidade no mercado(Potamotrygon magdalenae) como espécie exemplo para compreender de que modo os ambientes artificiais e os protocolos de manipulação influenciam o estado fisiológico das arraias de água doce em cativeiro. Para este fim, foi coletado sangue de cinco machos adultos e seis fêmeas adultas para realizar contagens completas de células sanguíneas e análises bioquímicas de sangue. Todos os animais amostrados mostraram boa condição corpórea, sem diferenças entre os sexos. Diferenças entre os sexos foram encontradas só na contagem diferencial de linfócitos. Os resultados de células sanguíneas vermelhas foram consistentes com potamotrigonídeos previamente estudados, enquanto o leucograma revelou valores mais elevados de leucócitos, trombócitos, heterófilos e linfócitos em P. magdalenae, em comparação com outros potamotrigonídeos. Todos os tipos de leucócitos descritos para elasmobrânquios foram encontrados, exceto para neutrófilos e basófilos. Todos os tipos de leucócitos descritos para elasmobrânquios foram encontrados, exceto para neutrófilos e basófilos. Os metabólitos do sangue mostraram influência da dieta ex situ nas proteínas totais, triglicerídeos e colesterol. Os resultados da glicose foram consistentes, enquanto a ureia mostrou níveis mais baixos do que os registrados para outras espécies de arraias de água doce. Os resultados da glicose foram consistentes, enquanto a ureia mostrou níveis mais baixos em P. magdalenae. Estes resultados enfatizam a importância da análise física, fisiológica e de saúde em arraias de água doce como parte da avaliação do bem-estar para melhorar os protocolos [...].

Hematology and blood biochemistry profile of the freshwater stingray Potamotrygon magdalenae as a tool for population assessment in artificial environments

Abstract Hematological and blood biochemical reference information is important to establish physiological status of freshwater stingray populations and improve care and management protocols in artificial environments. Here, we used a commercial freshwater stingray with high mortality rates in the market (Potamotrygon magdalenae), as an example to understand how artificial environments and handling protocols influence physiological status of captive freshwater stingrays. To this purpose, blood from five adult males and six adult females was collected to perform complete blood counts and blood chemistry analyses. All sampled animals showed good body condition with no differences between sexes. Differences between sexes were only found for the differential count of lymphocytes. Red blood results were consistent with previously studied potamotrygonids while white blood results showed higher values of leukocytes, thrombocytes, heterophils and lymphocytes in P. magdalenae compared to other Potamotrygonids. All types of leukocytes described for elasmobranchs were found except neutrophils and basophils. Blood metabolites showed an influence of ex situ diet in total protein, triglycerides and cholesterol. Glucose results were consistent while urea showed lower levels than those recorded for other freshwater stingrays. These results highlight the importance of physical, physiological and health analysis in freshwater stingrays as a part of welfare assessment to improve monitoring protocols and survival rates in public or private aquaria.

Resumo A informação de referência hematológica e bioquímica do sangue é importante para estabelecer o estado fisiológico das populações de arraias de água doce e melhorar os protocolos de cuidado e manejo em ambientes artificiais. Aqui, usamos uma espécie comercial de arraia de água doce com elevadas taxas de mortalidade no mercado (Potamotrygon magdalenae) como espécie exemplo para compreender de que modo os ambientes artificiais e os protocolos de manipulação influenciam o estado fisiológico das arraias de água doce em cativeiro. Para este fim, foi coletado sangue de cinco machos adultos e seis fêmeas adultas para realizar contagens completas de células sanguíneas e análises bioquímicas de sangue. Todos os animais amostrados mostraram boa condição corpórea, sem diferenças entre os sexos. Diferenças entre os sexos foram encontradas só na contagem diferencial de linfócitos. Os resultados de células sanguíneas vermelhas foram consistentes com potamotrigonídeos previamente estudados, enquanto o leucograma revelou valores mais elevados de leucócitos, trombócitos, heterófilos e linfócitos em P. magdalenae, em comparação com outros potamotrigonídeos. Todos os tipos de leucócitos descritos para elasmobrânquios foram encontrados, exceto para neutrófilos e basófilos. Todos os tipos de leucócitos descritos para elasmobrânquios foram encontrados, exceto para neutrófilos e basófilos. Os metabólitos do sangue mostraram influência da dieta ex situ nas proteínas totais, triglicerídeos e colesterol. Os resultados da glicose foram consistentes, enquanto a ureia mostrou níveis mais baixos do que os registrados para outras espécies de arraias de água doce. Os resultados da glicose foram consistentes, enquanto a ureia mostrou níveis mais baixos em P. magdalenae. Estes resultados enfatizam a importância da análise física, fisiológica e de saúde em arraias de água doce como parte da avaliação do bem-estar para melhorar os protocolos de monitoramento e as taxas de sobrevivência em aquários públicos ou privados.

Evaluation of the consistency of four hematology systems / 中华检验医学杂志

Objective:To provide consistent data basis for the application of reference intervals for children blood cell analysis in different testing systems.Methods:According to the requirements of American Institute for Clinical and Laboratory Standardization (CLSI) EP9-A3 document, 45 samples were collected and Sysmex XN20-A1 were used as reference system. Beckman DxH800, Siemens ADVIA 2120i, and Mindray BC5310 were comparison systems. Complete blood count and leukocyte classification were performed by four systems. The outliers of the detection results were tested by the generalized extreme student deviate (ESD) method. An optimal regression model was selected by scatter diagram, deviation diagram and frequency distribution diagram, which was used to fit the regression equation and calculate the deviation at the medical decision level and reference interval. The acceptable range for blood count deviation was cited from the Analytical Quality Specifications for Routine Tests in Clinical Hematology. The acceptable range for leukocyte classification was based on the EQA program of Royal College of Pathologists of Australasia (RCPA).Results:After the outliers were deleted, the scatter plot showed a linear relationship between the reference system and the three comparison systems. The deviation plot showed that the differences were variable. Deming regression or Passing-Bablok regression was selected according to the data distribution. The determination coefficient R2 of reference system and three comparison systems ranged from 0.95 to 0.99 in blood count and leukocyte classification. At the upper and lower limits of the reference interval, the deviations between XN-20A1 and ADVIA 2120 system were all acceptable, except for MONO# at 0.12×10 9/L. The deviations of all parameters at medical decision level were within acceptable ranges. The lower limit of PLT is partially unacceptable at the level of medical decision related to treatment and prognosis. Conclusions:The results of complete blood count and leukocyte classification in reference system and the comparison system had good consistency within the children′s reference interval. Our study provided a scientific basis for the feasibility of adopting a unified reference interval for different detection systems.

Haematological profile of Malaria patients at a tertiary care hospital of Konkan region, Maharashtra State, India

Background: Malaria is a numero-uno infectious, killer disease in the developing world including India. This disease is caused by Plasmodium parasitic species with mosquitoes acting as vectors of transmission. Hematological tests include RBC, WBC and platelet parameters, peripheral blood examination which change based on parasitaemia need to be evaluated in various malaria affected regions to get prompt malarial diagnosis. Prompt diagnosis leads to prompt treatment avoiding troublesome malarial complications. Objectives: The present observational cross-sectional study was undertaken to estimate the Hematological profile in malaria cases diagnosed in a tertiary care hospital of Konkan region, Maharashtra. Methods: All the patients referred to Hematology section, Department of Pathology with malaria were evaluated with clinical details. The data was collected from 1st January 2017 to 31st December 2020 for three years’ duration. Total malarial cases studied were 50 cases. CBC/ PBS examination was done on EDTA blood sample. The RBC parameters, WBC parameters and platelet counts were studied with respect to malarial parasitaemia. Parasite index was found on smear and malarial diagnostic confirmation was also done using rapid kit test. All the findings were filled in MS-Xcel sheet 2010 and data was analyzed manually. Results: Malaria caused by P.vivax was predominant in present study. Patients in age range of 15-30 years were more affected in present study, that is, younger people were affected. Male predominance was seen. Fever was most common presenting symptoms followed by chills and rigor in present study. Hb, RBC count, PCV – showed that anemia was more common hematological change in present study, as these values were lower than normal level. Red cell indices like MCV, MCH, MCHC, RDW and peripheral blood smear revealed all the values in a normal range showing normocytic normochromic RBCs in the present study. Patients with malaria having normal TLC followed by leucopenia were more common in present study. Thrombocytopenia was most common hematological change seen in present study. Conclusion: Hematological parameters are measurable indices of blood that serve as a marker for malarial diagnosis.

Caracterización del hemograma completo en adultos mayores cubanos tratados con Biomodulina T® / Character i zation of the complete blood count of Cuban older adults treated with Biomodulin a T ®

Introducción: Durante las últimas décadas es evidente el aumento progresivo de los adultos mayores en Cuba. El proceso de envejecimiento provoca cambios en el sistema inmune que afectan su funcionamiento y desarrollo. Objetivo: Caracterizar parámetros hematológicos e inmunológicos mediante el hemograma completo en adultos mayores cubanos antes y después de la administración de la Biomodulina T®. Métodos: Se realizó un estudio descriptivo y observacional para evaluar el efecto de la Biomodulina T® sobre los parámetros del hemograma completo. Se utilizó el paquete estadístico GraphPad Prism (versión 6.00). Los datos que presentaban una distribución normal, se procesaron utilizando la t Student. La prueba de rangos con signo de Wilcoxon se empleó cuando los datos no cumplían una distribución normal, ambos para un nivel de significación de p < 0,05. Resultados: Predominaron las mujeres en relación a los hombres, que representó 27,6 por cientoHubo superioridad de adultos mayores de 76-80 años de edad. El conteo global de leucocitos se mantuvo dentro de parámetros normales y solo en 5 pacientes disminuyeron las plaquetas después de la administración de Biomodulina T. Estos resultados no fueron estadísticamente significativos. Conclusiones: Se demostró que el tratamiento con Biomodulina T® no modifica los diferentes parámetros del hemograma completo en el adulto mayor(AU)

Introduction: In the last decade it has been evident the rise in the older adults in Cuba. The process of aging causes changes in the immune system that affects the development and function. Objective: To characterize hematological and immunological parameters by means of the complete blood count in Cuban older adults before and after the administration of Biomodulin T® Materials and methods: A descriptive and observational study was to conducted to evaluate the use of Biomodulina T, the statistic package used was the GraphPad Prism (version 6.00). The data that showed a normal distribution were processed using the Student´s t test. The Wilcoxon´s signed range test with was used when the data did not comply with the normal distribution. Both for a signification level of p < 0.05. Results: Women predominated in relation to men, representing 27.6 percent. There was a predominance of older adults aged 76-80 years. The global leukocyte count remained within normal parameters and platelets decreased only in 5 patients after the administration of Biomodulina T, that results were not statistically significant. Conclusion: It was shown that the Biomodulina T did not modify the hemogram results in the elderly patients(AU)

Feasibility of Preheating at 41 ℃ to Correct Red Blood Cell Parameters in the Presence of High-titer Cold Agglutinins / 中国医学科学院学报

Objective To explore the feasibility of preheating in 41 ℃ water bath for 30 minutes to correct the red blood cell parameters in the specimens containing high-titer cold agglutinins(CAs). Methods Two specimens containing high-titer CAs were selected during work,and the parameters of complete blood count at room temperature or after preheating in 37 ℃ or 41 ℃ water bath were compared.The smears were stained,and the distribution of red blood cells was observed with a microscope.Further,74 specimens without CAs were collected for complete blood count,and then the test results at room temperature and after preheating at 41 ℃ were compared. Results At room temperature,the specimens containing high-titer CAs showed significantly reduced red blood cell count(RBC)and hematocrit(HCT),abnormally increased mean corpuscular hemoglobin(MCH)and mean cell hemoglobin concentration(MCHC),abnormal percents of hemoglobin(HGB)and RBC,and aggregation of a large number of red blood cells.After being preheated at 37 ℃ for a certain time,the specimens demonstrated obviously improved parameters while still aggregation of a small number of red blood cells.After being preheated at 41 ℃ for 30 minutes,the specimens showed significantly increased RBC,normal HCT,MCH,and MCHC,and evenly distributed red blood cells.The 74 specimens without CAs showed the comparability was ≥80% between room temperature and preheating at 41 ℃ for 30 minutes or 60 minutes. Conclusion We can preheat the specimens containing high-titer CAs in a water bath at 41 ℃ to obtain accurate red blood cell parameters.

Sehgal index and its comparison with Mentzer's index and Green and King index in assessment of peripheral blood smear with marked anisopoikilocytosis

Background: Mild microcytic hypochromic anaemias due to iron deficiency (IDA) and beta thalassemia trait(β-TT) continue to be a cause of significant burden to the society, particularly in the poorer developing countries. The objective of the present study was to study the RBC based indices in patients of marked anisopoikilocytosis in determining the etiology of it, to standardize few automated red cell parameters, and also objective grading of RBC morphology on peripheral smear and interpreting its utility in indicating a diagnosis. Also, to establish a relation between value of RBC indices with that of degree of anisocytosis.Methods: A total of 500 patients diagnosed with mild microcytic hypochromic anaemia on complete blood count and peripheral blood film were included in the study. Hb, RBC count, MCV, MCH and RDW obtained from the electronic cell counter were used to calculate discrimination indices by various mathematical formulae. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden’s index (YI) were calculated.Results: Green and King index demonstrated the lowest sensitivity of 70.51%. Mentzer index demonstrated the highest specificity of 96.80%. The highest and lowest PPV were found for Mentzer index (97.09%) and Sehgal index (92.81%) respectively. Sehgal’s index demonstrated the highest NPV of 95.96% and lowest NPV was exhibited by G and K (87.9%). The highest and the lowest values for Youden’s index were shown by Sehgal’s index (87.82%) and G and K index (68.47%).Conclusions: Sehgal’s index followed by Mentzer index are highly sensitive and reasonably specific in differentiating β-TT from IDA and none of the indices is 100% sensitive and specific. Though HbA2 estimation is the gold standard for diagnosing β-TT, in developing countries, Sehgal index followed by Mentzer et al, index can be used to screen mild microcytic hypochromic anaemia cases to eliminate as many false positive cases as possible to reduce the financial cost.

Experience with NESTROFT for screening for thalassemia trait/ minor: evaluation against CBC and HPLC in a high prevalence region in Saurashtra, Gujarat, India

Background: Hemoglobinopathies pose a significant health burden in India. Prevention programmes can significantly reduce this burden. Although sophisticated methods of screening for β thalassemia trait are available, a cheap and simple method is beneficial for population screening. Although the Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT) has been evaluated in many studies, sample sizes were small in some and many earlier studies have not done complete blood count (CBC) and High-Performance Liquid Chromatography (HPLC) in all the cases. We evaluate the suitability of NESTROFT for detection of β-thalassemia trait in a high prevalence region in Saurashtra, Gujarat.Methods: Here, 1000 unrelated individuals were studied. NESTROFT, CBC and estimation of HbA2 and HbF or other hemoglobin variants were done by HPLC.Results: Prevalence of β thalassemia trait was 7.8% in this population. NESTROFT showed an overall sensitivity and specificity of 94.87 and 85.38 respectively for the detection of β thalassaemia trait. Using red cell indices (MCH <27 pg and MCV <80 fl), One β thalassemia trait with normal indices would have been missed. Among twelve individuals with other hemoglobinopathies (HbS, HbD, HbE, δβ thalassemia trait or HPFH), seven had a positive NESTROFT while three had normal MCV & MCH values.Conclusions: NESTROFT is a cost-effective sensitive test which does not require any equipment and can be done in remote areas. It remains a useful first line screening test when large populations have to be screened.

Coconut oil nanoemulsion attenuates methotrexate-induced hepatotoxicity and nephrotoxicity in Ehrlich ascites carcinoma-bearing mice

Objective: To evaluate the protective effect of the coconut oil nanoemulsion against methotrexate-induced hepatotoxicity and nephrotoxicity in Ehrlich ascites carcinoma-bearing Swiss albino mice. Methods: Forty mice were divided into four groups. Group I served as the untreated Ehrlich ascites carcinoma-bearing mice while Ehrlich ascites carcinoma-bearing mice in groups II-IV received an intraperitoneal injection of 0.2 mL/kg coconut oil nanoemulsion, 20 mg/kg methotrexate as well as 0.2 mL/kg coconut oil nanoemulsion mixed with 20 mg/kg methotrexate, respectively. The toxicities of the treatments were assessed by determining the complete blood count, performing the serum analysis for liver and kidney functions, evaluating the oxidative status and visualizing histological changes in the liver and kidney tissues. Results: Treatment with methotrexate and coconut oil nanoemulsion markedly diminished the liver parameters including aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total protein, direct bilirubin and total bilirubin which were raised by methotrexate treatment (P < 0.05). Similarly, creatinine and blood urea nitrogen, as the indicators of kidney function, were dramatically lowered in the combination treatment group compared to the methotrexate group (P < 0.05). In addition, treatment with methotrexate and coconut oil nanoemulsion reduced the malondialdehyde and increased catalase, glutathione reductase and superoxide dismutase, in the liver and kidney tissues (P < 0.05). The treatment with methotrexate and coconut oil nanoemulsion reduced white blood cell count and increased the hemoglobin amount (P < 0.05), but did not cause any change in platelets and red blood cell count. Conclusions: Coconut oil nanoemulsion as a nanocarrier has great potential in reducing the adverse side effects induced by methotrexate.

Coconut oil nanoemulsion attenuates methotrexate-induced hepatotoxicity and nephrotoxicity in Ehrlich ascites carcinoma-bearing mice

Objective: To evaluate the protective effect of the coconut oil nanoemulsion against methotrexate-induced hepatotoxicity and nephrotoxicity in Ehrlich ascites carcinoma-bearing Swiss albino mice. Methods: Forty mice were divided into four groups. Group Ⅰ served as the untreated Ehrlich ascites carcinoma-bearing mice while Ehrlich ascites carcinoma-bearing mice in groups Ⅱ–Ⅳ received an intraperitoneal injection of 0.2 mL/kg coconut oil nanoemulsion, 20 mg/kg methotrexate as well as 0.2 mL/kg coconut oil nanoemulsion mixed with 20 mg/kg methotrexate, respectively. The toxicities of the treatments were assessed by determining the complete blood count, performing the serum analysis for liver and kidney functions, evaluating the oxidative status and visualizing histological changes in the liver and kidney tissues. Results: Treatment with methotrexate and coconut oil nanoemulsion markedly diminished the liver parameters including aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total protein, direct bilirubin and total bilirubin which were raised by methotrexate treatment (P < 0.05). Similarly, creatinine and blood urea nitrogen, as the indicators of kidney function, were dramatically lowered in the combination treatment group compared to the methotrexate group (P < 0.05). In addition, treatment with methotrexate and coconut oil nanoemulsion reduced the malondialdehyde and increased catalase, glutathione reductase and superoxide dismutase, in the liver and kidney tissues (P < 0.05). The treatment with methotrexate and coconut oil nanoemulsion reduced white blood cell count and increased the hemoglobin amount (P < 0.05), but did not cause any change in platelets and red blood cell count. Conclusions: Coconut oil nanoemulsion as a nanocarrier has great potential in reducing the adverse side effects induced by methotrexate.

Insight Into Complete Blood Count In Malignancies

It is very well known that the tumor-host interaction is not limited to the tumor microenvironment but to also alter the entire physiological process to help the development and progression of cancer. Our immune system does not escape from the clutches of the cancer, i.e altered hematological parameters can influence the progression of cancer and vice versa. With this in mind we conducted this study in the Department of Pathology MMC&RI with an attempt to reveal the pattern of complete blood count in malignancies and their difference in localized and metastatic cancer. All the cases included in this study were the ones referred to Cytopatholgy, and diagnosed with cancer. There was significant statistical correlation between the various hematological parameters and the metastatic cancers implying their use to predict the tumor behavior

Analysis of complete blood counts in rotaviral gastroenteritis with special emphasis on platelet indices

Background: The objectives of this study was to analyze complete blood counts in rotaviral gastroenteritis with special emphasis on platelet indices.Methods: Children diagnosed as rotavirus gastroenteritis and healthy controls were enrolled in this study. Severity of acute gastroenteritis was classified into mild, moderate and severe grades using Vesikari score. Rotavirus was determined in fresh stool samples using rapid diagnostic rotavirus antigen test. Hemoglobin, leukocyte, neutrophil to lymphocyte percentage ratio, platelet counts, mean platelet volume (MPV), platelet distribution width (PDW) and platelet crit (PCT) levels were assessed for all children. It's a case control study conducted at Pediatric Speciality Hospital.Results: There were 30 cases with mean age 1.58 years. Healthy controls were 30 with mean age 2.10 years. Mean Hb was lower in cases. Mean of platelet counts was higher in cases. Mean MPV levels was lower in cases. Mean PCT value was higher in cases. Mean MPV to platelet ratio value was lower in cases. All parameters values showed no significant difference among mild, moderate and severe groups of rotaviral gastroenteritis cases. Platelet count was negatively correlated with Hb, MPVP and positively correlated with TLC and PCT. MPV was positively correlated with MPVP and PDW. PCT was negatively correlated with Hb, MPVP and positively correlated with TLC and platelet count.Conclusions: MPV can be used as negative acute phase reactant in rotavirus gastroenteritis and so is the MPV to platelet ratio. Platelet count is acute phase reactant in rotavirus gastroenteritis and so is the platelet crit value.

Evaluation of aspartate amino transferase to platelet ratio index as a non invasive marker for liver cirrhosis

Background: Cirrhosis is a condition in which the liver slowly deteriorates and is unable to function normally due to chronic long lasting injury. Liver biopsy is considered as a gold standard for the diagnosis of cirrhosis and has many problems like bleeding, infective peritonitis which limit use of liver biopsies in all patients.Methods: A comparative study was done (90 cases and 90 controls) who fulfilled the inclusion criteria in a tertiary center.Results: The present study was conducted using a total of 180 participants, 90 USG diagnosed cases of liver cirrhosis was compared with 90 healthy controls. The mean AST level in the cirrhosis was 66.50±27.06 as compared to 21.26±6.52 in controls which was statistically significant. In this study the sensitivity and specificity of APRI was found to be 100.0% and 84.44% respectively, and the positive and negative predictive values were 86.54% and 100% respectively with significantly Area under the curve (AUC) (0.999, P>0.01).Conclusions: A simple index like Aspartate platelet ratio index, consisting of 2 readily available laboratory results (AST level and platelet count), can predict cirrhosis with a high degree of accuracy.

Revisiting the complete blood count and clinical findings at diagnosis of childhood acute lymphoblastic leukemia: 10-year experience at a single center

Abstract Background Heterogeneity regarding clinical and laboratory findings at diagnosis of acute lymphoblastic leukemia exists. The frequency of complete blood count abnormalities and its combinations, symptoms and physical findings were investigated in Hispanic children from an open population at the diagnosis of acute lymphoblastic leukemia. Methods The patient charts and electronic records of under 16-year-old children diagnosed with acute lymphoblastic leukemia over 10 years at a regional hematology center of a university hospital were analyzed to retrieve data concerning the complete blood count at first evaluation. Type and distribution of abnormal data, frequency of symptoms and physical findings at presentation were documented. Results The records of 203 children aged 0-15 years diagnosed with acute lymphoblastic leukemia from 2006 to 2016 were revisited. The results of the blood workup showed a median white blood cell count of 7120 × 109/L (range: 450-600,000 × 109/L), and a median hemoglobin concentration of 7.5 g/dL (range: 2.4-15.3 g/dL), whereas the median platelet count was 47,400 × 109/L (range: 4000-544,000 × 109/L). Leukocytosis and leukopenia were present in 36.6% and 36.1% of cases, respectively; anemia was diagnosed in 82.9% children. The order of frequency for major clinical symptoms was fatigue 62%, fever 60%, bone and joint pain 39%, hyporexia 33% and weight loss 21%, while main physical findings were hepatomegaly 78%, splenomegaly 63%, lymphadenopathy 57%, pallor 48%, and purpura 30%. Conclusion Data differing from those classically expected at diagnosis of acute lymphoblastic leukemia in children were documented in a cohort of Hispanic children over one decade with a wide spectrum of complete blood count abnormalities, forms of presentation and frequency of physical findings.

Evaluation of hematologic profile may be needed for patients treated with oxcarbazepine / 소아과

PURPOSE: The major side effects of treatment with oxcarbazepine (OXC) are skin rash and hyponatremia. Hematologic side effects are reported rarely. The aim of this study was to investigate the rate and types of the hematologic side effects of OXC. METHODS: The medical records of 184 patients diagnosed with epilepsy or movement disorder and on OXC monotherapy, at the Department of Pediatrics of Inje University Sanggye Paik Hospital from July 2001 to July 2018, were retrospectively reviewed. RESULTS: Of the 184 patients, 10 (5.4%) developed leukopenia in addition to pancytopenia and 2 (1.0%) developed pancytopenia. Leukopenia developed in 11 days to 14 years after OXC administration and was more frequent in males than in females (male vs. female, 9 vs. 1; Fisher exact test, P0.05, t-test). CONCLUSION: OXC-induced leukopenia is not rare and may result in pancytopenia. Patients being treated with OXC should be regularly monitored for abnormal complete blood count profiles.

Prevalence of anemia in schools of the metropolitan region of Curitiba, Brazil

ABSTRACT Background: Anemia during childhood is one of the biggest public health problems worldwide, including Brazil. Insufficient or abnormal production of hemoglobin, loss of iron and excessive destruction of red blood cells are the most common causes of anemia. Among the reasons of anemia, iron deficiency accounts for 50% of anemia cases in developing countries. Affected individuals present a wide range of clinical problems, including delayed neuropsychomotor progression, impaired cellular immunity and reduction of intellectual capacity. This study aimed to evaluate the prevalence of anemia in children attending public schools in the metropolitan region of Curitiba, Paraná, Brazil. Method: A retrospective study was conducted of 409 children aged 8-12 years old included in an extension project of the Universidade Federal do Paraná. The results of complete blood count and hemoglobin electrophoresis of all children were evaluated. Anemia was considered when the hemoglobin levels were <11.5 g/dL. Results: The prevalence of anemia was found to be 2.2% of the population studied, with hypochromic microcytic anemia being the most common type. Seven children had sickle cell trait and one had β-thalassemia. Conclusion: The prevalence of anemia in this study was considered normal according the World Health Organization classification, which is different from the data found in other Brazilian regions.