Evaluation of Bone Turnover Markers in Patients with Acute and Chronic Leukemia.

This study investigated different bone biomarkers (cross-linked carboxy-terminal telopeptide of type 1 collagen (CTX-1), pyridinoline (PYD), osteocalcin (OC), interleukin-6 receptor (IL-6R), calcium (Ca), and magnesium (Mg)) in terms of their metabolism in 4 different leukemia subtypes (ALL, AML, CLL and CML). The design was case control study with 30 controls and 60 cases of leukemia patients. Authors have reported many results regarding decrease as well as increase of specific bone biomarker under investigation with each leukemia subtype when compared to control. In addition, Authors reported correlations between each biomarker level and leukemia subtypes.

Role of endoplasmic reticulum aminopeptidase-1 gene polymorphism (rs13167972) in occurrence susceptibility of ankylosing spondylitis in a sample of Iraqi male patients.

BACKGROUND: Ankylosing spondylitis (AS) is a chronic and systemic seronegative inflammatory spondyloarthropathy, an autoimmune disease that has been associated with impaired Endoplasmic Reticulum Aminopeptidase (ERAP)-1 activity, which is involved in priming antigenic peptides. The purpose of this study is to investigate the association of 3-UTR of ERAP1 gene polymorphism (rs13167972) with the AS occurrence susceptibility in a sample of Iraqi male patients. METHODS: The AS patients were diagnosed clinically and by magnetic resonance imaging (MRI) and other clinical and laboratory criteria like symptoms, increased C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). The blood grouping and Body Mass Index (BMI) were also investigated to be associated with AS occurrence. The genotyping of the 3-UTR region of the ERAP1 gene (rs13167972) was done by Sanger sequencing. RESULTS: The results revealed that the AS occurred significantly in the age group of 20-35 years (p = 0.013). The BMI shows that the AS patients were overweighted males (p = 0.013) and the most predominant blood group in AS patients was O- (p = 0.002). The ESR and serum level of CRP were significantly raised in AS patient sera (< 0.001). The results of the receiver-operating characteristics curve analysis (ROC) revealed that the CRP (AUC: 0.995, cut-off: 2.48 mg/L, had 95% %sensitivity, 100% specificity, p < 0.001) is more discriminative than BMI (AUC: 0.300, cut-off: 46.91 kg, had 0% sensitivity, 100% specificity, p = 0.001), and ESR (AUC: 0.808, cut-off: 7.50 mm/hr, had 60% sensitivity, 88% specificity, p < 0.001) in distinguishing between AS patients and control group. The genotyping of the 3-UTR region of ERAP1 gene (rs13167972) result shows that the AG and GG genotypes are significantly occurring in AS patients (70%, OR: 2.33, 95%CI: 1.02-5.36, p = 0.04). The G allele is significantly occurring in AS patients (47%, OR: 2.07, 95CI%: 1.15-3.71, p = 0.01). CONCLUSION: The AS occurred in young overweight males with blood group O-. The AG and GG genotypes are risk factors for AS development while the G allele is a risk factor that increases the chances for disease incidence.

Molecular docking analysis of MCL-1 inhibitors for breast cancer management.

Myeloid leukemia 1 (MCL-1), a BCL-2 protein family member, acts as an anti-apoptotic protein by interacting with pro-apoptotic BCL-2 proteins. Its overexpression is frequently observed in numerous cancer types including breast cancer, and is closely linked to the initiation and progression of tumors as well as poor prognosis and resistance to therapeutic interventions. Here, a database of 3402 chemicals with established therapeutic activity against various diseases was chosen and systematically screened against the MCL-1 protein. Visual inspection and binding energy analysis revealed that the compounds OSU-03012, Raltitrexed, Ostarine (MK-2866), Dovitinib (TKI-258), and Varespladib (LY315920) had strong binding affinity for the MCL-1 protein. Notably, their binding affinity was higher than that of the control compounds. These compounds exhibited strong interactions with critical amino acid residues of the MCL-1 protein. Furthermore, these compounds shared several common amino acid residue interactions with the control compounds. These findings suggest that these compounds may be useful as MCL-1 inhibitors in the treatment of breast cancer. However, additional experimental validation is required to confirm these findings.

Racemic cis-bis-[bis-(pyrimidin-2-yl)amine-κN]bis(dicyanamido-κN1)iron(II) dihydrate: synthesis, crystal structure and Hirshfeld surface analysis.

The title compound, [Fe(C2N3)2(C8H7N5)2]·2H2O, has been synthesized solvothermally and characterized by single-crystal X-ray diffraction. The octa-hedral iron coordination polyhedron contains two di(pyrimidin-2-yl)amine ligands coordinated in a bidentate fashion, and two monodentate dicyanimido ligands, each coordinated via a terminal N atom, with the latter in a cis orientation. The ligand configuration about the iron atom is chiral, although the compound crystallizes as a racemic mixture: the Fe-N distances (> 2.07 Å) are characteristic of high-spin iron(II). In the crystal, an extensive series of N-H⋯N, O-H⋯N and O-H⋯O hydrogen bonds links the independent mol-ecular components into a three-dimensional framework. The H atoms of both water mol-ecules are disordered. The structure also features some π-π and anion-π inter-actions. The inter-molecular inter-actions were investigated by Hirshfeld surface analysis and two-dimensional fingerprint plots. Comparisons are made with some related compounds.

Characteristics of COVID-19 Patients Admitted to Intensive Care Unit in Multispecialty Hospital of Riyadh, Saudi Arabia: A Retrospective Study.

During the early stages of the COVID-19 pandemic, infection rates were high and symptoms were severe. Medical resources, including healthcare experts and hospital facilities, were put to the test to ensure their readiness to deal with this unique event. An intensive care unit (ICU) is expected to be required by many hospitalized patients. Many hospitals worldwide lacked resources during the pandemic's peak stages, particularly in critical care treatment. Because of this, there were issues with capacity, as well as an excessive influx of patients. Additionally, even though the research location provides medical care to a sizable population, there is a paucity of scientific data detailing the situation as it pertains to COVID-19 patients during the height of the outbreak. Therefore, this study aimed to identify and describe the features of COVID-19 patients hospitalized in the ICU of one of the multispecialty hospitals in Riyadh, Saudi Arabia. An observational retrospective study was conducted using a chart review of COVID-19 patients admitted to the ICU between March 2020 and December 2020. To characterize the patients, descriptive statistics were utilized. An exploratory multivariate regression analysis was carried out on the study cohort to investigate the factors that were shown to be predictors of death and intubation. Only 333 (29.33%) of the 1135 samples from the hospital's medical records were used for the final analysis and interpretation. More than 76% of the patients in the study were male, with a mean BMI of 22.07 and an average age of around 49 years. The most frequent chronic condition found among the patients who participated in the study was diabetes (39.34%), followed by hypertension (31.53%). At the time of admission, 63 of the total 333 patients needed to have intubation performed. In total, 22 of the 333 patients died while undergoing therapy. People with both diabetes and hypertension had a 7.85-fold higher risk of death, whereas those with only diabetes or hypertension had a 5.43-fold and 4.21-fold higher risk of death, respectively. At admission, intubation was necessary for many male patients (49 out of 63). Most intubated patients had hypertension, diabetes, or both conditions. Only 13 of the 63 patients who had been intubated died, with the vast majority being extubated. Diabetes and hypertension were significant contributors to the severity of illness experienced by COVID-19 participants. The presence of multiple comorbidities had the highest risk for intubation and mortality among ICU-admitted patients. Although more intubated patients died, the fatality rate was lower than in other countries due to enhanced healthcare management at the ICU of the study center. However, large-scale trials are needed to determine how effective various strategies were in preventing ICU admission, intubation, and death rates.

Azathioprine-induced lymphoma in a patient with Takayasu arteritis: A case report from Iraq.

Key Clinical Message: Azathioprine, used for vasculitis and connective tissue diseases, carries long-term cancer risks. This case report raises awareness among healthcare providers about such risks and emphasizes the need for taking necessary precautions to avoid them while treating such diseases. Abstract: We present an Azathioprine-induced lymphoma case in a 51-year-old male patient with Takayasu arteritis who presented with painless cervical swelling, itching, weight loss, and decreased appetite. This case report aims to increase awareness of the potential long-term cancer risks associated with azathioprine use in the treatment of chronic diseases.

Analysis and prediction pathways of natural products and their cytotoxicity against HeLa cell line protein using docking, molecular dynamics and ADMET.

Natural product such as flavonoids and their derivatives have a discernible capability to inhibit tumor formation and the growth of cancer cell, which have a vital link between diet and chronic disease prevention. Several plants and spices that contain flavonoid derivatives have been used in traditional medicine as disease preventative and therapeutic agents. Therefore, flavonoids could be used as chemotherapeutic drugs, indicating their potential clinical utility in cancer treatment. The purpose of this research was to discover and produce innovative pharmaceuticals from natural sources by introducing structural changes into flavonoids' backbones and changing their structures to improve biological activity and anticancer effects. In the current study, it was expected that the percent unbound values for the 15 compounds in human plasma would be low, ranging between 0.188 and 0.391. However, all compounds have a safe range and are not toxic to the brain. Compounds 2, 10, and 13 were shown to be permeable to the CNS (log PS > -3), but all other compounds had difficulty penetrating the CNS. Furthermore, all compounds had a low total clearance, ranging from 0.038 to 1.216 ml/min/kg, indicating that these compounds have a long half-life. None of the compounds caused skin sensitization (SS), and only compounds 1, 11, and 12 are expected to be AMES-positive, suggesting that the other compounds are not mutagenic. The result of the study showed based on the Drug-likeness and ADMET studies, only 3 compounds, including 3, 4, and 15, have a good pharmacokinetics propriety, the lowest toxicity, and good binding affinity towards Caspase 3 V266APDB (ID: 5I9B) as potential inhibitor candidates for the HeLa cell line, they have a low total clearance property and no AMES mutagenicity or hERG inhibition properties. These compounds (3,4,15) were examined to act as new cytotoxic drug candidates and would have an interest as starting point for designing compounds against the HeLa cell line.Communicated by Ramaswamy H. Sarma.

Bilateral uveitis in silent ulcerative colitis: case report

Silent or subclinical inflammatory bowel diseases (IBD) is a relatively new term that has been used to describe individuals with asymptomatic active mucosal bowel inflammation, often unaware of their disease due to either the lack of or mild inflammatory symptoms. These patients are at risk for gastrointestinal and extra-gastrointestinal manifestations, with more advanced complications. In this article we intend to describe a case report of a patient with chronic history of many organ involvements including ocular, skin, and musculoskeletal, which was later placed under the umbrella of silent ulcerative colitis. (AU)

Association between ABO blood groups and the risk of infection with SARS-CoV-2 in Iraq.

OBJECTIVE: The primary goals of this research were to analyze the relationship between ABO blood types and the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and investigate the effect of vaccination in Iraq. METHODS: Data and outcomes were gathered from the medical records of 200 patients. Patients were categorized by blood group and vaccination status in the analysis. RESULTS: In total, 200 hospitalized patients (125 men and 75 women) with confirmed SARS-CoV-2 infection and blood group (ABO) and clinical data were enrolled. Of the 200 patients, 155 (77.5%) were vaccinated against SARS-CoV-2. The results illustrated that 25 patients died, which might have been attributable to a lack of vaccination or older age. Our analysis revealed that blood group O individuals were much less likely to be infected by SARS-CoV-2 than non-O subjects, whereas blood group A individuals carried a higher risk of infection. CONCLUSIONS: Our findings illustrated that immunization significantly reduces COVID-19 risk across all age groups, but there has been an increase in the number of cases because of decreased vaccine efficacy in older patients and persons with comorbidities. However, 45% vaccination coverage lowered the outbreak's peak.

trans-Bis(2,2'-di-pyridyl-amine-κ2 N,N')-bis-(1,1,3,3-tetra-cyano-2-eth-oxy-propenido-κN)copper(II).

The title compound, [Cu(C9H5N4O)2(C10H9N3)2], was synthesized solvothermally. The complex exhibits a distorted octa-hedral coordination geometry. The CuII atom is located on an inversion centre. The distorted octahedral CuN6 coordination sphere is composed of bidentate 2,2'-dipyrid-ylamine in the equatorial sites while the axial sites are occupied by 1,1,3,3-tetra-cyano-2-eth-oxy-propenide ligands. In the crystal, N-H⋯N hydrogen bonding results in chains parallel to [010].

Study of Selected Flavonoid Structures and Their Potential Activity as Breast Anticancer Agents.

Flavonoids contain pharmacological effects that help to protect cells from damage. However, the anticancer activity of flavonoids is related to their modulation of signal transduction pathways within cancer cells. Natural substances such as flavonoids have immune-stimulating anti-tumor effect that could lower breast cancer risk. However, various diseases included Alzheimer's and cancer disease are associated with flavonoids intake due to their ability as antioxidant agent to alter essential cellular enzyme's function. Therefore, through interaction between flavonoids and Cytochrome P450 (CYP) family enzymes led to make them chemopreventive agents for breast cancer. In this analysis, the chemo-informatics properties of 5 selective flavonoid derivatives and their efficiency as anti-breast cancer drugs were evaluated. Flavonoid ligands were docked with the predicted protein, which is human placental aromatase complexes with exemestane, a breast cancer drug (3S7S). Based on various docking energies, the molecular characteristics and bioactivity score of the following components, C15H12O6 2-(3,4-dihydroxyphenyl)-5,7-dihydroxy-2,3-dihydro-4H-chromen-4-one and C15H12O5 5,8-dihydroxy-2-(4-hydroxyphenyl)-2,3-dihydro-4H-chromen-4-one showed greatest molecular properties and bioactivity docking scores of -8.633117 and -8.633117 kcal/mol respectively. Therefore, both compounds could be considered antitumor agent.

The Impact of COVID-19 on Iraqi Community: a descriptive study based on data reported from the Ministry of Health in Iraq.

INTRODUCTION: Coronavirus is a new pandemic disease that has emerged in Wuhan, China, and then spreads around the world. The cases number of the COVID-19, which have been daily reported in Iraq, has risen slowly. However, no confirmed study has been undertaken to evaluate the situation of the COVID-19 in concerning the confirmed cases, death cases, and recovered. METHODOLOGY: The current study is undertaken to describe and assess the COVID-19 of the present situation in Iraq out of the range of the confirmed, deaths and recovered cases from the date 21 February to 30 April 2020 in Iraq. RESULTS: The study findings have revealed that there is a gradual increase of COVID-19 cases onwards until the top peak in 7th Apr. in which the cases reach 684, then decrease regularly. The total infected people of the study scope is 2085 persons according to the Ministry of Health in Iraq, while the World Health Organization (WHO) states 2003 person. The spatial distribution quantile map showed the hot spots in the province of Babylon, Maysan, and Diyala. However, less was found in three provinces (Nineveh, Salahaddin, and Al Anbar). The result shows that 39% recovered and 3% death cases out of total infected people. CONCLUSIONS: COVID-19 in Iraq comes to be limited via the procedures of Iraqi government. However, the infected people will be increased gradually and many international reports that predict the end of this pandemic in the world will be doubtful as there are many vaccines developed and under development which led to reduce to effect of this pandemic.

Modelling the impact of weather parameters on the microbial quality of water in distribution systems.

In this study, a framework for integrating weather variables and seasons into the modelling and prediction of the microbial quality in drinking water distribution networks is presented. Statistical analysis and Bayesian network (BN) modelling were used to evaluate relationships among water quality parameters in distribution pipes and their dependencies on weather parameters. Two robust predictive models for Total Bacteria in the network were built based on a deep learning approach (Long Short-Term Memory (LSTM)). The first model included water quality parameters alone as inputs while the second model included weather parameters. The seven-year dataset used in this study constituted water quality parameters measured at seven location in the water distribution network for the city of Ålesund in Norway, and weather data for the same period. Results of the initial statistical analysis and the BN models showed that, air temperature, the summer season, precipitation, as well as water quality parameters namely, residual chlorine, water temperature, alkalinity and electrical conductivity have strong relations with the counts of Total Bacteria in the distribution networks studied. It was found that the integration of the weather parameters in the Total Bacteria prediction models significantly improved the quality of the predictions. Compared to the LSTM 1, LSTM 2 achieved MAE and MSE values as high as to 6.8 and 4.9 times respectively when the model was tested on the seven locations. In addition, the R2 values were marginally higher in LSTM 2 (0.92-0.95) than in LSTM (0.81-0.86). The prediction results demonstrate the relevance of integrating weather parameters such as air temperature seasons in predicting bacteria levels in water distribution systems. This suggests that changes in the microbial quality of water in distribution systems and potentially drinking water sources could be reliably assessed by integrating online sensors of water quality and weather parameters with efficient models such as the LSTM. Applying this efficient modelling approach in the management of water supply systems could offer immense support in addressing current challenges in assessing the microbial quality of water and minimizing associated health risks.

catena-Poly[[bis-(quinolin-8-amine-κ2 N,N')cadmium(II)]-µ-cyanido-κ2 N:C-[dicyanidonickel(II)]-µ-cyanido-κ2 C:N].

In the title compound, [CdNi(C9H8N2)2(CN)4] n , the Cd and Ni atoms both lie on centres of inversion in space group P21/c. The Cd atom is coordinated by two bidentate quinolin-8-amine ligands and by the N atoms of two cyano ligands, while the square planar Ni atom is coordinated by the C atoms of four cyano ligands. These units form a one-dimensional coordination polymer containing an (-NC-Ni-CN-Cd-) n backbone, and the coordination polymer chains are linked into a three-dimensional array by a combination of N-H⋯N and C-H⋯N hydrogen bonds, augmented by a π-π stacking inter-action.

Isolation and identification of marine Bacillus altitudinis KB1 from coastal Kerala: asparaginase producer.

L-asparaginase is a target for many researchers as its properties against cancer, especially leukaemia, and protective agents reduce acrylamide in fried food. In this study, the water samples from Thumba Arattuvazhi Beach in Kerala were screened for l-asparaginase producing microorganisms. This was followed by colourimetric screening using modified M9 media with 0.009% Phenol red dye and using l-asparagine as a sole nitrogen source. Then, the Nessler assay was performed to quantify the enzyme. Molecular identification was made by 16SrRNA sequencing and aligned the sequence with GeneBank for phylogenetic tree construction using BLAST. Seawater was serially diluted for 10-1 to 10-6 using nutrient agar plates. A total of 19 bacterial colonies were isolated. The colonies were evaluated to produce l-asparaginase according to the pink zone around the colonies on the modified M9 medium using a red phenol indicator. The KB1 sample was selected for further studies according to plate colour assay. Nessler assay of L-asparaginase quantified as 2.537 IU/ml. Molecular characterisation showed the sequence association with Bacillus altitudinis the sequence submitted in Genebank as B. altitudinis KB1 strain. The l-asparaginase II gene (AnsB) was amplified based on the entire length of the hypothetical protein of annotated genome with accession number CP022319.2. The l-asparaginase activity in this study was 57% higher than the reference organism B. altitudinis BITHSP010. The l-asparaginase producing bacterium B. altitudinis KB1 from a marine source in Kerala can produce asparaginase, which can be utilised for biotechnology applications.

Synthesis, crystal structure and Hirshfeld surface analysis of bis-{2-[(pyridin-2-yl)amino]-pyridinium} tetra-cyano-nickelate(II).

In the title mol-ecular salt, (C10H10N3)2[Ni(CN)4], the dihedral angle between the pyridine rings in the cation is 1.92 (13)° and the complete anion is generated by a crystallographic centre of symmetry. An intra-molecular N-H⋯N hydrogen bond occurs in the cation, which closes an S(6) ring. In the crystal, the components are linked by N-H⋯N and weak C-H⋯N hydrogen bonds, which generate chains propagating in the [101] direction. Weak aromatic π-π stacking inter-actions are also observed. A Hirshfeld surface analysis and two-dimensional fingerprint plots indicate that the most important contact types in the crystal packing are N⋯H/H⋯N, C⋯H/H⋯C and H⋯H with contributions of 37.2, 28.3 and 21.9%, respectively.

Characteristics of Dye-Sensitized Solar Cell Assembled from Modified Chitosan-Based Gel Polymer Electrolytes Incorporated with Potassium Iodide.

In the present work, phthaloyl chitosan (PhCh)-based gel polymer electrolytes (GPEs) were prepared using dimethylformamide (DMF) as a solvent, ethyl carbonate (EC) as a co-solvent, and a set of five quaternaries of potassium iodide (KI) as a doping salt, which is a mixed composition of iodine (I2). The prepared GPEs were applied to dye-sensitized solar cells (DSSC) to observe the effectiveness of the electrolyte, using mesoporous TiO2, which was sensitized with N3 dye as the sensitizer. The incorporation of the potassium iodide-based redox couple in a polymer electrolyte is fabricated for dye-sensitized solar cells (DSSCs). The number of compositions was based on the chemical equation, which is 1:1 for KI:I2. The electrical performance of prepared GPE systems have been assessed using electrical impedance spectroscopy (EIS), and dielectric permittivity. The improvement in the ionic conductivity of PhCh-based GPE was observed with the rise of salt concentration, and the maximum ionic conductivity (4.94 × 10-2 S cm-1) was achieved for the 0.0012 mol of KI:I2. The study of dielectric permittivity displays that ions with a high dielectric constant are associated with a high concentration of added ions. Furthermore, the gel polymer electrolyte samples were applied to DSSCs to detect the conversion effectiveness of the electrolytes. For electrolytes containing various content of KI:I2 the highest conversion efficiency (η%) of DSSC obtained was 3.57% with a short circuit current density (Jsc) of 20.33 mA cm-2, open-circuit voltage (Voc) of 0.37 V, fill factor (FF) of 0.47, as well as a conductivity of 2.08 × 10-2 S cm-1.

Apocynin and catalase prevent hypertension and kidney injury in Cyclosporine A-induced nephrotoxicity in rats.

Oxidative stress is involved in the pathogenesis of a number of diseases including hypertension and renal failure. There is enhanced expression of nicotinamide adenine dinucleotide (NADPH oxidase) and therefore production of hydrogen peroxide (H2O2) during renal disease progression. This study investigated the effect of apocynin, an NADPH oxidase inhibitor and catalase, an H2O2 scavenger on Cyclosporine A (CsA) nephrotoxicity in Wistar-Kyoto rats. Rats received CsA (25mg/kg/day via gavage) and were assigned to vehicle, apocynin (2.5mmol/L p.o.), catalase (10,000U/kg/day i.p.) or apocynin plus catalase for 14 days. Renal functional and hemodynamic parameters were measured every week, and kidneys were harvested at the end of the study for histological and NADPH oxidase 4 (NOX4) assessment. Oxidative stress markers and blood urea nitrogen (BUN) were measured. CsA rats had higher plasma malondialdehyde (by 340%) and BUN (by 125%), but lower superoxide dismutase and total antioxidant capacity (by 40%, all P<0.05) compared to control. CsA increased blood pressure (by 46mmHg) and decreased creatinine clearance (by 49%, all P<0.05). Treatment of CsA rats with apocynin, catalase, and their combination decreased blood pressure to near control values (all P<0.05). NOX4 mRNA activity was higher in the renal tissue of CsA rats by approximately 63% (P<0.05) compared to controls but was reduced in apocynin (by 64%), catalase (by 33%) and combined treatment with apocynin and catalase (by 84%) compared to untreated CsA rats. Treatment of CsA rats with apocynin, catalase, and their combination prevented hypertension and restored renal functional parameters and tissue Nox4 expression in this model. NADPH inhibition and H2O2 scavenging is an important therapeutic strategy during CsA nephrotoxicity and hypertension.

Neutrophil/lymphocyte and platelet/lymphocyte ratios as potential markers of disease activity in patients with Ankylosing spondylitis: a case-control study.

BACKGROUND: The neutrophil/ lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have the potential to be inflammatory markers that reflect the activity of many inflammatory diseases. The aim of this study was to evaluate the NLR and PLR as potential markers of disease activity in patients with ankylosing spondylitis. METHODS: The study involved 132 patients with ankylosing spondylitis and 81 healthy controls matched in terms of age and gender. Their sociodemographic data, disease activity scores using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), and white blood cell, neutrophil, lymphocyte and platelet counts were recorded. The patients with ankylosing spondylitis were further divided according to their BASDAI scores into patients with inactive disease (BASDAI < 4) and patients with active disease (BASDAI ≥4). The correlations between the NLR, PLR and disease activity were analysed. RESULTS: There was a statistically significant difference in the NLR and PLR between the active and inactive ankylosing spondylitis patients (2.31 ± 1.23 vs. 1.77 ± 0.73, p = 0.002), (142.04 ± 70.98 vs. 119.24 ± 32.49, p <  0.001, respectively). However, there was no significant difference in both the NLR and PLR between the healthy control group and ankylosing spondylitis patients (p > 0.05). In addition, the PLR was significantly higher in both the active and inactive groups compared to those in the healthy control group (142.04 ± 70.98 vs. 99.32 ± 33.97, p = 0.014), (119.24 ± 32.49 vs. 99.32 ± 33.97, p = 0.019). The BASDAI scores were positively correlated with the PLR (r = 0.219, p = 0.012) and the NLR, but they were not statistically significant with the later (r = 0.170, p = 0.051). Based on the ROC curve, the best NLR cut-off value for predicting severe disease activity in ankylosing spondylitis patients was 1.66, with a sensitivity of 61.8% and a specificity of 50.6%, whereas the best PLR cut-off value was 95.9, with a sensitivity of 70.9% and a specificity of 55.5%. CONCLUSION: The PLR may be used as a useful marker in the assessment and monitoring of disease activity in AS together with acute phase reactants such as the ESR.

The role of a low erythropoietin level for the polycythemia vera diagnosis.

A low erythropoietin (EPO) level is a minor diagnostic criterion for polycythemia vera (PV). Controversies exist regarding the diagnostic value of a low EPO level when considering increasing availability of advanced molecular testing. We assessed the role of low EPO level for PV diagnosis in the context of positive JAK2 mutation status as well as other diagnostic parameters. Of 138 patients, 75 patients had PV and 63 had secondary erythrocytosis. Of the 75 patients with PV, 32% had EPO levels within the normal range. EPO level positively correlated with obesity and smoking status, making it an unreliable diagnostic marker in those patients. Although EPO level below normal as a standalone diagnostic modality was significantly associated with PV (odds ratio [OR] 0.857; p < 0.001), when JAK2V617F mutation status was included in the prediction model, the association of low EPO was not statistically significant (OR 0.962, p = 0.269). Positive JAK2V617F demonstrated a strong predictive value for PV (OR 670.5, p = 0.006) either alone or in combination with other variables. Results show that EPO level is not a reliable diagnostic marker due to physiologic variation in association with obesity and smoking.