Blood Count Research Articles

Home self-testing of complete blood counts in patients with breast cancer during chemotherapy: A proof-of-concept cohort study in e-oncology.

Before administration of myelosuppressive chemotherapy, complete blood counts (CBC) collected at the hospital/nursing stations are evaluated to avoid severe bone marrow suppression. This maintains disease fixation which often reduces their quality of life. This mixed-method study examined at home self-testing of CBC, the test quality, and the effects on patients' mental well-being. Patients with breast cancer receiving chemotherapy were recruited and trained to perform capillary finger prick CBC testing at home using the HemoScreen Point-of-Care instrument and to upload the test results to the hospital's IT system subsequently. A venous reference CBC sample was taken and tested at the hospital on the day of self-testing. Semi-structured interviews with open-ended components were performed to investigate the user experience and the impact of self-testing on the patients' everyday lives. Thirty-nine patients completed the self-testing education using the HemoScreen instrument. Eight patients withdrew, while the remaining 31 patients performed 161 home tests (2-11 tests per patient) over a 4-month period. The test results compared well with the venous reference CBCs except for platelet counts (correlation coefficient 0.26). Qualitative interviews with nine of the 31 patients emphasized that the patients were comfortable using the self-testing instrument and becoming an active partner in their own treatment. CBC self-testing at home produced clinically valid hemoglobin and white blood cell counts with the added benefit that the patients became active partners in their own treatment course, which was of great importance for the patients and increased their wellbeing.

Acute Myeloid Leukemia among Patients attending Sana’a Hospitals, Yemen: Prevalence, Subtypes and Hematological Patterns

Objectives: Acute myeloid leukemia (AML) is malignant disorder of cells of myeloid lineage in the bone marrow due to chromosomal abnormalities, leading to accumulation of myeloblasts in the bone marrow and infiltration to peripheral tissues. The aim of this study was to determine the prevalence, subtypes and hematological patterns of AML among patients attending Sana’a hospitals, Yemen. Materials and methods: This cross-sectional study was carried out on total 257 patients with hematological malignancies (HMs) during the period from November 1, 2023 to March 31, 2024. Among HMs, there were 79 patients diagnosed with AML by complete blood count (CBC), by Giemsa stained blood/BM films, and by immunophenotyping using flow cytometry. Data was analyzed using SPSS-26. Results: Among 257 patients with HMs, AML was found in 79 patients with prevalence of 30.7%. AML patients included 53 (67.1%) males and 26 (32.9%) females., with M:F ratio of 2:1 and aged between 4 and 80 years, FAB-M2 was the most common subtype of AML in 30 (37.97%) of patients; among them, there were 19 (24.05%) males and 11 (13.92%) females, the M:F ratio is 1.7:1. FAB-M2 was followed by M1 (26.58), M5 (17.2), M3 (7.59), M4 (5.06), M0 (3.8) and M7 (1.26). The hematological patterns included decreased Hb, increased WBC and decreased platelets in 97.5%, 82.3% and 96.2% of patients, respectively. Conclusion: Leukemia was the most prevalent type among hematological malignancies. The prevalence of AML was high and represent the second leukemia type. AML-M2 was the common subtype of AML.

The assessment of pentraxin 3: a diagnostic and prognostic biomarker in lower respiratory tract infections in children

BackgroundPentraxin 3 (PTX3) is an acute-phase reactant that is elevated in the plasma during inflammatory responses. We aimed to evaluate the utility of PTX3 as a clinical marker in children with lower respiratory tract infections (LRTIs) and the association between PTX3 and LRTIs severity.MethodsWe included 60 patients admitted to Fayoum University Hospital with LRTIs fulfilling the WHO criteria for diagnosing LRTIs. We collected data on peak temperature, respiratory rate, heart rate, oxygen saturation upon admission, and length of hospital stay. The complete blood count (CBC), C-reactive protein (CRP) level, and PTX3 were measured upon admission.ResultsPTX3 levels were significantly correlated with peak temperature, duration of hospital stay, the Pediatric Respiratory Severity Score (PRESS), total leucocytic count (TLC), CRP, and blood cultures.ConclusionPTX-3 represented the severity of the disease and predicted the prognosis. Pentraxin levels demonstrate a statistically significant sensitivity of (93.3%) and a specificity of (70%) at the cut-off value (of 8.84) with an area under the curve (90.7%) in the diagnosis of LRTIs.

PSVIII-9 Effects of growth implants and timing of vaccination on calf immunity and growth performance

Abstract This study assessed calf growth performance and blood parameters of beef calves under different growth implants and timing of vaccination protocols. Crossbreed beef calves (n = 59) were stratified by birth body weight (BW) and age (41 ± 5.2 kg of BW and 70 ± 8 d of age) and randomly assigned in a split-plot design with implant strategy as the main plot and timing of vaccination as the subplot. The main plot (treatment) consisted of 3 implant strategies: 1) Synovex C (SC; n = 20; 100 mg progesterone/10 mg estradiol benzoate, or 2) Synovex One Grower (SG; n = 19; 150 mg trenbolone acetate and 21 mg estradiol benzoate; or 3) no implant (CON; n = 20). Subplot treatments were the timing of vaccination booster against bovine respiratory disease pathogens on 1) weaning (WV; n = 29) or 2) 7-d post-weaning (PWV; n = 30). Cow-calf pairs were treated alike in a single pasture during the pre-weaning phase, receiving the same vaccine (Bovi-Shield Gold One Shot and Ultrabac 7) on d 0 (implantation day) and booster time (WV or PWV). After weaning (approximately 187 d of age), calves were allocated in a single pen receiving ad libitum hay until d 60 post-weaning. Body weight and blood were collected on d 0, weaning, d 0 and 28 relative to vaccination booster, and d 60 post-weaning. Blood was collected to determine insulin-like growth factor (IGF-1), cortisol, and leptin concentrations and to perform a complete blood cell count. WV calves had decreased cortisol concentrations on booster day and 28 d post-vaccine (P = 0.01). Regardless of implant treatment, calves tended to have decreased IGF-1 concentrations 28-d post-vaccine booster (P = 0.09). An effect of treatment (P < 0.01) was detected for lymphocyte counts, with CON having greater concentrations vs. SG and SC calves. A treatment × timing of vaccination (P < 0.01) interaction was detected for monocyte counts, where SG-PWV calves had the greatest concentrations. A treatment effect (P < 0.02) was observed for eosinophil percentage, where SG had reduced percentages than CON, while SC was intermediate. An effect of treatment was detected for leptin (P < 0.01), with SG calves having the least, CON being intermediate, and SC the greatest concentrations. From d 0 to 60 d post-weaning, SG tended to have greater ADG (P ≤ 0.07) compared with CON, while SC was intermediate. On d 28 and d 35 post-weaning, calves implanted with SG were heavier (P ≤ 0.04) than the CON but not than SC. In summary, this study demonstrates that growth implants and timing of vaccination significantly affect both physiological parameters and growth performance in beef calves. Implanting calves with Synovex One Grower resulted in improved growth performance.

191 Awardee Talk: Characterizing biological processes influencing the efficiency of nutrient utilization in growing cattle

Abstract 2Abstract: Residual feed intake (RFI), a metric of feed efficiency, is moderately heritable and minimally associated with body size and productivity, making it an ideal trait for investigation as a selection criterion to improve feed efficiency of growing cattle. The objective of this research was to characterize the inter-animal variation in biological processes of growing cattle selected to be divergent in RFI. Holstein heifers [n = 55; body weight (BW) = 351 ± 64 kg) with low- (n = 29) or high- (n = 26) genomically enhanced RFI (RFIg) were selected from a contemporary group of 453 heifers. Heifers were assigned to 1 of 2 pens, equipped with electronic feed bunks and a GreenFeed gaseous-exchange measurement system. Individual dry matter intake (DMI) and feeding behavior data were collected for 84-d. Body weight was measured weekly, and spot fecal samples collected at weighing. Phenotypic RFI (RFIp) was calculated as the residual from regression of DMI on ADG and mid-test BW0.75. On d 70 of the study a rumen fluid sample was collected via esophageal tubing. Blood samples were collected and analyzed for complete blood count (CBC). A mixed model including the fixed effect of RFIg classification and random effect of pen was used to evaluate the effect of RFIg classification on response variables. There were no differences (P > 0.05) in BW and ADG for heifers with divergent RFIg; however, low RFIg heifers consumed 7.5% less (P < 0.05) feed per day. Consequently, low RFIg heifers exhibited a more favorable (P < 0.05) RFIp (-0.188 vs 0.211 kg/d, respectively). Low RFIg heifers exhibited more favorable feeding behavior, with 8.7% fewer (P < 0.05) bunk visit events per day and an 11.2% slower (P ≤ 0.05) eating rate. Low RFIg heifers had 12.5% greater (P < 0.05) total rumen volatile fatty acid concentrations than high RFIg heifers, indicating potentially enhanced microbial fermentation and improved efficiency of feed utilization. Low RFIg heifers had 8.2% less (P < 0.05) methane emissions (g/d), 6.3% less (P < 0.05) carbon dioxide production (g/d), and 6.1% less (P < 0.05) heat production (Mcal/d) calculated according to Brouwer (1965) than high RFIg heifers. Dry matter digestibility did not differ (P > 0.05) between heifers with divergent RFIg. Overall, heifers selected to be more feed efficient exhibited more favorable energy efficiencies and feed efficiency phenotypes. To quantify the variation in RFIg explained by feeding behavior, gas flux, digestibility and rumen fermentation, and CBC partial least squares regression models were developed. Feeding behavior accounted for the largest proportion of variation in RFIg (28.8%). Upon sequential addition of gas flux, digestibility and rumen fermentation, and CBC to feeding behavior, 56.3% of the variation in RFIg was accounted for. Identifying the magnitude at which metabolic processes influence inter-animal variation in efficiency of nutrient utilization provides opportunities to discover valuable candidate biomarkers for selection of more feed efficient cattle.

The anti-inflammatory effects of Fuzapladib in an endotoxemic porcine model.

Endotoxemia is a systemic inflammatory condition caused by lipopolysaccharide (LPS) stimulation, which produces inflammatory cytokines. Fuzapladib (FZP) inhibits the activation of adhesion molecules found on the surface of inflammatory cells, mitigating inflammation. In this study, we evaluated the therapeutic effects of fuzapladib on inflammatory cytokines and cardio-respiratory function using an LPS-induced endotoxemic porcine model. Fifteen pigs were separated into three groups: low-FZP (n=5), high-FZP (n=5), and control (n=5). Pigs were administered LPS under general anesthesia, and complete blood cell count, blood biochemistry, inflammatory cytokines, and cardio-respiratory function were evaluated. Statistical analysis was performed using a linear mixed-effects model and the Steel-Dwass test, with a significance threshold of P<0.05. During the 4 hr experimental period, one pig in the control group and two pigs in the low-FZP group died due to hypoxemia and hypotension. In the early acute changes following LPS administration, the high-FZP group maintained significantly higher arterial oxygen partial pressure and normal blood pressure compared to the control group. Although interleukin-6 levels increased in all groups during the experiment, they were significantly lower in the high-FZP group compared to the control group. Other parameters showed no clinically significant differences. In conclusion, while high-dose fuzapladib did not reduce organ damage in the porcine endotoxemia model, it suppressed interleukin-6 production, delayed the progression of deterioration, and contributed to a reduction in mortality during the observation period.

The potential predictive value and relationship of blood-based inflammatory markers with the clinical symptoms of Han Chinese patients with first-episode adolescent-onset schizophrenia.

Inflammation is associated with the pathophysiology of schizophrenia. The blood markers for systemic inflammation include neutrophil-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), lymphocyte-monocyte ratio (LMR), system inflammation response index (SIRI), and platelet-lymphocyte ratio (PLR). However, these inflammation markers and their relationships with clinical phenotypes among Han Chinese patients with first-episode adolescent-onset schizophrenia (AOS) is unclear. This investigation aimed to elucidate the impact of inflammation on Han Chinese AOS patients as well as the association of blood-based inflammation markers with clinical symptoms. Altogether, 203 Han Chinese individuals participated in this study, 102 first-episode AOS patients and 101 healthy controls. The assessment of inflammatory indices was based on complete blood cell count. Furthermore, schizophrenia-related clinical symptoms were evaluated using the five-factor model of the Positive and Negative Syndrome Scale (PANSS). In Han Chinese first-episode AOS patients, levels of SIRI, PLR, SII, and NLR were significantly increased (p < 0.001), while LMR decreased (p < 0.001) compared to healthy controls. Furthermore, multivariate logistic regression showed that LMR, NLR, SII, and SIRI (all p < 0.05) were independently associated with AOS. Moreover, Receiver operating characteristics assessment indicated that NLR, SIRI, LMR, and SII could effectively distinguish AOS patients from healthy controls. Their areas under the curves were 0.734, 0.701, 0.715, and 0.730 (all p < 0.001). In addition, Correlation analysis revealed that LMR was negatively correlated with the PANSS total, negative, and cognitive factor scores (all p < 0.05); NLR was positively correlated with the cognitive factor score (p < 0.01); SII was negatively correlated with the positive factor score and positively with the negative and cognitive factor scores (all p < 0.05); SIRI was positively correlated with the PANSS total and cognitive factor scores (all p < 0.01). This research established the involvement of peripheral blood inflammatory markers (LMR, NLR, SII, and SIRI) with the clinical manifestations and pathophysiology of schizophrenia, and these can serve as screening tools or potential indices of the inflammatory state and AOS symptoms severity.

Increased packed cell volume alters point of care viscoelastic clotting parameters in horses.

Polycythaemia and coagulopathy are identified risk factors for non-survival in critically ill horses. Assessment of coagulation is recommended for critical care monitoring but may be affected by concurrent polycythaemia. To evaluate the effects of induced polycythaemia on coagulation parameters as measured by a point-of-care viscoelastic coagulation device (VCM Vet™). Prospective interventional study. Healthy adult horses (n = 7) were given 6 mcg/kg of phenylephrine IV over 15 min to induce transient polycythaemia. Samples for packed cell volume (PCV), total solids (TS), complete blood count (CBC), activated partial thromboplastin time (PTT), prothrombin (PT) and VCM Vet™ viscoelastic testing were collected at baseline (T0), 5 min (T1) and 2 h (T2) post-phenylephrine infusion. Splenic volume was measured by transabdominal ultrasonography. VCM Vet™ and plasma-based coagulation parameters, splenic volume and haematologic values were compared within and between time points. Splenic volume decreased from T0 (11.5 ± 4.8 L) to T1 (6.1 ± 2 L, p = 0.04) and returned to baseline volume by T2 (12.1 ± 3.9 L, p = 0.8), consistent with phenylephrine-induced splenic contraction. PCV increased from T0 (37% ± 4%) to T1 (56.3% ± 5.3%; p < 0.001) and returned to baseline at T2 (41.6% ± 3.6%; p = 0.1). A10 and A20 (amplitude at 10 and 20 min, VCM units) were decreased from T0 (12.6 ± 1.6, 18.9 ± 5) to T1 (5.4 ± 1.9, 7.6 ± 2.4; both p < 0.001) and remained lower than baseline at T2 (9.3 ± 2.1, 12.7 ± 3; both p = 0.01). PT and PTT remained within reference ranges with no significant difference over time (p = 0.5 and 0.09, respectively). PCV was negatively correlated with CFT (R = -0.61, p = 0.003), A10 (R = -0.9, p < 0.001) and A20 (R = -0.87, p < 0.001). Small sample size, limited to healthy mares. Phenylephrine-induced polycythaemia was associated with hypocoagulable viscoelastic traces using the VCM Vet™ device without effect on plasma-based coagulation assessments or platelet number. Further investigation of viscoelastic testing is needed in horses with increased PCV due to clinical illness.

Investigation of the effect of oral ivermectin on systemic inflammatory response and quality of life in scabies patients.

Scabies is a prevalent ectoparasitic infectious disease, caused by the mite Sarcoptes scabiei. As a consequence of the infestation, localised cutaneous inflammation, pruritus and polymorphic skin lesions develop. The primary symptoms of scabies manifest as hypersensitivity-like reactions and immune responses, the precise mechanisms of which remain poorly defined. The objective of this study was to evaluate the effects of oral ivermectin treatment in patients with scabies on the systemic immune response and the patient's quality of life (QoL). Patients admitted to the dermatology outpatient clinic and diagnosed with scabies were administered oral ivermectin treatment following diagnosis at week 0 and 2. Laboratory tests were conducted to measure complete blood count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels before treatment and at week 4. The systemic immune-inflammation index (SII) was calculated using the platelet, neutrophil and lymphocyte counts. Additionally, data pertaining to the Dermatological Life Quality Index (DLQI) were recorded. In 119 patients (51 males) diagnosed with scabies, increases in ESR, CRP, and SII values and decreases in inflammatory cell counts and DLQI scores were observed one month after treatment with oral ivermectin. The results of the study showed that the use of oral ivermectin, a scabicidal agent, triggered the inflammatory response and improved the QoL of the patients.

Back to Basics: The Diagnostic Value of a Complete Blood Count in the Clinical Management of COVID-19.

Since the beginning of the COVID-19 pandemic, scientists have struggled significantly to understand the complexity of COVID-19 pathophysiology. COVID-19 has demonstrated a notoriously unpredictable clinical course. This unpredictability constituted a significant obstacle to clinicians in predicting the disease course among COVID-19 patients, more specifically, in predicting who would develop severe cases and possibly die from the infection. This brief report aims to assess the diagnostic value of using a complete blood count (CBC) and applying high-dimensional analysis, i.e., principal component analysis (PCA), on it to differentiate between patients with mild and severe COVID-19 infection. The data of 855 patients were retrieved from multiple centres in Saudi Arabia. Descriptive statistics, such as counts, percentages, and medians (interquartile ranges) were used to describe patients' characteristics and CBC parameters. Analytical statistics, such as the Mann-Whitney U test, were used to compare between survivors and non-survivors. PCA was applied using the CBC parameters, and the results were compared between survivors and non-survivors. Patients in this study had a median age of 41, with an almost equal ratio of men to women. Most participants were Saudis, and non-survivors were 13.22% of the total cohort. The median values of all CBC indices were within reference ranges; however, some statistically significant differences were observed between survivors and non-survivors. Non-survivors had lower hemoglobin levels and lower hematocrit, lymphocyte, and eosinophil counts but higher WBC and neutrophil counts compared to survivors. PCA on the CBC results of survivors yielded a significantly different profile than non-survivors, indicating the possibility of its use in the context of COVID-19. The diagnostic value of CBC in the clinical management of COVID-19 should be utilized in clinical guidelines for managing COVID-19 cases.

A practical approach to febrile cancer patients: Diagnostic stewardship in Oncology units

Introduction Cancer and cytotoxic chemotherapy used for its treatment predispose to severe and often fatal infections. Prompt diagnosis and timely antibiotic therapy are crucial, with delays in therapy initiation having high mortality. Complete blood count (CBC) is an inexpensive, standardized, and preliminary investigation for the management and follow-up of cancer patients with diagnostic and prognostic value. Method We studied the types of infections associated with various cancers treated with chemotherapy, their etiologies and susceptibility patterns, and the hematological profile of these patients as predictors of infection. Results A total of 21 patients (12 solid and 9 hematological malignancies) presented with 31 febrile episodes. White Blood cell count (2079 cells/cu. mm), percentage of neutrophils (52.9%), absolute neutrophil (137.5 cells/cu. mm), and platelet count (1,77,507 cells/cu. mm) were significantly lower in the 11 patients with febrile neutropenia. The absolute lymphocyte count (412.7 cells/cu. mm) was reduced with a strikingly low Neutrophil-to-lymphocyte ratio (NLR) (6.07) in patients with neutropenia. Laboratory and radiological evidence were present in 14/15 episodes of hematological malignancies (p-0.218) whereas unexplained clinical sepsis was common in solid malignancies (p-0.0202). The majority of documented infections were bacterial, caused by gram-negative bacilli, often showing multi-drug resistance. Infectious etiologies were identified in 71.4% of the patients with febrile neutropenia for &gt;5days. Bacterial infections developed within 2 days of neutropenia, whereas viral and fungal infections manifested in prolonged neutropenia. Multi-site infections and higher mortality rates were observed in patients with febrile neutropenia. (p&lt;0.04) Conclusion Febrile neutropenia is a common complication among patients receiving chemotherapy for cancer, with an increased risk of morbidity and mortality. Early, rapid, and accurate diagnosis is key to prompt intervention. Hematological parameters such as Total Leukocyte count, platelet count, NLR, and Platelet-to-lymphocyte ratio are promising biomarkers in conjunction with morphological changes in neutrophils, thus proving that CBC and peripheral smears are simple, easily available, cost-effective, and highly dependable screening tools, especially in resource-poor settings.

Delta Immature Platelet Fraction Is Associated With Mortality in Bacteremia Patients.

Immature platelet fraction (IPF) for differentiating bacteremia has been explored, whereas its prognostic correlation remains uncertain. This study aims to confirm the predictive capability of IPF for bacteremia and investigate its association with prognosis. Patients with complete blood count (CBC) on the blood culture day (D1) and the preceding day (D0) were retrospectively recruited and categorized into bacteremia and nonbacteremia groups. Immature platelet (IP) analysis, alongside CBC, was conducted. Delta IPF, defined by the absolute values of D1 minus D0 results was calculated. The ability to distinguish bacteremia from nonbacteremia patients, and the correlation with mortality were analyzed. From February to December 2020, a total of 150 patients were enrolled, with 75 having bacteremia. The specificity for delta IPF ≥3.4% to predict bacteremia was 97.3% (95% confidence interval [CI]: 90.7-99.7). When delta IPF ≥3.4% combined with procalcitonin ≥0.5 (ng/mL), the sensitivity was 90.5% (95% CI: 69.6%-98.8%). Within the bacteremia group, delta IPF and the proportion of patients with delta IPF ≥1.5% were significantly higher in nonsurvival, while delta platelet levels did not. Furthermore, delta IPF ≥1.5% was independently associated with 30-day mortality (adjusted odds ratio: 3.88, 95% CI: 1.2%-11.4%; p = 0.020). The 30-day survival curve demonstrated a significant difference between patients with delta IPF ≥1.5% and those without (p < 0.001). Delta IPF correlates with mortality in bacteremia patients. Our findings suggest IPF not only helps detect bacteremia but also predicts prognosis in the early stage.

Performance of red blood cell indices for the detection of reticulocytosis in anemic and non-anemic dogs in Taiwan

Reticulocyte counts (RETIC) are considered the gold standard in detecting an erythroid bone marrow response (BMR) in anemic and non-anemic dogs. Reticulocytosis without anemia (RWA) is a potential indicator of disease. The prevalence of anemia or RWA, as well as the effectiveness of red blood cell (RBC) indices in identifying a BMR, may vary based on geographical locations and breed differences. The purpose of the study was to determine the prevalence of regenerative and nonregenerative anemia, and RWA in pet dogs of Taiwan, and to assess the sensitivity and specificity of combined increased mean cell volume and decreased mean cell hemoglobin concentration (iMCV+dMCHC) to detect reticulocytosis in this population.The final population analysis consisted of 149,076 dogs. A cross sectional, retrospective analysis of complete blood count (CBC) samples from a field of automated hematology analyzers in Taiwan from December 1, 2018 through December 31, 2020 was performed. Among 149,076 dogs, 11.8 % (n=17,600) had reticulocytosis (RETIC > 110K/µl) and 21.8 % (n=32,474) had anemia (HCT < 37.3 %). Of 32,474 anemic dogs, 17.8 % (n=5,789) had reticulocytosis. Of 116,602 dogs without anemia, 10.1 % (n=11,776) had reticulocytosis. Across all dogs, sensitivity/specificity of iMCV+dMCHC to detect BMR was 4.3 % and 99.4 %, respectively compared to RETIC. Among anemic dogs, sensitivity/specificity of iMCV+dMCHC to detect BMR was 9.8 % and 99.2 %, respectively. Among non-anemic dogs, sensitivity/specificity of iMCV+dMCHC to detect BMR was 1.6 % and 99.5 %, respectively. Therefore, most regenerative anemias and cases of RWA did not have a combined iMCV+dMCHC. To avoid overlooking potential illness, RETIC should be evaluated regardless of whether patients have anemia or not.

Inflammatory biomarkers and clinical adverse effects associated with Isotretinoin treatment: A prospective study

Background Isotretinoin is considered now one of the most important drugs in the treatment of different dermatological diseases. However, different body systems can be affected during the treatment due to isotretinoin induced apoptosis. Objectives To evaluate the clinical adverse effects and laboratory changes associated with isotretinoin used in the treatment of different dermatological diseases. Methods 73 patients on isotretinoin treatment fulfilled a questionnaire about side effects associated with isotretinoin. Complete blood count (CBC), fasting lipid profile, liver enzymes, and the inflammatory markers Monocytes/HDL ratio (MHR), Neutrophil/lymphocyte (NLR), and Platelets/lymphocyte ratios (PLR) were assessed before treatment and monthly during the treatment period. Results The commonest adverse effects were related to dryness of skin and mucus membrane. 32.9% complained of myalgia and 12.3% arthralgia. Headache was reported in 13.7%, mood alteration in 11%, and insomnia in 12.3%. 24.5% of studied females reported menstrual irregularities. There were no statistically significant changes in CBC. TG, cholesterol, AST, ALT, and MHR significantly increased while HDL, NLR and PLR ratios significantly decreased after isotretinoin treatment. Conclusion: isotretinoin affects different body systems by side effects that are reversible in most instances; however, some of them are serious and need regular monitoring especially in high- risk patients.

Prognostic value of serum amyloid A protein as a biomarker in the diagnosis of 2019 novel coronavirus disease (COVID-19)

BackgroundThe current study aimed to evaluate the prognostic value of serum amyloid A protein )SAA( protein as a biomarker in diagnosing 2019 novel coronavirus disease )COVID-19( infection. MethodsThe study was conducted on 123 patients with definitive COVID-19 infection referred to Shahid Beheshti and Sina hospitals in Hamedan province, Iran. Five-milliliter blood samples were taken from all included patients and serum was isolated using a centrifuge at 10,000 rpm for 10 minutes. Laboratory tests were conducted, including c-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), potassium level, sodium blood test, platelets (PLT), complete blood count (CBC), lymphocyte count, and neutrophil count. The SAA enzyme-linked immunosorbent assay (ELISA) Kit was applied to measure the SAA level in serum samples. Results123 patients included 73 males and 50 females, age ±50. Sixty-six (53.7%) patients had negative CRP while 80 (65%) patients had normal ESR. Potassium levels were not normal among 111 (94.9%) patients. Seventy-seven (63.1%) patients had normal CBC, while 108 (87.8%) patients had neutrophils above the normal range. 94 (97.9%) patients over the age of 50 were positive for SAA. In terms of gender, men were the most frequent patients with SAA. There was a statistically significant relationship between the serum level of SAA and outcomes of patients with COVID-19 (p = 0.0001). 94% of patients with SAA ≤50 were recovered from COVID-19 infection. The sensitivity rate of SAA compared to polymerase chain reaction (PCR) and computed tomography scan (CT scan) tests was 93% and 99%, respectively. Moreover, the accuracy of SAA compared to PCR and CT scan tests was 52% and 96%, respectively. ConclusionResults indicate the SAA is a sensitive, but not specific biomarker in the early detection of COVID-19. The quantitative levels of SAA can be useful in predicting treatment outcomes among patients with COVID-19.

Combating Pediatric Pneumonia: The Dynamic Duo of Cinnamon-Clove Steam and Physiotherapy

IntroductionPediatric Community-Acquired Pneumonia (CAP) is a prevailing respiratory infection that impacts children in non-medical settings, giving rise to substantial morbidity and mortality, especially in less developed areas. The current study was aimed at finding a holistic approach for improving the management and treatment of pediatric CAP. For that purpose, a comparative interventional study was conducted to investigate the effectiveness of chest physiotherapy (CPT) combining with Cinnamon varum and Syzygium aromaticum steam therapy in pediatric CAP. MethodsA total of 60 pediatric patient hospitalized with CAP were assessed. The study included both male and female participants aged between 3 -14 years. The study was conducted at Children Hospital and Institute of Child Health in Faisalabad, Pakistan. The subjects were divided into three equal groups: Group 1 received CPT, Group 2 underwent CPT accompanied with nebulization, and Group 3 received CPT along with steam therapy using Cinnamon varum and Syzygium aromaticum. Each participant received the assigned therapy twice a day for 7 consecutive days. The study was approved and registered by Ethics Review Committee, Government College University, Faisalabad, Pakistan (Reference number GCUF/ERC/214). ResultsAmong the three groups studied, those who received the combined therapy exhibited improved outcome by improving the complete blood count (CBC), spirometer index, arterial blood gases (ABGs) and smart-cop severity score for pneumonia. ConclusionsThe antimicrobial, anti-inflammatory and mucolytic properties of cinnamon and clove, along with the positive effects of CPT, resulted in reduced lung inflammation, enhanced respiratory performance, and improved vital signs.

The effects of time and anticoagulant type on hematologic values in cockatiels (Nymphicus hollandicus)

BackgroundAvian hematologic characteristics complicate evaluation; therefore, complete blood cell counts require manual analysis for best accuracy. Furthermore, the quality of samples may be affected by prolonged shipment. MethodsBlood was collected from the right jugular vein of twenty-four, 7-year-old (14 male, 10 female), wild-type cockatiels (Nymphicus hollandicus). Smears were prepared using fresh, untreated blood. The remainder was divided into dipotassium ethylenediaminetetraacetic acid (EDTA) and lithium heparin microtainers. A hematocrit tube and blood smear were prepared at baseline, 24, 48, and 72 hours after venipuncture. Packed cell volume (PCV), total solids (TS), estimated white blood cell (WBC) count, WBC differential (heterophils, lymphocytes, monocytes, eosinophils, basophils), hemolysis index (HI), and preparation quality were assessed and compared to baseline. After log transformation, the effects of anticoagulants across time points were compared. ResultsHeparinized samples had significant differences in WBC, heterophil, and lymphocyte counts at 48 hours, and PCV and TS at 72 hours compared to baseline. There was a positive proportional bias in PCV and TS from EDTA anticoagulant samples at 24, 48, and 72 hours, and from heparinized samples at 48 and 72 hours compared to baseline. The EDTA samples had increased PCV and TS compared to heparin at all time points, and higher WBC and heterophil counts at 48 hours compared to baseline. A type II methodological error cannot be excluded. ConclusionThese results suggest that the anticoagulant used and time spent in anticoagulant alters hematologic values in cockatiels, which may have significant clinical implications. The importance of sample processing within 24 hours and anticoagulant-specific reference intervals for hematologic variables should be considered.

Pediatric Sickle Cell Disease Patients' Hematological Changes during Vaso-Occlusive Crises (VOCS) Versus Steady State

Background: The primary acute outcome of sickle cell disease (SCD) is a vaso-occlusive crisis (VOC) with extreme pain. More than three vaso-occlusive crisis (VOC) hospitalizations in a year increase the risk of early death. The objective of the study was to evaluate the hematological alterations in complete blood count (hemoglobin, red blood cell indices, white blood cell count, and platelets) and C-reactive protein levels during vaso-occlusive crises in patients with sickle cell anemia (HbSS) compared to a stable symptomatic state. Methodology: This study is a prospective descriptive study conducted in a hospital setting. During the period from February to June 2015, a Sudan Sickle Cell Anemia Center (SSCAC) in North Kordofan State, Sudan, treated a total of 100 patients with sickle cell anemia. Out of these patients, 74 had a vaso-occlusive crisis and 26 had a steady-state condition. All patients had measurements of their complete blood count (CBC) and C-reactive protein (CRP) levels. We calculated the average values of CBC and CRP level counts during vaso-occlusive crises and compared them to the values during steady state using independent t-tests. We analyzed the collected data using the Statistical Tool for Social Sciences (SPSS) software tool, specifically version 13. Results: The statistical analysis of the patient sample during vaso-occlusive crisis and steady state revealed that the concentration of hemoglobin (Hb) was 6.55 g/dl ± 1.3 and 9.8 g/dl ± 2.4, respectively, with a p-value of 0.000. The packed cell volume (PCV) was 20.4% ± 3.9 and 30.7% ± 7.1, respectively, with a p-value of 0.000. The red blood cell (RBC) count was 2.5×106/µl ± 0.57 and 3.9×106/µl ± 1.1, respectively, with a p-value of 0.000. A lot more white blood cells (WBC) were present in vasoocclusive than in steady state, with numbers 19.36 x 109/l ± 10.645 and 76.76 x 109/l ± 20.19, respectively, and a P-value of ≤0.000. There was a notable statistical disparity in the platelet count, with values of (357.108109/l ± 162.838) and (290.4610×9/l ± 124.40), with a P value of 0.05. In vaso-occlusive crises, the amounts of hemoglobin, packed cell volume (PCV), and red blood cells (RBCs) are lower than they are in the steady-state phase. Conversely, white blood cell (WBC) and platelet levels are much greater in patients experiencing vaso-occlusive crises compared to those in a steady state. The levels of C-reactive protein (CRP) were significantly different between patients experiencing vaso-occlusive crises and those in a stable condition.

Sex- and age-based reference intervals for capillary complete blood count parameters among urban preschoolers in southeast China based on a large community population

Background and aimPediatricians commonly use the complete blood count (CBC) of capillary blood to evaluate health status, guide diagnoses, and determine treatment strategies. This study aimed to establish sex- and age-specific reference intervals (RIs) for 23 capillary CBC parameters for urban preschoolers in Fuzhou, Southeast China. Materials and methodsCapillary blood CBC data of 18,369 healthy preschoolers who underwent annual physical examinations at Fujian Maternity and Child Health Hospital between January 01, 2022, and November 31, 2023, were analyzed retrospectively. To fully validate the new RIs, the data of all apparently healthy children within the same age cohort at the same institution were comprehensively analyzed in December 2023. The new RIs were assessed by comparing them with the RIs currently used in laboratories and those obtained from different regions, sample types, or methodologies. ResultsDynamic temporal changes that differ between males and females were observed in the blood system of 3-7-year-old children in this region. The new sex- and age-specific RIs for capillary CBC parameters were feasible to guide clinical decision-making in the local region. ConclusionsOur findings demonstrated the importance of establishing sex- and age-specific RIs for each region and underscored the necessity of continuous adjustment of clinical Rls based on statistical rules and clinical responses.

Prevalence of hemoglobinopathies detected by high performance liquid chromatography in tertiary care centre, Kota, Rajasthan

Background: Hemoglobinopathies are the most common heterogeneous group of monogenetic disorder in the world. Their prevalence varies with geographical regions. India is developing country and many studies have shown a significant burden of hemoglobinopathies in India. Our aim is to estimate prevalence of various hemoglobinopathies in our region. Methods: The present study was conducted at the department of pathology, Government Medical College, Kota on patients referred for antenatal or voluntary premarital checkup, patients with clinical history and complete blood count (CBC) suggestive of hemolytic anemia, and family members of known cases of hemoglobinopathies. Transfusion-dependent patients were also included. However, patients with history of blood transfusion within the last 1 month were excluded. EDTA samples were used for CBC using 6-part differential cell counter and high-performance liquid chromatography (HPLC) using BIORAD D10 analyzer. The results were tabulated and analyzed. Results: Of the 226 cases studied, 139 (61.5%) were females and 87 (38.5%) were males. Most common age group was 21 to 30 years. The number of thalassemia traits were 26 (11.5%), sickle cell traits were 7 (3.1%), sickle cell homozygous was 1 (0.4%), compound heterozygous for sickle cell and thalassemia were 2 (0.9%), while the remaining 190 patients (84.07%) were found to have normal HPLC, with presence or absence of nutritional deficiency. Conclusions: In our study, we found a high prevalence of hemoglobinopathies among patients. The most common disorder detected was beta thalassemia trait. Most of the hemoglobinopathies found in our study could be accurately quantified by HPLC which is a rapid, sensitive, and reproducible method for the detection of different hemoglobinopathies.