Blood Count Research Articles

Assessment of Serum Osteopontin and Eosinophil Major Basic Protein Levels in Children with Bronchial Asthma

Bronchial asthma (BA) is a chronic inflammatory illness that causes airway narrowing, airway hyperresponsiveness, airway mucous plugging. The purpose of this study was to improve the assessment of severity and degree of control of childhood bronchial asthma and to assess serum level of Osteopontin (OPN) and eosinophil major basic protein (EMBP) for pre-school and school-age children with asthma. This case control work was performed on 90 patients categorized into 2 groups; asthmatic group: involved 45 asthmatic children and control group: included 45 age and sex matched healthy children free from any renal injury or chronic diseases. Laboratory investigations (complete blood count (CBC), analysis of OPN and EMBP) were done after ethical considerations. OPN can significantly predict asthma at cut off >10.86 (P value of <0.001, the area under curve (AUC) of 0.914) with 93.33% sensitivity, 86.67% specificity, 87.5% positive predictive value (PPV), 92.9% negative predictive value (NPV). EMBP can significantly predict asthma at cut off >39.86(P value of <0.001, AUC of 0.702) with 86.67% sensitivity, 44.44% specificity, 60.9% PPV, 76.9% NPV. There was no correlation between OPN and EMBP and between the severity of asthma and markers as OPN and EMBP. OPN (OR=1.154, 95% CI= 1.021 -1.303, P value =0.007), EMBP (OR=1.017, 95% CI= 1.001 - 1.011, P value =0.013) and eosinophils (OR=7.254, 95% CI= 1.862 -28.261, P value <0.001) were significant predictors of asthma, while WBCs was not a significant predictor. Asthmatic children had higher OPN and EMBP. The severity of asthma was not significantly correlated with OPN and EMBP. OPN and EMBP can significantly predict asthma. Serum OPN and EMBP could be good biomarkers in the diagnosis of BA in different age groups.

Relationship of Hematological Profiles with the Serum Complement System in Patients with Systemic Lupus Erythematosus.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder identified by hematological abnormalities including anemia, leukopenia, and thrombocytopenia. Complement system disturbance is implicated in the pathogenesis of SLE. In this work, we aim to study how a full assessment of the complement system, which includes the evaluation of its three pathways, relates to blood cell counts in a population of patients with SLE. New-generation functional assays of the classical, alternative, and lectin pathways of the complement system were conducted in 284 patients with SLE. Additionally, serum levels of inactive molecules (C1q, C2, C3, C4, factor D) and activated molecules (C3a), as well as regulators (C1-inhibitor and factor H), were evaluated. Complete blood cell counts were analyzed. Multivariable linear regression analysis was performed to study the relationship of hematological profiles with this full characterization of the complement system. After multivariable adjustments that included age, sex, SLICC-DI (damage), and SLEDAI (activity) scores, as well as the use of aspirin, prednisone, methotrexate, azathioprine, and mycophenolate mofetil, several relationships were observed between the C pathways and the individual products and blood cells profile. Lower values of C1q and C2 were associated with lower hemoglobin levels. Lower leukocyte counts showed significantly lower values of C4, C1 inhibitor, C3, factor D, and alternative pathway functional levels. Neutrophil counts showed significant negative relationships only with the alternative pathway and C1-inh. In the case of lymphocytes, associations were found, especially with functional tests of the classical and alternative pathways, as well as with C2, C4, C3, and C3a. On the contrary, for platelets, significance was only observed, after multivariable adjustment, with lower C2 concentrations. In conclusion, the serum complement system and hematological profile in SLE are independently linked, after adjustment for disease activity and damage. These relationships are basically negative and are predominantly found in lymphocytes.

Cold agglutinin syndrome secondary to Mycoplasma pneumoniae

A 47-year-old female presented with dyspnea, dry cough, and fatigue for ten days. On examination, she had severe pallor and bilateral crepts in the lungs. Complete blood count (CBC) showed a hemoglobin of 7.3 g/dL, reticulocyte count of 5.6%, and chest X-ray was normal. Her extended Direct Coombs test (DCT) showed C3d +3 and cold agglutinin titer of 1:256 at 4°C. A comprehensive respiratory panel showed positivity for Mycoplasma pneumonia. Thus, a diagnosis of cold agglutinin syndrome secondary to M. pneumonia was made, and she was started on injection doxycycline 100 mg IV twice a day, following which her symptoms and anemia improved without transfusion support.

Inflammation-based scores in patients with pheochromocytoma.

Pheochromocytoma is associated with systemic inflammation, but the underlying mechanisms are unclear. Therefore, we investigated the relationship between plasma metanephrine levels and haematological parameters - as a surrogate of inflammation - in patients with pheochromocytoma and the influence of preoperative α-blockade treatment. We retrospectively studied 68 patients with pheochromocytoma who underwent adrenalectomy (median age 53 years, 64.7% females) and two control groups matched for age, sex, and body mass index (BMI): 68 patients with non-functioning adrenocortical tumors (NFAT) and 53 with essential hypertension (EAH). The complete blood count (CBC) and several inflammation-based scores [Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Lymphocyte-to-Monocyte Ratio (LMR), Systemic-Immune-Inflammation Index (SII), Prognostic-Nutrition Index (PNI)] were assessed in all patients and, in a subset of pheochromocytomas, after adrenalectomy (n=26) and before and after preoperative α-blockade treatment (n=29). A higher inflammatory state, as indicated by both CBC and inflammation-based scores, was observed in patients with pheochromocytoma compared to NFAT and EAH. Plasma metanephrine levels showed a positive correlation with NLR (r=0.4631), PLR (r=0.3174), SII (r=0.3709), and a negative correlation with LMR (r=0.4368) and PNI (r=0.3741), even after adjustment for age, sex, ethnicity, BMI and tumor size (except for PLR). After adrenalectomy, we observed a reduction in NLR (p=0.001), PLR (p=0.003), SII (p=0.004) and a concomitant increase in LMR (p=0.0002). Similarly, α-blockade treatment led to a reduction in NLR (p=0.007) and SII (p=0.03). Inflammation-based scores in patients with pheochromocytoma showed pro-inflammatory changes that correlated with plasma metanephrine levels and are ameliorated by adrenalectomy and α-blockade.

Blood parameters in pediatric myelin oligodendrocyte glycoprotein antibody-associated disorders

Background and objectivesPatients with myelin oligodendrocyte glycoprotein antibody-associated disorders (MOGAD) clinically present e.g. with acute disseminated encephalomyelitis (ADEM), optic neuritis (ON), transverse myelitis (TM) or aquaporin-4-IgG (AQP4-IgG) negative neuromyelitis optica spectrum disorders (NMOSD)-like phenotypes. We aimed to analyze and compare blood parameters in children with MOGAD, AQP4-IgG-positive NMOSD (hence NMOSD), multiple sclerosis (MS) and healthy controls (HC). MethodsWe evaluated differences in complete blood counts (CBC), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR) and C-reactive protein (CRP) between these four groups and within the groups between clinical attack, acute treatment and remission. ResultsOur cohort consisted of 174 children and adolescents with a total of 550 timepoints: 66 patients had MOGAD (202 timepoints), 11 NMOSD (76 timepoints), 58 MS (219 timepoints) and 39 were HC (53 timepoints). At clinical attack, leukocyte counts were elevated in MOGAD compared to remission (p < 0.001) and compared to all other groups (p < 0.001). NLR was high in MOGAD and NMOSD, and PLR was high in NMOSD, however, after correction for multiple testing these findings did not remain significant. While glucocorticoids caused an increase of leukocyte counts and NLR in NMOSD and MS, these values remained stable during acute treatment in MOGAD. In remission, NLR normalized in MOGAD, while it stayed high in NMOSD. PLR increased in NMOSD and was significantly higher compared to all other groups. DiscussionSome blood parameters, mainly leukocyte and differential counts, might help clinicians to evaluate disease activity, differentiate relapses from pseudo-relapses and even distinguish between different disease entities.

An Introduction to the Complete Blood Count for Clinical Chemists: Red Blood Cells.

The most frequently ordered laboratory test worldwide is the complete blood count (CBC). In this primer, the red blood cell test components of the CBC are introduced, followed by a discussion of the laboratory evaluation of anemia and polycythemia. As clinical chemists are increasingly tasked to direct laboratories outside of the traditional clinical chemistry sections such as hematology, expertise must be developed. This review article is a dedication to that effort.

Evaluation of Epidemiological Risk Features and Hematological Parameters in the Lymphoma Patients in the Larkana Region

Background: Hodgkin lymphoma (HL) is a type of lymphatic cancer that is distinctly characterized and classified into various subtypes, with varying prognoses based on the stage at diagnosis and treatment modalities. Despite advances in treatment, the specific demographic and clinical factors influencing treatment outcomes and the incidence of side effects, such as chemotherapy-induced anemia and neutropenia, remain under-explored, particularly in diverse regional settings. Objective: This study aims to evaluate the epidemiological risk features and hematological parameters of lymphoma patients in the Larkana region, with a focus on the impact of chemotherapy on these parameters. Methods: A case-control study was conducted over twelve months at Linar Hospital in Larkana, involving 40 participants aged between 10 and 70 years. Informed consent was obtained, aligning with ethical standards akin to the Declaration of Helsinki. Two types of blood samples were collected pre- and post-chemotherapy for hematological analysis including total leukocyte count, hemoglobin, and platelet levels, which were assessed using Complete Blood Count (CBC) containers with EDTA. Statistical analysis was performed using Microsoft Excel 2010 and SPSS Version 23, utilizing descriptive statistics and the Student's t-test. Results: The study documented a decrease in mean hemoglobin levels from 11.42 ± 1.74 g/dL before chemotherapy to 10.65 ± 1.55 g/dL after (p = 0.001), mean white blood cell count from 7.30 ± 2.6 × 10^3/uL to 5.71 ± 2.1 × 10^3/uL (p = 0.003), and platelet count from 297.52 ± 116.2 × 10^3/uL to 230.2 ± 72.6 × 10^3/uL (p = 0.001). These findings indicate a significant hematological impact associated with chemotherapy. Conclusion: The significant reduction in critical hematological parameters among lymphoma patients’ post-chemotherapy highlights the need for rigorous monitoring and tailored management strategies to mitigate treatment side effects. The findings emphasize the importance of comprehensive patient care and support in improving treatment outcomes in lymphoma.

Association between blood inflammatory indices and heart failure: a cross-sectional study of NHANES 2009-2018

Background Inflammation plays a pivotal role in the pathogenesis of heart failure (HF). This study was aimed to the potential association between complete blood cell count (CBC)-derived inflammatory biomarkers and HF. Methods Data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018 were utilised. We evaluated the associations between HF and five systemic inflammation markers derived from CBC: systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR). Demographic characteristics, physical examinations, and laboratory data were systematically collected for comparative analysis between HF and non-HF individuals. Fitted smoothing curves and threshold effect analysis delineated the relationship. In addition, Spearman correlation and subgroup analyses were further conducted. Results A total of 26,021 participants were categorised into HF (n = 858) and non-HF (n = 25,163) groups. After adjusting for confounding variables, SIRI, NLR, and MLR had significant positive correlations with the risk of HF. Participants in the highest quarter groups of SIRI, NLR, and MLR showed a increased risk of developing HF compared to those in the lowest quarter group. Furthermore, subgroup and sensitivity analyses indicated that SIRI, NLR, and MLR had a stronger correlation to HF (all p < 0.05). Smoothing curve fitting highlighted a nonlinear relationship between CBC-derived inflammatory biomarkers and HF. Conclusions Our results illustrated a significant association between elevated levels of SIRI, NLR, and MLR and an increased risk of HF. SIRI, NLR, and MLR could potentially serve as systemic inflammation hazard markers for HF.

Predicting community acquired bloodstream infection in infants using full blood count parameters and C-reactive protein; a machine learning study

Early recognition of bloodstream infection (BSI) in infants can be difficult, as symptoms may be non-specific, and culture can take up to 48 h. As a result, many infants receive unneeded antibiotic treatment while awaiting the culture results. In this study, we aimed to develop a model that can reliably identify infants who do not have positive blood cultures (and, by extension, BSI) based on the full blood count (FBC) and C-reactive protein (CRP) values. Several models (i.e. multivariable logistic regression, linear discriminant analysis, K nearest neighbors, support vector machine, random forest model and decision tree) were trained using FBC and CRP values of 2693 infants aged 7 to 60 days with suspected BSI between 2005 and 2022 in a tertiary paediatric hospital in Dublin, Ireland. All models tested showed similar sensitivities (range 47% – 62%) and specificities (range 85%-95%). A trained decision tree and random forest model were applied to the full dataset and to a dataset containing infants with suspected BSI in 2023 and showed good segregation of a low-risk and high-risk group. Negative predictive values for these two models were high for the full dataset (> 99%) and for the 2023 dataset (> 97%), while positive predictive values were low in both dataset (4%–20%). Conclusion: We identified several models that can predict positive blood cultures in infants with suspected BSI aged 7 to 60 days. Application of these models could prevent administration of antimicrobial treatment and burdensome diagnostics in infants who do not need them.What is Known:• Bloodstream infection (BSI) in infants cause non-specific symptoms and may be difficult to diagnose.• Results of blood cultures can take up to 48 hours.What is New:• Machine learning models can contribute to clinical decision making on BSI in infants while blood culture results are not yet known.

Pradofloxacin for Treatment of Bartonella henselae in Experimentally Inoculated Cats.

Bartonella henselae is associated with numerous clinical syndromes in people. Cats are the definitive hosts for B. henselae, develop high levels of bacteremia, and are associated with human infections, particularly in the presence of Ctenocephalides felis. Several antibiotic protocols used for the treatment of B. henselae infection in cats have failed to clear bacteremia. The purpose of this study was to assess the safety and efficacy of a high-dose pradofloxacin protocol to eliminate B. henselae bacteremia. Bartonella henselae infection was initiated in 8 cats by intravenous inoculation of infected feline blood and then pradofloxacin was administered at 7.5 mg/kg, PO, twice daily for 28 days, starting 12 weeks after inoculation. Complete blood cell counts were performed prior to pradofloxacin administration and then every 2 weeks for 10 weeks. Bartonella PCR assay was performed prior to pradofloxacin administration and approximately every 2 weeks for 10 weeks and then weekly for 4 weeks. Methylprednisolone acetate (5 mg/kg) was administered by intramuscular injection to all cats on week 10. The cats remained normal and none developed a hematocrit, platelet count, lymphocyte count, or neutrophil count outside of the normal reference ranges. In the one month prior to pradofloxacin administration, all cats were PCR-positive for Bartonella DNA on at least two of four sample dates; after pradofloxacin administration, all cats were negative for B. henselae DNA in blood on all nine sample dates. The protocol appears to be safe and failure to amplify B. henselae DNA from the blood after the administration of pradofloxacin and one dose of methylprednisolone acetate suggests either an antibiotic effect or the organism was cleared spontaneously.

Diagnostic Significance of Hematological Parameters and C- Reactive Protein in Dengue Viral Infection: A Retrospective Cross-Sectional Study

Background: Dengue fever continues to pose significant challenges in public health, particularly within developing countries where it remains endemic. The ability to distinguish dengue infection from other febrile illnesses and assess its severity is crucial. The analysis of hematological parameters and inflammatory biomarkers, particularly C-reactive protein (CRP), offers valuable insights into the disease's progression. Objective: This study aimed to delineate the severity of dengue fever through detailed evaluation of complete blood count (CBC) and CRP levels, and to establish a correlation between these markers and the clinical severity of the infection. Methods: In this retrospective cross-sectional study, 135 suspected dengue fever patients from the City University of Science and Information Technology Peshawar were screened using the immune-chromatographic technique (ICT). Among them, 50 individuals (37%) tested positive for dengue. Both CBC and CRP levels were measured, with data analyzed using the statistical package SPSS version 22.0. The study spanned demographic data collection, gender and age distribution assessment, and detailed analysis of hematological parameters alongside CRP to predict disease severity. Results: Among the confirmed cases, the gender ratio skewed towards males (60%) compared to females (40%), with the most affected age group being 15-25 years (34%). Leukopenia was identified in 58% of patients with a mean WBC count of 2.62 × 10^9/L, neutrophilia in 66% with a mean neutrophil percentage of 80.15%, and lymphopenia in 56% with a mean lymphocyte percentage of 10.28%. Thrombocytopenia was observed in 76% of the cases. Elevated CRP levels were found in 88% of patients, with a mean CRP value of 23.10, indicating a strong predictive correlation with disease severity (p-value= 0.001). Conclusion: The study reaffirms the role of CBC and CRP levels in the clinical assessment of dengue fever, with both markers being indicative of infection severity. These findings can aid in the early detection and management of dengue fever, potentially guiding decisions regarding the necessity of hospitalization.

Domestic dogs maintain clinical, nutritional, and hematological health outcomes when fed a commercial plant-based diet for a year.

Domestic dogs can maintain health on complete and well-balanced canine plant-based nutrition (K9PBN). Novel insight on health outcomes in dogs consuming K9PBN is of relevance to veterinary professionals and consumers given a growing interest in non-traditional dog foods with perceived health benefits, while considering potential safety concerns. We aimed to investigate nutritional equivalence by measuring clinical health outcomes in adult dogs fed K9PBN over twelve months compared to a meat-based diet at baseline. We enrolled fifteen clinically healthy adult dogs living in households in Los Angeles County, California in a prospective cohort study and evaluated clinical, hematological, and nutritional parameters in dogs at 0, 6, and 12 months, including complete blood count (CBC), blood chemistry, cardiac biomarkers, plasma amino acids, and serum vitamin concentrations. The study found that clinically healthy, client-owned, adult dogs maintain health, based on physical exams, complete blood count, serum chemistry, plasma amino acids, serum vitamins, and cardiac biomarkers combined with client-reported observations, when fed commercial K9PBN over a twelve-month period. This study is the most comprehensive and longest known K9PBN investigation to date and provides clinically relevant evidence-based nutrition data and new knowledge on outcomes in clinically healthy dogs who thrive without consumption of animal-derived ingredients. These results also provide a valuable foundation for the future study of K9PBN as a potential nutritional intervention for clinically relevant pathologies in canine medicine. Lastly, it is of major relevance to One Health paradigms since ingredients produced independent of industrial food animal production are both more sustainable and help to circumvent ethical dilemmas for maintenance of health in domestic dogs.

The Significance of TNF-α, CRP, and Hematological Parameters in the Prediction of Plasmodium Falciparum Parasitemia

Malaria remains a significant public health concern in Sudan, with Plasmodium falciparum (P. falciparum) infection having widespread indirect consequences. Effective identification of infection severity is crucial for preventing complications. This study aimed to assess the predictive value of Tumor Necrosis Factor Alpha (TNF-α), C-reactive protein (CRP), and hematological parameters in P. falciparum parasitemia. The three-month cross-sectional study involved 54 P. falciparum-positive patients at Bashaire Teaching Hospital Khartoum, Sudan, along with an equal number of P. falciparum-negative individuals. Participants underwent Antigen Rapid Diagnostic Test (RDT), TNFα, CRP, and Complete Blood Count (CBC) assessments. The infected group comprised 68.5% male patients, with a mean age of 22.3 years. Significant variations were observed between the infected and uninfected groups in TNFα, CRP, Total White Blood Cells (TWBCs), and neutrophil levels, with infected individuals showing higher values. Conversely, infected individuals had lower hemoglobin, Red Blood Cells (RBCs), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), platelets, and lymphocytes. The study revealed a noteworthy association between MCV and parasitemia, while TNFα, CRP, Hb, RBCs, MCH, and MCHC showed no significant correlation. Hematological parameters should be considered in malaria patients.

Decoding Immuno-Competence: A Novel Analysis of Complete Blood Cell Count Data in COVID-19 Outcomes.

While 'immuno-competence' is a well-known term, it lacks an operational definition. To address this omission, this study explored whether the temporal and structured data of the complete blood cell count (CBC) can rapidly estimate immuno-competence. To this end, one or more ratios that included data on all monocytes, lymphocytes and neutrophils were investigated. Longitudinal CBC data collected from 101 COVID-19 patients (291 observations) were analyzed. Dynamics were estimated with several approaches, which included non-structured (the classic CBC format) and structured data. Structured data were assessed as complex ratios that capture multicellular interactions among leukocytes. In comparing survivors with non-survivors, the hypothesis that immuno-competence may exhibit feedback-like (oscillatory or cyclic) responses was tested. While non-structured data did not distinguish survivors from non-survivors, structured data revealed immunological and statistical differences between outcomes: while survivors exhibited oscillatory data patterns, non-survivors did not. In survivors, many variables (including IL-6, hemoglobin and several complex indicators) showed values above or below the levels observed on day 1 of the hospitalization period, displaying L-shaped data distributions (positive kurtosis). In contrast, non-survivors did not exhibit kurtosis. Three immunologically defined data subsets included only survivors. Because information was based on visual patterns generated in real time, this method can, potentially, provide information rapidly. The hypothesis that immuno-competence expresses feedback-like loops when immunological data are structured was not rejected. This function seemed to be impaired in immuno-suppressed individuals. While this method rapidly informs, it is only a guide that, to be confirmed, requires additional tests. Despite this limitation, the fact that three protective (survival-associated) immunological data subsets were observed since day 1 supports many clinical decisions, including the early and personalized prognosis and identification of targets that immunomodulatory therapies could pursue. Because it extracts more information from the same data, structured data may replace the century-old format of the CBC.

Clinical and diagnostic utility of platelet count and its parameters in COVID-19

The majority of the published studies have described the alterations in platelet count and platelet indices in both severe and non-severe Coronavirus Disease 2019 (COVID-19). However, their association with COVID-19 mortality remains unclear. In the present study, our aim is to determine the temporal evolution of platelet count and its parameters between survivors and non-survivors, as well as their potential association with clinical outcomes. This cross-sectional study included 1118 inpatients (≥18 years old) diagnosed as SARS-CoV-2 positive by a Real-Time Polymerase Chain Reaction (RT-PCR) and hospitalized between May 1st, 2020 and November 1st, 2020. Data of complete blood count (CBC) parameters evaluated on different days after admission was gathered and the median value of each CBC parameter was considered for assessing the difference between survivors and non-survivors. There was statistically significant variation between survivors and non-survivors for platelet count [p&lt;0.001, mean difference-80 x 109/L], mean platelet volume [p&lt;0.001, mean difference- 0.7 fL], platelet distribution width [p&lt;0.001, mean difference-2.5%] and platelet-lymphocyte ratio [p&lt;0.001, mean difference-123.8]. Thrombocytopenia occurred more commonly in deceased patients compared to survivors. Platelet count, Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) differed significantly between survivors and non-survivors, revealing distinct trends indicating their importance in the management of COVID-19 patients. These cost-effective parameters can be easily obtained from a CBC.

The dilution evaluation as a corrective measure for interference in the white blood cell scattergram in Beckman Coulter DxH 900.

The Beckman Coulter DxH 900 is a haematological analyser capable of counting and sizing blood cells, and obtaining a complete blood cell count (CBC). This analyses different parameters of red blood cells (RBC), platelets and white blood cells/leukocytes. Some automated CBC counters present limitations due to specimen characteristics, abnormal cells or both factors. In the presence of abnormalities, the DxH 900 has a flagging system, warning the laboratory technician that something needs to be verified. In the present work, we evaluated samples from oncologic patients, presenting a population erroneously perceived as being lymphocytes. The most common explanations for this situation are RBC resistant to lysis or serum hyperbilirubinaemia. In an attempt to solve and understand what the cause of this problem might be, we diluted our samples (1:3) and analysed the serum total bilirubin. To identify cells' abnormalities, the samples were also analysed by manual DLC counts. During the study, we also checked the different flags presented by the equipment. The results evidenced that the major interference was due to RBC lysis resistance, corresponding to 94.7% of the cases, while hyperbilirubinaemia was only present in 73.4%. Besides, we determined that some samples with normal bilirubin levels also presented interference, suggesting that hyperbilirubinaemia was not the main cause of the error. The most recurrent flag observed was "High event rate". The dilution solved all of the observed interferences. The results between diluted and manual counts showed a strong correlation, leading us to introduce dilution in our laboratory routine.

Bischofia javanica and Phaleria macrocarpa nano herbal combination on blood and liver-kidney biochemistry in Oral Squamous Cell Carcinoma-induced rats

This research explores a contemporary approach to managing Oral Squamous Cell Carcinoma (OSCC) by integrating nano-technology into herbal production, combining Bischofia javanica leaves and Phaleria macrocarpa fruits. Benzo[a]pyrene (BaP)-induced OSCC rats were treated with nano herbals from Bischofia javanica leaves, Phaleria macrocarpa fruits, a combination of both, and Vitamin C as a control. Blood and organ analyses were compared with negative and positive controls. BaP induction in OSCC revealed cell transformation into carcinoma, confirmed by Papanicolaou staining. OSCC induction also caused significant changes in Complete Blood Count (CBC) and serum lipid profile. Nano herbals from both plants showed potential in reducing hematological and lipid damage in OSCC, especially in white blood cells, red blood cells, hemoglobin, and platelets. Statistical analysis also indicated that the combination of nano herbals was more effective in reducing (Low-Density Lipoprotein) LDL and total cholesterol levels than uncombined use while increasing (High-Density Lipoprotein) HDL levels comparable to Vitamin C. Liver and kidney functions were also significantly affected by OSCC, with nano herbals showing potential in normalizing albumin levels and positively impacting liver enzymes. In conclusion, both individually and in combination, nano herbals from Bischofia javanica leaves, and Phaleria macrocarpa fruits have the potential to be a promising treatment strategy for OSCC.

Blood Whispers: Exploring Hematologic Indicators for Diagnosing and Predicting Severity of Vogt-Koyanagi-Harada Syndrome

ABSTRACT Purpose To investigate the association of clinical findings and indocyanine green angiography (ICGA) score with inflammatory markers derived from complete blood count (CBC) parameters in patients with Vogt-Koyanagi-Harada (VKH) to determine the diagnostic and predictive role. Methods Demographic characteristics, presenting complaints, ocular findings, optical coherence tomography findings, ICGA scores and best corrected visual acuity were recorded in treatment-naive VKH patients at presentation. Patients were divided into two groups as acute stage and chronic recurrent stage. CBC parameters were noted in patients at presentation and healthy controls (HC, n = 25). Neutrophil-lymphocyte-platelet-monocyte counts, neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR), monocyte/lymphocyte and systemic immune-inflammation index (SII) were recorded. The association between these markers and clinical severity were evaluated. Results Thirty-two patients with VKH (23 females/9 males) with a mean age of 34.1 ± 14.6 years were included in the study. There was an increase in neutrophil count, NLR and SII in patients with VKH compared to HC (p < 0.001). The cut-off values for these three parameters were 4.37, 2.24 and 562.35, respectively. Twenty-six patients presented in the acute stage and six patients presented in the chronic recurrent stage. Choroidal thickness, early stromal hyperfluorescence and total ICGA scores were higher in patients presenting in the acute stage (p < 0.001, 0.001 and 0.025, respectively). Patients with higher disease severity at presentation were treated earlier. Early stromal vessel hyperfluorescence and choroidal vasculitis scores were correlated with decreased lymphocyte count, increased NLR, PLR and SII (p < 0.05). Conclusion CBC-derived inflammatory parameters indicate that VKH is a systemic inflammation. These parameters can be used in the diagnosis and determination of disease severity of VKH.

Hematological indices in psoriatic enthesopathy: relation to clinical and ultrasound evaluation

BackgroundEnthesopathy is considered a crucial aspect of assessment and outcome in psoriatic arthritis (PsA). Musculoskeletal ultrasound (MSUS) is a critical tool for accurately detecting enthesitis. Recent research focuses on identifying simple biomarkers for detecting and monitoring psoriatic enthesopathy. Red cell distribution width (RDW), mean platelet volume (MPV), and neutrophil/lymphocyte ratio (NLR) are components of a complete blood count (CBC) and are reliable bio-inflammatory markers in various rheumatic diseases.Aim of workTo measure MPV, RDW, and NLR in psoriatic enthesopathy and determine their relationship to disease activity and MSUS findings.Patients and methodsThis study focused on 30 people with psoriatic arthritis (PsA) as per CASPAR criteria, along with 20 control subjects. Enthesopathy was evaluated clinically using the Leeds Enthesitis Index (LEI). The modified Disease Activity Index of Psoriatic Arthritis (DAPSA28) was calculated, and RDW, MPV, NLR, CRP, and ESR were measured. Each enthesis in LEI was radiologically assessed using plain radiography and MSUS according to OMERACT definitions.ResultsThere was a significant relationship between clinical tenderness, the presence of enthesophytes on plain radiography, and MSUS findings at entheses sites (p < 0.001 for each). Psoriatic patients had higher levels of RDW and MPV (p < 0.001 and 0.01, respectively) than controls, with no significant differences in NLR (p = 0.189) between the two groups. RDW and MPV levels were positively correlated with the DAPSA28 score.ConclusionMonitoring PsA disease activity can be improved by considering RDW and MPV as reliable indicators and using them to screen for psoriatic enthesopathy with MSUS indices.Key points• Clinically identifying enthesitis in patients with PsA can be challenging. Imaging MSUS indices hold promise for objective analysis, but there is no consensus on which indices to use in clinical trials and daily practice.• Patients with psoriatic enthesopathy have higher RDW and MPV levels, which are positively correlated with DAPSA28 score.• RDW and MPV can be considered in the turn of improved screening of psoriatic enthesopathy with MSUS scores.

Trifolium Pratense Improves Cyclophosphamide-Induced Thrombocytopenia and Leukopenia in a Rat Model of Chemotherapy

Background: Due to the toxicity of chemotherapy drugs in cancer patients, thrombocytopenia can lead to bleeding. Trifolium pratense L. is traditionally used as an anti-inflammatory compound for the treatment of various diseases. The aim of the present study was to evaluate the effect of T. pratense (red clover) extract (TPE) on thrombocytopenia and the related factors in a rat model of chemotherapy.&#x0D; Materials and Methods: In this experimental in vivo study, 28 rats were randomly divided into four groups of seven members (four males and three females) including Group1 as the control subjects, Group2 as thrombocytopenia cases, and Groups 3 and 4 with thrombocytopenic animals receiving TPE (100 and 200 mg/kg). Thrombocytopenia was induced by intraperitoneal injection of cyclophosphamide (CP) on three consecutive days. Then, the TPE was fed to rats for 14 days. At the end of the study, the rats' weight was measured. Blood samples were collected, complete blood count (CBC) was performed, and PF4 and clotting time were measured. After the dissection of the animals, the bone marrow and spleen were separated, and hisopathological changes were determined. The data were analyzed by one-way ANOVA and a post-hoc Tukey test.&#x0D; Results: Cyclophosphamide decreased the platelets and the white blood cells (WBCs) and increased PF4 and the clotting time significantly (P &lt; 0.05). Also, TPE significantly increased the platelets and the WBC counts but decreased the time of clotting and the PF4 factor (P &lt; 0.05). TPE increased megakaryocyte (P &lt; 0.001) and enhanced the bone marrow and spleen cellularity.&#x0D; Conclusion: T. pratense can increase the number of platelets and WBCs and improve thrombocytopenia and bone marrow cellularity induced by chemotherapy.