Blood Hemoglobin Levels Research Articles

Effect of nanoformulated cypermethrin, a parasiticide in Labeo rohita fingerlings: impact on biochemical, haematological, and stress response.

Cypermethrin is a pyrethroid insecticide used in aquaculture farms against ectoparasites. The conventional pesticide formulations are now being found to be greatly ineffective at low dosages, and their indiscriminate usage may cause undesired effects in ecosystems. So, the current study was designed to develop a nanoformulation of cypermethrin that would have many advantages over conventional pesticide formulations, and the toxic effects of this formulation were then tested on the carp Labeo rohita fingerlings. The 96-h LC50 was estimated at 0.018mg L-1 after the acute toxicity study. Chronic toxicity studies were carried out, exposing the fish to two sublethal doses via 1/10th (C1) and 1/50th (C2) of 96-h LC50 for a period of 45days. The nanoformulation exposure caused a significant reduction in the brain AChE enzyme activity. Catalase and glutathione-s-transferase enzyme activity in the gills and liver increased significantly, as did superoxide dismutase enzyme activity in the kidney. Serum total protein, triglycerides, cholesterol, and some serum enzyme activities decreased. In contrast, white blood cells, red blood cells, haemoglobin, and hematocrit levels decreased only in fish exposed to a higher dose. As baseline information, these findings may aid in understanding the toxic effect of nanoformulated cypermethrin on finfish.

Evaluation of Ethanolic Extract of Red Seaweed (Gracilariopsis lemaneiformis) on Growth and Haematological Parameters of Nile Tilapia (Oreochromis niloticus)

ABSTRACTSeaweed is multicellular marine macroalgae that enhances the immunity of aquatic organisms. The study was designed to assess the ethanolic extract (EtOH) extracted from red seaweed (Gracilariopsis lemaneiformis) on Nile tilapia (Oreochromis niloticus) to evaluate growth, immunity and haematological parameters. The EtOH was applied with fish feed in four treatments such as T1‐control (0% EtOH), T2 (5% w/v EtOH), T3 (10% w/v EtOH) and T4 (15% w/v EtOH) each with three replicates. The initial average weight of the fish was 17.53 ± 2.1 g. Results showed that the growth increased gradually with the percentage of red seaweed extract, whereas the mean weight gain was found significantly higher in T4 (51.5 ± 4.2) than in the control. The specific growth rate (%) and survival rate (%) were found higher in T4 at the lowest FCR compared to other treatments (p < 0.05). The blood haemoglobin level of Nile tilapia was higher in T4 (11.5 g/dL) and lowest recorded in T1 (7.5 g/dL). However, the level of blood glucose interacted inversely with blood haemoglobin. The plasma protein level was also varied among the treatments (p > 0.05). The blood parameters, refractive index (RI) and spleen somatic index (SSI) were significantly different among the treatments. The RI of blood plasma and SSI were found to be better in T4 treatment. The research indicated that red seaweed extracts significantly enhanced the growth and boosted the immunity level of Nile tilapia.

Biosynthesis of gold nanoparticles and its impacts on striped dwarf catfish (Mystus vittatus) as feed additives

The study evaluated the impacts of gold nanoparticles (AuNPs) on striped dwarf catfish’s (Mystus vittatus) growth, survival, and hematological parameters. Gold nanoparticles were synthesized using lemon (Citrus limon) extract, and four experimental diets incorporating 0, 10, 30, and 50 mg of AuNPs per Kg of fish feed were prepared as treatments T0 (control), T1, T2, and T3, respectively. Forty-five days old (0.7±0.00 g) 60 fingerlings were stocked in each glass aquarium and the diets were administered daily for 75 days. The treatment T2 resulted in a significant (P<0.05) increase in growth performances, feed conversion ratio, protein efficiency ratio, and survival rate. Besides, significant (P<0.05) differences were found in hematological parameters such as red blood cell count, hemoglobin level, and white blood cell count in the T2 treatment. However, a significant decrease in the white blood cell counts was observed in T3 treatment. Improved histological condition of hepatocytes was noticed in all treatments compared to the control. Hence, the results from this study suggest that the incorporation of 30 mg/Kg of biosynthesized AuNPs in the diet could be a promising strategy for enhancing the growth, survivability, and hematological parameters of M. vittatus.

Peptide Receptor Radionuclide Therapy and clinical associations with renal and hematological toxicities and survival in patients with neuroendocrine tumors: an analysis from two U.S. medical centers

PurposeRenal and hematological toxicity are side effects and dose-limiting factors of Peptide Receptor Radionuclide Therapy (PRRT). We aimed to assess the changes in renal and hematological function and associations with survival in neuroendocrine tumor (NET) patients treated with PRRT.MethodsA retrospective cohort of 448 NET patients treated with either 177Lu-DOTATATE or 90Y-DOTATOC were followed for changes of renal and hematological function. Renal function was assessed by monitoring changes in serum creatinine, blood urea nitrogen and estimated glomerular filtration rate. Hematological function was determined by examining changes in white blood cell counts (WBC), platelet counts, and hemoglobin levels over time. Piecewise linear mixed effect models were applied to model the longitudinal repeated measurements of renal and hematological function. Overall survival (OS) and progression-free survival (PFS) were modelled using Cox proportional hazard regressions.ResultsOf the 448 PRRT treated patients, 335 received 177Lu-DOTATATE (74.78%) and 113 were treated with 90Y-DOTATOC (25.22%). Comparing patients treated with 177Lu-DOTATATE to those treated with 90Y-DOTATOC, renal function did not differ significantly prior to, during or after PRRT. Compared with patients treated with 90Y-DOTATOC, significantly decreased indicators of hematological function were observed in those treated with 177Lu-DOTATATE prior to and during PRRT treatment (WBC: estimate, -0.10, 95% CI, -0.15 to -0.05; P < 0.001; platelet count: estimate, -2.53, 95% CI, -3.83 to -1.24; P < 0.001), and no significant recovery was observed in hematological function post PRRT. Individuals who received 177Lu-DOTATATE tended to have a longer PFS (hazard ratio, 0.47, 95%CI: 0.28–0.79, P = 0.004) compared with 90Y-DOTATOC, but there was no difference in OS.ConclusionThere was no significant renal, but minor hematological toxicity, in patients treated with 177Lu-DOTATATE compared with 90Y-DOTATOC. Compared to 90Y-DOTATOC, 177Lu-DOTATATE appears to enhance PFS, but not OS. Treatment with 177Lu-DOTATATE may necessitate follow-up for hematological toxicity irrespective of other therapies prior to PRRT.

Optimizing Anemia Detection Using Effective Computational Techniques

Worldwide, anemia is the most common blood disease. The World Health Organization (WHO) defines anemia as the lack of red blood cells, which prevents the body from carrying enough oxygen to satisfy its requirements. Anemia is characterized by decreased erythrocyte mass, blood hemoglobin, and hemocrit levels. Early detection and accurate diagnosis are essential for effective management and therapy. The study's goal is to develop an algorithm for optimizing anemia detection utilizing an effective computational technique. The study proposed a brand-new Dynamic Gannet-tuned Light Gradient Boosting Machine (DG-LGBM) model for the detection of anemia in typical clinical practice settings. In this study, anemia data is collected from a publicly available dataset from Kaggle. The data was preprocessed using data cleaning and normalization for the obtained data. The study aims to improve the predicted accuracy and efficiency of anemia diagnosis by utilizing clinical and biochemical markers. The results demonstrate that, in comparison to traditional methods, the DG-LGBM model performed better in terms of anemia detection rates, highlighting the potential of computational tools to completely transform anemia screening practices. In a comparative analysis, the proposed model is validated using precision (92%), recall (91.71%) f1-score (93.07%), and accuracy (91.06%) values. In addition to advancing the area of medical diagnostics, this study highlights the significance of technology in enhancing healthcare outcomes for impacted communities.

The effect of a new coronavirus infection on hemogram parameters in the early convalescence period of patients with coronary heart disease

Laboratory data, especially a general blood test, play an important role in the treatment of infectious diseases, including COVID-19. However, in patients with coronary heart disease (CHD) and COVID-19, a general blood test is rarely analyzed and is insufficient to fully assess an impact of the new coronavirus infection on patients with cardiac diseases. The aim of the study was to analyze a COVID-19 effect on hemogram parameters in the early recovery period of patients with coronary heart disease. The study was performed at the Kursk City Clinical Hospital for Emergency Medical Care in the years 2021–2022, which involved 58 mature-aged patients (45–59 years old) suffering from coronary heart disease who had a new coronavirus infection and 62 elderly patients suffering from coronary heart disease alone. Morning blood sampling was carried out from the forearm superficial veins into Vacutainer test tubes added with a coagulation activator. In elderly patients, 3–4 weeks after recovery, significant changes in red blood parameters persisted — a decline in the level of peripheral blood erythrocytes, hemoglobin and hematocrit. Elderly patients with coronary heart disease comorbid with a moderate new coronavirus infection, 3–4 weeks later had also higher count of leukocytes, neutrophils, segmented neutrophils and ESR level relative to comparison group. It should be noted that in the early convalescence period elderly patients with coronary heart disease and COVID-19 had significantly elevated ESR, which confirms ongoing sustained inflammatory process. After evaluating the information content according to the calculated Kullback informativeness assessment for analyzed general blood test parameters, it was found to peak for platelet and leukocyte counts as well as ESR level. Thus, among the analyzed indicators in the general blood test, it turned out that platelet and leukocyte count along with ESR level were most informative and of prognostic significance during early convalescent period of elderly patients with coronary heart disease comorbid with a new coronavirus infection, which are proposed to be used as biomarkers of early convalescent period.

An ensemble machine learning framework with explainable artificial intelligence for predicting haemoglobin anaemia considering haematological markers

Anaemia is a disorder marked by low blood levels of haemoglobin (HGB), affecting people of all ages and ethnicities and is a major global public health concern. Anaemia must be diagnosed as soon as possible to enable prompt treatment and intervention, which can reduce complications and enhance patient outcomes. With the ability to improve diagnostic precision and expedite patient care procedures, machine learning (ML) has become a potent instrument in the healthcare industry. Hence, we examine the use of ML approaches to predict haemoglobin-like anaemia in this research article. Based on a heterogeneous dataset of blood markars, we investigate the performance of many machine learning techniques such as Logistic Regression, CatBoost, XgBoost Decision Trees, KNN and others. The algorithms are further ensembled using a customized stacking approach. The ML models' judgments are interpreted using explainable artificial intelligence (XAI) methods. The xgboost and the stacking classifier obtained an accuracy, precision and recall of 99% each. Our research shows how ML models can help with the early diagnosis and treatment of anaemia, which will ultimately lead to better patient outcomes and healthcare results. Overall, the research shows how ML emphasizes the value of interdisciplinary cooperation in solving challenging medical problems.

Clinical characteristics of megaloblastic anemia with pancytopenia

ABSTRACT Objectives In this study, we aimed to explore the clinical characteristics of patients with megaloblastic anemia and pancytopenia. Methods Data on patient characteristics, laboratory examinations, clinical manifestations, and associated diseases were collected from Changzhou Hospital of Traditional Chinese Medicine. The participants were divided into two groups according to routine blood test results: megaloblastic anemia patients with pancytopenia (Group A) and megaloblastic anemia patients with simple anemia (Group B). Results The number of patients with fever and bleeding in Group A was much higher than that in Group B. Inpatient days and hospitalization costs in Group A were higher than those in Group B. White blood cell count, red blood cell count, haemoglobin level, and platelet count in Group A were lower than those in Group B. There were no significant differences in mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), and serum levels of lactate dehydrogenase (LDH), total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), albumin (ALB), vitamin B12, folic acid, and ferritin between the two groups. The incidence of associated diseases, particularly pulmonary infections, was significantly higher in Group A than in Group B. There was no significant difference in the degree of bone marrow hyperplasia between the two groups. Conclusion Patients with pancytopenia and megaloblastic anemia often developed infection and bleeding, which caused more severe anemia, higher hospitalization costs, and longer inpatient days. Early diagnosis and active treatment are required to reduce patient complications and costs.

A study on the efficacy and safety of long-term adjusted low-dose gonadotropin-releasing hormone agonist therapy for uterine fibroids and adenomyosis.

To investigate the efficacy and safety of long-term adjusted low-dose gonadotropin-releasing hormone agonist therapy (GnRH agonist drawback therapy) with nafarelin acetate in patients with uterine fibroids and/or adenomyosis with menstrual symptoms. This single-center, retrospective, observational study initially included 118 patients with uterine fibroids and/or adenomyosis with menstrual symptoms who had received GnRH agonist (nafarelin acetate) drawback therapy for at least 7 months between 2010 and 2020. Blood hemoglobin level, maximum fibroid diameter, area of the corpus uteri, blood estradiol level, daily dosage of nafarelin acetate, and bone density in the lumbar spine and femoral neck were assessed before and after the treatment initiation. The median treatment period was 28 months. Menstruation had ceased in all patients. The median hemoglobin level significantly increased from 8.6 to 13.2 g/dL before treatment and at 12 months after the treatment initiation in patients with fibroids and from 8.8 to 13.3 g/dL in patients with adenomyosis, respectively. Although the treatment did not exert a significant shrinking effect on the fibroids and adenomyosis, an increase in their size was not observed in any patient. The initial dose of nafarelin acetate was 400 μg/day and was lowered to 130 μg/day at 12 months. Only 29 patients (25%) had an estradiol level <30 pg/mL. The average rate of bone density change over 6 months was -1.23% in the lumbar spine and -1.12% in the femoral neck in patients with fibroids and -1.06% in the lumbar spine and -0.14% in the femoral neck in patients with adenomyosis, which were lower than the previously reported rates. GnRH agonist drawback therapy was found to be useful for the long-term conservative treatment of uterine fibroids and adenomyosis. The treatment was safely and inexpensively performed with few adverse events.

The evaluation of complete blood count parameters in the patients with idiopathic versus secondary cerebral venous thrombosis

Background: Several laboratory markers derived from a complete blood count (CBC) have been proposed as potential indicators for assessing the risk of cerebral venous thrombosis (CVT). However, limited and conflicting evidence exists regarding this association. This study aimed to evaluate the role of CBC parameters in CVT development and their link to disease characteristics. Methods: This case-control study included patients diagnosed with CVT between March 2018 and and March 2021. All participants with CVT were registered in the organized registry system at the Neurology Research Center of Shiraz University of Medical Sciences, Shiraz, Iran (CVT registry code: 9001013381). The control group consisted of age- and sex-matched individuals without systemic diseases. CBC results from the control group and the first recorded hospital CBC of the patient group were collected. Results: The study included 295 patients with CVT [49 with idiopathic CVT (iCVT) and 246 with secondary CVT (sCVT)] and 341 healthy individuals. Among the CVT group, 72.54% were women. Patients with CVT had higher red cell distribution width (RDW) and lower red blood cell (RBC) count, hemoglobin (Hb) levels, and hematocrit compared to the non-CVT group. In iCVT cases, male gender, RBC count, Hb levels, and hematocrit were notably higher compared to sCVT cases. Logistic regression analysis showed that female gender, smoking, and higher hematocrit values were associated with increased probability of iCVT. Conclusion: The study suggests that certain CBC parameters may serve as potential markers for assessing CVT risk and differentiating between iCVT and sCVT cases. Validation and further research are needed to explore the underlying mechanisms.March 2021.

Sex differences in inflammatory parameters after shoulder arthroplasty and blood loss.

In many diseases, sex differences in diagnostics and therapy play role that is increasingly becoming recognized as important. C-reactive protein (CRP) and white blood cell (WBC) levels are determined as inflammatory markers to detect inflammation and even infection after total shoulder arthroplasty (TSA). The general course of white blood cell, CRP, and hemoglobin (Hb) levels after TSA is well known, but there is insufficient evidence of a possible association with sex. Therefore, we aimed to investigate whether there is an influence of sex on CRP, WBCs, and Hb after TSA in the first 10 days after surgery in a complication-free course in male and female patients and to re-evaluate the specific postoperative CRP, WBC, and Hb course with their maximums (minimum for Hb) and further course until the end of the inpatient period. We retrospectively studied patients treated with TSA, reverse shoulder arthroplasty (RSA), and prosthesis replacement between 2015 and 2021. Patients with active inflammation, rheumatoid arthritis, secondary osteoarthritis, active cancer, and documented postoperative complications were not included. CRP, WBC, and Hb levels before shoulder arthroplasty (SA) and up to 10 days after SA were recorded and analyzed for sex differences. Data from a total of 316 patients (209 women and 107 men) were finally analyzed. There were no sex differences in the CRP and WBC values, but women had significantly lower preoperative Hb values, postoperative Hb values, and minimum Hb values. There were no significant differences in Hb, CRP, or WBC levels in the prosthesis exchange group. The progression of CRP and WBC levels showed no sex-specific significant differences after TSA within the first 7 postoperative days. The study confirmed a decreased Hb value for women at all stages of SA. Blood loss was significantly higher for RSA than for TSA for both men and women.

Dietary administration of Bacillus amyloliquefaciens AV5 on antioxidant activity, blood parameters, and stress responses of Nile tilapia (Oreochromis niloticus) raised under hypoxia and temperature variability

The ability of Nile tilapia to tolerate hypoxia, as well as low and high temperatures, presents a significant economic concern, as it adversely affects their growth and leads to increased mortality rates. A 42-day feeding trial was conducted to evaluate the impact of adding Bacillus amyloliquefaciens AV5 to a fish meal on the physiological response of Nile tilapia. Three meals were administered to fish (23.4 ± 0.3g) in triplicates. The diets included GC (without B. amyloliquefaciens AV5), G1 (106 cfu/g), and G2 (108 cfu/g). After the treatment trial, we assessed the antioxidant parameters, hemato-immunological indices, and stress-related genes in O. niloticus. Subsequently, we subjected the fish to hypoxia for 20h and low and high temperatures for 3h each. The findings demonstrated a significant rise in white blood cells, red blood cells, haemoglobin, and hematocrit levels in the blood of fish that were fed a meal supplemented with B. amyloliquefaciens AV5, compared to the control group (GC) (P<0.05), the serum of all fish groups that were supplemented with B. amyloliquefaciens AV5 exhibited an increase in catalase, total antioxidant capacity and superoxide dismutase activity and a decrease in lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, pyruvate kinase, myeloperoxidase, glucose, cortisol (P < 0.05). In addition, all fish diet groups that received B. amyloliquefaciens AV5 as a supplement exhibited elevated levels of HIF-1α and HSP70 expression in their livers (P<0.05). Nile tilapia in the G2 diet, exhibited improved values in most evaluated indices under various stress settings (P<0.05). These data indicate that the G2 supplement may be used as a preventive measure to weaken the impacts of environmental stress on O. niloticus.

Glycated hemoglobin as a prognostic factor for the progression of non-proliferative diabetic retinopathy in type 2 diabetes

Background. A promising direction of modern medicine is to increase the accuracy of predicting the possible outcomes of the disease, its complications or relapses. Several factors are important for the progression of diabetic retinopathy (DR) in type 2 diabetes (T2D), among which glycated hemoglobin, duration of T2D and others are discussed. The purpose was to determine the possibilities of predicting the progression of initial non-proliferative diabetic retinopathy (NPDR) based on the blood glucose, glycated hemoglobin and cholesterol indicators. Materials and methods. Three hundred and fifty-eight patients (358 eyes) with T2D and DR were examined and divided into groups: the first one — with NPDR (189 eyes), the second one — with pre-proliferative DR (96 eyes) and the third one — with proliferative DR (73 eyes). Patients were examined for 2 years using ophthalmological methods; serum fasting glucose, glycated hemoglobin and total cholesterol were determined by colorimetric method. The analysis of the research results was carried out in the EZR v. 1.54 package (Austria). Results. There was no significant difference between the groups at baseline in terms of age and T2D duration; these indicators were not associated with the DR progression (p = 0.512 and p = 0.339, respectively) as well. The independent risk factors for the NPDR progression in the univariate analysis were the content of blood glucose (p = 0.002; odds ratio (OR) = 1.08; 95% confidence interval (CI) 1.03–1.13) and total cholesterol (p &lt; 0.001; OR = 2.02; 95% CI 1.53–2.6 %). Based on the glycated hemoglobin blood level, a logistic model of the NPDR progression was constructed. The area under the receiver operating characteristic curve was 0.84 (95% CI 0.80–0.88), which indicated a strong association with the NPDR progression. The threshold for predicting the glycated hemoglobin level was 8.9 % with a sensitivity of 75.6 % (95% CI 68.6–82 %) and a specificity of 79.9 % (95% CI 73.5–85.4 %). Conclusions. It was found that the content of glycated hemoglobin in the blood above 8.9 % is an independent factor for the NPDR progression, which allowed to build a prognostic model with a very good quality of prognosis.

Togetherness Reminded by the Earthquake: Relationship Between Stress and Peptic Ulcer Perforation

Background: Severe stress is one of the leading causes of peptic ulcer perforations. Peptic ulcer perfora-tion is a clinical condition that can be fatal if not treated urgently. This study aimed to investigate the effects of social stress caused by the earthquakes in Kahramanmaraş on peptic ulcer perforation. Materials and Methods: A retrospective evaluation was conducted on 66 peptic ulcer perforation cases operated on in three major centers in Şanlıurfa, considering two large earthquakes that occurred on February 6, 2023, and by comparing the 6-month periods before and after the earthquakes. Patients were assessed in terms of age, gender, diagnostic method, perforation site, surgical technique, operation time, length of hospital stay, and mortality. Our study also evaluated laboratory parameters such as white blood cell (WBC) count, hemoglobin, urea, creatinine, and albumin levels. Results: In the 6 months prior to the earthquakes, 21 patients underwent surgery for peptic ulcer perfo-ration, whereas 45 patients were operated on for the same reason in the 6 months following the earthquakes; there were two deaths in each group. The number of patients operated on after the earthquakes was significantly higher than the number of patients operated on before the earthquakes. Furthermore, the two groups were also compared in terms of demographic data and laboratory findings; no significant differences between the two groups were observed regarding these parameters. Conclusions: Stress plays a remarkable role in the development of peptic ulcer perforation. In stressful situations that affect the general population, such as earthquakes, it is essential to assess stress tenden-cies and dyspeptic complaints in patients presenting to the hospital. Patients with positive findings should undergo endoscopy if necessary, followed by appropriate gastric treatment.

A new herbal anesthetic agent for common carp (Cyprinus carpio) sedation and anesthesia: nutmeg (Myristica fragrans) essential oil.

In aquaculture, interest in natural essential oils is increasing alongside synthetic anesthetic agents. In this context, the anesthetic efficacy of nutmeg essential oil, which had not been previously tested, was investigated in common carp (Cyprinus carpio). The study, conducted using three different concentrations (800 μL/L "LC", 1,200 μL/L "MC", and 1,400 μL/L "HC"), found that induction times were <3 min for MC and HC, while LC had a longer induction time, exceeding acceptable levels. Within the first 4 h, white blood cells, red blood cells, hemoglobin, and hematocrit levels increased to >5 103/μL, >1 106/μL, >6 g/dL, and >12%, respectively. However, they returned to control levels after 8 h. Histological signs were more severe with higher concentrations, and necrosis was only observed in the HC group. Alkaline comet assay results showed DNA migration only in the HC group. According to the PROMETHEE multi-criteria decision-making model, the LC concentration is suitable for sedation, while the MC concentration should be used for deep anesthesia. The current study demonstrates that nutmeg essential oil can be used as an alternative to commercial synthetic anesthetic agents.

Investigating the protective effects of epigallocatechin-gallate against polystyrene microplastics-induced biochemical and hematological alterations in rats

BackgroundPolystyrene microplastics (PS-MPs) are widely used and found in drinking water and food, concerns have been raised about their potential health effects, especially in causing oxidative stress and inflammation in living organisms. ObjectivesThe aim of this study was to investigate the protective effects of epigallocatechin-gallate (EGCG), a natural antioxidant and anti-inflammatory compound, against PS-MPs-induced biochemical and hematological alterations in rats. MethodsMale Wistar rats were divided into four groups: control, EGCG-treated (80 mg∙ kg-1/d), PS-MPs-exposed (0.01 mg∙kg-1/d), and PS-MPs+EGCG-treated groups. PS-MPs were orally administered for 56 days, while EGCG was given concomitantly by gavage. At the end of the treatment period, blood samples were collected for hematological and biochemical analyses. Oxido-nitrergic stress markers, including malondialdehyde (MDA), nitric oxide (NO), reactive nitrogen species (RONS) and reduced glutathione (GSH), Superoxide dismutase (SOD), catalase (CAT), as well as inflammatory markers, such as tumor necrosis factor alpha (TNF-α), interferon gamma (IFY-γ) and interleukin-10 (IL-10), were also measured in serum. ResultsTreatment with PS-MPs caused a significant increase in MDA, RONS, NO levels and a decrease in SOD, CAT and GSH levels, indicating the induction of oxido-nitrergic stress. PS-MPs also caused an increase in the levels of TNF-α, IFY-γ, MPO and decreased IL-10, indicating the induction of inflammation. Additionally, PS-MPs caused alterations in hematological and serum transaminase parameters, including a decrease in red blood cell count, hemoglobin, and hematocrit levels, neutrophil and eaosinophil and an increase in white blood cell count, lymphocyte count, AST, ALT, ALP, LDH and GGT. PS-MPs also caused disturbances in electrolyte balance and renal function markers. However, treatment with EGCG significantly attenuated these alterations induced by PS-MPs, indicating its protective effects. ConclusionThe results of this study demonstrate that EGCG can protect against PS-MPs-induced biochemical and hematological alterations in rats, possibly through its antioxidant and anti-inflammatory properties.

AVERAGE LINKAGE CLUSTERING METHOD AND MOLECULAR DOCKING STUDY ON DATE PALM (PHOENIX DACTYLIFERA L.) AS POTENTIAL ANTI-ANEMIA AGENT

Anemia, characterized by blood hemoglobin (Hb) levels below the World Health Organization's (WHO) normal limit, remains a significant health concern. Date fruit (Phoenix dactylifera L.) stands out as an herbal plant boasting the highest iron content at 13.7 mg, suggesting its potential as an anti-anemia agent. This study aimed to explore the anti-anemia potential of active compounds in date fruit using average linkage clustering and validated using molecular docking. Compounds from dates were gathered via GC-MS analysis and online databases, totaling 145 compounds—50 from GC-MS and 95 from Knapsack and Dr. Duke databases. Additionally, 5 lead compounds served as positive controls for comparison. SwissADME online servers assessed the compounds' properties, serving as materials for the clustering method. The average linkage clustering method was employed, yielding an excellent dendrogram with a cophenetic correlation of 0.711. Notably, a total of 17 date fruit compounds are in the same cluster as the lead compounds. Molecular docking revealed 4 date palm fruit-derived compounds as potential PHD enzyme inhibitors, promising for anemia treatment. In conclusion, the average linkage clustering method and validation using molecular docking approaches highlight date fruit's potential as an alternative anemia treatment, showcasing the significance of interdisciplinary methodologies in drug discovery.

Effect of pharmacist interventions in chronic kidney disease: a meta-analysis.

Pharmacists are uniquely placed with their therapeutic knowledge to manage people with chronic kidney disease (CKD). Data is limited regarding the impact of pharmacist interventions on economic, clinical, and humanistic outcomes (ECHO). A systematic review and meta-analysis of randomized controlled trials (RCTs) of interventions with pharmacist input was conducted, which included adults with a diagnosis of CKD, including those with and without kidney replacement therapy. Data was extracted on ECHO: economic (e.g. healthcare-associated costs), clinical (e.g. mortality), and humanistic (e.g. patient satisfaction) outcomes. Where appropriate, a random-effects model meta-analysis generated a pooled estimate of effect. A direction of effect plot was used to summarize the overall effects for clinical outcome domains. 32 RCTs reported a total of 10 economic, 211 clinical, and 18 humanistic outcomes. Pharmacist interventions resulted in statistically significant improvements in systolic blood pressure and hemoglobin levels, but not in diastolic blood pressure, estimated glomerular filtration rate, creatinine, and low-density lipoprotein cholesterol levels. Mixed findings were reported for clinical and economic outcomes, whilst pharmacist interventions resulted in an improvement in humanistic outcomes such as patient satisfaction and patient knowledge. Findings showed pharmacist interventions had mixed results for various outcomes. Future studies should be more robustly designed and take into consideration the role of the pharmacist in prescribing and deprescribing, the findings of which will help inform research and clinical practice.

Effects of 60 degrees of flexion and perioperative use of tranexamic acid on recovery after knee replacement

Abstract OBJECTIVE To explore the effect of 60 knee flexion combined with multiple tranexamic acid application on postoperative recovery of knee replacement patients. METHODS Knee replacement patients admitted to our hospital from October 2020 to September 2022 were selected as the study subjects, and randomly divided into two groups. Postoperative D-dimer, prothrombin time and partial thrombin time were recorded in the two groups, and the differences between the two groups were compared. Erythrocyte, hemoglobin and erythrocyte volume were recorded before, 1 day and 3 days after surgery and the affected limb circumference were also assessed. RESULTS On the 1st and 3rd day after surgery, the red blood cells, hemoglobin, and hematocrit levels in the experimental group were higher than those in the control group, and the differences were statistically significant(P&amp;lt;0.05). The difference in VAS score and circumference between the two groups on the 1st day and 3rd day after surgery was compared, and the difference was statistically significant. The difference in VAS score and circumference was lower in the control group(P&amp;lt;0.05). After surgical treatment, knee joint function recovered, knee joint mobility and HSS score improved, and the difference between the experimental groups was statistically significant (P&amp;lt;0.05). CONCLUSION Perioperative 60-degree flexion combined with multiple tranexamic acids can significantly reduce blood loss in patients undergoing knee replacement surgery, increase red blood cells, hemoglobin levels and red blood cell volume on postoperative days 1 and 3, and reduce postoperative swelling of the affected limb.

Lysine (K)-specific methyltransferase 2A (KMT2A) rearrangements among Iraqi de novo acute myeloid leukemia

Abstract: BACKGROUND: The classification of acute myeloid leukemia (AML) has evolved extensively over the last 20 years significantly, impacting the diagnosis and prognosis of the patients. The lysine (K)-specific methyltransferase 2A (KMT2A) gene, which has more than 80 gene fusions, is present in approximately 10% of all leukemias. Most KMT2A rearrangements are associated with adverse prognosis and need heavy chemotherapy protocol upfront. OBJECTIVE: This study aims to study the prevalence of KMT2A gene fusion among Iraqi patients with AML and its association with clinical and hematological parameters and patients’ outcomes. PATIENTS, MATERIALS, AND METHODS: A prospective cohort study conducted between December 2020 and May 2022 enrolled 115 Iraqi adults newly diagnosed with AML at the Hematology Unit of Baghdad Teaching Hospital. The patients were also monitored at this facility during the study period. Genetic rearrangements were detected using the Leukemia Q-Fusion Screening Kit through Real-Time Quantitative Reverse Transcription PCR (RT-qPCR) analysis. RESULTS: KMT2A rearrangements were identified in 23 (20%) patients. The most common was t(10;11) which presented in 15 (13%) patients, followed by t(9;11) in 5 (4.3%) patients and t(11;17) in 3 (2.6%) patients. Patients with KMT2A rearrangements were significantly older and more likely to have splenomegaly. At 1-month posttreatment, they had significantly lower red blood cell counts and hemoglobin levels and higher blast percentages. Only 4.3% achieved complete remission (CR) compared to 76.1% without KMT2A rearrangements, with a significantly higher mortality rate (30.4% vs. 5.4%, P = 0.0001). Regarding the treatment response, no significant differences were observed among the different fusion types of KMT2A rearrangements. CONCLUSION: KMT2A rearrangements are more prevalent among Iraqi AML patients compared to the global trend and are associated with older age, higher rates of splenomegaly, poorer hematological recovery, and worse outcomes, regardless of the KMT2A rearrangement fusion type.