Blood Smear Examination Research Articles

Asymptomatic Wuchereria Bancrofti Filariasis Discovered from a Dengue Positive Patient: A Case Report from Tamil Nadu

Concurrent infection by dengue and filaria with in a single individual is rarely known. This type of case can present with a very challenging clinical profile to Clinicians and Hematologist. Filarial co-infection can be a risk factor of severity in dengue infection. Filaria is chronic infection while dengue is an acute infection. Filarial infection is endemic in the tropical regions and a public health problem in Africa, Asia. Co-infection with filarial nematodes, if unrecognized, can result in untoward therapeutic consequences. Both Infection is transmitted by mosquito vectors (Culex, Anopheles, Aedes and Mansonia species) and humans are the definitive host. We report a case of co-infection of Wuchereria bancrofti and Dengue, which was diagnosed by peripheral blood smear examination (W. Bancrofti) and NS 1 antigen positivity (Dengue). We present here a case of 20-year-old male with dengue and microfilaria co-infection with bilateral hydrocele.

Equine piroplasmosis in northern Algeria: Haematological and serological parameters

Equine piroplasmosis is an acute, subacute or chronic tick-borne disease due to Babesia caballi and/or Theileria equi, affecting Equidae and causing economic losses to horse breeders and poor performances during tournaments. The objectives were fourfold: first to determine the seroprevalence of piroplasmosis in horses via cELISA, second to establish the haematological profile of piroplasmosis in horses of different Algerian areas through optical microscopy, third to identify the risk factors associated with the infection, and forth to try to elucidate any eventual correlation between piroplasmosis and anaemia. The study was carried out in different regions of northern Algeria. A total of 182 horses of both sexes were blood tested to estimate the prevalence of Theileria equi and Babesia caballi via competitive ELISA and to examine microscopically thin stained blood smears looking for haematological alterations using a standard cell counter. Parasites were detected in 42.9% of horses after microscopic examination of thin blood smears. The seroprevalence of equine piroplasmosis infection using competitive ELISA was 39% and 1,1% for Theileria equi and Babesia caballi respectively. Therefore, equine piroplasmosis is present in different regions of Algeria with a predominance of positivity in the central region (54,5%). Season (winter), region (central) and intended activity are the risk factors significantly associated with the prevalence of the disease. Anaemia was observed in 34,61% of individuals but there was no significant differences between positive and negative populations. Piroplasmosis is endemic in Algeria. Measures such as limiting horses’ mobility should be taken to reduce/prevent dissemination

Epidemiological study on Ixodid tick infestation and tick borne haemopathogens on cattle in Awi Zone, northwest Ethiopia.

BackgroundTick and tick borne haemopathogens are the main challenge of livestock production and productivity in Ethiopia particular in northwest Ethiopia due to favourable climate condition.ObjectivesThe objectives of this study was to determining the prevalence of Ixodid tick infestation and tick borne haemopathogens on cattle, identifying the existing Ixodid tick species, assessing seasonal variation and major risk factors associated with tick infestation and tick borne haemopathogens.MethodsA cross‐sectional study was conducted from December 2020 to july 2021 on Ixodid tick infestation and tick borne haemopathogens on cattle in the northwest Ethiopia. A toatal of 384 cattle were used for this study. Tick species were identified using morphological identification keys under a stereomicroscope. Thin blood smear examination were conducted to assess tick borne haemopathogens.ResultsThe overall prevalence of Ixodid tick infestation and tick borne haemopathogens were 45% and 3%, respectively. Babesia bigemina was the only haemoparasite detected in the present survey. Potential risk factors were investigated for their association with tick infestation and B. bigemina using logistic regression and chi‐square test, respectively. Accordingly, age, body condition, agroecological systems and season were significantly (p < 0.05) associated with tick infestation whereas season and body condition were significantly (p < 0.05) associated with B. bigemina infection. A total seven tick species were identified. Amblyomma varigatum (55%) and Boophilus decoloratus (15.7%) were the predominant Ixodid tick species encountered. A total of 128 blood samples were collected from Jawi district and examined using thin blood smear. Of them, 3% were infected by the B. bigemina ConclusionsTick infestation in this study was high and seems to play vital role for the reduction of production, productivity and for the transmission B. bigemina. Therefore, sound and effective tick control and prevention strategies are needed to mitigate the risk factors for tick infestation and B. bigemina infection in Ethiopia.

Clinicopathological Features of Pancytopenia in Adults and the Role of Bone Marrow Study in Etiological Categorization

Background and Objectives: Pancytopenia is a combination of anemia (with a reduction of the red blood cell count), leukopenia, and thrombocytopenia. Leukopenia is usually mainly due to a reduction in the neutrophil count although the number of other granulocytes, monocytes, and lymphocytes are often also reduced. Pancytopenia is a manifestation of many serious and life-threatening diseases. This study was undertaken to evaluate the clinicopathological features of pancytopenia and the role of bone marrow study for etiological categorization. Settings and Design: This is a cross-sectional observational study conducted in a tertiary referral center of north east India, for a period of 1 year (from August 2020 to July 2021). Materials and Methods: Proper history taking and clinical examination were done for all patients attending with hemoglobin &lt;10 mg/dL, total leukocyte count &lt;3000 cells/cmm, and platelet count &lt;1 lakh/cmm. The investigations done were peripheral blood smear examination with Leishman stain, special staining, as well as specific biochemical and radiological investigations as per requirement in cases; bone marrow aspiration (under all aseptic precaution); and bone marrow trephine biopsy (under all aseptic precaution). The results are presented in tables and compared with similar studies. Results: A total of 42 cases of pancytopenia were evaluated. The age group of 18–20 years was the most commonly affected. Male-to-female ratio was 1.33:1. All the patients presented with generalized weakness and pallor, and a large portion also with abdominal discomfort, hepatomegaly, and splenomegaly. Anisocytosis and macrocytosis were the most common peripheral blood smear findings. Vitamin B12 level was decreased in 75% of all the evaluated cases (15 of 20 cases). Bone marrow was hypercellular in most of the cases (80.95%) followed by hypocellular marrow (14.29%). Megaloblastic erythroid hyperplasia was the most common abnormality found in bone marrow. Megaloblastic anemia was the most common etiology followed by hypoplastic/aplastic anemia. A significant portion (7.14%) also showed bone marrow involvement by myeloma. One case of involvement by metastatic tumor was found. Conclusions: Most cases of pancytopenia were due to megaloblastic anemia and so easily curable. The bone marrow study is essential to evaluate a case of pancytopenia to know the exact etiology for proper management.

Platelet Satellitism in a Patient with Bronchial Asthma

Platelet satellitism is uncommon phenomenon characterized by formation of platelet rosette around polymorphonuclear leucocytes in blood smear prepared from Ethylenediaminetetraacetic acid anticoagulated blood. This phenomenon may cause reporting of spurious thrombocytopenia unless proper examination of blood smears. Here we describe a case of platelet satellitism in a 29 year old female which has been incidentally found on evaluation of eosinophilia in a bronchial asthma patient.

FRUIT PEEL EXTRACT OF Sygyzium cumini AS AN ALTERNATIVE STAINING FOR PERIPHERAL BLOOD SMEAR PREPARATIONS

Peripheral Blood Smear is preparations of human blood cells made by smear method and through a staining process in hematological examination to see the elements of peripheral blood cells, namely erythrocytes, leukocytes and platelets. The result of the Peripheral Blood Smear examination is the quality of the staining. This study was conducted with the aim of observing blood cells in blood smear preparations using aqueous extract from the skin of the jamblang fruit (Sygyzium cumini) as an alternative dye to replace Giemsa dye. This research was conducted by comparing the results of erythrocytes, leukocytes and platelets with Giemsa staining and using an alternative staining of fruit peel extract. The sample in this study used blood, and then it was made as a thin blood smear. The results of this study showed that only erythrocytes had a slightly good staining quality while platelets and leukocytes were not good because the acid content in Sygyzium cumini extract could not bind the cell nucleus in platelets and leukocytes. The morphology of normal erythrocyte cells obtained was round and oval disc-like (biconcave) with a purple center and pale edges.

Comparison of parasitological, serological and molecular diagnostic tests for detection of subclinical Trypanosomosis in two organised dairy herds

Trypanosomosis also known as ‘Surra’ caused by Trypanosoma evansi is of significant economic importance in livestock production. Diagnosis of subclinical infection and carrier state of disease is far difficult. Therefore, the present study was conducted to compare parasitological, serological and molecular diagnostic tests for detecting subclinical trypanosomosis in two dairy herds of Murrah buffalo (n=27) and crossbred cattle (n=22) in Hisar district of Haryana. Peripheral blood samples collected from all the animals were subjected to blood smear examination and DNA isolation for molecular detection by PCR, and like-wise serum samples were collected and subjected to latex agglutination test (TE-LAT) for T. evansi antigen detection. PCR products from positive samples were purified and sequenced for confirmation of T. evansi DNA. None of the animals in the two herds was found positive for T. evansi parasites by microscopic examination of thick blood smears. In buffalo farm, 29.62% samples each were found moderately and weak positive by TE-LAT, whereas PCR assay test yielded 40.74% samples positive for T. evansi DNA. In cattle farm, TE-LAT showed 18.18%, 31.89% and 9.09% samples to be strong, moderate and weak positive, whereas 50% samples were found PCR-positive for T. evansi DNA. Agreement among TE-LAT and PCR assay, as expressed by the kappa value, was found to be poor. To conclude, each test has its own merits and limitations. While TE-LAT is suitable for screening purpose, PCR assay confirms parasite in blood. For clinical diagnosis, results of laboratory diagnostic tests must, however, be correlated clinically before initiating the therapy.

The Infection Rate of Fasciola and Anaplasma in Cattle and Buffaloes in Qena, Egypt

Fascioliasis is caused by two species of trematodes that mainly affect the liver. It belongs to the group of foodborne disease infections. It is a zoonotic disease, while anaplasmosis is a tick-borne disease. Both diseases occur worldwide, particularly in regions with intensive animal production. Therefore, the current study aimed to investigate the incidence rate of Fasciola and Anaplasma infections among cattle and buffalo in a part of southern Egypt, “Qena province,” in different seasons among male and female animals with special reference to the harmful effects of Fasciola in the liver of infected animals. The study was carried out from January 2020 to January 2021. A total of 437 cattle and 188 buffaloes of mixed breeds with an age range from 1 to 3 years were selected randomly for the study. Fecal samples were obtained and analyzed for the presence of fluke eggs using direct smear, flotation, and sedimentation techniques. Samples of liver fluke were collected from the liver of slaughtered animals for histopathology. The results revealed that fascioliasis incidence among cattle and buffalo in Qena was 3.43 and 4.26%, respectively. The microscopic examination of blood smears from cattle and buffaloes revealed that 7.5% had an Anaplasma infection; in addition, the infection rate concerning gender indicated that it was higher in females 7.57% than males 6.67%. The findings of fascioliasis and anaplasmosis in farm animals indicate that the danger of both diseases in farm animals, which affects the economic production of animals, increases the risk of infection with zoonotic agents for farmworkers.

Myelomatous pleural effusion.

A 66-year-old woman was admitted to the emergency department reporting 1 week of asthenia and fever that had persisted despite antibiotherapy. She had been diagnosed of smoldering multiple myeloma (MM) IgG kappa 11 years before. However, treatment with bortezomib, lenalidomide and dexamethasone (VRd) was not started until the previous year, when the patient presented with rib pain and the diagnostic workup was repeated. Bone marrow aspirate showed infiltration of clonal plasma cells, and bone disease was demonstrated in positron emission tomography/computed tomography scan. After the fourth cycle of VRd, an increase in serum monoclonal component was observed. Urgent laboratory tests showed hemoglobin, white blood cell and platelet counts of 110 g/L, 7.5 × 109/L and 190 × 109/L, respectively, with 1570 mg/dl of IgG, 643 mg/dl of kappa light chain, 933 U/L of LDH, and 6.5 mg/L of beta2-microglobulin. Chest X-ray revealed left pleural effusion (PE). A thoracocenthesis was performed. Cytological examination of PE and peripheral blood smear showed plasma cell infiltration (Figure 1A–F). PE flow cytometry revealed 96% infiltration of abnormal cells expressing CD38, CD138, CD56dim and CD19 loss expression (Figure 2A–E). Pleural fluid electrophoresis and immunofixation revealed monoclonal IgG kappa (Figure 2F–G) and bone marrow aspirate showed 90% infiltration of plasma cells. Blood and bone marrow cultures were negative. A diagnosis of myelomatous pleural effusion (MPE) was made. Treatment with daratumumab, carfilzomib and dexamethasone was started. However, 10 days later the patient died. MM is a malignant plasma cell disorder that accounts for approximately 10% of all hematologic malignancies. Only 6% of these patients develop pleural effusion, mostly benign [1]. MPE is a very rare finding, present in less than 1% of all cases. Cytological identification of malignant plasma cells within pleural effusion is considered the most accurate diagnostic method. There is no standardized therapy. The prognosis is dismal, with an overall median survival ranging from 2 to 4 months [2-4]. None. The authors declare no conflict of interest. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from a first degree relative of the patient included in the study. All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Silvia Escribano Serrat, Javier Cucharero Martín, Fiorella Medina Salazar, Estefanía Bolaños Calderón, Isabel Ortega Madueño and Fernando Ataúlfo González Fernández. The first draft of the manuscript was written by Silvia Escribano Serrat and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. None.

Comparison of the Results of Automatic Blood Analyser and Manual Peripheral Smear Method in Total and Differential Leukocyte Count in Goats

The Abacus Vet 5 (AV5) is a volumetric impedance-based automated haematology analyser that offers a total and 3-part differential (lymphocytes, neutrophils and monocytes) white blood cell (WBC) count in goats. This study aimed to compare the total and differential leukocyte counts (absolute and relative) measured with the AV5 haematology analyser with the results obtained by the manual method from blood smears in goats. It is also aimed to compare the compatibility between the two methods. The blood samples of 40 hair goats (9 healthy and 31 diseased) were analysed by both methods. The relationships between the values were evaluated with a correlation coefficient, and the agreements between the methods were assessed with the Bland-Altman method. The correlation between two methods were excellent for total WBC counts (rho = 0.963, p = 0.000), absolute neutrophils (rho = 0.964, p = 0.000), lymphocytes (rho = 0.928, p = 0.000), a good for the neutrophil percentages (rho = 0.824, p = 0.000), and a weak for absolute monocytes (rho = 0.426, p = 0.006). Although the bias for lymphocyte (−8.25 %) and neutrophil (10.02 %) percentages was relatively significant and the confidence intervals were wide, the agreement for all parameters was acceptable between the two methods in the Bland atman method. In conclusion, the AV5 haematology analyser performed well for total, and differential WBCs counts in goats. However, abnormal results should still be confirmed by a blood smear examination. In addition, instrument performance evaluations, including increased sample sizes, should be performed in further studies.

Pathomorphological changes in German boxer dog infected with Babesia canis parasites. Clinical case

The article covers the results of a comprehensive pathomorphological study of Babesia canis parasitic infestation in a dog of the German boxer breed. In April 2020, a male German boxer with pronounced clinical signs of anorexia, remitting fever, hematuria, and manifestations of general jaundice was admitted to the Dr. Markevych clinic (Lviv). The anamnesis evidenced that after daily walks in the park of Lychakiv district (Lviv) the pet’s owner had been detecting 3–5 Ixodes ticks on the dog’s body for several days in a row. Cytological examination of blood smears stained by the Romanovsky–Giemsa method revealed a massive lesion of erythrocytes by the Babesia canis parasite. The applied treatment strategy, namely the introduction of the drug with the active substance imidocarb dipropionate, was not successful. The dog died in the clinic. An autopsy was performed in agreement with the pet owner. Macroscopic examination revealed foamy fluid in the trachea, pulmonary edema and lobar pneumonia, massive diffuse hemorrhages on the epicardium and costal pleura, splenomegaly, serous lymphadenitis, acute venous stasis, hepatic and renal dystrophy, and pancreonecrosis. General anemia and transudate accumulation in serous cavities were established. Tissue fragments of lungs, kidneys, liver, spleen, and pancreas were selected for a histopathological examination and fixed in 10 % neutral aqueous formalin solution, followed by dehydration in alcohols, filling into paraffin blocks and subsequent production of histopreparations. Staining was performed with eosin and Ehrlich’s hematoxylin according to the conventional methods. Microscopically, the lungs showed the alveoli swelling, thickening of the alveoli walls with blood overflow, bronchioles’ inflammatory infiltration with the accumulation of desquamated epithelium and exudate in the lumens of large bronchi. Extracapillary glomerulonephritis and hyaline-drop renal tubular dystrophy were observed in the kidneys. Vascular endothelium edema, granular hepatocyte dystrophy, sharp dilation of central vein and intraparticle and interparticle capillaries were found in the liver. Significant hyperplasia was observed in the red pulp of the spleen. Reticuloendothelial proliferation, erythrocyte proliferation with a diffuse accumulation of hemosiderophages due to increased erythrocyte disintegration, sinus dilatation, and atrophy of white pulp lymph nodes were also revealed.

Comparative evaluation of various methods of diagnosis of malaria and assessment of hematological parameters in malarial infection

Background:Malaria remains a substantial health problem in many parts of world, especially in the tropical developing nations. Management of malaria requires early and accurate diagnosis. The aim of this study was to measure and compare the diagnostic accuracy of different methods of diagnosis of malaria and to study the limitations mostly due to low parasite density. We also evaluate the haematological changes in malaria patients.Material and methods: The study was conducted on blood samples of patients presenting with pyrexia, attending the various Departments of VSS Institute of Medical Science &amp;Research,Burla, Sambalpur. Blood samples were subjected to thick and thin blood smear examination, QBC method and Rapid Diagnostic Tests (RDTs). Haematological parameters including haemoglobin, total leukocyte count, differential count and total platelet count of malaria positive cases were studied. Results: Out of 186 cases of fever, 105 patients were positive for malaria by thick peripheral blood smears. Plasmodium falciparum constitutes 86.66% whereas P. vivax and mixed infections constitute 8.57% and 4.77% respectively of total malaria . The sensitivity of QBC test approached 100% with parasite densities above 500/cu.mm.Antigen detection method was found to be highly sensitive (92.70%) for the diagnosis of P. falciparum infection.

RBC Indices and Morphological Pattern of Anemia in Geriatric Population: A Cross-sectional Study in Eastern India

Background: Geriatric anemia is one of the neglected and undiagnosed health problems throughout the world leading to increased morbidity and mortality among this vulnerable age group. Anemia in elderly is often an indicator of an underlying co-morbid condition. Morphological pattern of anemia may reflect the underlying etiology and thus directs the appropriate way to management of the condition. Aims: To evaluate the severity and morphological pattern of anemia in geriatric age groups. Materials and Methods: Elderly individuals aged 60 years or older of either sex with Hb level &lt;12 gm/dl in women and &lt;13 gm/dl in males were included in this study as geriatric anemic population. Blood samples were analyzed for Hb, hematocrit (Hct), Mean corpuscular volume (MCV), Mean corpuscular haemoglobin (MCH), Mean corpuscular haemoglobin concentration (MCHC) and Red cell distribution width (RDW-CV). Anemia was graded as mild, moderate and severe according to WHO criteria. Morphological classification was done based on RBC indices and peripheral blood smear examination. Statistical analysis was done using SPSS software. Results: Total 277 geriatric anemic subjects were included in this study. Female to male ratio was 1.9:1. Most of the participants (60.29%) were in the age group of 60-69 years. Majority had mild anemia (48.02%). Normocytic-normochromic was the most predominant morphological subtype (74.73%). Mean Hb, MCH and MCHC were found to be significantly lower in geriatric females compared to males (P &lt; 0.05). Conclusion: Normocytic-normochromic anemia of mild degree was the most common type of anemia among geriatric population. Evaluation of morphological pattern of anemia may help in appropriate management of underlying condition.

SARS-CoV-2 infection evolving into aplastic anaemia

Aplastic anaemia can develop due to various viral infections. However, SARS-CoV-2 infection evolving into aplastic anaemia is rarely seen. Here, we present a case of a 6-year-old boy who presented with epistaxis and rashes all over the body after recovery from COVID-19. Peripheral blood smear examination revealed pancytopenia with neutropenia and also reticulocytopenia. Bone marrow biopsy showed a hypoplastic marrow (cellularity of 10%), leading to a diagnosis of aplastic anaemia.

Morphological Types of Anemia Associated with Chronic Renal Diseases

Introduction: Anemia develops early in the course of renal disease and worsens as kidney function declines; a typical consequence of CKD is caused by a disruption in erythropoietin production as well as caused by iron and vitamin shortages, blood loss, shortened erythrocyte life span, chronic inflammation, and the uremic environment. Aim: Our study aimed to identify and classify different types of anemia that complicated patient with chronic kidney disease. Methods: 40 patient were included in this study, 32 males (80%) and 8 females (20%), the age range was 40-70 for male and 48-68 for female .Depending on clinical sign, symptoms and laboratory diagnostic test All those patient are diagnosed previously as a cases of chronic renal failure by clinicians in our city and develop anemia during the course of diseases, so clinicians referred patients to our laboratory to find the cause of anemia. Depending’s on hematological laboratory data, peripheral blood smear examination from these 40 patients, which showed different types of anemia. Results: the most common types of anemia was Normochromic anemia (62.5 %) which develop in 25 patients followed by hypochromic microcytic anemia (8 %) which develop in 8 patients, and followed by macrocytic anemia (12.5 %) which develop in 5 patients and the less common type of anemia was hemolytic anemia (5 %) which was founded in 2 patients.. Conclusion: All types of anaemia can be detected in-patient with different types of renal diseases and it’s important to used different type of laboratory test to diagnosed type of anemia to treat it.

DETECTION OF SPLENDIDOFILARIA SP. (ONCHOCERCIDAE:SPLENDIDOFILARIINAE) MICROFILARIA WITHIN ALASKAN GROUND-DWELLING BIRDS IN THE GROUSE SUBFAMILY TETRAONINAE USING TAQMAN PROBE-BASED REAL-TIME PCR.

Grouse and ptarmigan (Galliformes) harbor fairly diverse helminth faunas that can impact the host's health, including filarial nematodes in the genus Splendidofilaria. As host and parasite distributions are predicted to shift in response to recent climate change, novel parasites may be introduced into a region and impose additional stressors on bird populations. Limited information is available on the prevalence of filariasis in Alaska galliforms. To date, no molecular surveys have been completed. Past studies relied on examining blood smears or total body necropsies, which are time-consuming and may not detect filarial parasites with low prevalence in hosts. Therefore, we developed a TaqMan probe-based real-time PCR assay targeting the cytochrome c oxidase 1 gene (COI) of Splendidofilaria to decrease processing times and increase sensitivity as well as provide baseline data on the diversity of filariid infections in galliform species in Alaska. We screened a combined total of 708 galliform samples (678 unique individual birds) from different tissues (blood, muscle, and lung) for the presence of filarial DNA across the state of Alaska. Real-time PCR screening revealed an overall prevalence of filarial infection of 9.5% across species: Bonasa umbellus (0%, n = 23), Dendragapus fuliginosus (0%, n = 8), Falcipennis canadensis (26.8%, n = 198), Lagopus lagopus (2.6%, n = 274), Lagopus leucura (0%, n = 23), Lagopus muta (3%, n = 166), and Tympanuchus phasianellus (12.5%, n = 16). We observed microfilarial infections throughout most of Alaska except in Arctic regions and the Aleutian Islands where viable vectors may not be present.

Unstable hemoglobin Montreal II uncovered in an adult with unexplained hemolysis exacerbated by a presumed viral infection: a case report

BackgroundUnstable hemoglobinopathies are rare inherited disorders of hemoglobin causing a reduction of hemoglobin molecule solubility. This results in an unstable hemoglobin tetramer/globin polypeptide, which precipitates within the red blood cell. Affected red blood cells have a reduced lifespan due to oxidative stress and cellular rigidity, and tend to be phagocytized by spleen macrophages more rapidly. Unstable hemoglobin is frequently under- or misdiagnosed, because its clinical presentation varies broadly. Therefore, testing for unstable hemoglobinopathies is indicated in cases of unexplained hemolytic anemia. However, this approach is not systematically followed in clinical practice.Case reportA 25-year-old Caucasian man with a recent history of a presumed viral upper respiratory infection was referred to the hematology outpatient clinic because of hemolytic anemia. The patient had scleral icterus, moderate splenomegaly, and mild macrocytic anemia with high reticulocyte count. Unconjugated bilirubin and lactate dehydrogenase were elevated. Haptoglobin was undetectable. Direct antiglobulin test was negative. Blood smear examination revealed anisopoikilocytosis, polychromasia, bite cells, and basophilic stippling, but no Heinz bodies. High-performance liquid chromatography and capillary electrophoresis showed slightly increased hemoglobin A2, normal fetal hemoglobin, and a variant hemoglobin. Deoxyribonucleic Acid sequencing revealed the heterozygous mutation c430delC in the beta-globin gene hallmark of hemoglobin Montreal II and the heterozygous mutation c287C>T in the alpha-globin gene corresponding to hemoglobin G-Georgia, indicative of the not yet described combination of double-heterozygous hemoglobin Montreal II and hemoglobin G-Georgia variants. Hemoglobinopathy Montreal II was here not associated with β-thalassemia syndrome, and carriers did not show ineffective erythropoiesis. In addition to the case report, we provide information about the largest pedigree with hemoglobinopathy Montreal II identified to date.ConclusionWe emphasize that a transitory acute condition may uncover an underlying inherited red blood cell disorder. In this regard, awareness should be raised among hematologists caring for adult patients that unstable hemoglobinopathies should be considered in the differential diagnosis of unexplained hemolytic anemias.

Clinicopathological study of acute myeloid leukemia in a tertiary care hospital

Background- The diagnosis of acute myeloid leukemia is based on peripheral blood smear and bone marrow examination. Immunophenotyping characteristics and cytogenetics have clinical relevance besides morphological features in these cases. Present study aims at clinicohematological evaluation of cases of acute myeloid leukemia diagnosed at hematology unit of our tertiary care hospital. Objectives –Present study aimed to diagnose and classify cases of acute myeloid leukemia with clinicohematological correlation. Material and methods- newly diagnosed cases of acute myeloid leukemia within a period of 1 year from May 2020 to May 2021 were included in this cross sectional and prospective study. In addition to hematological work up, flow cytometry, cytogenetics and molecular studies were taken into consideration for clinicohematological evaluation.Result- The study included 14 cases of acute myeloid leukemia which were classified as per FAB classification as AML M1- 7 cases, M3 – 3 cases and M4 and M5 – 2 cases each.

Molecular identification of Theileria spp. in ruminants and ticks from southern littoral of Caspian Sea, Iran.

The present study aimed at evaluating the presence of tick-borne apicomplexan parasites including Theileria ovis, Theileria lestoquardi, Theileria annulata, and Theileria orientalis in 92 cattle and 105 sheep from 6 different districts of Guilan and Mazandaran Provinces, inthe southern littoral of Caspian Sea. Furthermore, ixodid ticks were collected from the same animals. Stained blood smears were microscopically evaluated for the presence of blood parasites, and a specific PCR was applied for the detection of Theileria species. Besides, ticks were subsequently examined by species-specific PCR. Microscopic examination of blood smears demonstrated no evidence of intraerythrocytic piroplasms. Species-specific diagnostic PCRs demonstrated that 52.17% of sheep blood samples were positive for T. ovis. In addition, 31.03% and 24.13% of cattle blood samples were positive for T. annulata and T. orientalis, respectively. Moreover, 3 species of the ixodid ticks, namely, Rhipicephalus annulatus (58.47%), Ixodes ricinus (29.82%), and Haemaphysalis inermis (11.69%), were identified in Guilan Province, while Hyalomma detritum (73.03%) and Rhipicephalus sanguineus (26.92%) were found in Mazandaran Province. Additionally, by obtaining the data with respect to tick-borne apicomplexan parasites in 122 infected ticks, 35.24%, 22.95%, and 2.45% of tick samples were positive for T. annulata, T. orientalis, and T. ovis, respectively. Species-specific PCR revealed that H. inermis and R. annulatus were positive for T. orientalis. In addition, T. annulata was found in R. annulatus, H. inermis, and H. detritum. Besides, T. ovis was the only species of Theileria found in R. sanguineus. In conclusion, the results revealed that T. annulata infection was prevalent among cattle and ovine theileriosis caused by T. ovis was the only Theileria species found in sheep in the studied areas of the southern littoral of Caspian Sea. R. annulatus, H. inermis, and H. detritum were the main vectors for T. annulata, followed by H. inermis and R. annulatus for T. orientalis, and R. sanguineus for T. ovis.

Acute myeloid leukemias in Batna Epidemiological and cytological profile of acute myeloid leukemias

Background Acute myeloid leukemias (AMLs) are heterogeneous clonal hematologic malignancies caused by the transformation of a hematopoietic stem cell or an already-committed progenitor to the myeloid lineage. The objective of this work is to describe the epidemiological and cytological characteristics of peripheral blood and marrow in 126 patients with AML at the Batna Anti-Cancer Center between 2016 and 2019. Methods The diagnostic criteria are based on the morphology of cells under the microscope, cytochemistry, clinical presentation, immunophenotyping of blasts by flow cytometry, cytogenetics, and the search for certain molecular markers. Results The age of the patients ranged from 15 to 88 years. Morphological examination of blood and marrow smears and myeloperoxidase reaction allowed AML to be classified according to the criteria of the French–American–British group: (1) 9.5% of AML0, (2) 17.5% of AML1, (3) 11.1% of LAM2, (4) 13.5% of LAM3, (5) 15.1% of LAM4, (6) 16.7% of LAM5, (7) 3.2% of LAM6, and (8) 0% of LAM7. There were 12.7% of cases difficult to classify, and 0.8%biphenotypic cases. Conclusions Discrepancies in terms of percentages are noted between the subtypes M0, M1, and M2. These results must be supplemented by studies of cytogenetics and molecular biology.