Blood Count Research Articles

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

The most frequently ordered laboratory test worldwide is the complete blood count (CBC). As clinical chemists are increasingly assigned to assist or direct laboratories outside of the traditional clinical chemistry sections, such as the automated hematology section, expertise must be established. This review article is a dedication to that ongoing effort. In this primer, the white blood cell (WBC) test components of the CBC are introduced, followed by a discussion of the laboratory evaluation of leukopenia and leukocytosis. The laboratorian's approach to consult cases should be guided by the patient's clinical history and presentation while being able to provide key laboratory-based insights to assist in resolving result discrepancies that may otherwise go unnoticed.

Alteration of Blood Parameters in Non-Dialyzed Patients of Chronic Kidney Disease

Chronic kidney disease (CKD) is a serious health problem that can lead to end-stage renal disease. Patients with CKD are usually suffered from anemia, which is one of the major consequences of kidney damage which in turn lead to reduce quality of life, increased risk of cardiovascular disease and cognitive impairment. The study aimed to assess the hematological abnormalities in the CKD patients during pre-dialyzed conditions in EL-Beyda City. The study was included 107 patients who are attended to Nephrology Department in EL-Bayda Medical Center in the period from November 2021 to March 2022. The study was included all CKD stages and were not on dialysis and they were following upped by these centers regularly each month. Data sources were obtained from the personal interview with patients and the records files in Nephrology units. Blood samples were taken in EDTA tube to measure complete blood counts (CBC) include hemoglobin (Hb), hematocrit (HCT), Mean cell volume (MCV), Mean cell hemoglobin (MCH), Mean cell hemoglobin concentration (MCHC), white blood cells (WBC) and platelets count (PLT), as well as renal function tests (blood urea and creatinine). The data were analyzed by Minitab version17. Out of 107 patients were included in this study, 63(58.8%) of patients were females and 44(41.1%) were males, The majority of patients had chronic diseases which could be the contributing cause of CKD; 62% were suffered from hypertension, 40% suffered from diabetes. Anemia was the main abnormality in our study which observed in 49 of participants (45.8%) while the others were non anemic accounting 54% (14.6±0.23). There was a significant difference in the mean of hemoglobin and hematocrit between anemic and non-anemic participants (p- value=0.000). Red cell indices showed normocytic normochromic anemia, thrombocytopenia was noticed in 7 (14%) of patients and leukocytosis was reported in 9 (18%) of them. We can conclude that developing of anemia in CKD patients is associated with poor outcomes and requires a careful management to avoid comorbidities.

Lifetime age-related changes in clinical laboratory results, aging clocks and mortality predictors in 2412 Golden Retrievers.

In this study, we investigated age-related changes in clinical laboratory data and their association with mortality in dogs from the Golden Retriever Lifetime Study. By analyzing complete blood count (CBC) and biochemistry data from 2'412 Golden Retrievers over 16,678 visits, we observed significant changes during the first 2 years of life and throughout aging. Based on these observations, we developed a biological aging clock using a LASSO model to predict age based on blood markers, achieving an accuracy of R = 0.78. Although the biological age clock and pace of aging did not significantly improve mortality prediction, a model incorporating all blood biomarkers showed better predictive power for lifetime (C-index = 0.763) and 1-year mortality (AUC = 0.817). Our findings underscore the importance of comprehensive blood analysis for aging and mortality prediction in dogs and open the door for the development of novel methods to investigate aging in companion animals.

Complete blood counts as potential risk factors of early dissemination to liver and lungs in resected colorectal cancer: a retrospective cohort study

PurposeLiver and lung metastases demonstrate distinct biological, particularly immunological, characteristics. We investigated whether preoperative complete blood count (CBC) parameters, which may reflect the immune system condition, predict early dissemination to the liver and lungs in colorectal cancer (CRC).MethodsIn this retrospective single-centre study, we included 268 resected CRC cases with complete 2-year follow-up and analysed preoperative CBC for association with early liver or lung metastasis development. Next, selected CBC and clinicopathological parameters were analysed with uni- and multivariable Cox regression. Independent factors affecting liver or lung metastasis-free survival were incorporated into composite scores, which were further evaluated with receiver operating characteristic (ROC) curves and dichotomised using a modified, specificity-focused, Youden approach to identify particularly high-risk patients.ResultsCompared to metastasis-free patients, early liver metastases were related to decreases in red blood cells, haematocrit, lymphocytes and elevated monocyte-to-lymphocyte ratio, while lung metastases to lower eosinophil counts. A composite score of independent factors (erythrocytopenia, lower lymphocyte count and pN) yielded HR of 8.01 (95% CI 3.45–18.57, p < 0.001) for liver-specific metastasis-free survival (MFS). For lung-specific MFS, the combination of eosinopenia, pN and primary tumour location showed HR of 13.69 (95% CI 4.34–43.20, p < 0.001).ConclusionEarly CRC metastases to the liver and lungs are associated with partially divergent clinicopathological and peripheral blood features. We propose simple, clinically implementable scores, based on routinely assessed parameters, to identify patients with an increased risk of early dissemination to the liver or lungs. After validation in independent cohorts, these scores may provide easily available prognostic information.

An Efficient Acute Lymphoblastic Leukemia Screen Framework Based on Multi-Modal Deep Neural Network.

Acute lymphoblastic leukemia (ALL) is a leading cause of death among pediatric malignancies. Early diagnosis of ALL is crucial for minimizing misdiagnosis, improving survival rates, and ensuring the implementation of precise treatment plans for patients. In this study, we propose a multi-modal deep neural network-based framework for early and efficient screening of ALL. Both white blood cell (WBC) scattergrams and complete blood count (CBC) are employed for ALL detection. The dataset comprises medical data from 233 patients with ALL, 283 patients with infectious mononucleosis (IM), and 183 healthy controls (HCs). The combination of CBC data with WBC scattergrams achieved an accuracy of 98.43% in fivefold cross-validation and a sensitivity of 96.67% in external validation, demonstrating the efficacy of our method. Additionally, the area under the curve (AUC) of this model surpasses 0.99, outperforming well-trained medical technicians. To the best of our knowledge, this framework is the first to incorporate WBC scattergrams with CBC data for ALL screening, proving to be an efficient method with enhanced sensitivity and specificity. Integrating this framework into the screening procedure shows promise for improving the early diagnosis of ALL and reducing the burden on medical technicians. The code and dataset are available at https://github.com/cvi-szu/ALL-Screening.

Pre-operative Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios as Predictors of Morbidity and Mortality in Diabetic Foot Infection Amputation Patients

Background: Diabetic foot infection is a complication of uncontrolled diabetes. Some cases require amputation to avoid the spread of infection; however, this can also lead to poor outcomes. Inflammatory markers, such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), have been explored as predictors of outcomes following amputation; however, only a few published studies are available. Objective: The study aimed to determine the diagnostic value of pre-operative neutrophil-lymphocyte and platelet-lymphocyte ratios in predicting in-hospital morbidity and mortality among diabetic foot infection patients who underwent amputation in a tertiary government hospital. Methodology: This retrospective cohort study included a total of 535 diabetic foot ulcer patients who underwent amputation at a tertiary government hospital. Data was collected via medical chart review. Complete blood count (CBC) parameters closest to the time of amputation were obtained to calculate the neutrophil-lymphocyte and platelet-lymphocyte ratios. Stata software was used for data processing and analysis. Results: Only 10.28% of patients experienced in-hospital morbidity and/or mortality. Based on Youden’s index, the optimal cutoff points of neutrophil-lymphocyte and platelet-lymphocyte ratios were 7.27 and 32.40, respectively. Both markers showed 98% sensitivity in predicting the outcome. Specificity was 99% for the neutrophil-lymphocyte ratio and 93% for the platelet-lymphocyte ratio. Accuracy parameters remained high when morbidity and mortality were analyzed separately, and subgroup analyses by major and minor amputations were performed. Conclusion: Neutrophil-lymphocyte and platelet-lymphocyte ratios accurately predict in-hospital morbidity and mortality among diabetic foot infection patients who underwent amputation. The low cost and wide availability of a CBC make NLR and PLR valuable options in low-resource settings. Future studies should explore these markers' utility in predicting long-term outcomes after amputation.

The Clinical Value of Novel Inflammatory Biomarkers for Predicting Mycoplasma pneumoniae Infection in Children.

Mycoplasma pneumoniae (MP) is a major cause of community-acquired pneumonia (CAP), posing diagnostic challenges. This study evaluates novel inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and system inflammation response index (SIRI) for MP diagnosis in children. Complete blood count (CBC) results of 424 children with MP infection and 150 health children were collected. NLR, MLR, PLR, SII and SIRI, were respectively calculated. Shapiro-Wilk test, Student's t-test, Mann-Whitney U-test and Pearson chi-squared test were used to analyze the clinical data of the patients and participants. Multiple logistic regression analysis was conducted based on the results of single factor analysis. Receiver operating characteristic (ROC) curve was drawn to evaluate the potential of the above biomarkers for MP infection. Compared with the control group, white blood cell (WBC) count, neutrophil (NEU) count, monocyte (MON) count, NLR, MLR, PLR, SII and SIRI were significantly higher and lymphocyte count (LYM) and platelet (PLT) were significantly lower than those in MP group. The results of multivariate logistic regression analysis indicate that MLR and SIRI can serve as major risk factors for MP infection in children. The predictive accuracy of logistic regression model based on MLR and SIRI is 83.28%. The area under the curve (AUC) results showed that SIRI has better predicting value of MP infection (AUC = 0.892, Sensitivity = 75.7%, Specificity = 92.0%). This study described the significance of novel inflammatory biomarkers in children with MP infection and may provide new auxiliary diagnostic indicators for MP infection.

Evaluation of Complete Blood Count in Chronic Lymphoid Leukemia Patients

Chronic Lymphoid Leukemia (CLL) is characterized by the uncontrolled proliferation of lymphocytes, usually in the elderly, which can lead to various hematological abnormalities in patients. Analysis of hematological parameters is very important for the diagnosis, prognosis, and monitoring of treatment response in CLL. This study aimed to compare the complete blood count (CBC) parameters of CLL patients with a healthy control group. The study included 50 patients diagnosed with CLL and 50 healthy controls without a history of cancer. CBC parameters (WBC, RBC, HGB, HCT, MCV, MCH, MCHC, RDW, RDW-SD, PDW, PLT, MPV, PCT, NEU%, LYM%, MONO%, EOS%, BASO%, NEU#, LYM#, MONO#, EOS#, BASO#, NRBC#) of CLL patients and control group were statistically compared. According to the analysis results, no significant difference was found between MCV, RDW, RDW-SD, PDW, MPV, BASO%, NEU#, and EOS# values of the patient and control groups (p&amp;gt;0.05). However, WBC, RBC, HGB, HCT, LYM%, MONO%, LYM#, MONO#, BASO#, and NRBC# values of the patient group were significantly higher relative to the control group (p&amp;lt;0.05). MCH, MCHC, PLT, PCT, NEU%, and EOS% parameters were significantly higher in the control group relative to the patient group (p&amp;lt;0.05). As a result, significant differences were observed in some CBC parameters between patients and the control groups. Particularly, the significant difference observed in some parameters emphasizes that the hematological profile of CLL can be used in the diagnosis and monitoring processes. Our findings support

Linear regression analysis for complete blood count parameters during radiotherapy.

This study aimed to evaluate the correlations between complete blood count (CBC) during radiotherapy and patient and treatment factors. Data of cancer patients, including age, sex, concurrent chemotherapy (CCRT), radiotherapy dose (equivalent dose in 2‑Gy fractions with an alpha/beta value of 10 Gy, EQD2Gy10), radiotherapy location, and baseline CBC were collected. Linear regression was used to determine results during radiation. Validation data comprised 20% of the whole cohort. Atotal of 496 radiotherapy courses and 1884 weekly CBC results during treatment were analyzed. Baseline hemoglobin (Hb) was positively associated with subsequent Hb. Each 1 g/dL increase in baseline Hb predicted a0.73 g/dL increase in Hb during treatment (95% confidence interval [CI] 0.7-0.76). Male sex was associated with a0.16 g/dL higher Hb (95% CI 0.04-0.29), while female sex showed the opposite trend. CCRT was associated with a0.18 g/dL reduction in Hb (95% CI -0.33 to -0.03). Radiotherapy to the pelvis, bone, and head and neck regions resulted in Hb reductions of 0.18, 0.34, and 0.94 g/dL, respectively (95% CI -0.33 to -0.03, -0.53 to -0.15, and -1.26 to -0.62, respectively), while brain irradiation increased Hb by 0.22 g/dL (95% CI 0.05-0.38). Age, cumulative dose, and thoracic irradiation did not show asignificant correlation with Hb changes. Adjusted R‑squared for the development and validation data were 0.6 and 0.71 for Hb, 0.42 and 0.11 for white blood cell count, 0.36 and 0.32 for neutrophils, 0.42 and 0.06 for absolute neutrophil count, and 0.43 and 0.36 for platelets, respectively. Hb levels during radiotherapy could be explained using linear regression, although they did not negatively correlate with cumulative dose.

Smartphone based non invasive real time white blood cell counter leveraging blue light and static magnetic field

White blood cells (WBCs), also known as leukocytes, are one of the most significant parts of the immune system. They generate antibodies, protect the body from illnesses, and heal wounds. Accurate estimation of WBCs is key for diagnosing cancer, infections, leukemia, lymphoma, and other diseases. However, the widely used Complete Blood Count (CBC) test presents challenges, including prick anxiety, discomfort, and logistical inconvenience to patients. This study introduces a ubiquous White Blood Cell counting system, UbiWhite, a novel smartphone-based, non-invasive system for real-time WBC counting from fingertip videos. Our system uses optical and magnetic techniques to provide accurate WBC counts without blood extraction. An initial experimentation was carried out on 20 adult participants to verify the system’s effectiveness compared to standard CBC tests (IRB #4051). The developed algorithms exhibit 1.04 and 1.23 RMSE, respectively. Our innovation provides an easy, affordable, and instantaneous solution for monitoring WBCs in various healthcare settings, including homes and critical care units. Additionally, it serves as a beacon of hope for low- and middle-income nations, where access to and affordability of traditional lab tests are limited.

The Complete Blood Count Sepsis Index Using Monocyte Distribution Width for Early Detection of Sepsis in Patients Without Obvious Signs.

Exploiting the complete blood count (CBC) with differential (CBC-diff) for early sepsis detection has practical value for emergency department (ED) care, especially for those without obvious presentations. The objective of this study was to develop the CBC Sepsis Index (CBC-SI) that incorporates monocyte distribution width (MDW) to enhance rapid sepsis screening. A retrospective observational study. The ED of the University of Kansas Medical Center, United States. All adult patients (age 18 or over) presenting to the ED between August 8, 2020, and April 1, 2022, that received a CBC-diff as part of routine clinical care. MDW, WBC count, and neutrophil-to-lymphocyte ratio were used to develop a CBC-SI (0 low to 5 high risk) for early sepsis detection. The diagnostic performance of CBC-SI was evaluated for patients with and without obvious early signs of sepsis. In a cohort of 51,407 ED visits, 1,683 (3.3%) met sepsis criteria; 1,343 (79.8%) septic patients presented with obvious signs and 340 (20.2%) without. The overall area under the curve of the CBC-SI was 0.83 (95% CI, 0.81-0.85). A CBC-SI of greater than or equal to 1 point exhibited a sensitivity of 83.1% (95% CI, 79.9-86.2%) and specificity of 64.8% (95% CI, 64.0-65.5%). Superior performance was observed in the patient subgroup presenting without obvious signs; greater than or equal to 1 point, 81.1% (95% CI, 73.2-88.9%) sensitivity and 69.1% (95% CI, 68.3-69.9%) specificity. Septic patients without obvious signs exhibited delays in antibiotic administration from arrival (median 4.7 vs. 3.4 hr; p < 0.001) and higher rates of ICU admission (43.8% vs. 27.9%; p < 0.001) and in-hospital mortality (14.7% vs. 9.8%; p = 0.011) compared with the septic subgroup presenting with obvious signs. The CBC-SI demonstrated strong performance for early sepsis detection. Its performance was best for nonobvious presentations, suggesting highest utility in a subgroup that is most susceptible to delayed interventions and poorer outcomes.

Preclinical and Toxicology Assessment of ISFP10, an Inhibitor of Fungal Phosphoglucomutase (PGM).

Previously, the novel small molecule ISFP10 has been shown to inhibit fungal phosphoglucomutase (PGM) activity in Aspergillus fumigatus and Pneumocystis spp. With 50-fold selectivity over the human PGM molecule due to the presence of a unique yet conserved cysteine residue present in a number pathogenic fungal PGMs, use of this compound may provide a novel broad-spectrum approach to treating fungal infections. Accordingly, we sought to determine the tolerability in test animals receiving this compound, as well as the potential antifungal activity of ISFP10 on cultures of the common fungal pathogens Candida albicans and Candida glabrata . C57BL6 mice received once daily intraperitoneal (IP) injections of 100 mL of vehicle control (DMSO) or ISFP10 at a concentration of 10 mg/kg. Body weights were recorded daily for 7 days of treatment. On the final day, mice were weighed and euthanized. Postmortem blood collection was conducted via cardiac puncture and distributed to EDTA and lithium heparin tubes for complete blood count (CBC) and comprehensive blood chemistry panels, respectively. Liver, kidney, and lung tissue were also harvested and placed in 10% formalin for H&E staining and blinded histopathologic scoring. Lung samples were further analyzed for proinflammatory cytokines using enzyme-linked immunosorbent assays (ELISA) and quantitative PCR (qPCR). Furthermore, ISPF10 was tested for antifungal activity via 8-hour growth curve analysis in a concentration-dependent fashion against Candida albicans and Candida glabrata . There was no significant difference in the daily or final body weights of the mice receiving 10 mg/kg of ISFP10 compared to those of the vehicle control group. Extracellular matrix (ECM) transcripts for IL-6 and TNFα were statistically similar via qPCR. ELISA results of proinflammatory cytokines for IL-6 was not significant whereas TNFα levels in lung tissue from the ISFP10 treatment group were significantly reduced, indicating a potential anti-inflammatory effect of ISFP10 at this dosage. Overall, blood chemistry and CBC analysis revealed no overall significant differences between the two groups, except for increased neutrophil counts and decreased potassium levels in samples collected from ISFP10 treated animals compared to the vehicle control group. These laboratory abnormalities were not of clinical significance to the test animals. Blinded histopathological examination revealed no abnormalities or evidence of critical organ toxicity from all groups. Inhibition of C. albicans and C. glabrata culture growth by ISFP10 was concentration-dependent in YPD liquid media containing the ISFP10 compared to vehicle control. Our preliminary testing of ISFP10 revealed no inherent safety or toxicology concerns within the observed parameters. These data further support significant culture suppressive activity against C. albicans and C. glabrata . Taken together, these observations of ISFP10 further indicate that targeting PGM might be a novel and viable therapeutic strategy for serious fungal infections. An inhibitor specific to fungal PGM enzymes, termed ISFP10, was generally well tolerated when administered via intraperitoneal (IP) injection in mice. ISFP10 displays antifungal activity in a concentration-dependent manner against C. albicans and C. glabrata .

Clinical manifestations of COVID-19 infection and its impact on the outcome in children and adolescents with benign and malignant hematological disease in Egypt: a single-center experience

BackgroundIt is known that viral infections are associated with increased morbidity and mortality in immunocompromised children. Few reports describe the clinical manifestations and outcomes of COVID-19 infection in children and adolescents with benign and malignant hematological disease with a large sample size from our Egyptian population.AimAs a preliminary step in developing a national registry for children and adolescents with hemato-oncological disease who were diagnosed with COVID-19 infection, in this study we aimed to determine (a) the frequency of COVID-19 infection in children with hematological disease, (b) the presenting clinical manifestations, and (c) the associated underlying disease outcome and its clinical determinants.MethodsWe collected data from medical records of a retrospective cohort including all children and adolescent patients who were known to have a benign or malignant hematological disease attending the hematology and oncology outpatient clinic or were hospitalized between February 2022 and March 2023 in a university hospital in Cairo, Egypt, for tertiary care. All patients (n = 620) were tested for SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test by nasopharyngeal swab. For all patients, the collected data included the demographic data, diagnosis, cause of hospital visit, cause and duration of admission if needed, presence of symptoms suggestive of COVID-19 infection, and concurrent medications. Baseline laboratory investigation were collected included complete blood count (CBC), liver and kidney functions, C-reactive protein (CRP), serum ferritin, lactate dehydrogenase, and coagulation test. For COVID-19-positive patients, the additional data collected included the duration of COVID-19 infection, its course, full examination during this illness, its severity, and the outcome of COVID-19 infection and the underlying disease.ResultsOut of the 620 children and adolescents with benign (n = 271) and malignant (n = 349) hematological diseases in in-patients and out-patients’ settings, 86 patients (13.8%) tested positive for SARS-CoV-2. COVID-19 infection was more common in patients with hematological malignancy (n = 56, 65.1%) than those with benign hematological disease (27 patients, 31.4%). Among COVID-19-positive patients, 20 patients (23.3%) required intensive care unit admission compared to 30 (5.6%) COVID-19-negative patients (p-value < 0.000). Death was reported in 5 COVID-19-positive patients (5.8%) compared to 19 in COVID-19-negative patients (3.6%) (p-value = 0.314). The factors associated with mortality in COVID-19-positive patients (3 patients with hematological malignancy and 2 patients with aplastic anemia) was abnormal neurological examination [OR = 17.3; p-value = 0.009].ConclusionThe current study showed that COVID-19 was higher among patients with hematological malignancies than those with benign hematological disease. COVID-19 was tolerable among the studied patients with underlying hematological disease where 94.1% of the COVID-19-positive patients survived. Mortality was associated with abnormal neurological examination in COVID-19-positive patients with underlying hematological disease.

Bronchiolitis Severity Affects Blood Count and Inflammatory Marker Levels: A Real-Life Experience.

Bronchiolitis is the most common cause of lower respiratory tract infection (LRTI) in the first year of life. We analyzed the association between complete blood count (CBC), c-reactive protein (CRP), and novel inflammatory indexes (NLR, PLR, MLR, ELR, LMR, NPR, LPR, LNR, PNR, SII, SIRI) in predicting bronchiolitis severity at hospital admission. We retrospectively collected data from 95 infants hospitalized for bronchiolitis in a third-level hospital during three epidemic seasons. Five outcomes of severity were analyzed: BRAS; pediatric intensive care unit (PICU) admission; ventilatory support; intravenous (IV) rehydration; and length of stay (LOS). Lower age and weight at admission were statistically associated with four of the five severity outcomes. Prolonged LOS (≥6 days) was associated with high values of total white blood cells, lymphocytes, and eosinophils. Only three inflammatory indexes (PLR, MLR, and PNR) showed a significant association with one outcome (prolonged LOS). A new index (RBC/AiW/1000) was statistically associated with each severity outcome for a value > 350. We proposed a comprehensive analysis of the association between CBC, CRP, and novel inflammatory indexes and bronchiolitis severity. RBC/AiW/1000 could represent a future predictive marker of disease severity at hospital admission in infants with bronchiolitis.

The Diagnostic Value of Neutrophil and Monocyte Cell Population Data Obtained From a Hematology Analyzer in Neonatal Sepsis.

We aimed to investigate the diagnostic value of leukocyte cell population data (CPD) parameters obtained from an automated hematology analyzer to be able to use it in the diagnosis of neonatal sepsis. Our study was a retrospective and cross-sectional analysis. The neonates were classified into 3 groups: culture-positive sepsis (n = 20), clinical sepsis (n = 87), and control (n = 269). CPD parameters were determined during complete blood count (CBC) by volume-conductivity-scatter (VCS) technology with DxH 900 Coulter Cell Analyzer. Mean neutrophil volume (MNVNE), standard deviations of volumes of neutrophils (SDVNE), standard deviations of volumes of monocytes (SDVMO), and monocyte distribution width (MDW) were significantly increased in the culture-positive sepsis group compared with the clinical sepsis and control groups (P < .05). We have demonstrated the diagnostic utility of leukocyte CPD parameters, especially MNVNE, MDW, and their combination, for neonatal sepsis. These parameters are advantageous because they are obtained during routine CBC analysis without the need for additional blood collection and extra costs.

Predictive Value of Complete Blood Count (CBC)-Derived Indices-C-Reactive-Protein-Albumin-Lymphocyteindex (CALLY), Glucose-to-Lymphocyte Ratio (GLR), Prognostic Nutritional Index (PNI), Hemoglobin, Albumin, Lymphocyte, Platelet (HALP), and Controlling Nutritional Status (COUNT)-on Body Composition Changes After Bariatric Surgery.

Obesity is linked to increased risks of cardiovascular disease, diabetes, and certain cancers. Bariatric surgery (BS) aids in weight management, significantly altering body composition. This study evaluates the predictive value of five complete blood count (CBC)-derived indices[C-reactive-protein-albumin-lymphocyte (CALLY), glucose-to-lymphocyte ratio (GLR), prognostic nutritional index (PNI), hemoglobin, albumin, lymphocyte, platelet (HALP), and controlling nutritional status (COUNT)]on body composition changes post-BS. A retrospective study was conducted on 240 patients undergoing BS atSina Hospital,Tehran, Iran. Indices were calculated using routine laboratory tests, and body composition changes were measured using bioelectrical impedance analysis at 3 and 6months post-surgery. RESULTS: Higher pre-surgical GLR values positively correlated with increased fat-free mass (FFM) (p = 0.005 1, p = 0.003 2), muscle mass (MM) (p = 0.011 1, p = 0.008 2), and total body water (TBW) (p = 0.005 1, p = 0.005 2) post-surgery.In contrast, higher PNI was negatively associated with changes in FM (p = 0.029 1, p = 0.015 2), FFM (p = 0.002 1, p = 0.018 2), TBW (p = 0.002 1, p = 0.015 2) and MM (p = 0.003 2), particularly after laparoscopic sleeve gastrectomy (LSG). Furthermore, there was a significant correlation between pre-surgical HALP score and changes in FFM (p = 0.002 1, p = 0.042 2), TBW (p = 0.002 1) and MM (p = 0.011 1, p = 0.041 2). In addition, the modified HALP score showed a more significant correlation compared to the HALP score to predict the changes FM (p = 0.002 1, p = 0.002 2), FFM (p = 0.001 1, p = 0.006 2), TBW (p = 0.001 1, p = 0.003 2) and MM (p = 0.001 1, p = 0.023 2) particularly, after 6months. Our findings suggest that pre-surgical assessment of GLR, PNI, and HALP indices may provide valuable insights into predicting changes in body composition after bariatric surgery. Specifically, these indices could serve as tools for tailoring preoperative nutritional strategies and post-surgical interventions. However, as this study is retrospective, further prospective research with longer follow-ups is required to validate these findings and evaluate their utility in clinical practice. 1 3months after metabolic bariatric surgery. 2 6months after metabolic bariatric surgery.

Preoperative anemia is associated with prolonged hospital stay and increased facility discharges after glioblastoma resection.

Despite numerous operative and non-operative treatment modalities, patients with glioblastoma (GBM) have a dismal prognosis. Identifying predictors of survival and recurrence is an essential strategy for guiding treatment decisions, and existing literature demonstrates associations between hematologic data and clinical outcomes in cancer patients. As such, we provide a novel analysis that examines associations between preoperative hematologic data and postoperative outcomes following GBM resection. We performed a retrospective analysis of patients who underwent GBM resection from January 2016 to December 2020. Standard demographic and clinical variables were collected, including pre-operative complete blood count (CBC), and inferential analyses were performed to analyze associations between CBC parameters and postoperative outcomes. One hundred and eighty nine (189) patients met inclusion criteria, with a mean age of 60.7 years. On multivariate regression analysis, controlling for age, gender, and performance status, we observed trends suggesting anemic patients may have longer lengths of stay (t statistic = 3.23, p = 0.0015) and higher rates of discharge to inpatient facilities [OR 3.01 (1.09-8.13), p = 0.029], though these associations did not reach statistical significance after correction for multiple comparisons (Bonferroni-corrected significance threshold p < 0.01). Preoperative anemia may be a useful pre-operative predictor of postsurgical GBM outcomes. Further study is required to determine whether pre-operative hemoglobin optimization can improve postoperative clinical outcomes, and whether other hematologic and inflammatory markers are predictive of postoperative recovery and functional status.

Value of routine blood count surveillance in detecting relapse in acute lymphoblastic leukemia.

Children with acute lymphoblastic leukemia (ALL) have excellent outcomes, with >85% survival without relapse following contemporary therapies. Clinical and complete blood count (CBC) assessments are commonly used surveillance methods to detect relapses. We aimed to evaluate the efficacy of routine blood testing for detecting relapse using a systematic method of assessing normal and abnormal results. This a retrospective, single center study included children aged 1-14 years diagnosed with ALL who completed therapy and were in complete remission. Demographic data, leukemia subtypes, risk stratification, treatment responses, and outcomes were also reviewed. CBC tests were evaluated, and abnormal results were categorized. The relapse groups were classified as asymptomatic and symptomatic relapses. The clinical outcomes of relapse and complications were analyzed. The sensitivity, specificity, positive predictive value, and negative predictive value of surveillance laboratory tests for predicting relapse after the end of treatment were evaluated. In total, 187 patients underwent 2074 CBC tests. Ten patients underwent full surveillance, whereas the remaining patients underwent partial surveillance. The median number of surveillance blood draws per patient was 12. Relapse was observed in nine patients. Only three patients had asymptomatic relapses. Neutropenia, leukopenia, pancytopenia, thrombocytopenia, and anemia were observed in 98, 89, 10, 6, and 3 patients respectively. The sensitivity and specificity of neutropenia, leukopenia, thrombocytopenia, anemia, and pancytopenia were 11.11% and 47.9%, 0% and 50%, 33.3% and 98.31%, 0% and 99.4%, and 33.3% and 96.07%, respectively. No differences were observed between patients who had asymptomatic relapses and those whose clinical outcomes or consequences had symptomatic relapses. Relapse after completion of therapy in ALL is rare. Regular blood count surveillance does not predict clinical outcomes or relapse. Prospective studies are required to assess appropriate risk-based surveillance and its effects on patient outcomes and quality of life.

Accuracy Of Mentzer Index In Diagnosis Of Iron Deficiency Anemia In 2-5 Years Old Children

Objectives: To assess the validity and reproducibility of the Mentzer Index in differentiating iron deficiency anemia from non–iron deficiency anemia in children in the age group of 2-5 years from the standard methods of diagnosis. Place and Duration of Study. From June 2024 to November 2024 Paediatrics Department Bolan Medical Complex Hospital Quetta. Methods: A cross sectional descriptive study was carried out among 150 children aged between 2- 5 years attending health facilities with signs of anemia. The Patients’ blood picture, particularly Mean corpuscular volume (MCV) and Red blood cell (RBC) in the complete blood count (CBC) were used to determine the subjects Mentzer Index. In order to confirm IDA, serum ferritin levels were employed. The chosen level of significance was p &lt; 0.05, and the data were presented using standard deviations. Results: Finally we confirmed from serum ferritin that out of 150 patients, 92 patients had IDA. The mean Mentzer Index of the patients with IDA was 14.8 ± 1.5 and the patients with thalassemia traits was 11.3 ± 1.1 (p &lt; 0.001). The observed sensitivity and specificity of the Mentzer Index for the diagnosis of IDA were estimated to be 89% and 91% respectively. Conclusions: Mentzer Index is useful, inexpensive, and can work as a preliminary predicting tool for screening of the IDA in young children. It is a very sensitive test that is specific; this is a handy tool for centres that could be lacking a lot of equipment. More research work is required to support this study and its results. Keywords: Mentzer Index, iron deficiency anemia, children, diagnosis

Hemoglobin H disease caused by compound heterozygosity for α0-thalassemia Lamphun deletion and α+-thalassemia 3.7 kb deletion (--Lamphun/-α3.7) in a Thai elderly case

We report here for the first time with the deletional HbH disease caused by a compound heterozygosity for α0-thalassemia Lamphun type deletion and α+-thalassemia 3.7 kb deletion (--Lamphun/-α3.7) in a Thai elderly (61-year-old) subject. She was seen by her physician for fatigue and dyspnea. A physical examination revealed that she was a slightly pale patient. A complete blood cell count (CBC) showed microcytic hypochromic anemia (Hb 91 g/L, MCV 73.0 fL, and MCH 21.0 pg). However, she had no history for receiving a blood transfusion. Thus, the better understanding of genotype, phenotype, hematological and clinical features of this HbH disease (--Lamphun/-α3.7) will be useful for treatment, genetic counseling, prevention, and control programs of thalassemia in Thailand.