Blood Count Research Articles

Efficacy of a capsicum extract on growth, blood parameters and intestinal bacterial population of broilers

Context The ban on antibiotics in broiler feed has led to the need for alternative additives that can be used in poultry production, particularly in tropical climates where animals experience high levels of stress. A capsicum extract (CE), derived from chili peppers, is a potential feed additive that may enhance the performance of broiler chickens. Aims This experiment investigated the effects of CE on the growth performance, blood parameters, and intestinal bacterial population of broilers raised under high stocking density in a tropical region. Methods Four hundred and thirty-two 1-day-old Ross-308 male broiler chicks were divided into six treatments, each with six replicate pens of 12 birds. The experiment followed a randomised complete-block design. Feeding was conducted for 38 days in the following three phases on the basis of breeder recommendations: starter, grower, and finisher. CE was supplemented in the feed at concentrations of 80, 160, 240, and 320 mg/kg. All feeds were pelleted to different sizes for each phase. Growth performance was assessed at the end of each phase. Blood samples were collected to determine the complete blood count (CBC) and serum growth-hormone concentration. Chicks were euthanised using CO2 inhalation, and samples from the jejunum were collected for histological analysis. The caecocolonic contents were sampled for microbiological testing. Key results CE supplementation at concentrations of 160 and 240 mg/kg improved the performance of broilers equivalent to enramycin supplementation at 250 mg/kg, with additional benefits observed in water intake when supplemented at 240 mg/kg. The slight improvement in villous height may have contributed to the enhanced growth performance. Both the lowest (80 mg/kg) and highest (320 mg/kg) supplemented concentrations of CE slightly improved broiler performance compared with the control group. The lowest dose of CE also had a beneficial effect in reducing the E. coli:Lactobacillus ratio. Conclusions It is concluded that CE supplementation may improve performance of broilers under moderate heat-stress conditions by increasing feed and water intake with an enhanced bodyweight gain. Implications A capsicum extract can be used as an antibiotic alternative in broiler production in hot tropical environments.

Postmenopausal Hormone, Hematology and Immune Modulation in Rheumatoid Arthritis Patients

Background: There is a significant hormonal shift in Postmenopausal women with low levels of estrogen and progesterone. These changes may cause the pathogenesis of autoimmune diseases, rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), which exhibit a higher prevalence in women. It is crucial to determine the pathophysiology and treatment strategies and to understand the hematological, hormonal, and immunological differences in postmenopausal women with RA and SLE. This study determined the hematological, hormonal, and immunological parameters in postmenopausal RA and SLE patients. Methods: 75 postmenopausal women (aged 52-65 years) were recruited in this study, comprising 25 with RA, 25 with SLE, and 25 with healthy controls. Blood samples were collected for complete blood count (CBC), erythrocyte sedimentation rate (ESR), and serum hormone and immunoglobulin assays. Statistical analyses were conducted using Fisher's test, t-test, and ANOVA, with significance at p < 0.05. Results: In postmenopausal RA and SLE patients, significant blood parameter differences were observed versus controls. RA showed elevated WBC count (18.189±0.782) and PLT (373.778±14.644), lower RBC (4.009±0.149) and Hb (11.705±0.328). SLE had lower WBC (3.016±0.595), RBC (4.293±0.112), and Hb (12.270±0.312), and higher RDW (18.830±1.719) and lower MPV (8.327±0.314). Hormonal differences included higher FSH and lower LH, estrogen, and testosterone in both groups, while RA exhibited decreased cortisol and increased progesterone, and both diseases showed elevated rheumatoid factor (RF), ESR, and immunoglobulin E (IgE). Conclusion: Postmenopausal women with RA and SLE showed distinct hematological, hormonal, and immunological profiles compared to healthy controls. This study demonstrated the complex interplay between hormonal changes and autoimmune diseases, warranting further investigation into their underlying mechanisms and potential implications for treatment strategies.

The long-term effect of periodontitis treatment on changes in blood inflammatory markers in patients with generalized aggressive periodontitis.

Periodontitis is characterized by local inflammatory conditions in the periodontium, its severe form has been associated with elevated systemic inflammatory markers. However, the long-term effects of periodontal inflammation control on systemic inflammatory markers are unclear. This study aimed to investigate the long-term effects of periodontal therapy on the levels of peripheral venous blood inflammatory markers in patients with generalized aggressive periodontitis (GAgP), all of whom were now diagnosed as Stage III or IV Grade C periodontitis. Patients with GAgP were consecutively recruited from April 2013 to August 2014 (T0). Active periodontal treatment (APT) was provided, and follow-ups were conducted over a 3- to 5-year period (T1). Clinical parameters were assessed and fasting venous blood was collected at T0 and T1. Complete blood cell counts were obtained, and biochemical analyses were performed to evaluate the levels of serum components. The correlations between probing depth (PD) and hematological parameters were analyzed. A total of 49 patients with GAgP completed APT and follow-ups. Probing depth (PD) reduced from 5.10 ± 1.07 mm at T0 to 3.15 ± 0.65 mm at T1. For every 1-mm reduction in PD after treatment, the neutrophil count, neutrophil-lymphocyte ratio, and total protein concentration were reduced by 0.33 × 109 /L, 0.26, and 1.18 g/L, respectively. In contrast, the albumin/globulin ratio increased by 0.10. This study indicated that periodontal therapy may have beneficial effects on peripheral venous blood inflammatory markers in patients with GAgP during long-term observation.

The Role of Neutrophil-Lymphocytes Ratio in the Prognosis of CIN2+ Recurrence after Excisional Treatment

Objectives: The main risk factor involved in CIN2+ recurrence after treatment is the HPV persistent infection. The dysregulation of the immune system permits only HR-HPVs to become persistent infections, to promote cancer development, and to increase the risk of recurrence after treatment. Therefore, there is a shift to a Th2-type cytokine pattern during the carcinogenesis pathway; for this reason, the neutrophil-lymphocytes ratio (NLR) could be a marker of this immunological change. The study aimed to analyse the predictive role of NLR in the recurrence of high-grade CIN (CIN2+) after excisional treatment in a real-world life setting of patients treated for CIN2+. Design: This study wascross-sectional study. Participants/Materials, Setting, Methods: We examined a retrospective database of 444 patients, who attended the colposcopy service of our department from 2011 to 2020 due to an abnormal screening Pap smear, and we compared the clinical characteristics to NLR performed at the time of diagnosis. All analysed patients were treated according to an established protocol (colposcopy every 6 months for the first 2 years and every year for over 3 years) and HPV-DNA test and cervical biopsy were performed at entry and the end of follow-up. All patients underwent a blood sample examination, including complete white blood cell counts and collecting neutrophil and lymphocyte values expressed as 103/mL. Results: The sensitivity (SE) and specificity (SP) of the NLR cut-off point of 1.34 for the diagnosis of CIN2+ recurrence were 0.76 and 0.67, respectively. We found that CIN2+ recurrences were significantly higher in patients with NLR p = 0.033) and the 5-year recurrence-free survival was higher in patients with NLR ≥1.34 (97% vs. 93%, p = 0.030). Limitations: Firstly, the retrospective analysis and low incidence of recurrence may limit the conclusions. Second, for the retrospective design of the study, we did not take into consideration the patient’s comorbidities and habits (smoking) that may influence the NLR. On the other hand, the median duration of follow-up in our study was 26 months (IQR: 22–31), which fully reflects the incidence of recurrences. Conclusions: It is well known that CIN2+ lesions are sustained by deregulation of the immune system caused by persistent HPV infection, which may lead to cervical cancer. Among the actors underlying dysregulation of immunity, lymphocytes are involved in the permission of persistent infection and for this reason, NRL could be a reliable and cost-effective biomarker in predicting the risk of recurrence, especially for high-grade cervical lesions.

The spleen is the graveyard of CD4+ cells in patients with immunological failure of visceral leishmaniasis and AIDS

BackgroundVisceral leishmaniasis (VL), or kala-azar, is a common comorbidity in patients with AIDS in endemic areas. Many patients continue to experiences relapses of VL despite virological control, but with immunological failure. These patients remain chronically symptomatic with hypersplenism, for example with anemia, leukopenia, and thrombocytopenia, and are at risk of severe co-infection due to low CD4+ count. Therefore, in this study, splenectomized patients with VL and HIV infection were investigated to understand why the CD4+ count fails to recover in these patients, evaluating the importance of spleen mass for hypersplenism and immunological failure.MethodsFrom a retrospective open cohort of 13 patients who had previously undergone splenectomy as salvage therapy for relapsing VL, 11 patients with HIV infection were investigated. This study compared the patients’ complete blood cell count (CBC) and CD4+ and CD8+ cell counts before and after splenectomy with respect to spleen weight.ResultsCBC was substantially improved after splenectomy, indicating hypersplenism. However, to the best of our knowledge, this is the first study to show that spleen mass is strongly and negatively correlated with CD4+ cell count (ρ = −0.71, P = 0.015).ConclusionsThis finding was unexpected, as the spleen is the most extensive lymphoid tissue and T-lymphocyte source. After reviewing the literature and reasoning, we hypothesized that the immunological failure was secondary to CD4+ loss initially by apoptosis in the spleen induced by productive HIV infection and, subsequently, by pyroptosis sustained by parasitic infection in spleen macrophages.Graphical

Diagnostic insights from chemometric analysis of hemogram inflammatory indexes in male smokers with and without asthma or chronic obstructive pulmonary disease.

Diagnosis of asthma and chronic obstructive pulmonary disease (COPD) becomes difficult in a primary healthcare center due to ambiguous interpretation of spirometry and lack of facility to access established biomarkers. While routine hematological indices are easily available and accessible. The study aimed to evaluate the role of different hemogram indexes in males in COPD, asthma, and healthy smokers. Lung function tests and complete blood count (CBC) were done for 50 male subjects each from asthma, COPD, and healthy smokers. Multivariate analysis (MVA) was performed on blood indices data set. Receiver operating characteristic (ROC) curve was plotted to observe the performance of indexes. Pearson correlation was used to establish association between the lung function and blood indices. Most of the indices were elevated in COPD. Whereas, asthma patients showed a significant increase in eosinophil basophil ratio (EBR), lymphocyte-monocyte ratio (LMR), and mean platelet volume-platelet count ratio (MPR). Orthogonal (O)- Partial Least-Squares Discriminant Analysis (PLSDA) and variable importance in projection (VIP) score established EBR, neutrophil-lymphocyte ratio (NLR) and LMR, as discriminants for asthma. Whereas, Systemic Inflammatory Response Index (SIRI), NLR and EBR were the key variables for COPD. NLR (r = -0.73, p < 0.001) and SIRI (r = -0.71, p < 0.001) were found to be negatively correlated with forced expiratory volume in 1 s (FEV1) percentage of the predicted value (%pred) in asthma and COPD, respectively. EBR showed the sensitivity and specificity of 96% and 86% respectively in asthma. NLR was having sensitivity of 82% and 90% specificity in COPD. Our study in males shows routine hematological indices as being cost-effective, feasible, and seem to have tremendous potential as screening markers among chronic respiratory diseases in a primary healthcare center.

Analysis of CBC and CRP for Children using Machine Learning Models

Complete Blood count (CBC) and C- Reactive Protein (CRP) tests provide valuable information about a child's health status and help healthcare providers to diagnose and manage various medical conditions effectively. Paediatric health assessment often relies on these two critical blood tests as normal reports to check the primary condition of the children. Integration of CRP prediction models into clinical decision support systems can facilitate early detection of inflammatory conditions, guide treatment strategies, and improve patient outcomes in paediatric populations. Machine Learning (ML) algorithms are used to enhance diagnostic accuracy, and improve the overall efficiency of paediatric care. The most important test for diagnosing infections is the CBC. The CRP readings are classified into three classes i.e., 0 to 3 mg/L, 3 mg/L to 20 mg/L, more than 20 mg/L. With the test reports of the CBC, prediction of CRP levels was found with highest accuracy from Cat Boosting Classifier [0.976], Neural Network [0.972], Logistic Regression [0.971] and Random Forest Classifier [0.966]. The results prove that the Cat Boosting Classifier performs best among all the used models followed by other algorithms and performs well in predicting the new CRP reading class in all the prediction scenarios given the available dataset. Automating the analysis of CBC and CRP tests can streamline healthcare processes using ML models.

Haematological Profile and its Clinical Implications in Dengue Viral Infections

Introduction: Dengue fever is the most common arboviral disease in the world. Transmission to humans of dengue virus initiates a spectrum of illness, from inapparent to severe and sometimes lethal infections. Complete blood count (CBC) is an important part of diagnostic workup of patients. Comparison of various findings in CBC and peripheral blood film can help the physician in diagnosis, management and assessment of prognosis of the patients. Objectives: To find out the pattern of haematological findings in dengue infection. Methods: This cross sectional study was carried out on 62 dengue cases in CMH Savar from May to October 2019. Diagnosis of dengue was based on clinical features, haematological and biochemical findings and confirmed by serological tests. Haematological parameters analyzed include haemoglobin (Hb), haematocrit, total leucocyte count (TLC), differential leucocyte count (DLC), platelet count and peripheral blood film. Results: Important findings in haematological profile were haemoconcentration, raised haematocrit, low WBC count, early neutrophilia and late lymphocytosis, reactive lymphocytes in peripheral blood and thrombocytopenia. Haemoglobin ranged from 10.0-18.5gm/dl. Haematocrit was raised in 13(20.96%) cases. Thrombocytopenia (platelet count &lt;1.5 Lac/mm3) was observed in 59(95.16%) cases. Platelet count 1-1.5 Lac was seen in 4(6.45%) cases, 50,000-1 Lac in 25(40.32%) cases, 20,000-50,000 in 26(41.93%) cases and &lt; 20,000 in 4(6.45%) cases. Leucopenia (TLC&lt;4000/mm3) was seen in 46(74.19%) cases and &gt;11000mm3 in 2(3.22%) cases. On peripheral blood smear reactive lymphocytes including plasmacytoid lymphocytes were seen in almost all the cases. Conclusion: CBC examination gives enough clue for early diagnosis of dengue infection which can be confirmed by dengue serology. Serial CBC examination is also important in disease monitoring, treatment of the patient and prediction of prognosis. JAFMC Bangladesh. Vol 19, No 1 (June) 2023:11-14

Obstrüktif Uyku Apnede (OUA) Ortalama Trombosit Hacmi (OTH) ve OUA'da Sürekli Pozitif Hava Yolu Basıncı (CPAP) Tedavisinin OTH Üzerine Etkisi

Aims: In this study, our objective was to evaluate mean platelet volume (MPV), an indirect marker of platelet activation, in patients with obstructive sleep apnea (OSA), and assess the effect of OSA treatment with continuous positive airway pressure (CPAP) on MPV&#x0D; Methods: In this study, records of consecutive patients who underwent polysomnographic evaluation for OSA symptoms in the Sleep Disorders Laboratory during a one-year period were reviewed retrospectively. Patients who had both complete blood count and MPV measurements were included in the study.&#x0D; Results: A total of 158 patients, including 51 females (32.3%) and 107 males (67.7%), were included in the study. The mean age of the patients was 51±13 (min-18, max-82) years. OSA was detected in 74.1% (117/158) of the patients. It was determined that as the severity of OSA increased, hemoglobin and hematocrit values increased significantly. There was no significant difference in platelet count according to the presence and severity of OSA. The MPV was significantly lower in severe OSA cases compared to those without OSA and mild OSA cases. A negative correlation was observed between MPV and the apnea-hypopnea index, desaturation index, and the amount of oxygen saturation below 90% during sleep. There was no significant difference in median erythrocyte and thrombocyte counts, hematocrit percentage and hemoglobin values before and after treatment in OSA patients who used CPAP therapy. However, a significant decrease in MPV was observed after OSA treatment compared to pre-treatment. (p=0.021).&#x0D; Conclusions: The results of the study do not support an increase in MPV and hence platelet activation in severe OSA patients compared with those without OSA. However, the results suggest that one month of CPAP treatment reduces MPV and thus platelet activation in severe OSA patients. Further controlled, prospective studies including treatment outcomes are needed on this subject.

Validation of ToucHb, a non-invasive haemoglobin estimation: Effective for normal ranges, needs improvement for anaemia detection.

Non-invasive methods for haemoglobin estimation hold enormous potential for early detection and treatment of anaemia, especially in limited resource settings. We sought to validate the diagnostic accuracy of ToucHb, a non-invasive haemoglobin estimation device available in the Indian market. We prospectively evaluated the diagnostic performance of the ToucHb device using the Automated complete blood count (CBC) method as the gold standard. Persons referred for haemoglobin estimation to the central laboratory of the government medical college hospital in Mysore, southern India were included in the study. Out Of 140 people approached, 127 gave consent; 65% (n = 82) were female with median age of 37 (IQR 28-45). ToucHB reported median haemoglobin value of 14 g/dL compared to 13.3 g/dL for CBC. Within 1 g/dL and 2 g/dL of CBC, 55.2% (70/127) and 74% (94/127) of ToucHb haemoglobin observations fell, respectively. The Bland-Altman plot showed a mean difference of 3 g/dL in haemoglobin between ToucHb and CBC among those with anaemia. The ToucHb device showed 22.2% sensitivity and 94.5% specificity for anaemia detection. In rural resource-limited settings, point of care non-invasive devices such as ToucHb can improve access and acceptance for anaemia screening. However, ToucHb has showed low sensitivity for anaemia detection and low accuracy at lower haemoglobin values. The utility of the instrument is especially limited in detecting anaemia, while it can estimate haemoglobin accurately among those with haemoglobin is in the normal range. Based on these findings, ToucHb and devices that work on the core technology deployed in ToucHb may be better suited to monitor known haemoglobin level rather than in anaemia screening or detection in primary/ secondary care and community settings.

Peripheral and intestinal T lymphocyte subsets in dogs with chronic inflammatory enteropathy.

Dysregulated T lymphocyte response is thought to play a key role in chronic intestinal inflammation (CIE). To evaluate the presence of changes in peripheral and intestinal T lymphocyte subsets and to describe potential immune and inflammatory biomarkers in dogs with CIE. Sixteen healthy dogs and 26 dogs were diagnosed with CIE. Prospective case-control study evaluating peripheral and intestinal T lymphocytes using flow cytometry and inflammatory markers obtained from complete blood cell counts. Dogs with CIE had higher peripheral activated T helper (Th) lymphocytes (87/μL [18-273] CIE, 44/μL [16-162] healthy control (HC, P = .013) and regulatory T cells (Treg; 108/μL [2-257] CIE, 34/μL [1-114] HC, P = .004). In the intestinal epithelium, CIE dogs presented lower percentages of Th (4.55% [1.75-18.67] CIE, 8.77% [3.79-25.03] HC, P = .002), activated Th cells (0.16% [0.02-0.83] CIE, 0.33% [0.05-0.57] HC, P = .03) and CD4/CD8 ratio (0.08 [0.02-0.39] CIE, 0.21 [0.07-0.85] HC, P = .003). Conversely, higher percentage of activated T cytotoxic cells (20.24% [3.12-77.12] CIE, 12.32% [1.21-39.22] HC, P = .04) and interferon-gamma (IFN-γ) producing T lymphocytes (7.36% [0.63-55.83] CIE, 1.44% [0.00-10.56] HC, P = .01) within the epithelium was observed. In the lamina propria the percentage of Treg lymphocytes was higher (6.02% [1.00-21.48] CIE, 3.52% [0.18-10.52] HC, P = .02). Systemic and intestinal immune alterations occur in dogs with CIE suggesting that blood IFN-γ producing T lymphocytes and the systemic immune-inflamation index (SII)could potentially serve as biomarkers for the disease.

Dextran sulfate bulk and surface-modified microfiltration membrane for simultaneous blood plasma harvesting and low-density lipoprotein removal during plasmapheresis

Plasmapheresis is currently used for the harvesting of blood plasma in medical labs and plasma donation centers. This is a fast, single-step membrane process for both collection of blood plasma and simultaneous blood cell isolation. This paper presents the development of a novel membrane that can be used to simultaneously harvest blood plasma and isolate low-density lipoprotein (LDL), known as bad cholesterol, from the blood. To achieve this goal, dual surface and bulk modification by dextran sulfate (DS) was performed on a polyethersulfone (PES) membrane containing single wall carbon nanotubes (SWCNT). DS is an anionic ligand that repels negatively charged substances like red blood cells (RBCs) and adsorbs positively charged substances like Apo B100; the apoprotein of LDL. Scanning Electron Microscope (SEM), Energy Dispersive X-Ray (EDX), and Fourier Transform Infrared (FTIR) spectroscopy analyses provided evidence of the grafting of DS on single wall carbon nanotubes (DS-SWCNT). Surface studies including water contact angle, zeta potential analysis, surface morphology, Attenuated Total Reflectance-FTIR (ATR-FTIR), and EDX, confirmed the presence of DS on the PES membrane surface. The SEM cross-section results showed the formation of a two-zone morphology with an open structure on the upside and a dense structure on the downside that provide optimal conditions for efficient separation of blood cells. The complete blood count (CBC) and biochemistry analyses revealed dual bulk and surface-modified membrane, and a specific sample (DM2) showed the best performance for blood cells and LDL separation. The maximum separation of blood cells was 87% RBC, 98% white blood cells (WBCs), and 83% platelets (PLTs). Moreover, DM2 exhibited a sieving ratio for LDL of 0.33. Blood compatibility analyses confirmed that DM2 and other related samples had low hemolysis and prolonged coagulation times.

Pregnancy and neonatal outcomes in 25 pregnant women diagnosed with new-onset acute myeloid leukemia during pregnancy.

The aim was to analyze the pregnancy and neonatal outcomes of pregnant women with new- onset acute myeloid leukemia (AML) diagnosed during pregnancy. In this retrospective study 25 pregnant women who were diagnosed with new-onset AML during pregnancy from January 2010 to January 2021 were enrolled. A total of 4, 13 and 8 pregnant women with new-onset AML were diagnosed during the first, second, and third trimesters, respectively. Twelve of the 25 pregnant women underwent therapeutic abortion and 13 gave birth (9 preterm and 4 full-term newborns). The gestational age at initial clinical manifestations (13.4 ± 3.7 vs. 27.7 ± 5.6weeks, P < 0.01) and diagnosis (16.9 ± 4.4 vs. 29.7 ± 5.5weeks, P < 0.01) was lower in the pregnant women who underwent therapeutic abortion than in those who gave birth. Eighty-four percent (21/25) of the pregnant women with new-onset AML during pregnancy survived and were in remission and all the newborns were born alive. Three of the 13 newborns were exposed to chemotherapy, but no congenital malformations were observed. Eight newborns were admitted to the neonatal intensive care unit (NICU), and all recovered. The complete blood counts and biochemical examinations of the 8 newborns were normal. New-onset AML during an earlier stage of pregnancy may increase the risk of poor pregnancy outcomes. The neonatal outcomes of pregnant women with new-onset AML during pregnancy are good with proper treatment.

Dioscin alleviates aplastic anemia through regulatory T cells promotion

ABSTRACT Objectives: Aplastic anemia (AA) is one of the immune-mediated bone marrow failure disorders caused by multiple factors, including the inability of CD4 + CD25 + regulatory T cells (Tregs) to negatively regulate cytotoxic T lymphocytes (CTLs). Dioscin is a natural steroid saponin that has a similar structure to steroid hormones. The purpose of this study is to look into the effect of Dioscin on the functions of CD4 + CD25+ Tregs in the AA mouse model and explore its underlying mechanism. Methods: To begin with, bone marrow failure was induced through total body irradiation and allogeneic lymphocyte infusion using male Balb/c mice. After 14 consecutive days of Dioscin orally administrated, the AA mouse model was tested for complete blood counts, HE Staining of the femur, Foxp3, IL-10 and TGF-β. Then CD4 + CD25+ Tregs were isolated from splenic lymphocytes of the AA mouse model, Tregs and the biomarkers and cytokines of Tregs were measured after 24 h of Dioscin intervention treatment in vitro. Results: Dioscin promotes the expression of Foxp3, IL-10, IL-35 and TGF-β, indicating its Tregs-promoting properties. Mechanistically, the administration of Dioscin resulted in the alteration of CD152, CD357, Perforin and CD73 on the surface of Tregs, and restored the expression of Foxp3. Conclusion: Dioscin markedly attenuated bone marrow failure, and promoted Tregs differentiation, suggesting the maintenance of theimmune balance effect of Dioscin. Dioscin attenuates pancytopenia and bone marrow failure via its Tregs promotion properties.

Relationship between Iron Saturation Indices and Psychiatric Disorders among Persons Seeking Care at Selected Psychiatry Health Facilities in Ghana

Aim: This study investigated the relationship between iron metabolism and psychiatric disorder and whether iron saturation indices could predict disease severity.&#x0D; Study Design: The study was a case-control study.&#x0D; Place and Duration of Study: The study was conducted between December 2020 to March 2022 in some selected psychiatric facilities in Ghana.&#x0D; Methodology: Venous blood was collected and serum iron, TIBC, ferritin, transferrin and full blood count were quantified to calculate intraindividual variation and to assess the relationships of these iron saturation indices to severity of psychiatric disorders.&#x0D; Results: Serum iron (38.98±14.55 µmol/L), ferritin (100.23±84.98 ng/mL) and transferrin saturation (44.35±14.6%) were significantly (p&lt;0.05) higher in group with psychiatric disorders compared with the controls (29.25±8.0 µmol/L; 75.25±42.71 ng/mL and 28.66±7.1%). However, total iron binding capacity (TIBC) (102.47±15.01 µmol/L), UIBC (73.22±13.12 µmol/L) and transferrin (4.08±0.6 g/L) concentrations were considerably greater in control group than in the case subjects (88.95±19.73 µmol/L; 49.97±18.32 µmol/L and 3.54±0.79 g/L). One unit increase in BMI is associated with 1.27 (aOR=1.27, p&lt;0.001) times risk of psychiatric disorders and males are 6 (aOR=5.87, p&lt;0.005) times at risk of disorders. At a cut off of ≤65.79 µmol/L, UIBC can distinguish psychiatric disorders from controls.&#x0D; Conclusion: Serum iron and transferrin saturation appears to be good prognostic markers of diseases severity but serum iron at cut off of &gt;35.23 µmol/L better classified individuals of severe form of psychiatric disorder.

Association of hematological ratios with psoriasis: a nationwide retrospective cohort study.

Psoriasis is a common skin disorder linked to systemic inflammation and immune dysregulation. It is believed to involve activated T cells and neutrophils. Recent research has highlighted the potential role of hematological ratios, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), eosinophil-to-lymphocyte ratio (ELR), eosinophil-to-neutrophil ratio (ENR), and eosinophil-to-monocyte ratio (EMR), as markers for inflammatory skin diseases, including psoriasis. We aimed to investigate hematological ratios between children and adults, patients and controls, and patients with moderate-to-severe and mild psoriasis. This national retrospective cohort study included over 16,000 psoriasis patients in Israel. Patients with comorbidities influencing blood counts were excluded. Ratios were calculated from blood counts taken within 30 days of diagnosis. Multivariable logistic regression, including age, gender, ethnicity, smoking status, and socioeconomic status, was performed. Findings revealed age-specific variations in blood counts, hematological ratios, and differences between mild and moderate-severe patients and patients versus controls. Moderate-severe psoriasis patients had elevated neutrophil and eosinophil counts (4.57 vs. 4.25, P < 0.001, and 0.24 vs. 0.22, P = 0.047, respectively), as well as increased NLR (2.46 vs. 2.29, P < 0.001). Multivariable logistic regression analysis confirmed the significance of neutrophil and platelet counts as well as NLR and PLR in predicting psoriasis severity. This was a retrospective study without subjective data on disease severity. This study highlights hematologic ratios' diagnostic and prognostic potential in psoriasis.

Association between systemic immunity-inflammation index and hypertension in US adults from NHANES 1999–2018

Hypertension is a disease closely related to inflammation, and the systemic immunity-inflammation index (SII) is a new and easily detectable inflammatory marker. We aimed to investigate the association between SII and hypertension risk in a adult population in the US. We utilized data from the National Health and Nutrition Examination Survey spanning from 1999 to 2018, incorporating comprehensive information from adults reporting hypertension. This included details on blood pressure monitoring, complete blood cell counts, and standard biochemical results. The SII was computed as the platelet count multiplied by the neutrophil count divided by the lymphocyte count. We employed a weighted multivariate logistic regression model to examine the correlation between SII and hypertension. Subgroup analyses were conducted to explore potential influencing factors. Furthermore, smooth curve fitting and two-piecewise logistic regression analysis were employed to describe non-linear relationships and identify inflection points. This population-based study involved 44,070 adults aged 20–85 years. Following Ln-transformation of the SII, multivariable logistic regression revealed that, in a fully adjusted model, participants in the highest quartile of Ln(SII) had a 12% increased risk of hypertension compared to those in the lowest quartile, which was statistically significant (OR:1.12; 95% CI 1.01, 1.24; P < 0.001), with a P for trend = 0.019. Subgroup analysis indicated no significant interactions between Ln(SII) and specific subgroups except for the body mass index subgroup (all P for interaction > 0.05). Additionally, the association between Ln(SII) and hypertension displayed a U-shaped curve, with an inflection point at 5.89 (1000 cells/μl). Based on this research result, we found a U-shaped correlation between elevated SII levels and hypertension risk in American adults, with a inflection point of 5.89 (1000 cells)/μl). To validate these findings, larger scale prospective surveys are needed to support the results of this study and investigate potential mechanisms.

Combined delta neutrophil index and red blood cell distribution width as a new biomarker to predict endometriosis

The aim of this study was to evaluate the use of delta neutrophil index (DNI) in predicting endometriosis. A retrospective, case-control study was performed in a tertiary care center. DNI, red cell distribution width (RDW), and other blood parameters obtained from complete blood counts of 267 patients, consisting of 122 (45.7%) endometriosis patients with proven pathology reports of stages 3-4, and a control group of 145 women who underwent laparoscopy for simple ovarian cyst and/or diagnostic purposes and had normal histopathology, were compared. Receiver operating characteristic and logistic regression analyses were performed. DNI and RDW were significantly higher in endometriosis patients than in the control group (p=0.034 and p=0.003, respectively). Other parameters obtained from complete blood counts (leukocyte, neutrophil, lymphocyte, monocytes, and platelet counts and neutrophil-to-lymphocyte ratio), did not differ (p>0.05). For DNI, at a cut-off value of 0.025, area under the curve (AUC) was 0.572 and it was statistically significant [p=0.042; 95% confidence interval (CI): 0.503-0.642, sensitivity: 45.9%, specificity: 67.6%, Youden’s index: 0.135]. For RDW, AUC: 0.601 for cut-off value of 13.65 was statistically significant (p=0.004, 95% CI: 0.553-0.669, sensitivity: 50.8%, specificity: 67.6%, Youden’s index: 0.184). The logistic regression model established with the combined marker obtained by multiplying the DNI and RDW was statistically significant (p<0.001, Nagelkerke R2=0.72, 95% CI: 2.58-47.26, B: 2.40, negative predictive value: 78.6%, positive predictive value: 37.7%). DNI, a new inflammatory marker, and RDW, known to be associated with inflammation, may be useful minimally invasive biomarkers of endometriosis.

Concurrent use of fam-trastuzumab-deruxtecan-nxki and larotrectinib in metastatic breast cancer: A case report

A 60-year-old female presented in 2010 with left breast invasive lobular carcinoma, estrogen receptor (ER)+ (98%), progesterone receptor (PR)+ (98%), Her2 (2+), Ki67 (8%), Stage IIIC, T2 N3. She had lumpectomy, adjuvant chemo and radiation, took anastrozole until July 2019 when she had metastasis to bone. She started on palbociclib and fulvestrant. Imaging showed minimal improvement. In March 2022, her bone pain worsened and blood counts dropped and became transfusion dependent, bone marrow biopsy showed breast cancer metastases, ER+ (35%), PR−, Her2 (2+). PDL1 was negative, NTRK 1 was positive. She started on larotrectinib for her NTRK1 mutation, which showed some improvement and added fam-trastuzumab-deruxtecan-nxki for her Her2neu weekly positive, resulting in normalization of her blood counts. She has been on this combination which has never been reported, for over a year and has remained in remission with no significant toxicity. Targeting these two mutations simultaneously with possible additive effect can open some new trial ideas.

Effect of prior lenalidomide or daratumumab exposure on hematopoietic stem cell collection and reconstitution in multiple myeloma.

The roles of Lenalidomide (Len) and Daratumumab (Dara) in multiple myeloma treatment are well-established, yet their influences on hematopoietic stem cell harvesting and reconstitution remain disputed. We conducted a systematic database review to identify cohort studies or RCTs evaluating the effect of the use of Len or Dara on hematopoietic stem cell collection and peripheral blood count recovery in multiple myeloma patients. Effects on hematopoietic collection or reconstitution were estimated by comparing standardized mean differences (SMD) and mean differences (MD), or median differences. Eighteen relevant studies were identified, summarizing mobilization results. For Len, data from 13 studies were summarized, including total CD34+ cell yield, collection failure rate, and time to neutrophil and platelet engraftment. Results indicated that Len exposure led to decreased stem cell collection [SMD=-0.23, 95% CI (-0.34, -0.12)]. However, collection failure (<2×106) could be mitigated by plerixafor [OR=2.14, 95% CI (0.96, 4.77)]. For Dara, two RCTs and three cohort studies were included, showing that Dara exposure resulted in a reduction in total stem cells even with optimized plerixafor mobilization [SMD=-0.75, 95% CI (-1.26, -0.23)], and delayed platelet engraftment recovery [MD=1.20, 95% CI (0.73, 1.66)]. Our meta-analysis offers a comprehensive view of Len and Dara's impacts on hematopoietic stem cell collection and reconstitution in multiple myeloma. Len usage could lead to reduced stem cell collection, counteracted by plerixafor mobilization. Dara usage could result in diminished stem cell collection and delayed platelet engraftment.