Complete Blood Count Analysis Research Articles

The Relationship between Raised Mean Platelet Volume and Severity of Newly Diagnosed Acute Ischaemic Stroke

Introduction and Objective: Stroke is one of the leading causes of mortality and long-term disability throughout the world. Mean platelet volume (MPV), a marker of platelet activation, is calculated and provided by automatic blood cell count equipment during routine complete blood count analysis is a surrogate marker of platelet function and a potential mediator of the association between inflammation and thrombosis. So, to investigate MPV in ischaemic stroke and its role to discriminating more severe stroke from mild one the current study was done. Methods: This observational case control study was carried out in Department of Medicine, Dhaka Medical College Hospital (DMCH) from July 2015 to June 2016. 100 patients with attack of ischaemic stroke who presented within 24 hours of symptoms onset were divided into 2 groups (group-1: mRS score 0-2, and group-2: mRS score 3 or more) based on severity. Severity of ischaemic stroke was assessed by the modified Rankin Scale. At the same time 100 age and sex matched controls were taken. Blood samples were collected from both groups and MPV was measured. The results were statistically compared by SPSS 22.0. Statistical significance was accepted at <0.05. Results: The MPV values were more in case group in comparison to control group (10.88±1.23 vs 10.03±1.03; z score-5.31; p value <0.01). Comparison between the 2 groups revealed that MPV value was higher and more significant in group 2 of cases than group 1(10.15± 0.739 in group 1 versus 11.63± 1.04 in group having 2; z score-7.7, p value <0.001). 6 patients of group 2, who could not overcome the situation and died within 24 hours of admission had MPV value of 12.92±0.30. After controlling the risk profiles associated with ischaemic stroke by means of binary logistic regression model, the effect of MPV in ischaemic stroke remained statistically significant (OR: 4.418, 95% CI 2.468-7.908, p= 0.000). ROC curve was 0.85 and standard error 0.039 (95% CI: 0.779-0.932; p<0.01), ...

Can New Advanced Clinical Parameters Be Used in the Diagnosis of Vitamin B12 Deficiency?

The measurement of vitamin B12 levels has low sensitivity for the diagnosis of vitamin B12 deficiency, therefore, clinicians may prefer to decide the deficiency with the patient's clinic. In this study, the diagnostic values of the classical and advanced clinical complete blood count parameters were investigated to find a new marker in the diagnosis of vitamin B12 deficiency. 150 adult volunteers were included in the study and volunteers were divided into two groups according to their vitamin B12 levels (with or without vitamin B12 deficiency) and hemoglobin levels (with or without anemia). The differences and correlations of laboratory test results between groups were examined. Equivalent of reticulocyte hemoglobin, equivalent of erythrocyte hemoglobin and delta-hemoglobin were found significant differences between groups with or without vitamin B12 deficiency. Hypo-hemoglobinised red cells and hyper-hemoglobinised red cells were found significant difference between groups with or without anemia. Significant positive correlations were found between vitamin B12 levels and equivalent of reticulocyte hemoglobin, equivalent of erythrocyte hemoglobin and delta-hemoglobin. Significant positive correlations were found between hemoglobin levels and macrocytic red blood cells, equivalent of reticulocyte hemoglobin, equivalent of erythrocyte hemoglobin, delta hemoglobin and hyper-hemoglobinised red cells; negative correlations with microcytic red blood cells and hypo-hemoglobinised red cells. It is suggested that these advanced clinical parameters of complete blood count analysis may be used to determine vitamin B12 deficiency.

Impact of oral isotretinoin on the inflammatory markers: can lymphocyte/HDL-C and platelet/HDL-C ratios be new indicators of inflammation in acne vulgaris patients?

Introduction The effect of isotretinoin on inflammatory markers has been reported with conflicting results. No studies have been reported on the relationship between isotretinoin and lymphocyte/high-density lipoprotein cholesterol [HDL-C] ratio (LHR), neutrophil/HDL-C ratio (NHR), or platelet/HDL-C ratio (PHR) in acne patients. Objectives We aimed to investigate how isotretinoin affects the inflammatory markers, including LHR, NHR, and PHR, in acne vulgaris patients. Methods A total of 361 patients with moderate-to-severe acne vulgaris who received systemic isotretinoin for at least six months were included. Complete blood count and biochemical analyses, including monocyte/HDL-C ratio (MHR), NHR, LHR, PHR, neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), the aggregate index of systemic inflammation (AISI), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI), obtained at the treatment onset and the end of the first, third, and sixth months of treatment were investigated. Results There was no significant difference in MHR and NHR levels between repeated measures. A significant increasing trend was seen in LHR and PHR (P = 0.001 and P = 0.011, respectively). HDL-C levels gradually and significantly declined during the six months (P < 0.001). Serum NLR, derived NLR, SII, SIRI, MLR, and AISI showed a significant decrease in line with clinical improvement in acne during the six months of therapy (P < 0.05). Conclusions Declining levels of NLR, MLR, SII, SIRI, and AISI may indicate the anti-inflammatory effects of isotretinoin on the pilosebaceous unit, whereas increasing levels of LHR and PHR may show systemic inflammatory activity of isotretinoin.

Clinical spectrum of pediatric tuberculosis and early diagnosis by clinical, radiological, and CBNAAT in a Tertiary Care Teaching Hospital in South India

Background: In India, an estimated 220,000 children contract tuberculosis (TB) annually, yet the absence of a gold standard test hinders effective diagnosis and reporting of childhood TB. Objective: This study aimed to analyse the clinical profile of childhood tuberculosis, utilizing relevant laboratory investigations for early diagnosis. Methods: A cross-sectional observational study was conducted at a tertiary care hospital in South India from October 2019 to October 2021. Children under 18 with tuberculosis were included. Data on demographics, symptoms, family TB history, nutritional status, and clinical findings were collected. Laboratory tests included complete blood count, ESR, Mantoux test, chest X-rays, and sputum analyses for acid-fast bacilli (AFB). Results: Among 54 children, the most common age group was over 10 years (51.3%), with a male preponderance (53.3%). Pulmonary TB was diagnosed in 44.4% of cases, while 55.5% had extrapulmonary TB, predominantly pleural (40%). Fever (60.5%) and cough (42.7%) were the most common symptoms. The Mantoux test was reactive in 40.7% of patients, particularly among the undernourished. Chest X-rays indicated TB in 93.25% of pulmonary cases, while CBNAAT showed positive results in 10 cases, with a sensitivity of 18.8% and specificity of 81.25%. Conclusions: Diagnosing childhood TB remains complex, relying on symptom evaluation, clinical history, and laboratory tests. Despite advances in diagnostic methods, negative CBNAAT results do not exclude TB, highlighting the need for thorough clinical assessment and investigation.

Incidence of myelosuppression in AML is higher compared with that in ALL.

Acute myeloid leukemia (AML) and acute lymphocytic leukemia (ALL) are two subtypes of acute leukemia. However, studies investigating the ability of complete blood count (CBC) parameters to distinguish between patients with AML and ALL remain scarce in the literature. The objective of the present study was to compare the parameters of CBC analysis between Chinese patients with AML and ALL and between patients with M3 AML and non-M3 AML. Prognostic factors for overall survival were also estimated, including sex, age, white blood cell count and hemoglobin. The present study included 147 patients, including children and adults, with newly diagnosed acute leukemia. Information on the age, sex, leukemia subtype, initial CBC results and clinical follow-up findings was recorded and compared between the indicated groups using statistical tests of Mann-Whitney U test and χ2 test. Leukopenia (white blood cell count <3.5x109/l), both leukopenia and anemia, both leukopenia and thrombocytopenia and pancytopenia were found to be significantly more frequent among patients with AML compared with that in patients with ALL (P=0.015, 0.016, 0.015 and 0.019, respectively). For patients with ALL, anemia was recognized as a predictor of a favorable outcome (Hazard ratio, 0.185; 95% CI, 0.046-0.747; P=0.018). These findings suggest that normal hematopoiesis is more frequently inhibited in patients with AML compared with that in patients with ALL. Patients with AL with peripheral blood findings indicative of leukopenia, pancytopenia, or both leukopenia and anemia or both leukopenia and thrombocytopenia are more likely to have AML.

Therapeutic potential of oleanolic acid in modulation of PI3K/Akt/mTOR/STAT-3/GSK-3β signaling pathways and neuroprotection against methylmercury-induced neurodegeneration

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder that gradually deteriorates motor neurons, leading to demyelination, muscle weakness, and eventually respiratory failure. The disease involves several pathological processes, such as increased glutamate levels, mitochondrial dysfunction, and persistent neuroinflammation, often exacerbated by environmental toxins like mercury. This study explores the therapeutic potential of Olea europaea active phytoconstituents oleanolic acid (OLA) against ALS by targeting the overactivated PI3K/Akt/mTOR/STAT-3/GSK-3β signalling pathways. Methods involved in-silico studies, in vitro and in vivo experiments in which varying doses of methylmercury 5 mg/kg, p.o. and OLA (100 and 200 mg/kg, i.p.) were administered to rats for 42 days. Behavioural assessments, gross morphological, histopathological, and neurochemical parameters were measured in cerebrospinal fluid (CSF), blood plasma, and brain homogenates (cerebral cortex, hippocampus, striatum, midbrain, cerebellum) along with complete blood count (CBC) analysis. Results revealed OLA's significant neuroprotective properties. OLA effectively modulated targeted pathways, reducing pro-inflammatory cytokines, restoring normal levels of myelin basic protein (MBP) and neurofilament light chain (NEFL), and reducing histopathological changes. Gross pathological studies indicated less tissue damage, while CBC analysis showed improved hematology parameters. Additionally, the combination of OLA and edaravone (10 mg/kg, i.p.) demonstrated enhanced efficacy, improving motor functions and extending survival in ALS model rats. In conclusion, OLA exhibits significant therapeutic potential for ALS, acting as a potent modulator of key pathological signaling pathways. The findings suggest the feasibility of integrating OLA into existing treatment regimens, potentially improving clinical outcomes for ALS patients. However, further research must validate these findings in human clinical trials.

Impact of Sleep Quality on Hemogram-Derived Inflammatory Indices in Medical Undergraduates: A Cross-Sectional Study

The link between sleep-related disorders and inflammation is well-known, but the association between inflammatory indices and sleep deprivation is still unclear. In our study, we aimed to investigate the relationship between irregular sleep patterns and systemic inflammation using Hemogram-Based Inflammatory Indices. We collected demographic information from 90 undergraduate medical students through a confidential questionnaire. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Blood samples were obtained for complete blood count analysis, with platelet (P), lymphocyte (L), and neutrophil (N) counts measured. These values were then used to calculate hemogram-based inflammatory indices, including the Systemic Immune-Inflammation Index (SII), Platelet-to-Lymphocyte Ratio (PLR), and Neutrophil-to-Lymphocyte Ratio (NLR). A high prevalence of inconsistent sleep was observed among medical students, with 53% reporting a PSQI score greater than 5(mean score 5.9±2.9). Subjects with poor sleep quality had elevated SII values. Additionally, female participants who experienced poor sleep quality demonstrated a significant positive correlation with SII (r=0.322; p&lt;0.049). Irregular sleep patterns are associated with greater systemic inflammation milieu specifically with SII compared to NLR and PLR. This effect was more pronounced in female participants, suggesting a potential gender-specific influence.

Toxoplasma gondii infection affects the complete blood count and disturbs the markers of oxidative stress from the vital organs of wild rodents

Rodents are the synanthropic mammals that are existing in close proximity to humans and their belongings and have the potential to act as the reservoir for a variety of parasites having zoonotic potential. Present study was designed to report the molecular prevalence and phylogenetic evaluation of Toxoplasma gondii in the blood samples of four wild rodent species [Rattus rattus (N = 122), Mus musculus (N = 64), Rattus norvegicus (N = 57) and Dryomys nitedula (N = 1)] that were trapped during May 2022 till July 2023 from three districts in Punjab (Jampur, Dera Ghazi Khan and Multan) and three districts (Upper Dir, Mardan and Bunar) in Pakistan. Results revealed that 44/244 (18%) rodents amplified ITS-1 gene of Toxoplasma gondii through PCR. Parasite prevalence varied between the rodent species. Highest rate of infection was found in Rattus norvegicus followed by Rattus rattus and Mus musculus. For both rat species, Toxoplasma gondii infection significantly varies between the sampling districts. DNA sequencing and BLAST analysis confirmed the presence of Toxoplasma gondii in rodent blood samples. Phylogenetic analysis showed that Pakistani isolates were genetically diverse and clustered with the isolates that were reported from worldwide countries. Complete blood count analysis revealed that parasite infected rodents had disturbed lymphocyte, mean platelet volume, mean corpuscular volume (and mean corpuscular hemoglobin concentration. Markers of oxidative stress analysis revealed that infected rodent had elevated malondialdehyde levels in liver and kidney while disturb catalase concentrations in kidney and heart as compared to uninfected animals. In conclusion, we are reporting a relatively high prevalence of Toxoplasma gondii in Pakistani rodents. Infection leads to disturbed complete blood count and markers of oxidative stress in the vital organs. We recommend large scale studies in various geo-climatic regions of Pakistan to report the incidence and prevalence of this pathogen among the rodents in order to prevent their infections in local people as well as in livestock.

Leukocyte-Poor Platelet-Rich Plasma for the Management of Knee Osteoarthritis: A Retrospective Study With 12 Months of Follow-Up.

Introduction The knee, the most frequently affected joint in osteoarthritis (OA), impacts the life quality of millions of individuals globally, resulting in a considerable healthcare burden. Conservative treatments are preferred, turning to surgical intervention when necessary. Nonetheless, these conventional modalities have drawbacks. Recently, the use of regenerative medicine therapies, including autologous peripheral blood-derived orthobiologics (APBOs), such as leukocyte-poor platelet-rich plasma (LP-PRP), has evolved and demonstrated the ability to manage knee OA. The primary objective of this investigation was to evaluate the efficacy of LP-PRP via widely used patient-reported outcome measures (PROMs) in grade I or II (on the Kellgren-Lawrence scale) knee OA patients. The secondary objective was to characterize the formulated LP-PRP and determine the efficiency of the leukodepletion filter used for leukocyte removal and platelet recovery. Methods This investigation was a retrospective analysis of data collected from patients treated at a single center over a period of 15 months.Data from 40 patients included in this study were intra-articularly injected with 3mL of formulated LP-PRPunder ultrasound guidance. PROMs questionnaires, including Kujala and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, were used and responses were documented at baseline and up to 12 months follow-up. The characterization of the formulated LP-PRP and the efficiency of the leukodepletion filter in removing leukocytes and recovering platelets were assessed via complete blood count (CBC) analysis. Results The intra-articular administration of LP-PRP resulted in statistically significant improvements in Kujala and WOMAC scores in patients with Grade I or II OA of the knee at all follow-up time points (four to 12 months) compared to the respective baseline scores. The subgroup analysis showed significant improvements in Kujala and WOMAC scores inboth male and female grade I or II knee OA patients with or without comorbidities, including diabetes and/or hypertension. The characterization of formulated PRP showedplatelet concentration to be at least 6x compared to the baseline whole blood levels, the absolute platelet count to be at least 5 billion, and total leukocytes, lymphocytes, neutrophils, and RBCs were depleted by over 88%, 82%, 98%, and 98%, respectively. In addition, the utilization of the PuriBlood leukocyte reduction filter (Puriblood Medical Co. Ltd., Baoshan Township, Taiwan) led to the depletion of approximately 93% of leukocytes and the recovery of about 83% of platelets. Conclusions Administration of LP-PRP resulted in significant improvements in pain and function of patients suffering from grade I or II OA of the knee. In addition, the leukodepletion filter used to formulate LP-PRP, successfully resulted in the depletion of leukocytes while recovering the platelets. More sufficiently powered, multi-center, prospective, non-randomized, and randomized controlled trials with long-term follow-up are needed to further establish the effectiveness of this formulation in knee OA patients.

Evaluation of Relationship Between C-Reactive Protein, Leukocyte Count and Platelet Indices in Dogs with Leukocytosis

A complete blood count and acute-phase protein analyses are the laboratory tests that are used in veterinary medicine practice. Leukocytes, also known as white blood cells (WBCs), are the primary biological components of inflammatory and immunological responses. C-reactive protein (CRP) is a powerful predictor of inflammation and/or infection in veterinary medicine. Starting at that point, the investigation of the alterations and relationship between WBC count, platelet indices, and blood serum CRP levels in dogs with leukocytosis was the aim of this study. A total of 135 bloodwork records, from January 2018 to December 2022, of dogs were analyzed. The inflammatory panel of complete blood count data, including WBC, PLT, MPV, PDW, PCT, and MPV/PLT, and CRP levels in blood serum chemistry analyses were investigated. The inflammatory panel of complete blood count data was categorized according to CRP levels in blood serum chemistry analyses. There was no significant difference in platelet indices according to the blood serum levels of CRP in the dogs’ bloodwork records. The WBC count in dogs with an equal or above 10 mg/dL CRP level was significantly higher than the other levels of CRP. A moderately positive correlation was detected between CRP and WBC in the bloodwork of all dogs, undivided according to inflammatory status, and of dogs with an inflammatory status. Consequently, in veterinary clinical practice, C-reactive protein measures in dogs may be more applicable in cases where an important rise in WBC over the cut-off value is observed in the complete blood count, commonly used to diagnose inflammatory or infectious status.

Clinical and hematological profile of patients with pancytopenia at a tertiary medical center in Ethiopia.

Pancytopenia is an important hematological problem encountered in routine clinical practice associated with a multitude of disease states. The possible causes of pancytopenia can be influenced by geography, socioeconomic conditions, and endemic illnesses. Information regarding the underlying clinical conditions and morphologic features of blood cells of pancytopenia is limited and varied across different regions. Thus, this study was designed to assess the peripheral morphologic features of blood cells and the underlying clinical causes of pancytopenia. A facility-based cross-sectional study was conducted at the Jimma Medical Center hematology laboratory from June 13 to November 13, 2022. A total of 3mL of whole blood was collected from each subject for complete blood count analysis and peripheral blood morphology examination. Data on sociodemographic and clinical conditions were collected from medical records using a checklist. The data were analyzed using Statistical Package for the Social Sciences version 26. A total of 163 patients with pancytopenia were identified within the 5 months. Hyper-reactive malarial splenomegaly was the most prevalent cause (29.4%), followed by megaloblastic anemia (20.2%), chronic liver disease (10.4%), and acute leukemia (8.6%). Anisocytosis was the predominant peripheral blood morphology finding (82.2%), along with microcytosis (49.7%), ovalocytosis (31.3%), and macrocytosis (30.7%). Severe anemia was observed in 57% of cases, whereas the majority (92%) exhibited moderate leukopenia. A significant proportion (42.3%) had a platelet count below 50,000/μL. Unlike previous studies conducted in other parts of the world, this study showed that hyperreactive malarial splenomegaly was the leading cause of pancytopenia. This emphasizes the necessity of considering this condition as a possible cause for pancytopenia, particularly in malaria-endemic areas. The findings of the hematological profiles and peripheral blood morphology strongly suggest that early identification and prompt management of patients with pancytopenia require collaboration between clinical and laboratory investigations.

Performance of red blood cell indices for the detection of reticulocytosis in anemic and non-anemic dogs in Taiwan

Reticulocyte counts (RETIC) are considered the gold standard in detecting an erythroid bone marrow response (BMR) in anemic and non-anemic dogs. Reticulocytosis without anemia (RWA) is a potential indicator of disease. The prevalence of anemia or RWA, as well as the effectiveness of red blood cell (RBC) indices in identifying a BMR, may vary based on geographical locations and breed differences. The purpose of the study was to determine the prevalence of regenerative and nonregenerative anemia, and RWA in pet dogs of Taiwan, and to assess the sensitivity and specificity of combined increased mean cell volume and decreased mean cell hemoglobin concentration (iMCV+dMCHC) to detect reticulocytosis in this population.The final population analysis consisted of 149,076 dogs. A cross sectional, retrospective analysis of complete blood count (CBC) samples from a field of automated hematology analyzers in Taiwan from December 1, 2018 through December 31, 2020 was performed. Among 149,076 dogs, 11.8 % (n=17,600) had reticulocytosis (RETIC > 110K/µl) and 21.8 % (n=32,474) had anemia (HCT < 37.3 %). Of 32,474 anemic dogs, 17.8 % (n=5,789) had reticulocytosis. Of 116,602 dogs without anemia, 10.1 % (n=11,776) had reticulocytosis. Across all dogs, sensitivity/specificity of iMCV+dMCHC to detect BMR was 4.3 % and 99.4 %, respectively compared to RETIC. Among anemic dogs, sensitivity/specificity of iMCV+dMCHC to detect BMR was 9.8 % and 99.2 %, respectively. Among non-anemic dogs, sensitivity/specificity of iMCV+dMCHC to detect BMR was 1.6 % and 99.5 %, respectively. Therefore, most regenerative anemias and cases of RWA did not have a combined iMCV+dMCHC. To avoid overlooking potential illness, RETIC should be evaluated regardless of whether patients have anemia or not.

Clinical and Diagnostic Value of High-Density Lipoprotein-Based Inflammatory Indices and Lipid Ratios in Young Adults with Schizophrenia.

This study aimed to assess High-density Lipoprotein (HDL)-based Inflammatory Indices and lipid profile changes in antipsychotic-naive first-episode schizophrenia (AN-FES) patients, chronic schizophrenia (CS) patients, and explore the clinical and predictive value of these parameters for schizophrenia. The study cohort included 52 AN-FES patients, 46 CS patients, and 52 healthy controls (HCs), with an average age of 24 years. Upon admission, patients underwent complete blood count and lipid profile analyses. Various ratios were calculated, including neutrophil-to-HDL (NHR), monocyte-to-HDL (MHR), lymphocyte-to-HDL (LHR), and platelet-to-HDL (PHR), as well as lipid ratios like triglycerides/HDL, non-HDL/HDL, total cholesterol/HDL, and low-density lipoprotein/HDL. For the AN-FES group, these evaluations were repeated after two months of treatment with atypical antipsychotics. Statistical analyses included correlation analysis, Receiver Operating Characteristic (ROC) curve analysis, and univariate and multivariate regression. Compared to HCs, CS patients exhibited significantly higher MHR and NHR values, while AN-FES patients showed elevated levels of PHR, MHR, and NHR. No significant differences were observed in LHR or lipid ratios across the three groups. In the AN-FES cohort, MHR correlated positively with neutrophil counts, and NHR with monocyte counts. Additionally, white blood cell counts were positively associated with both MHR and NHR. Following treatment, NHR levels decreased, whereas TG/HDL ratios increased, with MHR and PHR remaining elevated. ROC analysis highlighted NHR as the most diagnostically valuable parameter (AUC = 0.799), with 86.5% specificity at an optimal cutoff of 3.534, outperforming MHR and PHR. Regression analyses recognized NHR (OR=2.225) as an independent risk factor for schizophrenia, even after adjusting for confounders. HDL-based inflammatory indices, particularly NHR, may serve as valuable diagnostic and prognostic markers in young adults with schizophrenia, even though significant alterations in lipid ratios were not observed in this demographic.

Optimization of Complete Blood Count Results with Variations in Specimen Handling and Whole Blood Secondary Homogenization Techniques

Specimen homogenization and the addition of anticoagulants are pre-analytical steps that influence the accuracy of the test results. Complete blood count (CBC) is a screening test that supports disease diagnosis and aids in determining the appropriate therapy for patients. Inadequate specimens are inappropriate for subsequent testing, as they can lead to inaccurate results in the CBC examination. This study aims to determine the optimization of complete blood count results with variations in specimen handling and secondary homogenization techniques for whole blood. The type of research used is quantitative analysis using laboratory experimental methods. The study was conducted in May 2024 in the Clinical Pathology Laboratory of the Diploma-4 Medical Laboratory Technology Study Program, Faculty of Health Sciences, Muhammadiyah University of Sidoarjo, using 48 blood samples. The results of the MANOVA test indicate that the type of anticoagulant has a significant effect on the erythrocyte count (p=0.041) but does not have a significant impact on the leukocyte count (p=0.844) and platelet count (p=0.920). Meanwhile, the homogenization technique does not significantly affect the erythrocyte count (p=0.959), leukocyte count (p=0.991), or platelet count (p=0.867). This study concludes that the secondary homogenization technique has no significant effect. In contrast, the type of anticoagulant significantly impacts the results of the Complete Blood Count (CBC) test. This research suggests collecting whole blood specimens using Ethylene Diamine Tetra Acetate (EDTA) vacutainers as the anticoagulant and applying a secondary homogenization technique before performing the CBC analysis.

The treatment and diagnostic plan for chronic myeloid leukemia in Libyan oncology centers

Background: CML is one of the best understood diseases from the aspect of its cytogenetic abnormalities and the molecular mechanisms involved. CML was the first human disease in which a specific abnormality of the karyotype, the Philadelphia (Ph) chromosome, could be linked to a malignant disease. Later on, it was shown that the Ph chromosome results from a reciprocal translocation between the long arms of chromosomes 9 and 22, which produces the BCR-ABL fusion oncogene. Accordingly, in this study; we are going to determine whether the team workers in Libyan oncology centers actually following these steps of guidelines as it has been used internationally or there are some differences and special circumstances prevent them to apply the guidelines. Objectives: The present study aimed to explore the methods and plans used for diagnosis and treatment of CML patients in Libyan oncology centres and to confirm the most effective methods in diagnosis and treatment of CML by using a statistical analysing of some special data related to a well investigated cases by making a comparison between those plans. Methods: 173 and 153 CML patient files who has registered in Sabratha oncology institute and Misurata oncology institute -which are both considered as the main oncology centers in Libya- during the last sixteen years were investigated. Then, ten CML case files have randomly chosen from total CML patient files (51) and (78) cases from both oncology institutes which represents (35% and 45%) of all cases respectively (Male and Female, five from each institute). All results of laboratory investigations (CBC, biochemistry profiles, blood film, bone marrow, cytogenetic and molecular analysis) have been recorded and statistically analyzed to know the hematological, cytogenetic and molecular responses during the treatment period. CML patients chosen were at varying disease stages (chronic, accelerated, and blastic phases). The drugs used for treatment included 500 mg of Hydroxyurea, 400 mg, 600 mg and 800 mg of Glivec, and 600 mg of Tasigna in rare cases. Results and conclusion: The study has indicated the existence of a clear deficiency gap represented in a widespread lack of many capabilities such as the lack of some devices, equipments, operating materials and qualified experts. Moreover, the study has confirmed that the treatment plan has modified depending on the results of the complete blood count (CBC) only during all periods of the treatment without achieving other important investigation used for treatment follow up such as bone marrow aspiration, blood film examination, cytogenetic examination and molecular diagnostic. This study-as the first study dealing with this important topic- clarified many shortcomings of the diagnostic and treatment plan followed in both oncology institutes. As a recommendation, it is necessary to apply all international standard steps of the diagnosis and treatment in particular.

Feeding rats with used cooking oil elevates malondialdehyde, TNF-α, and creatinine compared to tempe fried with used oil.

In vivo studies on the hazards of deep-fried foods were commonly done by feeding used-or heated-cooking oil to rats. The aim of this study was to determine the effect of feeding tempe deep-fried in palm, olive, and coconut oils and the used frying oil on the blood biochemical profile of laboratory rats. An in vivo randomized control group study with pre-test and post-test was conducted. This study included healthy male Sprague-Dawley rats aged 2-3 months and weighing 100-200 grams. After acclimatization, the rats were randomly assigned to seven groups, which were: (1) regular diet (control diet); (2) diet of tempe deep-fried in 5× used palm oil (Tempe-in-used-Po); (3) diet of tempe deep-fried in 5× used coconut oil (Tempe-in-used-Co); (4) diet of tempe deep-fried in 5× used olive oil (Tempe-in-used-Oo); (5) diet of 5× used palm oil (Used-Po); (6) diet of 5× used coconut oil (Used-Co); and (7) diet of 5× used olive oil (Used-Oo). Each rat received 15 grams of a treatment diet daily and blood samples were collected after four weeks for a complete blood count and serum biochemistry analysis. The results showed that the final body weight and the weight gain of Tempe-in-used-Po, Tempe-in-used-Co, Tempe-in-used-Oo group, and Used-Po groups increased significantly compared to the control, Used-Co, and Used-Oo groups. However, there was a significant increase in serum tumor necrosis factor-alpha (TNF-α) in the Used-Co and Used-Oo groups (p<0.05), suggesting the used oil's detrimental effect. The Used-Co and Used-Oo were the only two groups whose creatinine increased significantly (p<0.05). Subsequently, only the Used-Oo group had a significantly increased malondialdehyde (MDA) level compared to all groups (p<0.05). These results prove that the effect of feeding fried food differs from used oils. Feeding used oil did not reflect the consumption of fried foods as part of the whole diet and generally resulted in more harmful effects. This is the first study to report an in vivo rat feeding study of deep-fried tempe and the used oil as part of the diet.

Preclinical and Toxicology Assessment of ALW-II-41-27, an Inhibitor of the Eph Receptor A2 (EphA2).

The EphA2 receptor inhibitor ALW-II-41-27 has proven to be an effective in vitro antagonist of Pneumocystis β-glucan-induced proinflammatory signaling. This suggests its potential as a candidate for initial anti-inflammatory drug testing in the rodent model of Pneumocystis pneumonia (PCP). Initially, single-dose intraperitoneal (IP) injections of ALW-II-41-27 were administered at concentrations of 0, 10, 15, 20, and 30 mg/kg over a 24-h treatment period. Pharmacokinetics were assessed in plasma, bronchoalveolar lavage fluid (BALF), and epithelial lining fluid (ELF). Following these assessments, a final single mg/kg dosing was determined. Mice received daily IP injections of either vehicle or 20.0 mg/kg of ALW-II-41-27 for 10 days, with their weights recorded daily. On day 11, mice were weighed and euthanized. Lungs, liver, and kidneys were harvested for H&E staining and pathology scoring. Lung samples were further analyzed for proinflammatory cytokines using enzyme-linked immunosorbent assay (ELISA) and extracellular matrix production using quantitative PCR (qPCR). Postmortem blood collection was conducted for complete blood count (CBC) blood chemistry analysis. Lastly, ALW-II-41-27 was administered to mice prior to fungal β-glucans challenge to determine in vivo effects on lung inflammation. This report describes the PK assessment of ALW-II-41-27 given via IP in C57BL/6 mice. After PK data were generated, we tested ALW-II-41-27 at 20 mg/kg IP in mice and noted no significant changes in daily or final weight gain. ELISA results of proinflammatory cytokines from lung tissues showed no major differences in the respective groups. qPCR analysis of extracellular matrix transcripts were statistically similar. Examination and pathology scoring of H&E slides from lung, liver, and kidney in all groups and subsequent pathology scoring showed no significant toxicity. Blood chemistry and CBC analyses revealed no major abnormalities. Additionally, administering ALW-II-41-27 before intratracheal inoculation of fungal β-glucans, known to induce a strong proinflammatory response in the lungs, significantly reduced lung tissue IL-1β levels. In our initial general safety and toxicology assessments, ALW-II-41-27 displayed no inherent safety concerns in the analyzed parameters. These data support broader in vivo testing of the inhibitor as a timed adjunct therapy to the deleterious proinflammatory host immune response often associated with anti-Pneumocystis therapy.

An mpox quadrivalent mRNA vaccine protects mice from lethal vaccinia virus challenge

The outbreak of 2022 monkeypox virus (MPXV) infection in nonendemic regions is a global public health concern. A highly effective and safe MPXV vaccine that is available to the general public is urgently needed to control the mpox pandemic. Here, we developed a multivalent mRNA vaccine candidate, MPXV-1103, which expresses the full-length B6, A35, A29 and M1 proteins with three flexible linkers (G4S1)3 in a single sequence. Compared with the monovalent MPXV mRNA vaccine candidates or the quadrivalent mRNA vaccine from mixtures of the four monovalent MPXV mRNA vaccines, MPXV-1103 elicits a robust humoral response and an MPXV-specific T-cell response and protects mice from lethal vaccinia virus (VACV) challenge, with no live virus detected in the nasal or lungs even at dosages as low as 1 μg. Furthermore, analysis of complete blood counts and photomicrographs of tissue from the main organs of mice vaccinated with MPXV-1103 at doses of 5 μg and 20 μg revealed that two doses of MPXV-1103 did not cause any observable pathological changes in the mice. Collectively, our results suggest that MPXV-1103, with features of high efficacy, safety and a simplified manufacturing process, is a promising vaccine candidate for defending against MPXV infection.

Consistency analysis of two fingertip capillary blood sampling methods for complete blood count

This study was performed to analyze fingertip capillary blood sampling in pediatric patients using microcapillary blood collection tubes and microhematocrit tubes and to compare the blood cell analysis results obtained via these two blood collection methods. Finger capillary blood was collected from 110 outpatients using microcapillary blood collection tubes and microhematocrit tubes and complete blood count analysis was performed with a Sysmex XS-900i hematology analyzer and manual microscopy for blood cell morphology. Paired data was evaluated for agreement and bias using the microhematocrit samples as the reference group and the samples from the microcapillary blood collection tubes as the observation group. The two blood collection methods demonstrated good agreement for measuring red blood cell (RBC) parameters (i.e., RBC, Hb, Hct, MCV, MCH and MCHC), wherein the relative bias was > allowable total error (TEa) in 0.91%, 1.82%, 11.82%, 1.82%, 0.91% and 8.18% of the parameter measures, respectively. According to industry requirements, the proportion of samples meeting the acceptable bias level should be > 80%. Additionally, the estimated biases at each medical decision level were within clinically acceptable levels for RBC, Hb, Hct, and MCV. However, the proportion of WBC and PLT counts with relative bias > TEa was 25.45% and 35.45%, respectively. Furthermore, the relative bias of the WBC count at the medical decision level of 0.5 × 109/L and that of the PLT counts at the medical decision levels of 10 × 109/L and 50 × 109/L were clinically significant. Bland–Altman analysis further showed a mean bias of 0.66 × 109/L (95% LoA, − 0.79 to 2.11) for the WBC count and 39 × 109/L (95% LoA, − 46 to 124) for the PLT count from the blood samples collected in the microcapillary blood collection tubes compared with the counts of those collected in the microhematocrit tubes. Neutrophil, monocyte, lymphocyte, eosinophil, and PLT counts increased significantly in the microcapillary blood collection tubes compared with those in the microhematocrit tubes, along with an elevated number of instrument false alarms (P < 0.05). The two capillary blood collection devices exhibit performance differences. Therefore, clinicians should pay attention to the variation in results caused by different blood collection methods.

Hematological parameters of hypertensive patients in northeast Ethiopia: A comparative cross-sectional study

IntroductionHypertension has emerged as a significant public health concern, ranking among the leading causes of mortality in low- and middle-income countries. Moreover, it is closely associated with structural and functional alterations in hematopoietic cells. Therefore, this study aimed to evaluate the hematological parameters of hypertensive patients in Northeast Ethiopia. MethodsA comparative cross-sectional study was conducted from January to March 2023, involving 248 participants. This included 124 hypertensive patients and 124 apparently healthy controls selected using a systematic random sampling technique. Socio-demographic and clinical data were collected through a structured questionnaire, and anthropometric measurements were obtained following established guidelines. Ethical approval was obtained from the Ethical Review Committee of the College of Medicine and Health Sciences at Wollo University. After obtaining informed consent, approximately 5 ml of venous blood was drawn from each participant for complete blood count and fasting blood glucose analysis, performed using the Mindray BC-3000 Plus hematology analyzer and the DIRUI CS-T240 automated clinical chemistry analyzer, respectively. Data analysis involved independent t-tests, Mann-Whitney U-tests, correlation tests, and logistic regression. A p-value of <0.05 was considered statistically significant. ResultsThe study found that white blood cell count, platelet count, platelet distribution width, red cell distribution width, and mean platelet volume were significantly higher in hypertensive patients compared to the control group (p < 0.05). Conversely, red blood cell count, hematocrit, and hemoglobin levels were significantly higher in the control group than in hypertensive patients (p < 0.05). Additionally, white blood cells and platelets exhibited a positive correlation with systolic and diastolic blood pressure (p < 0.05), while red blood cell count, hematocrit, and hemoglobin demonstrated a negative correlation with blood pressure indices and body mass index. Anemia was observed in 20.2 % of hypertensive patients. Notably, an abnormal body mass index (AOR: 3.5, 95 % CI: 1.3–9.6, p = 0.011) and high systolic blood pressure (AOR: 4.6, 95 % CI: 1.3–15.5, p = 0.013) were significantly associated with anemia among hypertensive patients. ConclusionThis study identified significant differences in various hematological parameters between hypertensive patients and the control group. Routine assessments of hematological parameters should be considered to effectively manage hypertension-related complications in hypertensive patients.