Complete Blood Count Analysis Research Articles

Automated complete blood counter, urine analyzer and urine dipstick test results are correlated with thoma cell counting chamber counts in the diagnosis of dialysis related peritonitis in children

IntroductionPeritoneal dialysis is the treatment of choice for end-stage renal disease. Peritoneal dialysis related peritonitis is of great importance for patient and technical survival. The aim of our study was to evaluate the accuracy and the correlation between the three methods (complete blood count, urinalysis device, urine dipstick test) and with the reference manual method (Thoma Cell Counter Chamber). Materials and methodsWe retrospectively analyzed 167 peritoneal fluid samples taken from 25 patients receiving peritoneal dialysis treatment. Leukocyte counts were evaluated with Thoma Cell Counter Chamber, complete blood count, urinalysis device and urine dipstick test. ResultsThere was a significant positive correlation between Thoma Cell Counter Chamber and complete blood count results (Spearman's rho=0.70), between Thoma Cell Counter Chamber and urinalysis device (Spearman's rho=0.73), and between Thoma Cell Counter Chamber and urine dipstick test (Spearman's rho=0.71). Area under curve for complete blood count, urinalysis device and urine dipstick test were 0.93, 0.94 and 0.89 respectively, indicating good accuracy. Sensitivity and specificity were 89.7% and 86.7% in the complete blood count analysis (associated criterion: 130 cells/mm3). Sensitivity and specificity were 89.7% and 86.7% in the urinalysis device (associated criterion: 10 cells/HPF). Sensitivity and specificity were 79.6% and 91.4% when in the urine dipstick test analysis (associated criterion: +1 positivity). The Bland-Altman plot showed good agreement. ConclusionAutomatic complete blood count and urinalysis devices have good correlation and agreement with manual method in the diagnosis of peritonitis in the pediatric age group. Urine dipstick test in the home setting can be useful for screening patients with suspected peritonitis.

AG-946 Normalizes Glycolysis and Improves Red Cell Indices in a Humanized Sickle Cell Mouse Model

We have previously demonstrated that enzymes of the glycolysis pathway and deoxy hemoglobin (deoxyHb) reversibly bind to the cytoplasmic domain of Band 3 (CdB3). For these studies we generated 3 transgenic mice in which the endogenous mouse Band 3 was replaced with: i) human wild type CdB3 (WT); ii) human CdB3 lacking the deoxyHb binding site (Hb-); iii) human CdB3 with high-affinity binding site for deoxyHb (Hb+). In the humanized WT strain, glycolytic enzymes (including fructose-1,6-biphosphate [FBP], dihydroxyacetone phosphate/ glyceraldehyde-3-phosphate [G3P] and 3-phosphoglycerate/2-phosphoglycerate [PG]) bind to CdB3 in oxygenated conditions and are displaced by the binding of deoxyHb in deoxygenated conditions. Erythrocytes from the mutant lines were insensitive to oxygen concentration (Chu et al. Blood 128, 2016, Zheng et al. JBC 294, 2019, Zhou et al. Sci. Adv. 5, 2019), showing that CdB3 constitutes a molecular switch regulating assembly of glycolytic enzymes on the erythrocyte membrane based on the oxygenation state. To study if this mechanism plays a role in Sickle Cell Disease (SCD), we crossed the humanized Band 3 mouse strains to the Townes SCD mouse model. -Hb_SS mice had a significantly higher percentage of sickled cells and a higher rate of sickling compared to WT_SS animals. ++Hb_SS mice showed a decrease in the percentage of sickled cells and the rate of sickling. We hypothesized that the inability of the glycolytic enzymes to reversibly bind to CdB3 in the -Hb mice inhibited glycolysis. To test this hypothesis, we analyzed a panel of 28 cellular metabolites in each genotype (WT_AA, _AS, and _SS; -Hb_AA, _AS, _SS; and ++Hb_AA, _AS, _SS) using an API 4500 triple quadrupole mass spectrometer (AB Sciex), with a polymeric amino column (apHera by Supelco) with stable isotope spike in controls allowing the absolute quantification of each metabolite. Consistent with the constitutive binding of the terminal glycolytic enzymes to CdB3 in -Hb erythrocytes, glycolysis was inhibited, as evidenced by significant accumulation of the intermediates at the top of the glycolysis pathway, including FBP, G3P and PG (p values all <0.01) compared to WT cells. In the ++Hb mutant where the terminal glycolytic enzymes are constitutively displaced from CdB3, significantly lower levels of FBP, G3P and PG compared to WT cells were observed (p values all <0.01). AG-946 is a novel small-molecule activator of erythrocyte pyruvate kinase that mediates the final step of glycolysis yielding 2 ATP and 2 pyruvate molecules per glucose molecule. We hypothesized that treatment of the -Hb-SS animals treated with AG-946 would reduce the levels of the glycolytic intermediates by accelerating the terminal stage of glycolysis. We designed a pilot study in which -Hb-SS mice were fed control chow for 4 weeks and then randomly separated into a group receiving control chow and a group receiving AG-946 at an approximate dose of 10 mg/kg/day. After 8 weeks on study, blood was collected from treated and untreated animals for analysis of complete blood counts, plasma levels of AG-946, the levels of 28 metabolites, intracellular 2,3-DPG, and the rate and degree of sickling. AG946 was well tolerated, all mice in both arms of the study gained weight over the 8 weeks. At the end of the study, the plasma levels of AG946 in the treated animals ranged from 736 to 2281 nM. In the treated animals we observed a complete normalization of the levels of the glycolytic intermediates and 2,3-DPG while the levels in the untreated group were unchanged. Treated animals showed significant increases in the red blood cell counts (from 4.6 + 0.52 in the control group to 7.07 + 0.21 1012/L in the treated group), hematocrit (from 24.7 + 1.8% to 33 + 1.8%) and hemoglobin (6.9 + 0.8 to 8.9 + 0.3 g/dL; p values all <0.016). We observed significant decreases in the MCV (53.5 + 2.3 to 46.6 + 1.1) and MCH (14.9 + 0.05 to 12.6 + 0.25; p values all <0.01). These differences did not correlate with the plasma levels of AG-946 indicating that levels of 736 nM are sufficient to correct the block in glycolysis and improve the red cell indices. No differences were observed in MCHC or WBC, or in the rate or degree of sickling. We conclude that AG-946 treatment effectively enhances glycolysis in humanized Band 3/SS mice. The normalization of glycolytic intermediates is accompanied by increases in critical red cell indices (RBC, HCT, Hb, and MCV). AG946 may be an effective treatment for sickle cell disease.

Using a Humanized Animal Model to Determine the Minimum JAK2V617F Mutant Allele Burden Required to Generate MPN Pathologies

Myeloproliferative neoplasms (MPNs) are clonal hematological diseases driven by somatic mutations acquired in hematopoietic stem cells (HSCs) and characterized by the deviant, unregulated proliferation of one or more myeloid lineages. Chronic MPN can present as polycythemia vera (PV; excess erythrocytes), essential thrombocythemia (ET; excess platelets), or myelofibrosis (MF; bone marrow fibrosis). More than 300,000 patients are currently living with an MPN diagnosis in the United States. The JAK2V617F variant is an acquired somatic mutation recurrently found in MPN patients and is used as a diagnostic marker along with increased hematocrit, increased hemoglobin, and adverse thrombotic events. In MPN patients, the frequency of JAK2V617F mutant cells varies widely but is known to induce an MPN phenotype with both high (>50%) and very low (<5%) variant allelic frequency (VAF). The reason for this is currently unknown. Most JAK2-mutant animal models model a VAF which is much higher than the lower end of detectable VAFs found in MPN patients. This results in a very limited understanding of what the minimal mutant cell burden required for disease manifestation is. The understanding of genotype/phenotype relationships in patients with low JAK2V617F VAF chronic MPN is paramount to our understanding of this disease and its hematological progression. To this end, we have designed a clinically relevant, humanized mouse model wherein we employ CRISPR and homology directed repair (HDR) via a single stranded oligo donor nucleotide sequence (ssODN) to knock-in the JAK2V617Fmutation at the endogenous locus of human cells at low VAF. In addition, a synonymous JAK2V617V mutation was introduced via CRISPR/ssODN in parallel cells to serve as a control tracked by VAF alongside the VAF of JAK2V617F in their corresponding cohorts. The respective ssODNs were nucleofected into either umbilical cord blood (UCB) derived CD34+ cells or healthy adult bone marrow (BM) derived CD34+ cells to investigate the possibility that developmental age is a variable in low JAK2V617F VAF inducing a clinical MPN phenotype. After nucleofection, 20,000 CD34+ cells were intra-tibially transplanted into sub-lethally irradiated (250 rads) NSGS mice. The low cell input was utilized to limit engraftment and initial disease burden of mutant cells. Effect was measured by mutant allele burden by droplet-digital PCR (ddPCR) analysis, flow cytometry at selected timepoints to track human cell engraftment, spleen weight, and complete blood count (CBC) analysis including hematocrit, hemoglobin, white blood cells, and platelets. At 4 months post-transplant, peripheral blood hCD45+ engraftment across all cohorts averaged less than 3%. Average VAF of circulating hCD45+ cells increased in both JAK2V617F cohorts 5 months post-transplant compared to day 0 post nucleofection. Notably, overall JAK2V617F VAF in each sample remained <5% when adjusted to include both human and mouse derived peripheral blood cells. Remarkably, both hematocrit (p= .037 in UCB cohorts and p=.0096 in BM cohorts; Figure 1A) and hemoglobin (p=.046 in UCB cohorts and p=.0026 in BM cohorts; Figure 1B) were significantly elevated in both JAK2V617F cohorts compared to their respective JAK2V617V controls, while white blood cell and platelet counts remained unchanged within normal ranges. In addition, spleen weights were significantly increased in both JAK2V617F cohorts compared to their respective controls. These data demonstrate a successful clinical model of MPN which induces a classical MPN phenotype where a low VAF of JAK2V617F corresponds with a significant increase of hematocrit, hemoglobin, and spleen weight in a humanized mouse model compared to relevant controls. In addition, we demonstrate that while engraftment due to low hCD34+ cell input remains low after 4 months, the VAF of JAK2V617F within the hCD45+ sub- population increases. This successfully enables the overall VAF contributing to the MPN phenotype to remain at clinically relevant lower levels compared to other models with much higher VAF contributions. We believe this model to be of high clinical relevance into the investigation of how low JAK2V617F burden relates to disease development and progression in MPN patients. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Hematological parameters of reproductive-age women using hormonal contraceptives at University of Gondar Comprehensive Specialized Referral Hospital, Northwest Ethiopia: A comparative cross-sectional study.

More than one-third of reproductive aged women in Ethiopia use hormonal contraceptives to prevent conception. The present study aimed to compare the hematological parameters of reproductive-age women taking hormonal contraceptives at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest Ethiopia in 2021. A comparative cross-sectional study was conducted from April to June 2021. A total of 240 study participants were recruited by using a consecutive sampling technique. Data on socio-demographic variables and clinical data were collected through face-to-face interviews using a structured questionnaire and medical record reviews, respectively. Three milliliter venous blood was collected for complete blood count analysis using Unicel DxH 800 coulter hematology analyzer. Data was entered into Epi-data 4.4.3.1 version then exported to IBM SPSS v25 for analysis. Kruskal-Wallis H, Dunn-Bonferroni pairwise comparison test, and Spearman's correlation analysis were used for inferential statistics. P&lt;0.05 were considered statistically significant. The median and interquartile range of platelet count among combined oral contraceptive users was 285(238-332) which is significantly higher than that of depot medroxyprogesterone acetate users 246(220-226) (p = 0.010), implant user 247(221-297) (p = 0.034), and controls 256(224-278) (p = 0.015). The result also showed long-term use of implant negatively correlated with red blood cell count (p = 0.033). This finding concludes that combined oral contraceptive users had a higher platelet counts than controls while long-term use of implants can result in low red blood cells count. Therefore, a baseline evaluation of complete blood count in women desiring contraceptive methods would also be recommended.

A COMPARATIVE STUDY OF DECAF SCORE AND MODIFIED DECAF SCORE IN PREDICTING HOSPITAL MORTALITY RATES IN ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common and lead to catastrophic events. Accurate prognostic tool for patients with exacerbation who required hospital admission is needed to predict the risk of in-hospital mortality and help physicians to select the appropriate level of care. Aim The aim was to compare the ability of conventional DECAF (dyspnea, eosinopenia, consolidation, acidemia, frequency of hospital admission) and modified DECAF scores to expect the in-hospital mortality rate. Patients and Methods: A prospective, observational study was carried out on 100 patients with AECOPD admitted at the respiratory ICU and chest department. All patients were subjected to complete medical history taking, chest examination, dyspnea assessment by extended modified Medical Research Council Dyspnea, complete blood count, chest radiograph, ECG, and arterial blood gas analysis. Both conventional DECAF score [(D) dyspnea, (E) eosinopenia, (C) consolidation, (A) acidemia, (F) atrial fibrillation] and modified DECAF score [(D) dyspnea, (E) eosinopenia, (C) consolidation, (A) acidemia, (F) frequency of hospital admission] were calculated. In-hospital mortality was recorded. Results: Nine (9%) patients died during their hospital stay. The modified DECAF score showed a good prediction of in-hospital mortality (area under the receiver operating characteristic curve=0.95) and was higher in accuracy than the original DECAF score (area under the receiver operating characteristic curve=0.92). Both were (sensitive 100%) but the modified DECAF was more specific (specificity=86.81) than the DECAF score (specificity=80.22). Conclusion: Both the conventional DECAF score and the modified DECAF score are practical and can be calculated easily using simple questions and routine investigations available during the initial admission. Both were good predictors of mortality and the requirement of invasive mechanical ventilation. The modified DECAF was superior in predicting in-hospital mortality in AECOPD than the original score.

Platelet-to-lymphocyte ratio and mean platelet volume-to-platelet count ratio for predicting mortality in critical COVID-19 patients

Introduction: Defining the markers that can be used in clinical practice for predicting the mortality of critical patients will be cautionary for taking necessary measures in high-risk cases. Although there are a large number of studies conducted during the pandemic, no mortality marker to predict the prognosis of intensive care unit (ICU) patients with COVID-19 has yet been defined. Platelet indices can be easily evaluated with a complete blood count (CBC) analysis, one of the most accessible tests worldwide. This study aimed to evaluate the role of platelet indices such as mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), platelet-to-lymphocyte ratio (PLR), and MPV-to-platelet count ratio (MPV/PLT) in predicting the mortality of ICU patients with COVID-19. &#x0D; Material and Method: This single-center, retrospective, cross-sectional study included 201 critical COVID-19 patients over 18 years of age who were hospitalized in ICU between August 2020 and February 2021. Patients were divided into two groups as survivors and non-survivors. The relationship of MPV, PDW, PCT, PLR, and MPV/PLT parameters evaluated at ICU admission with mortality was investigated. &#x0D; Results: There was no significant difference between the survivor and non-survivor groups in terms of platelet count, MPV, PCT, and PDW. The comparison of the platelet ratios revealed higher PLR and MPV/PLT ratio in the non-survivor group than in the survivor group (p

Effect of relative centrifugal force on the biological properties of liquid platelet-rich fibrin produced via horizontal centrifugation.

Platelet-rich fibrin (PRF) in liquid form has shown advantages in tissue engineering including acting as injectable fillers and drug carriers. However, few studies have investigated the best relative centrifugal force (RCF) for preparing liquid PRF. The aim of the present study was to find out optimal centrifugation force for preparing liquid PRF. Liquid PRF was prepared using horizontal centrifugation (liquid H-PRF) with RCF ranging from 100g, 300g, 500g, to 700g for 8min. The volume, weight, solidification time, and tensile properties were subsequently investigated. Scanning electron microscopy (SEM) and rheologic tests were carried out to investigate the microstructure and rheologic properties of liquid H-PRF after natural polymerization. The total number, concentration, and distribution of cells within each liquid H-PRF was evaluated by complete blood count (CBC) analysis and hematoxylin-eosin staining. As RCF values increased, the volume and weight of liquid H-PRF both increased accordingly. SEM images revealed that as the centrifugal force increased, the fibrin bundles became thinner with a denser fibrin network, and rheologic tests revealed improved mechanical properties. CBC analysis demonstrated that 500g group had the highest number of leukocytes and neutrophils, whereas 100g group yielded the highest concentration of leukocytes and platelets. Furthermore, histological analysis suggests that cells obtained by 500g for 8min were most evenly distributed in liquid H-PRF. In summary, the present study provided insights into the contents of liquid H-PRF prepared at different centrifugation forces, enabling clinicians to choose proper centrifugation forces based on their needs. The present findings provide theoretical basis for clinical choice of liquid H-PRF protocol from mechanical, cell contents, and histological aspects.

Prevalence of Anemia in Pregnant Women

Aim: To determine the prevalence of anemia in pregnant women in Punjab. Study Design: Cross-sectional study. Place and Duration of Study: Department of Obstetrics &amp; Gynaecology, DHQ Hospital, Faisalabad from 1st October 2021 to 31st March 2022. Methodology: One hundred and fifty pregnant females were enrolled, clinically assessed for their anemic status and were divided into two groups in reference to suspicion of anemia. Group A had those pregnant females who were suspected for anemia while group B were with no suspicion of anemia. Both Group A and Group B had 75 pregnant females. The complete blood count and serum analysis of ferritin, iron and folic acid was performed in each patient after withdrawal of 5cc blood. The demographic details of each patient as well as dietary habits in context of meat, fruit and vegetables from last month were also documented. Results: There were 37.3% pregnant females within suspected anemia group while 36% pregnant females in no suspected anemia group. The frequency of abortion was higher in group A than B with an odds ration as 1.17-1.18. There were more over weight and obese women in suspected anemia Group A while under-weight were more common in Group B. Pregnant females in Group A were consuming less amount of meat, fruit and vegetables than females in group B. The suspected anemia pregnant females blood analysis reports showed 74.6% been iron deficient in comparison with 41.3% non-suspected pregnant females Conclusion: Anemia was prevalent in both suspected and unsuspected group and 75% of the suspected anemia group were also iron deficient. Keywords: Iron deficiency anemia, Pregnancy, Hemoglobin, Incidence, Developing countries

Correction of iron deficiency in patients with abnormal uterine bleeding

INTRODUCTION: Iron deficiency (ID) occurring latently or as iron deficiency anemia (IDA) is common in gynecology, particularly in patients with abnormal uterine bleeding (AUB).&#x0D; AIM: We aimed at exploring the efficiency of a medication containing ferrous sulfate and multivitamins for the correction of latent ID and treatment of mild IDA in AUB patients.&#x0D; MATERIALS AND METHODS: We performed a comprehensive clinical, laboratory, and instrumental examination of 60 women aged 35 to 50 years with AUB, revealing many gynecological pathologies (endometrial polyps or hyperplasia, ade nomyosis, and uterine myoma). The examined patients with AUB were divided into two groups: women with latent ID (group 1, n=38) and women with IDA (group 2, n=22). Moreover, all the patients had extragenital pathology in addition to gynecological diseases. As a treatment, ferrous sulfate with multivitamins was prescribed for 13 months.&#x0D; RESULTS: Before treatment, the hemoglobin level in the examined patients ranged from 95 to 130 g/L, with an average of 127.11.8 g/L in group 1 and 100.32.1 g/L in group 2. Serum iron concentrations in the examined groups were 9.80.2 and 6.91.3 mol/L, respectively. After treatment, the average levels of hemoglobin and serum iron increased significantly and reached normal levels in all those examined. Hemoglobin was 143.31.8 g/L in group 1 and 122.51.5 g/L in group 2, whereas serum iron was 14.90.2 mol/L in group 1 and 13.51.0 mol/L in group 2. Furthermore, a significant increase to normal values was observed in other indicators of complete blood count and biochemical analysis.&#x0D; CONCLUSIONS: The results of the study reveal a high clinical efficiency of ferrous sulfate and multivitamins in the treatment of ID in patients with AUB.

Nötrofil Hacim, İletkenlik ve Işık Saçılımı Parametrelerinin Bakteriyel Enfeksiyonlarda Hızlı Tanı Aracı Olarak Kullanımının Araştırılması

Aim: Early diagnosis of bacterial infections is crucial in planning treatment. Thus, it is important to determine the gram staining property of bacteria as well as the presence of bacterial infection. The acute bacterial infection leads to morphological changes in neutrophils. In this study, we investigated the use of neutrophil volume, conductivity and light-scattering (VCS) parameters as potential indicators for rapid diagnosis of bacterial infections, and to distinguish infections caused by gram-positive and gram-negative bacteria.&#x0D; Material and Methods: Patients with urinary tract infections, pneumonia, wound site infections and sepsis were included. The control group comprised patients without bacterial infections. The blood samples of the patients were examined for white blood cell and neutrophil counts; neutrophil VCS parameters were determined using a Coulter Analyzer. The VITEK 2 Compact System was used to detect microbial growth.&#x0D; Results: The blood sample data of 472 patients sent to our laboratory for Complete Blood Count analyses from various clinics were analyzed in this study. A total of 370 samples showed significant growth in their bacteriological culturing, whereas the remaining 102 samples showed no growth. For the detection of bacterial growth, the specificities of median neutrophil volume (MNV) and median neutrophil conductivity (MNC) were found to be 96% and 99%, respectively. In addition, median neutrophil light scattering (MNS) was higher in the gram-negative bacterial group than in the gram-positive bacterial group. &#x0D; Conclusion: The use of neutrophil VCS parameters is an effective and time-saving method to identify bacterial infections and distinguish between gram-positive and gram-negative bacterial infections.

HemoScreen hematology analyzer compared to Sysmex XN for complete blood count, white blood cell differential, and detection of leukocyte abnormalities.

We compared a point-of-care HemoScreen hematology analyzer to an automated Sysmex XN analyzer for complete blood count (CBC) and white blood cell (WBC) differential, and evaluated its capacity to detect leukocyte abnormalities. A total of 100 K2-EDTA whole blood samples, median age 56 years (2 months to 92 years), were compared. For CBC and WBC differential we compared 74 samples with no confirmed abnormal leukocytes. For 26 samples both analyzers gave flagging regarding leukocytes and the accuracy of the flagging was compared. Abnormal leukocytes were confirmed with manual microscopy (200 cells). HemoScreen CBC and WBC differential were highly comparable to Sysmex XN for most of the essential parameters (r=0.909-0.975). More variation was seen for basophil and monocyte counts (r=0.452 and 0.753, respectively). Sysmex XN gave more false WBC abnormal flagging (n=15 altogether) compared to HemoScreen. In addition, Sysmex XN, as well as HemoScreen, gave false WBC flagging for eight samples confirmed normal. The samples verified by microscopy review to truly contain leukocyte abnormalities (n=18) were flagged abnormal with both analyzers. The specificity for analyzer flagging was 72% and 88% for Sysmex XN and HemoScreen, respectively. HemoScreen hematology analyzer is essentially comparable to Sysmex XN for CBC and WBC differential analysis. Most importantly, HemoScreen detected all the samples confirmed to include abnormal leukocytes. HemoScreen was less prone for false WBC flagging compared to Sysmex XN, thereafter requiring less microscopy review. These abilities increase its utility in small health care units. Studies with a larger number of abnormal leukocyte samples are needed to confirm HemoScreen performance.

Parameters of complete blood count, lipid profile and their ratios in predicting obstructive coronary artery disease in patients with non-ST elevation acute coronary syndrome

Aim. To evaluate the predictive potential of the parameters of complete blood count (CBC), lipid profile and their ratios for predicting obstructive coronary artery disease (oCAD) in patients with non-ST elevation acute coronary syndrome (NSTEACS).Material and methods. The study included 600 patients with NSTE-ACS with a median age of 62 years who underwent invasive coronary angiography (CA). Two groups were formed, the first of which consisted of 360 (60%) patients with oCAD (stenosis ≥50%), and the second — 240 (40%) with coronary stenosis &lt;50%. The clinical and functional status of patients before CAG was assessed by 33 parameters, including parameters of CBC, lipid profile and their ratio. For statistical processing and data analysis, the Mann-Whitney, Fisher, chi-squared tests, univariate logistic regression (LR) were used, while for the creation of predictive models, multivariate LR (MLR) was used. The quality was assessed by 4 metrics: area under the ROC curve (AUC), sensitivity (Se), specificity (Sp), and accuracy (Ac).Results. CBC and lipid profile analysis made it possible to identify factors that are linearly and non-linearly associated with oCAD. Univariate LR revealed their threshold values with the highest predictive potential. The quality metrics of the best prognostic model developed using MLR were as follows: AUC — 0,80, Sp — 0,79, Ac — 0,76, Se — 0,78. Its predictors were 8 following categorical parameters: age &gt;55 years in men and &gt;65 years in women, lymphocyte count (LYM) &lt;19%, hematocrit &gt;49%, immune-inflammation index &gt;1000, high density lipoprotein cholesterol (HDL-C) to low density lipoprotein cholesterol (LDL-C) ratio &lt;0,3, monocyte (MON)-to-HDL-C ratio &gt;0,8, neutrophil (NEUT)-to-HDL-C ratio &gt;5,7 and NEUT/LYM &gt;3. The relative contribution of individual predictors to the development of end point was determined.Conclusion. The predictive algorithm (model 9), developed on the basis of MLR, showed a better quality metrics ratio than other models. The following 3 factors had the dominant influence on the oCAD risk: HDL-C/LDL-C (38%), age of patients (31%), and MON/HDL-C (14%). The influence of other factors on the oCAD risk was less noticeable.

Systemic immune-inflammation index as a novel predictor of atrial fibrillation after off-pump coronary artery bypass grafting.

SUMMARYOBJECTIVE:This study aims to examine the predictive role of systemic immune-inflammation index on postoperative new-onset atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting.METHODS:A total of 722 patients undergoing elective off-pump coronary artery bypass grafting between January 2017 and September 2021 were included in this study and divided into two groups as the atrial fibrillation group (n=172) and the non-atrial fibrillation group (n=550). Both groups were compared in terms of patients’ baseline clinical features, operative and postoperative variables, and preoperative hematological indices derived from the complete blood count analysis. Multivariate logistic regression and receiver-operating characteristic curve analyses were performed to detect the independent predictors of postoperative new-onset atrial fibrillation.RESULTS:The median age and length of hospital stay in the atrial fibrillation group were significantly higher than those in the non-atrial fibrillation group. The median values of white blood cell, platelet, neutrophil, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune-inflammation in the atrial fibrillation group were significantly greater than in those in the non- atrial fibrillation group. Logistic regression analysis demonstrated that age, platelet, platelet/lymphocyte ratio, and systemic immune-inflammation were independent predictors of postoperative new-onset atrial fibrillation. receiver-operating characteristic curve analysis revealed that systemic immune-inflammation of 706.7×103/mm3 constituted cut-off value to predict the occurrence of new-onset atrial fibrillation with 86.6% sensitivity and 29.3% specificity.CONCLUSION:Our study revealed for the first time that systemic immune-inflammation predicted new-onset atrial fibrillation after off-pump coronary artery bypass grafting.

Short-term celecoxib (celebrex) adjuvant therapy: a clinical trial study on COVID-19 patients.

BackgroundIt is known that severe acute respiratory coronavirus 2 (SARS-CoV-2) is the viral strain responsible for the recent coronavirus disease 2019 (COVID-19) pandemic. Current documents have demonstrated that the virus causes a PGE2 storm in a substantial proportion of patients via upregulating cyclooxygenase-2 (COX-2) and downregulating prostaglandin E2 (PGE2)-degrading enzymes within the host cell.AimHerein, we aimed to study how short-term treatment with celecoxib (Celebrex), a selective COX-2 inhibitor, affects demographic features, early symptoms, O2 saturation, and hematological indices of cases with COVID-19.MethodsA total of 67 confirmed COVID-19 cases with a mild or moderate disease, who had been referred to an institutional hospital in south-eastern Iran from October 2020 to September 2021, were enrolled. Demographic characteristics, symptoms, and hematological indices of the patients were recorded within different time periods. One-way ANOVA or Kruskal–Wallis tests were used to determine differences between data sets based on normal data distribution.ResultsO2 saturation was statistically different between the control group and patients receiving celecoxib (p = 0.039). There was no marked difference between the groups in terms of the symptoms they experienced (p > 0.05). On the first days following Celebrex therapy, analysis of complete blood counts showed that white blood cell (WBC) counts were markedly lower in patients treated with a high dose of celecoxib (0.4 g/day) than in controls (p = 0.026). However, mean lymphocyte levels in patients receiving a high dose of celecoxib (0.4 g/day) were markedly higher than in patients receiving celecoxib with half of the dose (0.2 g/day) for one week or the untreated subjects (p = 0.004). Changes in platelet count also followed the WBC alteration pattern.ConclusionCelecoxib is a relatively safe, inexpensive, and widely available drug with non-steroidal anti-inflammatory properties. The therapeutic efficacy of celecoxib depends on the administrated dose. Celecoxib might improve disease-free survival in patients with COVID-19.

Hematological Parameters Alteration in Thai Garlic Farmers Exposed to Mixed Pesticides

Fungicides, herbicides, and insecticides are commonly agrochemicals used to eliminate pests during garliccultivation. Occupational exposure to mixed pesticides can cause hematological abnormalities. The aim of thisstudy was toassess the adverse effects of chronic mixed pesticide exposure in the garlic farmers by using thehematological parameters. The blood sample was collected from 137 Thai farmers who chronically exposed tomixed pesticide and 59 control group who were not a history of exposure to mixed pesticide. Complete BloodCount (CBC) analysis was performed to investigate the hematological parameters alteration pattern of Thaifarmers. Statistical analysis also performed by using Mann-Whitney U test. Our investigations revealed thatthemean values of white blood cell (WBC) count, lymphocyte, basophil, platelet distribution width, mean plateletvolume and platelet large cell ratio significantly decreased in the chronic exposed group but did not affect whencompared with the normal reference ranges. The results clearly demonstrated that chronic exposure to the mixedpesticides during garlic cultivation alters the hematological parameters. The farmers should be aware and checktheir health to prevent the adverse effects from pesticide intoxication.

Hematological And Clinical Analysis of Hepatitis B Patients from Quetta, Pakistan

Background: Hepatitis B Virus (HBV) infection is still a serious worldwide health concern. The primary mechanisms of HBV transmission in Pakistan include the use of infected tools in medical and dental practices, unsafe blood transfusion, and a family history of HBV infection. Pakistan has a high HBV prevalence, with 4.55 million persons affected. The cause for this might be a lack of sufficient health facilities, a bad economic situation, and insufficient knowledge regarding the spread of infections such as HBV.&#x0D; Aim of the study: The goal of this study was to look at the possible risk factors that may lead to HBV infection and analysis of Hematological and liver function tests which are two tests that are used to determine the health of a person.&#x0D; Methods: Blood samples from 244 individuals infected with HBV infection (including both males and females) were collected and processed for complete blood count and liver function analysis. General characteristics were recorded interview and questionnaire.&#x0D; Results: A total of 244 HBV-positive patients were included in the study. Their ages were range from 17-78 years. The HBV rate was higher in males 175 (71.7%) and 69 (28.3%) in females. Out of one hundred forty-four patients, 143 (58.60%), individuals were from rural areas and 101 (41.60 %) were from urban areas. majority of the individuals 148 (60.7%) were married and 87 (35.7%) were unmarried. According to their education, most of the participants 101 (41.4%) were illiterate and only 61 (25.0%) had a higher level of education. Dental history and smoking habits were recorded in 71 (29.1%) patients respectively. Similarly, a family history of hepatitis B infection was recorded in 51 (20.9%) and only 15 (6.1%) had a blood transfusion history.&#x0D; Conclusion: In rural areas of Quetta, Balochistan, Pakistan, the current study demonstrated a significant incidence of HBV infection. The observed prevalence is gender and age-dependent, possibly because of their increased exposure to common risk factors. To prevent the spread of HBV infection, it is advised that people be made aware of the potential risk factors and that vaccination be extended in high prevalent regions.&#x0D;

Multicentric T‐cell lymphoma in a 21‐year‐old Tennessee walking horse mare

AbstractWe report a 21‐year‐old Tennessee walking horse mare afflicted with a multicentric T‐cell lymphoma. A T‐cell‐rich, B‐cell lymphoma had been removed from the mare's left upper eyelid 4 years earlier. The owner reported that the mare had a poor appetite, difficulty swallowing and difficulty breathing while eating. Initial physical examination revealed no abnormalities. Complete blood count and serum biochemical analyses revealed lymphopenia, anaemia and elevated serum globulins. A mass arising from the base of the tongue was found and determined to be a T‐cell lymphoma by histologic and immunohistochemical examination. The mare was anorexic during hospitalisation, showed signs of kidney failure, suffered severe weight loss and was consequently euthanased. During postmortem examination, a second mass, confirmed by immunohistochemical examination to be also a T‐cell lymphoma, was found arising from the abdominal surface of the diaphragm. Early diagnosis of T‐cell lymphoma is difficult, because affected horses display a wide variety of clinical signs.

Hematological Abnormalities in Culture Positive Neonatal Sepsis.

BackgroundIn neonatal sepsis, anemia, leukocytosis, thrombocytopenia, and a shortened coagulation time are the most common hematologic abnormalities. However, there is inadequate information regarding the hematological abnormalities in neonatal sepsis. Thus, we aimed to determine the magnitude of hematological abnormalities in neonatal sepsis.MethodsThis is a cross-sectional study that included 143 neonates with culture proven sepsis aged 1–28 days from September 2020 to November 2021 at the University of Gondar Specialized Referral Hospital. The sociodemographic data was collected using a pre-tested structured questionnaire, and the clinical and laboratory data was collected using a data collection sheet. A total of 2 mL of venous blood was taken using a vacutainer collection device for the complete blood count (CBC) and blood culture analysis. A univariate and multivariate logistic regression model was used to investigate factors associated with hematological abnormalities in neonatal sepsis. Statistical significance was declared when a p-value was less than 0.05.ResultsThe prevalence of anemia, thrombocytopenia, and leucopenia in neonatal sepsis was 49% (95% CI: 40.89–57.06), 44.7% (95% CI: 36.8–52.9), and 26.6% (95% CI: 22.01–29.40), respectively. On the other hand, leukocytosis and thrombocytosis were found in 7.7% (95% CI: 4.35–13.25) and 11.9% (95% CI: 7.56–18.21), respectively. Being female (AOR: 3.3; 95% CI: 1.20–3.82) and being aged less than 7 days (AOR: 2.44; 95% CI: 1.6–6.9) were found to be significant predictors of anemia.ConclusionThe magnitude of anemia, leucopenia, and thrombocytopenia is high in neonatal sepsis. Furthermore, being female and being younger than 7 days were risk factors for anemia. Thus, the diagnosis and treatment of anemia, leucopenia, and thrombocytopenia prevents further complications in neonatal sepsis.

Correlation between hemolysis index and storage period to potassium levels of Packed Red Cell in Sanglah General Hospital, Bali, Indonesia

Background: The quality of a blood product is determined by collecting, processing, storing, and transporting it. When blood is stored, there will be mechanical and biochemical changes. Mechanical changes consist of morphological changes and hemolysis, while one of the biochemical changes is increased plasma potassium levels. This study aimed to determine the correlation between the hemolysis index and the storage period to potassium levels of the packed red cell (PRC).&#x0D; Methods: This study was a cross-sectional study at Sanglah Hospital. The sample was taken from the tube in the PRC blood bag and then a complete blood count and potassium analysis were performed. Data were analyzed using SPSS version 25 for Windows.&#x0D; Results: From 70 subjects, the median hemolysis index was 0.15% (0-1.69%), the mean storage period was 12.06±4.95 days, and the mean potassium level was 12.06±3.92 mmol/L. The Spearman test results showed a positive weak significant correlation between the hemolysis index and potassium levels (r=0.360; p=0.002). The Pearson test results also showed a positive weak significant correlation between the parameter of the storage period and potassium levels (r=0.357; p=0.002).&#x0D; Conclusion: There was a positive weak significant correlation between the hemolysis index and the storage period to potassium levels of the PRC.

New Hematological Parameters as Inflammatory Biomarkers: Systemic Immune Inflammation Index, Platerethritis, and Platelet Distribution Width in Patients with Adult Attention Deficit Hyperactivity Disorder.

ObjectivesThe potential role of neuroinflammation in adult attention deficit hyperactivity disorder (ADHD) patients has been investigated with peripheral hemogram-related inflammatory markers. Systemic immune inflammation index (SII) is defined as a new index that has been developed for the balance of inflammatory and immune status.MethodsOur study was based on a prospective routine complete blood count(CBC) analysis of 74 Adult ADHD patients and 70 healthy participants. The DSM-5-Clinician version and Barratt impulsivity scale-11 were used to evaluate the participants.ResultsThere was no statistical difference in the comparison of the SII ratios, platelet distribution width (PDW), and plateretritis (PCT) (p>0.05 for each) in a group of a young adults with ADHD and in a comparison control group. These inflammatory indicators were found to be similar between patients newly diagnosed with ADHD (n=40) and patients using methylphenidate (n=34) (p>0.05 for each). The relationship between ADHD clinical symptoms and severity and inflammation was evaluated. A significant negative correlation was observed between attention deficit scores and PCT (r=−0.301, p=0.009). A positive significant correlation was found between hyperactivity scores and SII (r=0.247, p=0.034). A significant positive correlation was found between Barrat motor scores and PDW(r=241, p=0.038). In the regression analysis, the PCT variable changed the attention deficit variable (β=.33, t(70)= −2.703, p=.009, pr2= .094) predicted negatively and significantly.ConclusionsWe demonstrated the association of SII, which is independently associated with adverse outcomes in many diseases, and the severity of hyperactivity symptoms in adult ADHD. The fact that PCT predicts attention deficit negatively and decisively shows the importance of inflammatory assessments specific to clinical presentations. The critical importance of platelets in inflammatory processes in ADHD has been demonstrated once again with inflammatory markers such as SII, PLT, and PDW, which can be accessed by an easily applicable complete blood count method.