Complete Blood Count Parameters Research Articles

Real-world effectiveness, safety and immunogenicity of ocrelizumab in turkish multiple sclerosis patients: a single-center experience for 4-year follow-up.

The aim of this study was to evaluate postmarketing ocrelizumab safety and effectiveness in a real-world population with multiple sclerosis (MS) and matching these parameters among MS disease types. This was a retrospective, single-center study with MS patients treated with ocrelizumab. Demographic, clinical characteristics and immunological data were analyzed, including annualized relapse rate (ARR), relapse-free rate, Expanded Disability Status Scale (EDSS), complete blood count parameters, immunoglobulin (Ig) levels, liver function tests (LFT), hepatitis markers and adverse events in the 4-year follow-up. A total of 96 patients, 22 with relapsing-remitting MS (RRMS), 54 with secondary progressive MS (SPMS), and 20 with primary progressive MS (PPMS) who were treated with at least two doses of ocrelizumab between January 2018 and September 2023 were included in the study. Sixty-five (68%) were women and 31 (32%) were men. The mean age was 48.4 ± 11.1years (20-70years). Ninety-three patients were evaluated in the first year, 65 in the second year, 39 in the third year and 24 in the fourth year of treatment. 96% of patients were relapse-free rate in the first year, 91% in the second year, 85% in the third year and 75% in the fourth year. Eighty-six percent of patients were progression free in the 1st year of treatment, 71% in the 2nd year, in 64% in the 3rd year, and in 62% in the 4th year. During the follow-up of the cases, EDSS remained stable in 77% of RRMS patients, improved in 14%, and worsened in 9%; while EDSS remained stable in 65% of SPMS patients with attacks, it improved in 9% and worsened in 26%; while EDSS remained stable in 60% of PPMS patients, worsening was observed in 40%. There is a significant decrease in IgM and IgG values during the follow-up of ocrelizumab therapy (p < 0.001, p = 0.014). There is no significant difference in IgA, lymphocyte and neutrophil values (p = 0.713, p = 0.086, p = 0.999). No significant relationship was found between low serum IgM levels and the risk of developing infection (p > 0.05). Liver function tests was found to be within normal limits in 94% of the patients over a 4-year period. No hepatitis B, C or A infection, hepatitis B reactivation, tuberculosis, HIV infection, malignancy or drug related death occurred during 4-years follow-up. The most common side effect during ocrelizumab treatment is urinary tract infection (29%); others were upper respiratory tract infections (13%), numbness/tingling of the face, trunk, or extremities (8%), insomnia (6%), headache (5%), and soft tissue infections (cellulitis and dental abscess, 2%). Our results show that ocrelizumab reduces the frequency of attacks and prevent the disease progression in RRMS patients, and reducing the disease progression by primarily stabilizing EDSS scores in SPMS with attacks and PPMS. It is thought that the relatively high rates of urinary tract infection detected in this study may be related with advanced stage of the disease. The absence of hepatitis B reactivation, chronic infection or malignancy in the 4-year follow-up of our cases supports the long-term safety of ocrelizumab treatment. Ocrelizumab may be preferred as an effective and reliable treatment of different types of MS due to non-serious side effects.

Establishing reference intervals for common hematology test parameters from apparently healthy geriatrics in Asella town, Southeast Ethiopia, 2020: a community-based cross-sectional study

BackgroundReference intervals are an important method tool for identifying abnormal laboratory test results. Complete blood count reference values are useful to interpret complete blood count (CBC) results and make clinical decisions, but these values have not been established for geriatrics in Asella town. Therefore, this study aimed to establish reference intervals (RIs) for complete blood count (CBC) parameters from geriatric participants/subjects in Asella town, Southeast Ethiopia.MethodsA community-based cross-sectional study was conducted from December 2019 to May 2020. An interviewer-administered questionnaire was used to collect data on sociodemography and other characteristics from 342 eligible geriatric participants. Weight, height, and vital signs were measured, and 8 mL of blood sample was collected. Screening tests such as HIV, HBsAg, HCV, syphilis, stool examination, and urinalysis were performed. The hematological parameter was measured using a Sysmex kx-21 hematology analyzer. The data were analyzed using SPSS version 21 software. The non-parametric independent Kruskal–Wallis test and Wilcoxon rank-sum test (Mann–Whitney U test) were used to compare the parameters between age groups and genders. The 97.5 and 2.5th percentile were the upper and lower reference limit for the population.ResultsAccording to the study’s findings, the reference intervals of red blood cell, white blood cell, platelet count, hemoglobin (HGB), and hematocrit (HCT) in male geriatrics were 3.8–5.85 × 1012/L, 3.1–9.66 × 109/L, 115.8–353 × 109/L, 12.4–17.76 g/dL, and 35.06–50.2%, respectively. The respective values for women were 3.94–5.48 × 1012/L, 3.13–8.4 × 109/L, 137.5–406 × 109/L, 12.5–16.4 g/dL, and 36.09–48.2%. Most of the hematological parameters showed significant differences between the two genders (p value &amp;lt;0.05).ConclusionAccurate gender and age-specific reference intervals are crucial in managing patient health. The current study offers essential CBC hematological parameters that can assist clinicians in interpreting laboratory results and can improve healthcare quality in the geriatric population. Therefore, it is more relevant to use the current RIs in the geriatric set-up.

Behind the veil of anemia: Assessment of iron, folic acid, and vitamin B12 deficiencies and their association with red cell indices in anemic and non-anemic women

During pregnancy anemia is a common health issue with various factors influencing its occurrence. It is a major public health problem in India. It is believed that 2.36 billion individuals are affected globally, and it is also an endemic problem in India. Iron deficiency often leads to iron deficiency anemia (IDA), significantly influencing maternal and fetal health.This study aims to investigate the complete blood count and nutritional parameters including Iron profile, vitamin B12, and Folic acid in anemic and non-anemic participants.The study involved 458 women of which 300 were anemic women and 158 were non-anemic women, predominantly from rural areas. The severity of anemia was classified as per WHO guidelines. The CBC was estimated by a 3-part hematology analyzer Medonic M-series, while the iron profile, vitamin B12, and folic acid were measured by using an automated analyzer Abbott Architect 1000 SR.The severity of anemia among the anemic women, classified according to WHO guidelines, revealed that 38.7% had mild anemia, 32.7% had moderate anemia, and 28.6% had severe anemia. 39.3% women exhibited microcytic hypochromic cells, 38% had normocytic normochromic cells, and 22.7% exhibited macrocytic cells. 56.6% had iron deficiency, 10% had folate deficiency, 16.7% had vitamin B12 deficiency, 6.7% had iron+vitamin B12+folic acid deficiency and 10% had vitamin B12+folic acid deficiency. Based on the severity only vitamin B12 was significantly reduced in severe (145.65±58.43) than moderate (177.06±66.24) and mild group (174.43±68.43), p=0.042. Hemoglobin showed a positive correlation with iron level (r=0.523, p&amp;#60;0.0001), and a negative correlation with ferritin (r=-0.355, p&amp;#60;0.0001).: These findings provide valuable insights into the nutritional status of the anemic women and highlights the need for targeted interventions to address micronutrient deficiencies during pregnancy.

Complete Blood Count Reference Intervals for Children Aged Less Than 1 to 12 Years in the Northern Region of Ghana.

Reliable laboratory diagnostic results are key for evaluating and improving children's health. To interpret these results, child-specific reference intervals (RIs), which account for constant biological changes and physiological development with sex and age, are required, as recommended by the Clinical and Laboratory Standards Institute (CLSI). This study presents age- and sex-specific reference intervals for complete blood count (CBC) parameters in children (<1-12 years old) in the Northern Region of Ghana. In this cross-sectional study, 600 healthy children from randomly sampled schools in Tamale (the Northern Region) were recruited and screened. Data from 388 eligible children were used to nonparametrically determine the reference intervals of CBC parameters at the 2.5th and 97.5th percentiles. The CBC reference intervals were compared for variations in sex and age groups using the Wilcoxon rank-sum test. There were no statistically significant differences in most CBC parameters by sex (RBC, Hb, HCT, MCH, RDW (CV/SD), WBC, LYM#, MON#(%) NEU#(%), EOS#(%), and BAS#(%); p > 0.05) and age group (RBC, MCV, RDW (CV/SD), WBC, LYM#, MON#(%) NEU#(%), EOS#(%), and BAS%; p > 0.05). However, there were observable differences between this locally established CBC reference interval and that used for children at Tamale Teaching Hospital (manufacturer's RIs). This study emphasises the importance of determining reference intervals representative of the local child population and incorporating them into the current reporting system of laboratories in the Northern Region to ensure the provision of effective and efficient healthcare services.

Predicting in-hospital mortality in infective endocarditis: insights from complete blood count parameters and NT-proBNP

Abstract Funding Acknowledgements None. Introduction Infective endocarditis (IE) is a rare condition with an increasing incidence rate and complexity of cases over the last few years, accompanied by a high mortality rate ranging from 18% to 25%. Recent studies have shown the utility of new outcome predictors based on complete blood count (CBC), such as red blood cell distribution width (RDW) and neutrophils/lymphocytes ratio (NLR). Drawing retrospectively from an 8-year experience, we provide a perspective from a tertiary center on predictors of in-hospital mortality based on basic laboratory test results in patients with valve-related IE. Purpose The aim of the study was to assess the clinical accuracy of CBC-based parameters as in-hospital mortality predictors. Methods From a tertiary center database (serving a stable population of 2.5 million citizens), we selected all patients hospitalized due to valve-related infective endocarditis between 2015 and 2022. We analyzed clinical data (including sex, age, IE localization, and etiological factors, number of cases, management and mortality), laboratory test results at admission (including CBC parameters, C-reactive protein - CRP, procalcitonin - PCT, N-terminal prohormone of brain natriuretic peptide - NT-proBNP, estimated glomerular filtration rate - eGFR, Creatinine - Crea, urea - UR). For three NT-proBNP, NLR, and RDW we provided a further analysis to compare their clinical accuracy. Univariable logistic regression was used to assess the impact of specific factors on mortality. To determine the optimal cutoff values for predicting mortality, we analyzed the area under the curve (AUC) from receiver operating characteristic (ROC) curves and used Youden's index. P-values &amp;lt; 0.05 were considered statistically significant. Results A total of 194 consecutive patients with confirmed IE were included in the study, the majority of whom were men (75.3%) with an overall median age of 62 years. The overall mortality rate was 27.8%. The most common localization was left-sided IE (92.3%). In 39.7% of cases, the etiological factor was unidentified, while Staphylococcus spp. were the most common bacteria among the identified cases. We identified significant impacts on mortality in most of the analyzed laboratory tests (RDW, platelet count, hemoglobin, NLR, PCT, NT-proBNP, eGFR, Crea, UR). Results showed that for every 1000pg/ml of NT-proBNP the risk of in-hospital death increases by 6%. ROC analysis was performed for the three parameters (RDW, NLR, and NT-proBNP), and each parameter showed an acceptable area under the curve - AUC (RDW: 0.69; NLR: 0.62; NT-proBNP: 0.78). Although we found the highest AUC for NT-proBNP (p&amp;lt;0.001). Conclusions Although CBC parameters are easy to assess and useful in predicting in-hospital death in IE, the accuracy of NT-proBNP is higher. The management of IE cases requires a complex approach, and NT-proBNP, which also reflects the clinical state of patients, still remains a more useful tool.In-hospital deaths ROC analysis

Can failure be predicted in methotrexate treatment with the modified parameter?

The objective of the study was to increase the prediction of success of single-dose methotrexate therapy in ectopic pregnancy patients with modified parameters obtained from complete blood count and beta-human chorionic gonadotropin (β-hCG) parameters. In this way, it was aimed to predict patients whose methotrexate treatment may fail and rupture, to avoid unnecessary methotrexate treatment, to shorten the duration of hospital stay and to reduce patient mortality. 233 patients diagnosed with ectopic pregnancy between January 1, 2017, and March 01, 2022, in the obstetrics and gynecology service of a tertiary center were included in the study. The mean of β-hCG was 1976 in the methotrexate group and 2358 in the surgery group (p < 0.05). The ROC curve determined the effect of BW (β-hCGxWBC/1000) and BP (β-hCGx1000/PLT) markers in diagnosing patients who will need surgery in ectopic pregnancy. The areas under the ROC curve for β-hCG, BW and BP were 0.86, 0.99 and 0.94, respectively (p < 0.05). β-hCG > 2139.03, BW > 30.96 and BP > 10.17 values were significantly associated with the need for surgery in ectopic pregnancy patients (p < 0.05). Logistic regression analysis revealed that a 1-unit increase in BP caused a statistically significant 1.77-fold increase in surgical need in patients with ectopic pregnancy. In contrast, a 1-unit increase in BW caused a 2.34-fold increase in surgical need (p < 0.05). The study results showed that BW and BP values together with β-hCG are effective in predicting ectopic pregnancy patients who may undergo surgery.

Residual polycyclic aromatic hydrocarbons and firefighters' hematological profile

IntroductionFirefighters are exposed to polycyclic aromatic hydrocarbons (PAHs) during fire suppression, but the extent of PAH penetration through turnout gear and its impact on blood cell components remains uncertain. The main objective of this study is to investigate the residual levels of PAHs on turnout gear and skin, and to assess their potential effects on blood cell components in firefighters. We hypothesize that firefighting activities lead to increased PAH exposure, which in turn may induce alterations in blood cell composition. We also hypothesize that differences in PAH exposure and corresponding blood cell changes will be observed between volunteer and career firefighters.MethodsForty-seven firefighters were recruited from 11 fire departments in Oklahoma. PAH levels on gear and skin were measured, and complete blood count (CBC) parameters were analyzed. Parametric and non-parametric tests were used to examine differences in PAH exposures and hematological profiles between volunteer and career firefighters and possible changes over time. Generalized estimating equation (GEE) models were performed to assess the relationships between PAHs and blood cells.ResultsOur analysis revealed significant hematological differences between volunteer and career firefighters, with volunteers exhibiting lower aerobic capacity and higher systemic inflammation. Increased levels of specific PAHs were found on volunteers' gear post-fire.ConclusionOur findings indicate an association between PAH exposure and changes in blood parameters, emphasizing the need for improved decontamination protocols and protective measures, particularly for volunteer firefighters.

Evaluation of systemic immune-inflammation index for predicting severity of lower extremity arterial disease.

Predictive value of systemic immune-inflammation index (SII) has been shown in clinical outcomes and complexity of coronary artery disease, acute coronary syndrome, and heart failure. We sight to evaluate value of SII in patients with lower extremity arterial disease (LEAD). A total of 271 patients diagnosed with LEAD were included to our study. Blood samples of the patients were collected and analyzed for biochemical variables and complete blood count parameters. SII value of each patient was calculated. The complexity of atherosclerotic disease was classified according to Trans-Atlantic Inter-Society Consensus (TASC II) classification. Patients with TASC C-D were older than patients in TASC A-B group (63.06 ± 9.24years and 60.85 ± 8.75years, respectively). Other co-morbidities were comparable in both groups. Hemoglobin level and lymphocyte count were significantly lower, neutrophil, platelet counts, and SII values were significantly higher in patients with TASC C-D disease compared to that of patients with TASC A-B disease. SII showed significant correlation with the severity of LEAD (r = 0.363, p < .001). SII value of 664.24 predicted TASC C-D disease with a sensitivity and specificity of 60.8% and 73.3%, respectively. Results of multivariate logistic regression analysis showed that SII had higher odds ratio compared to platelet, neutrophil, and lymphocyte counts. Higher SII may indicate probability of more complex LEAD. This relationship seems plausible in terms of similar pathophysiology of coronary artery disease and peripheral artery disease.

187 Polyphenols as a partial replacement for vitamin E in nursery pig diets

Abstract A total of 300 pigs [241×600; DNA, Columbus, NE; initial body weight (BW) = 6.0 ± 0.01 kg] were used in a 42-d trial to determine the effects of vitamin E levels and partially replacing vitamin E with a polyphenol (Cabanin CSD, R2 Argo, Denmark) on growth performance, complete blood count (CBC), serum thiobarbituric acid reactive substances (TBARS), serum superoxide dismutase (SOD), and serum cytokines. Sixty pens of pigs were weighed and allotted to 1 of 5 dietary treatments in a completely randomized design with 12 pens/treatment with 5 pigs/pen. A control treatment was formulated to provide 15 IU/kg of vitamin E. This control treatment was then used as a base for 3 replacement strategies to determine the effects of replacing an additional 60 IU/kg of vitamin E above baseline with polyphenol in diets containing a basal level of vitamin E (15 IU/kg). First, an additional 60 IU/kg of vitamin E was added for a total of 75 IU/kg of vitamin E. Second, 50% of the additional vitamin E (30 IU/kg) was replaced with the vitamin E equivalency of polyphenol. Third, all 60 IU/kg of the additional vitamin E was replaced with the equivalency of polyphenol. To evaluate whether there are negative effects of feeding nursery pigs a high level of polyphenol, a fifth treatment was formulated to provide 575 IU/kg of vitamin E equivalence with 75 IU/kg from vitamin E and 500 IU/kg from polyphenol. Whole blood and serum samples were collected on d 10 and 42, and pig BW and feed disappearance measured on d 10, 21, 31, 38, and 42. For growth performance, there was no evidence of differences (P &amp;gt; 0.10) in average daily gain (ADG) and average daily feed intake (ADFI) as vitamin E equivalence increased or between replacement strategies throughout the entire 42-d experimental period (Table). From d 10 to 21, increasing vitamin E equivalence from 15 to 75 IU/kg increased (quadratic, P = 0.086) gain to feed ratio (G:F) with no further increase at 575 IU/kg. From d 21 to 42 and overall, there was a tendency for increased (linear, P &amp;lt; 0.10) G:F as the vitamin E equivalence increased. There was a vitamin E equivalence × day interaction (P = 0.050) for serum SOD activity where increasing vitamin E equivalence increased (linear, P &amp;lt; 0.05) serum SOD activity on d 42, but not on d 10 (P &amp;gt; 0.10). For serum TBARS, there was no evidence of differences (P &amp;gt; 0.10) between treatments, vitamin E equivalence levels, or day, and negligible differences in complete blood count parameters and serum cytokines. In summary, increasing vitamin E equivalence tended to increase G:F, which may be related to the improved SOD activity. These data indicate that when diets contain requirement levels of vitamin E, additional vitamin E equivalency can be provided by polyphenol or vitamin E to achieve similar levels of performance.

Integrating Routine Hematological and Extended Inflammatory Parameters as a Novel Approach for Timely Diagnosis and Prognosis in Sepsis Management.

Sepsis is one of the major causes of morbidity and mortality in hospitals, especially in low- and middle-income countries, and represents a challenge to health care providers to carry out early detection, and accurate diagnosis and prognosis with cost-effective diagnostic tools. An observational prospective study was conducted from December 2021 to December 2022 to investigate the extended inflammatory parameters (EIPs) for sepsis management and analyze the survival of septic patients in the emergency unit, intensive care unit (ICU) and inpatient ward. Patients suspected of having sepsis underwent a sequential organ failure assessment (SOFA) evaluation and had blood drawn for complete blood counts (CBCs). Significant changes were observed in various CBC parameters and EIPs, and the sepsis group was followed up with for 30-day mortality. The study highlighted a significant difference yet strong discriminatory power to differentiate sepsis with an AUC of 0.924 against the non-sepsis group and an AUC of 0.991 against the healthy control group using combination of white blood cells and EIPs. Furthermore, the study showed good predictive ability for 30-day mortality with a hazard ratio of 2.311. In summary, this study provides evidence that the utilization of EIPs may be valuable in diagnosing and predicting patient outcomes, and thus will be beneficial for sepsis management in the hospital.

Short Prewarming at 41°C to Correct the Interference in Samples with the Presence of Cold Agglutination.

Cold agglutinins (CAs) in blood samples can cause a reversible agglutination of red blood cell (RBC) which result in an incorrect complete blood count (CBC). So, it is important to explore new simple and feasible treatment conditions for clinical work. The CAs group included 32 samples with CAs. The parameters of CBC at room temperature or after prewarming at 37°C or 41°C for different time periods were compared. The consistency and correlation of those parameters were analyzed. The morphology of erythrocytes in the CAs group was observed manually. The control group included 45 samples without CAs and prewarmed at 37°C or 41°C for different time periods. The differences were also analyzed. CAs have a significant effect on CBC. After prewarming at 37°C or 41°C the interferences are all corrected. Consider prewarming at 37°C for 120 minutes as the standard procedure. The consistency and correlation analysis showed there was no statistical difference between the results of each subgroup and standard group, except the MCHC of group 41°C 10 minutes. The correlation of parameters between all subgroups and the standard group is satisfied. Microscopic examination showed no RBC aggregation or fragmentation after prewarming at 41°C or 37°C. According to the maximum bias requirements for expert performance in Validation, Verification, and Quality Assurance of Automated Hematology Analyzers, 2nd Edition (CLSI H26-A2), the differences in overall results in control group are negligible. The 41°C 2 minutes prewarming method is a rapid and effective way for treating samples with CAs. It is an efficient way to obtain more reliable CBC results, without specific instruments.

Differences in complete blood count parameters in patients with COVID-19 diagnosis based on vaccination status (literature review)

Relevance. Due to the large-scale vaccination campaigns against the SARS-CoV-2 coronavirus taking place worldwide, the question arises as to how vaccination may affect complete blood count (CBC) parameters in COVID-19 cases. Research objective: assess differences in complete blood count parameters in COVID-19 patients based on their vaccination status. Materials and methods. A review of publications was conducted describing and presenting the complete blood count parameters in patients with verified COVID-19, by stratifying them into vaccinated and unvaccinated individuals against the SARS-CoV-2 virus-caused disease. Subsequently, a meta-analysis of the results for each CBC parameter was carried out by describing identified differences among patients with mild and moderate COVID-19, lacking comorbidities affecting CBC indicators. Results. The analysis conducted allowed to determine that the complete blood count parameters do not exceed the reference range in most cases in both groups, excepting those of individuals with a severe disease course. The exception is the erythrocyte sedimentation rate (ESR) (42 [20.5–63.5] (∑n = 107, Me [Q1–Q3])) mm/h in unvaccinated individuals. Also, a slightly lower absolute lymphocyte count is observed in vaccinated individuals (0.95 [0.58–1.62] × 109/L (∑n = 441, Me [Q1–Q3])). There is a twofold greater range of leukocyte quartile values in vaccinated individuals compared to unvaccinated individuals: 7.07 [4.07–12.31] × 109/L (∑n = 555, Me [Q1–Q3]) vs 5.68 [4.02–8.34] × 109/L (∑n = 2202, Me [Q1–Q3]). A similar pattern is observed for monocytes. Conclusion. Conducting a meta-analysis of laboratory parameters in COVID-19 cases among vaccinated and unvaccinated individuals allows for determining the effectiveness of vaccination as well as identify the major trends in dynamic changes for essential blood parameters among unvaccinated and vaccinated individuals in general or with certain immunobiological preparations.

Clinical and diagnostic utility of platelet count and its parameters in COVID-19

The majority of the published studies have described the alterations in platelet count and platelet indices in both severe and non-severe Coronavirus Disease 2019 (COVID-19). However, their association with COVID-19 mortality remains unclear. In the present study, our aim is to determine the temporal evolution of platelet count and its parameters between survivors and non-survivors, as well as their potential association with clinical outcomes. This cross-sectional study included 1118 inpatients (≥18 years old) diagnosed as SARS-CoV-2 positive by a Real-Time Polymerase Chain Reaction (RT-PCR) and hospitalized between May 1st, 2020 and November 1st, 2020. Data of complete blood count (CBC) parameters evaluated on different days after admission was gathered and the median value of each CBC parameter was considered for assessing the difference between survivors and non-survivors. There was statistically significant variation between survivors and non-survivors for platelet count [p&lt;0.001, mean difference-80 x 109/L], mean platelet volume [p&lt;0.001, mean difference- 0.7 fL], platelet distribution width [p&lt;0.001, mean difference-2.5%] and platelet-lymphocyte ratio [p&lt;0.001, mean difference-123.8]. Thrombocytopenia occurred more commonly in deceased patients compared to survivors. Platelet count, Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) differed significantly between survivors and non-survivors, revealing distinct trends indicating their importance in the management of COVID-19 patients. These cost-effective parameters can be easily obtained from a CBC.

Blood Whispers: Exploring Hematologic Indicators for Diagnosing and Predicting Severity of Vogt-Koyanagi-Harada Syndrome

ABSTRACT Purpose To investigate the association of clinical findings and indocyanine green angiography (ICGA) score with inflammatory markers derived from complete blood count (CBC) parameters in patients with Vogt-Koyanagi-Harada (VKH) to determine the diagnostic and predictive role. Methods Demographic characteristics, presenting complaints, ocular findings, optical coherence tomography findings, ICGA scores and best corrected visual acuity were recorded in treatment-naive VKH patients at presentation. Patients were divided into two groups as acute stage and chronic recurrent stage. CBC parameters were noted in patients at presentation and healthy controls (HC, n = 25). Neutrophil-lymphocyte-platelet-monocyte counts, neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR), monocyte/lymphocyte and systemic immune-inflammation index (SII) were recorded. The association between these markers and clinical severity were evaluated. Results Thirty-two patients with VKH (23 females/9 males) with a mean age of 34.1 ± 14.6 years were included in the study. There was an increase in neutrophil count, NLR and SII in patients with VKH compared to HC (p < 0.001). The cut-off values for these three parameters were 4.37, 2.24 and 562.35, respectively. Twenty-six patients presented in the acute stage and six patients presented in the chronic recurrent stage. Choroidal thickness, early stromal hyperfluorescence and total ICGA scores were higher in patients presenting in the acute stage (p < 0.001, 0.001 and 0.025, respectively). Patients with higher disease severity at presentation were treated earlier. Early stromal vessel hyperfluorescence and choroidal vasculitis scores were correlated with decreased lymphocyte count, increased NLR, PLR and SII (p < 0.05). Conclusion CBC-derived inflammatory parameters indicate that VKH is a systemic inflammation. These parameters can be used in the diagnosis and determination of disease severity of VKH.

JAKCalc: A machine-learning approach to rationalized JAK2 testing in patients with elevated hemoglobin levels.

The demand for Janus Kinase-2 (JAK2) testing has been disproportionate to the low yield of positive results, which highlights the need for more discerning test strategies. The aim of this study is to introduce an artificial intelligence application as a more rational approach for testing JAK2 mutations in cases of erythrocytosis. Test results were sourced from samples sent to a tertiary hospital's genetic laboratory between 2017 and 2023, meeting 2016 World Health Organization criteria for JAK2V617F mutation testing. The JAK2 Somatic Mutation Screening Kit was used for genetic testing. Machine learning models were trained and tested using Python programming language. Out of 458 cases, JAK2V617F mutation was identified in 13.3%. There were significant differences in complete blood count parameters between mutation carriers and non-carriers. Various models were trained with data, with the random forest (RF) model demonstrating superior precision, recall, F1-score, accuracy, and area under the receiver operating characteristic, all reaching 100%. Gradient boosting (GB) model also showed high scores. When compared with existing algorithms, the RF and GB models displayed superior performance. The RF and GB models outperformed other methods in accurately identifying and classifying erythrocytosis cases, offering potential reductions in unnecessary testing and costs.

Reference intervals of complete blood count parameters in the adult western Sudanese population

BackgroundA complete blood count (CBC) analysis is one of the most common conventional blood tests that physicians frequently prescribe.The objectiveof this study was to determine the reference intervals (RIs) of CBC parameters in the population of healthy adults living in the western Sudan region.MethodsA cross-sectional study of healthy people residing in the western area of Sudan was carried out. We assessed the CBC RIs in samples taken from 153 individuals using an automated haematology analyser (Sysmex KX-21) and a modified Box–Cox transformation procedure to transform the data into a Gaussian distribution after eliminating outliers using the Dixon method. IBM SPSS Statistics version 25 was used to analyse the data, and t tests were employed to examine variations in the mean CBC parameters according to sex and age. P was considered significant at ≤ 0.05.ResultsBeyond all the other measured values, the only CBC parameters that significantly differed between the sexes were haemoglobin (HGB) and white blood cell (WBC) counts. Women were found to experience more WBC counts than men did. However, they have less HGB RIs.The male participants in our study exhibited lower WBC count RIs, a significantly lower limit, and a greater upper limit of platelet RIs than did the individuals from other nations.ConclusionsCompared with males, females had higher platelet and WBC counts and lower HGB.

Impact of Flaxseed Oil Supplementation on Tobacco Dependence, Craving, and Haematological Parameters in Tobacco-Dependent Subjects.

Background Tobacco is prevalently used in smoking or smokeless forms and remains a major public health concern worldwide, with its adverse effects on overall health. Omega-3 fatty acid (FA) has shown its promising effects in various health conditions. Objective The purpose of this study was to evaluate the effect of flaxseed oil (omega-3 supplementation) on tobacco dependence, craving, withdrawal symptoms, and haematological parameters in tobacco users. Methods In this randomised, single-blind, placebo-controlled study, 104 tobacco users (54 in the omega-3 group and 50 in the placebo group) were supplemented with 10 ml of food-grade flaxseed oil and 10 ml of placebo for six months, respectively. Their demographics, frequency of daily tobacco use, tobacco dependence, tobacco craving, tobacco withdrawal symptoms, and complete blood count (CBC) were assessed at baseline (before intervention) and after a six-month intervention. Results The demographic characteristics of the two groups were similar except for gender at baseline. There were 50 males and four females in the omega-3 group, while there were 42 males and eight females in the placebo group. After a six-month flaxseed oil intervention, BMI values showed a significant reduction (p = 0.0081) in the omega-3 group when compared to baseline; however, CBC parameters did not show any significant changes when comparing baseline to follow-up values. On the contrary, haemoglobin and red blood cells (RBCs) showed significant changes when comparing the follow-ups of the omega-3 group with the placebo group, indicating p = 0.0016 and p = 0.0163, respectively. Also, omega-3 effectively decreased daily tobacco use frequency (p<0.0001), tobacco dependence (p<0.0001), and craving (p<0.0001). Conclusion Supplementation of 10 ml of flaxseed oil per day (omega-3 FA) for six months significantly reduced tobacco dependence and cravings. Additionally, the flaxseed oil supplementation effectively reduced the frequency of daily tobacco intake and modulated tobacco withdrawal symptoms. Thus, our results suggest that flaxseed oil supplementation is a useful adjunct for tobacco users who intend to quit tobacco use.

Monocyte/High-Density Lipoprotein Ratio: An Indicator of Oxidative Stress and Disease Severity in Lichen Planus Patients

Aim: Although the etiopathogenesis of lichen planus is not clearly known, it has been noticed to be associated with various factors such as drugs, infections, autoimmune factors, genetic factors, and oxidative stress mechanisms. Oxidative stress is implicated in the pathogenesis of various diseases such as cancer and chronic inflammatory diseases. Complete blood count parameters can be utilized as oxidative stress diagnostic biomarkers for many diseases related to chronic inflammatory processes. In recent clinical studies, it has been shown that the monocyte/high-density lipoprotein (HDL) ratio (MHR) may be useful as a marker of oxidative stress in many chronic dermatoses. However, as far as we know, the relationship between oxidative stress and monocyte/HDL ratio in lichen planus cases has not been studied in the literature yet. Materials and Methods: The files of cases who were followed up with lichen planus in the dermatology clinic of a tertiary university hospital between February 2018 and July 2021 were reviewed retrospectively. There were 201 participants in the analysis, including 99 histopathologically and clinically verified LP cases and 102 age and sex-matched controls. Results: Monocyte values (p=0.16) and HDL levels (p=0.26) were not statistically different for both groups, but the MHR value (p=0.04) was detected to be statistically significantly higher in the lichen planus group than in the control group. In oral lichen planus cases, whilst the oral disease severity score and uric acid values were not correlated (p=0.11), the oral disease severity score was correlated with the CRP (p=0.03) and MHR (p=0.001) values. Conclusions: In the study, we found that MHR levels were significantly higher in lichen planus patients compared to the control group. Again, we detected that MHR had a better correlation with oral mucosa disease severity score than CRP. We suggest that MHR may be a potential index to assess disease activity in follow-up patients with lichen planus. Keywords: Lichen planus, oral mucosa, monocyte/high-density lipoprotein ratio

Identifying prognostic factors for survival in intensive care unit patients with SIRS or sepsis by machine learning analysis on electronic health records.

Systemic inflammatory response syndrome (SIRS) and sepsis are the most common causes of in-hospital death. However, the characteristics associated with the improvement in the patient conditions during the ICU stay were not fully elucidated for each population as well as the possible differences between the two. The aim of this study is to highlight the differences between the prognostic clinical features for the survival of patients diagnosed with SIRS and those of patients diagnosed with sepsis by using a multi-variable predictive modeling approach with a reduced set of easily available measurements collected at the admission to the intensive care unit (ICU). Data were collected from 1,257 patients (816 non-sepsis SIRS and 441 sepsis) admitted to the ICU. We compared the performance of five machine learning models in predicting patient survival. Matthews correlation coefficient (MCC) was used to evaluate model performances and feature importance, and by applying Monte Carlo stratified Cross-Validation. Extreme Gradient Boosting (MCC = 0.489) and Logistic Regression (MCC = 0.533) achieved the highest results for SIRS and sepsis cohorts, respectively. In order of importance, APACHE II, mean platelet volume (MPV), eosinophil counts (EoC), and C-reactive protein (CRP) showed higher importance for predicting sepsis patient survival, whereas, SOFA, APACHE II, platelet counts (PLTC), and CRP obtained higher importance in the SIRS cohort. By using complete blood count parameters as predictors of ICU patient survival, machine learning models can accurately predict the survival of SIRS and sepsis ICU patients. Interestingly, feature importance highlights the role of CRP and APACHE II in both SIRS and sepsis populations. In addition, MPV and EoC are shown to be important features for the sepsis population only, whereas SOFA and PLTC have higher importance for SIRS patients.

Complete Blood Count in Multiple Sclerosis

Multiple sclerosis (MS) is a chronic disease that affects the central nervous system in primarily young adults. Although the exact etiology of MS is unknown, autoimmune mechanisms are thought to play a crucial role, especially with CD4+ T cells involved in the immune response. Inflammatory reactions involving T cells and macrophages are commonly observed in MS lesions. B lymphocytes, plasma cells, and antibodies also contribute to MS pathogenesis. Neutrophils, lymphocytes, monocytes, and platelets, key immune system components, play roles in inflammatory processes, but their association with MS prognosis remains inconclusive. Due to its heterogeneous nature, clinical manifestations of MS vary depending on the location of the affected central nervous system. While several potential biomarkers have been identified for MS diagnosis and monitoring, none have been universally accepted. Studies have examined complete blood count parameters in MS patients, including erythrocyte, platelet, and leukocyte populations. Changes in these parameters have been observed in MS patients compared to healthy controls and may be related to disease prognosis. For example, increased erythrocyte fragility and altered hemoglobin levels have been reported in MS patients. Leukocyte counts and ratios, such as the neutrophil/lymphocyte ratio, have shown associations with disease severity. Platelet activation and interaction with immune cells have also been implicated in MS pathophysiology. Nevertheless, further research is needed to fully understand the role of complete blood count parameters in MS. Identifying reliable biomarkers for early diagnosis and prognosis prediction would greatly enhance MS management. Moreover, these benefits could lead to substantial improvements in achieving complete recovery of patients, surpassing the focus on current symptomatic treatments.