Complete Blood Picture Research Articles

THE EFFECT OF EICOSAPENTANOIC ACID ADMINISTRATION ON CLINICAL OUTCOME OF PATIENTS WITH MAJOR DEPRESSION: A PILOT STUDY

Background. Major depressive disorder (MDD) is a common brain disorder that affects approximately 10% of the world population and leads to significant disability. The current study aimed to evaluate the impact of Omega3 PUFAs administration on the clinical outcome of patients with depression. Patients and Methods. A prospective, randomized controlled study conducted at the outpatient clinics of a University Hospital, Cairo, Egypt on patients diagnosed with depression according to a strict inclusion and exclusion criteria. Forty two patients were randomly assigned to either; Group1; (intervention n=21); received the prescribed antidepressant + omega3 (2100mg) for 8 weeks, or Group 2; (control, n=21); received the prescribed antidepressant only for 8 weeks. Baseline evaluation and 8-week assessment included; patient demographic-data collection, history taking and clinical assessment of DSM-5 criteria & HAM-D score. Laboratory assessment included; complete blood picture (CBC), prothrombin time (PT), activated partial thromboplastin time (aPTT). Patients were followed up regularly every 2 weeks for 8 weeks for the occurrence of side effects due to antidepressants/ Omega 3 and compliance with medications. Results. The 2 groups were comparable at baseline. The test group showed a significant improvement in the HAMD score from baseline values and versus the control. There was no significant difference in the reported side effects between the 2 groups. Conclusion. Omega -3 PUFAs administration at a dose of 2100 (EPA1350 mg/ , DHA 600 mg/ 150 mg other omega 3 FA) for 8 weeks, improved depression symptoms and was well tolerated.

Early predictors of brain damage in full-term newborns with hypoxic ischemic encephalopathy.

Objective of the studyTo evaluate the value of serum creatine phosphokinase-brain specific (CK-BB) and urinary lactate/creatinine (L/C) ratio as early indicators of brain damage in full-term newborns with hypoxic ischemic encephalopathy (HIE).Patients and methodsA case–control study including 25 full-term new-born infants with perinatal asphyxia who were admitted to neonatal intensive care unit (NICU) with a proven diagnosis of HIE, compared to 20 healthy age- and sex-matched full-term newborns. All newborn infants were subjected to full history taking, clinical examination, routine investigations (cord blood gases and complete blood picture), and assessment of serum CK-BB (cord blood, 6 and 24 hours after birth) and urinary L/C ratio (collected within the first 6 hours, on the 2nd and 3rd day after birth).ResultsThe serum CK-BB and urinary L/C ratio in infants with HIE were significantly higher in samples collected throughout the monitoring period when compared with the control group (all P<0.001). The cord CK-BB and urinary L/C ratio within the first 6 hours were significantly higher in infants with severe HIE than in infants with mild and moderate HIE (P<0.001). Cord CK-BB level at 12.5 U/L had 100% sensitivity and 84% specificity in the detection of severe HIE infants. Urinary L/C ratio of more than 10.5 collected within the first 6 hours after birth had 100% sensitivity and 78% specificity for the detection of severe HIE infants.ConclusionThe serum CK-BB and urinary L/C ratio in HIE infants were significantly increased early in the course of the disease, which can be used as useful indicators for predicting the development of HIE.

Critical flicker frequency is diagnostic of minimal hepatic encephalopathy

Minimal hepatic encephalopathy may affect up to 80% of cirrhotic patients, in the absence of overt hepatic encephalopathy. The objective of the study is to evaluate the accuracy of diagnosis...

Cord blood screening for congenital infectious diseases and haematological change in Sulaimani Provence.

Aims: to determine the seroprevalence of immunoglobulin A (IgA) and immunoglobulin G (IgG) anti-Toxoplasma, anti- Helicobacter pylori antibodies in cord blood serum and to access the usefulness of haematological parameters in diagnosing of toxoplasmosis and H. pylori infection. Toxoplasma gondii specific IgA, IgG and H. pylori specific IgG antibodies were assessed by Chorus enzyme immune assay. 19 out of 70 (27.1%) cord blood serum samples were found positive for anti-Toxoplasma gondii IgG antibody and there was only one (1.4%) positive for IgA. Regarding the detection of specific anti -H. pylori IgG, 30 cord blood samples were tested in which 26 (86.6 %) were found positive and four (13.4%) negative. The positive mean with H. pylori infection was significantly greater than H. pylori-negative mean (88.37 ± 53.69 and 5.8 ± 0.46, respectively, P = 0.005). The comparison of hematological profiles between positive and negative cord blood samples (IgG ≥ 8 and IgG &lt; 4; IgA &gt;1.2 and IgA &lt; 0.8) showed no statistically significant variations in higher and lower value of IgG and IgA titration (P &gt; 0.05).Conclusions: The Results revealed that all the cord blood serum samples were negative for IgA antibodies except one sample (1.4%), indicate that all these newborn infants were rarely infected with congenital toxoplasmosis. Neonates born from H. pylori–infected mother, are provided with a high amount of specific IgG H. Pylori antibodies, which are transferred transplacentally. The complete blood picture (CBC) test shows the non-significant effect of T. gonidii and H. pylori on most of the hematological parameters.

VIVAX MALARIA;

Background: The primary health care physician is usually perplexed withregards to selection of initial therapy for patients presenting with fever. Some degrees ofhematological changes do exist in most patients with malaria. How often these changes doexist with malaria in our set up? And whether these changes are due to associated fever oractually resulting because of malaria. Objective: 1-To measure the frequency of abnormalhematological changes in malaria patients in our set up. 2-To compare the hematologicalparameters among subjects with laboratory proven malaria, fever but no malaria diagnosisand healthy controls. Design: Cross-sectional analysis. Place and duration of study: Thisstudy was carried out from May 2010 to Dec- 2010 at department of medicine PNS SHIFA, anddepartments of pathology PNS SHIFA and RAHAT, Karachi. Subjects and methods: Subjectswith history of fever and a clinical suspicion of malaria were recruited from primary physician’sOPD along with healthy age and sex-matched control. First, the frequencies of various abnormalfindings in hematological parameters were measured in subjects diagnosed to have malaria.Later, group-1: [Malaria (Laboratory positive) (n=74)], Group-2: [Fever (Laboratory negative)(n=104)] and group-3: [Age and sex matched controls (n=54)] were evaluated by one wayANOVA followed by post-hoc comparisons for significant differences among groups. Bloodcomplete picture were measured by automated hematology analyzer (Specifications: CELTAC- alpha, MEK-6410 K). Malaria parasite presence was confirmed by both slide examinationtechnique and immune-chromatographic (ICT) testing. Main outcome measures-Hemoglobin,white blood cells (WBC), platelets, PDW, % neutrophil. Results- 21.62 % cases from malariahad anemia, while the occurrence of leucopenia was 62.16%. This leukpenia was associatedwith relative neutrophil excess (63.51%). Thrombocytopenia was the most consistent findingamong our studied subjects (97.30%). The difference between the three groups were significantfor platelets [Group-1, Malaria (Laboratory positive) group= 86.42 (95%CI: 78.43-94.41)][Group 2, Fever (Laboratory negative) group = 192.47 (95%CI: 177.69-207.25)] and (Group-3,Age and sex matched control group=278.89 (95%CI: 254.16-303.62)] {p&lt;0.001}, and WBC[Group-1, Malaria (Laboratory positive) group= 5.55 (95%CI: 5.08-6.01)] [Group 2, Fever(Laboratory negative) group = 6.68 (95%CI: 6.14-7.20)] and (Group-3, Age and sex matchedcontrol group=8.78 (95%CI: 8.01-9.55)] {p&lt;0.001}. The results for % neutrophil and PDW werealso significant, but post-hoc comparison did not show significant differences between groupsthus differentiating a case of malaria from non-malaria fever or control. Conclusion: Malariadue to Plasmodium vivax is associated with thrombocytopenia and leucopenia in our set up.Moreover, the associated hematological parameters including % neutrophil and PDW may helpin augmenting a clinical diagnosis of malaria.

Etiopathogenesis of childhood proptosis

Aim: To study the etiology, presentation and management of proptosis in children less than 14 years of age. Materials and Methods: This is prospective interventional study conducted at the department of Oculoplasty and Orbital diseases of Sarojini Devi eye hospital, Hyderabad. Period of study was from August 2012 to July 2014. 120 eyes of 111 children presenting as proptosis to the department were included in the study. Adult cases of Proptosis were excluded from the study. All cases underwent a detailed proptosis evaluation by an experienced oculoplasty surgeon. CT scan of orbit, axial and coronal view, 2mm cut without contrast was modality of imaging in all cases. CT scan with contrast was done in selected cases. Complete blood picture and surgical profile investigations were done. Cases were posted for excision or incision biopsy under general anaesthesia. Histopathological diagnosis was obtained in required cases. Culture and sensitivity of pus was done in infective cases. Results: 111(14.83%) cases of childhood proptosis were there out of 748 cases of proptosis presented during the study period to the department. The Male to Female ratio was 55:46. 102 cases were of unilateral proptosis and 9 were bilateral. Common etiology for childhood proptosis was 28 congenital, 18 infective, 20 parasitic, 36 neoplasm, 6 secondaries and 3 trauma cases. Of 111 cases 28 had acute proptosis, 25 had Sub acute presentation and 58 cases had chronic presentation. Management of 111 cases was done as follows: 48 cases underwent surgery, 41 were managed medically, 10 cases were referred to Medical Oncologist and 12 cases of congenital crouzons disease and microphthalmos were not intervened. Conclusion: Childhood proptosis forms 14.83% of total proptosis cases presenting at department of Oculoplasty and Orbital diseases. Etiological spectrum is different when compared to adult Proptosis.(1) Keywords: Congenital, Infective, Neoplasm, Parasitic, Proptosis

DIAGNOSTIC AND PROGNOSTIC SIGNIFICANCE OF BONE MARROW BIOPSY IN NON HODGKINS LYMPHOMA

Background: Trephine bone marrow biopsy is the standard method for the diagnosis of neoplasia. In the last few years its role has been defined further by the widespread introduction of immunohistochemistry (IHC), the method that increased the diagnostic power of the trephine bone marrow biopsy by detecting specific antigens in the tumor tissue using nonflourescent chromogens that can be seen by conventional microscopy. Objective: to evaluate the diagnostic and prognostic significance of bone marrow biopsy in non-Hodgkin's lymphomas. Correlation of bone marrow biopsy finding with other prognostic markers in non-Hodgkin’s lymphomas is another aim. Methods: The study was performed on 50 patients of NHL diagnosed by LN histopathology. All patients were subjected to: clinical examination and laboratory investigations including complete blood picture, liver function tests, kidney function tests, Erythrocyte sedimentation rate, serum lactate dehydrogenase, B2 microglobulin, bone marrow aspiration, immunophenotyping of bone marrow aspiration of the disseminated cases, bone marrow trephine biopsy for: histological classification according to WHO, staging of NHL and Immunohistochemical staining for CD3 and CD20. Results: Twenty patients (40%) positive for infiltration on examination of marrow biopsy and 30 patients (60%) were negative. The results of fifty NHL cases showed only in six cases, both bone marrow biopsy and aspiration were positive (12%; 95% CI, 4.0: 22.0), and in 30 out of 50, the two parameters were negative (60%, 95%CI, 46: 54). Thus, the agreement level between BMB and BMA in the diagnosis of NHL was 27% and discrepancies between bone marrow biopsy and aspirate were found in the remainder. In 14 of 50 specimens, BMB alone was positive (28%; 95% CI, 16 : 42). Conclusion: Bone marrow biopsy morphology and immunohistochemical staining remain the cornerstone for proper staging in NHL patients to increase the diagnostic and prognostic accuracy, for appropriate treatment protocols. Key words: NHL, non Hodgkin's lymphoma, BMB, Bone marrow biopsy. BMA, bone marrow aspiration and IHC, immunohistochemistry, diagnosis, prognosis.

Impact of microRNA-375 and its target gene SMAD-7 polymorphism on susceptibility of colorectal cancer.

Colorectal cancer (CRC) has a high morbidity and mortality. Many studies reported that mir-375 is frequently down-regulated in many cancers including esophageal cancer, hepatocellular carcinoma, breast cancer and leukemias. Our aim was to study the expression of microRNA-375 and its target gene SMAD-7 polymorphisms (rs4939827) in CRC patients in comparison to control subjects and to correlate these results with clinical data of patients to elucidate their role in pathogenesis and early diagnosis of CRC. The present study was conducted on 122 subjects divided into 86 patients with CRC and 36 age- and sex-matched controls. The followings were done to all subjects: full history taking, full clinical examination, complete blood picture, serum (ALT, AST), serum albumin, CEA, TLC, PLT, and creatinine. Gene expression of miRNA-375 from serum was done by real-time PCR. Gene polymorphism SNPs of SMAD7 (rs4939827) was also done in DNA extracted from blood by real-time PCR. As regards the polymorphism of SMAD7, we found that CC (wild) genotype has high percentage in controls compared to CRC cases (36.1% vs 15.1%). Meanwhile, the mutant and heterozygotes genotypes showed high percentage among cases compared to controls (33.7%, and 51.2% respectively) vs (22.2%, and 41.7% respectively) with no significant statistical analysis. There was a statistically significant high T-allelic frequency among cases and C-allelic frequency among controls. There was a statistically significant association between fold change in micro RNA (-375) and the susceptibility to CRC as there is down-regulation of the microRNA-375 in CRC group with fold change in 0.42±0.27. Micro RNA-375 and rs4939827 SNP in SMAD7 could be considered as potential markers for detecting and early diagnosing CRC patients.

The correlation between serum levels of soluble platelet -selectin in preeclampsia with &amp; without intrauterine growth retardation versus normal pregnancy

Background: preeclampsia is characterized by endothelial dysfunction with vasoconstriction due to cell adhesion molecules or mediators released by defective placentation. Soluble platelet selectin, one of the cell adhesion molecules, is elevated in many inflammatory conditions including preeclampsia.Objective: To investigate if soluble platelet-selectin levels can be used as a marker for adverse outcomes in pregnancy complicated with sever preeclampsiaPatients and methods:This study involved 115 pregnant women in their third trimester of pregnancy; divided into Group A: involves 25 pregnant women with preeclampsia complicated by intrauterine growth restriction.Group B: involves 35 pregnant women with preeclampsia without intrauterine growth restriction.Control group: involve 55 pregnant women with normal blood pressure and normal fetal growth .The data were conducted from patients by special questionnaire, this involve name, age, parity, examination included vital signs, abdominal, obstetrical examination and investigations including :Liver function test, Renal function test, Complete blood picture and maternal serum levels of soluble platelet selectin was measured by enzyme-linked immunosorbent assay ,albumin in urine and serial obstetrical ultrasound scan to confirm the diagnosis of intrauterine growth retardation and Doppler study to determine fetuses at risk .Results: this study revealed a significantly higher concentration of soluble platelet selectin levels in serumofpreeclamptic women with and without intrauterine growth retardation versus normotensive and normal fetal growth. The maternal serum levels of sP-selectin in preeclampsia without intrauterine growth restriction were significantly higher than preeclampsia complicated by intrauterine growth restriction .Sensitivity was 91.7% and specificity 100% at cut off value 6.975 ng/ml of maternal soluble platelet _selectin for prediction of adverse pregnancy outcome .Conclusion: soluble platelet -selectin levels have a positive significant correlation with the severity of preeclampsia, so it can beconsidered as a marker for its severity and can be used as a predictor for adverse outcomes as itsnegatively correlated with these complications

Relationship between Diabetic Retinopathy and Methylenetetrahydrofolate Reductase Gene Polymorphism

Purpose: To assess MTHFR rs1801133 (C677T) gene polymorphism in diabetic patients as a risk factor for diabetic retinopathy and to establish the changes in Platelet indices & count in diabetic patient as compared to the healthy control group. Patients and Methods: The study included 40 patients with Type 2 Diabetes Mellitus. They were divided into 2 equal groups, 20 patients with Diabetic Retinopathy, 20 patients without Diabetic Retinopathy. Patients were selected from those attending the outpatient Ophthalmology Unit and Diabetes Clinic of Al-Zahraa University Hospital in the period from June 2014 to June 2015. Their ages ranged between 34 to 66 years old. They were 14 males and 26 females. Twenty cases apparently healthy individuals were selected as a control group. All cases were subjected to full history taking and complete ophthalmological examination. Also laboratory investigations were done including complete blood picture, kidney and liver function tests, coagulation profile, urine analysis, lipid profile, fasting and postprandial blood sugar and Genetic study for detection of MTHFR gene C677T mutation (rs 1801133)by real time PCR. Results: In all diabetic patients the mutant homozygous TT showed a highly statistically significant increase in FBS (p=0.000), PPBS (p=0.000), HbA1C (p=0.000) and cholesterol (p=0.001) as compared to wild type. Also in all diabetic patients the mutant homozygous TT showed a highly statistically significant increase in FBS (p=0.002), PPBS (p=0.001), HbA1C (p=0.019) and cholesterol (p=0.012) as compared to heterozygous mutant type. Conclusion: The homozygous mutant type (TT) of rs1801133 was detected in 10% of DR patients group while absent in DWR group and the control group. The heterozygous mutant type (CT) was increased in DR group (50%) as compared to DWR group (35%) and the control group (25%).

Assessment of annexin A5 and annexin A2 levels as biomarkers for pre-eclampsia: A pilot study

Deficient anticoagulant activity of annexin A5 and deficient profibrinolytic activity of annexin A2 have been linked to increased risk of thrombotic events. Placental dysfunction due to fibrin deposition/microthrombi has been implicated in the pathogenesis of pre-eclampsia (PE). In this study, we aimed to assess serum levels of annexin A5 and annexin A2 in a cohort of PE patients and investigate their role as biomarkers for the development of the disease. We examined 80 women in total; 40 healthy pregnant women and 40 pregnant women with PE after 20weeks of pregnancy. Women were subjected to full clinical assessment, ultrasonography, and laboratory testing including complete blood picture, liver and kidney function tests and assessment of serum and urine proteins. Annexin A5 and annexin A2 were analyzed using enzyme-linked immunosorbent assay. The study showed serum annexin A2 but not annexin A5 was significantly reduced (P=0.029) in women with PE (total and severe cases) compared to those with normal pregnancy. The ROC analysis of annexin A2 level for the prediction of development of PE showed an area under the curve of 0.64 (P=0.029), and the best cut-off value was 0.89ng/ml with a sensitivity of 70.0% and a specificity of 70.0%. Univariate analysis showed annexin A2 of <0.89ng/ml, proteinuria, lower platelet count and higher BP were associated with significantly higher risk to develop PE. Based on this pilot study, serum annexin A2 levels may be a useful biomarker for pre-eclampsia. However, a larger study is required before a final conclusion is made.

The Role of Renal Resistive Index in Assessment of Functional Renal Impairment in Patients with Liver Cirrhosis

Background and study aim: Renal dysfunction often develops in patients with liver cirrhosis. Hepatorenal syndrome (HRS) represents the end-stage of reduction in renal perfusion. Duplex Doppler ultrasonography of the kidneys is a non-invasive method to assess blood flow and arterial vascular resistance as a parameter for vasoconstriction. This study aimed to assess the role of renal resistive index as a non-invasive marker for early detection of functional renal impairment in patients with liver cirrhosis. Patients and Methods: This study was conducted on 20 patients with liver cirrhosis without ascites vs. Session [CurrentTestPartID] patients with liver cirrhosis and ascites and 20 healthy subjects as control group. Patients and control were subjected to complete blood picture, liver and kidney functions, serum electrolytes, twenty four hours urinary sodium, abdominal ultrasonography and duplex Doppler evaluation of the renal arteries with calculation of mean renal RI. Results: Highly significant difference between cirrhotic patients with ascites and cirrhotic patients without ascites and controls regarding mean renal resistive index for both kidneys (P<0.001). At Cutoff point of renal RI 0.71, the sensitivity, specificity and accuracy to predict HRS were 100%, 80% and 82% respectively with AUC= 0.997. A statistical high significant positive correlation between RI and serum creatinine, child class, MELD score and MELD-Na (r=0. 0.818, r= 0. 0.539, r= 0.739 r= 0.807 respectively and P<0.001). A statistical high significant negative correlation between RI and serum sodium, Session [UserIDID] hours urinary sodium, and platelets (r= -0.778, r= 0. -0.688, r= -0.422 respectively and P<0.001). Conclusion: Renal duplex Doppler ultrasound is useful as a non-invasive method for the evaluation of the renal hemodynamic changes in cirrhotic patients and can predict HRS.

EFFECT OF OBESITY AND STATIN;

Objectives: To observe the effect of obesity and subsequent atorvastatinadministration on MPV in high fat diet induced obese male and female Sprague Dawley rats.Study Design: Randomized control trial (RCT). Setting: Department of Physiology, Army MedicalCollege, Rawalpindi. Animal procurement and blood sampling was done at National Instituteof Health (NIH), Islamabad and biochemical assays were performed at Centre for Research inExperimental and Applied Medicine (CREAM), Army Medical College, Rawalpindi. Period: Thestudy was completed in 12 months. Material and Methods: Ninety healthy Sprague Dawley(male and female) rats were purchased and divided randomly into three equal groups. Ratsin normal control group (Group I) were given normal chow diet for three weeks. Rats in obesecontrol group (Group II) were given high fat diet for three weeks. Rats in obese treated group(Group III) were administered atorvastatin for three weeks in a dose of 10 mg/kg/day orally bygavage method after obesity induction. Terminal sampling was done at the end of the studyby intra-cardiac puncture. MPV is a part of blood complete picture that was analysed by KX 21Sysmex Hematology Analyzer. Results: High fat diet induced obesity resulted in a significant(p &lt; 0.05) increase in MPV. The MPV was significantly (p &lt; 0.05) decreased after atorvastatinadministration. The result was comparable for both genders. Conclusions: Obesity increasesMPV and hence the risk of adverse cardiovascular outcome. Atorvastatin apart from its knownlipid lowering effect, decreases MPV and can play a beneficial role in decreasing cardiovascularmorbidity and mortality.

Primary tuberculosis of thyroid: a rare case report

Case report: The thyroid gland is rarely affected by tuberculosis. Incidence of tuberculosis of the thyroid is 0.1–0.4%. We present a case of a 43-year-old male with painless swelling over the front of neck with history of loss of weight. On local examination swelling was soft to firm, measuring 2×2 cm and moved with deglutition. Clinical diagnosis of colloid goitre was made. The patient’s complete blood picture, thyroid function test, and chest X-ray were normal. USG showed a hypoechoic lesion in the left lobe of the thyroid. On FNAC, 1 mL pus-like material yielded, which on microscopy showed caseous necrosis, with epithelioid cells, lymphocytes, histiocytes, plasma cells and occasional thyroid follicular cells. ZN stain for acid fast bacilli was positive. A diagnosis of granulomatous thyroiditis of Koch’s aetiology was made. Primary tuberculosis of thyroid was first diagnosed by Bruns in 1893, in a middle-aged woman with enlarged gland with no evidence of primary pulmonary tuberculosis. The reasons for reactive immunity of the thyroid for tuberculosis may be explained as bactericidal attribute of colloid in gland, extensive vascularity, high iodine content, and intact capsule of thyroid. Thyroid tuberculosis should always be considered as a differential diagnosis during assessment of a midline cervical mass, as preoperative diagnosis can avoid unnecessary surgery.

English

Objectives: To observe the effect of obesity and subsequent atorvastatinadministration on MPV in high fat diet induced obese male and female Sprague Dawley rats.Study Design: Randomized control trial (RCT). Setting: Department of Physiology, Army MedicalCollege, Rawalpindi. Animal procurement and blood sampling was done at National Instituteof Health (NIH), Islamabad and biochemical assays were performed at Centre for Research inExperimental and Applied Medicine (CREAM), Army Medical College, Rawalpindi. Period: Thestudy was completed in 12 months. Material and Methods: Ninety healthy Sprague Dawley(male and female) rats were purchased and divided randomly into three equal groups. Ratsin normal control group (Group I) were given normal chow diet for three weeks. Rats in obesecontrol group (Group II) were given high fat diet for three weeks. Rats in obese treated group(Group III) were administered atorvastatin for three weeks in a dose of 10 mg/kg/day orally bygavage method after obesity induction. Terminal sampling was done at the end of the studyby intra-cardiac puncture. MPV is a part of blood complete picture that was analysed by KX 21Sysmex Hematology Analyzer. Results: High fat diet induced obesity resulted in a significant(p &lt; 0.05) increase in MPV. The MPV was significantly (p &lt; 0.05) decreased after atorvastatinadministration. The result was comparable for both genders. Conclusions: Obesity increasesMPV and hence the risk of adverse cardiovascular outcome. Atorvastatin apart from its knownlipid lowering effect, decreases MPV and can play a beneficial role in decreasing cardiovascularmorbidity and mortality.&nbsp

Serum Hepcidin Level and Human Factors Engineering (HFE) C282Y Mutation in Egyptian Children with Beta-Thalassemia

Objective: Thalassemia is an important hematological disorder. The possibility of iron overload development may be increase by Interaction between thalassemia and HFE gene mutations. This study aim to investigate the possible association between serum hepcidin level as indicator of iron concentration and the presence of HFE gene mutations.Methods: The study contains two groups, group I: include seventy six children with beta thalassemia, group II include 51 apparently healthy gender and age matched children served as controls. Children was passed through full history taking, clinical examination. Complete blood picture, iron, ferritin, hepcidin, renal and liver functions were measured. HFE gene C282Y mutation was assayed by SNP real time PCR.Results: Frequency of the A genotype and A allele of HFE gene C282Y mutation shows a significant increase in beta thalassemia group in comparison controls. Also, serum Iron and ferritin levels were significantly increase with decrease in hepcidin level in AA when compared to AG and GG genotypes. The splenectomy percent was significantly increased among AA genotype in the patient group. The number and % of patients with ferritin level equal or more than 2500 ng/ml and decrease in hepcidin level as an index of iron overload was significantly increase in patients with AA and AG genotypes.Conclusion: There were significant negative associations between serum hepcidin levels as indication of iron toxicity and HFE C282Y mutation in Egyptian Beta thalassemia children.

Neurobehavioral and hematological health disorders among fuel supply station workers

Objectives This study aimed to study neurobehavioral and hematological health disorders among fuel supply station workers and its relation to the workplace environment. Background Gasoline and its constituents are one of the most hazardous chemicals to the nervous and hematological systems. Patients and methods A case–control nested cross-sectional study was carried out on 92 workers in all licensed fuel supply stations in Shebin El-Kom district, Menoufia governorate, and 92 nonoccupationally exposed matched participants matched for age and sex were selected as a nonexposed group. Environmental studies for light-chain aromatic hydrocarbons [benzene, toluene, ethyl benzene, and xylene (BTEX components)] were carried out. Neurobehavioral test battery and complete blood picture were applied. Results The mean values of BTEX levels (3.69 ± 1.88, 120.59 ± 1.17, 133.70 ± 7.20, and 114.35 ± 6.86 ppm, respectively) were higher than the threshold limit value of the American Conference of Governmental and Industrial Hygienists (0.5, 100, 100, and 100 ppm for BTEX, respectively). Fuel supply station workers had significantly lower performance on the neurobehavioral test battery than nonexposed participants (P Conclusion Exposure to BTEX concentrations higher than permissible levels resulted in deteriorated performance on the neurobehavioral test battery and abnormal hematological findings in exposed workers. Regular use of good-quality personal protective equipment especially masks and gloves and periodic medical examination is highly recommended.

Study of Neutrophil-lymphocyte Ratio as Novel Marker for Diabetic Nephropathy in Type 2 Diabetes.

Introduction:Diabetic nephropathy (DN) is a microvascular complication of diabetes. DN is clinically manifested as an increase in urine albumin excretion. Total white blood cell count is a crude but sensitive indicator of inflammation and studied in many cardiac and noncardiac diseases as an inflammatory marker such as acute myocardial infarction, stroke, and heart failure. In this study, the association of neutrophil-lymphocyte ratio (NLR) with DN is studied.Patients and Methods:It is an observational cross-sectional study. Totally 115 diagnosed type 2 diabetes mellitus patients were registered in this study. NLR was calculated by analyzing differential leukocyte count in complete blood picture. Albuminuria was tested by MICRAL-II TEST strips by dipstick method.Results:Totally 115 diabetic patients were registered. About 56 patients had DN and 59 had normal urine albumin. Mean NLR for a normal group is 1.94 ± 0.65 and in DN group is 2.83 ± 0.85 which was highly significant (P < 0.001). Estimated glomerular filtration rate (P = 0.047) and serum glutamate pyruvate transaminase (P < 0.001) were also significant.Conclusion:The results of our study show that there was a significant relation between NLR and DN. Therefore, NLR may be considered as a novel surrogate marker of DN in early stages.

Incidence & prognosis of acute kidney injury in individuals of snakebite in a tertiary care hospital in India.

Background & objectives:The snakebites are considered to be an occupational hazard in agriculture workers and the snake handlers, resulting in a considerable morbidity, mortality and economical implications. This study was conducted to determine the incidence, clinical presentation, renal injury and clinical outcome in snakebite victims who developed acute kidney injury (AKI).Methods:This hospital-based prospective, observational study was done on 100 cases who were admitted for the management of snakebite and found to develop AKI in a tertiary care hospital at Hyderabad, India. Renal function tests, complete blood picture, urine routine examination, ultrasound examination of abdomen and coagulation profile were done and the prognosis was assessed by noting recovery, mortality, morbidity and/or progress to chronic stage.Results:A total of 100 patients with a mean age of 43.80±12.63 yr (range 18-70); 62 males and 38 females were studied. All had bites on lower limbs. A total of 86 patients arrived in the hospital within 24 h, and 14 arrived after 24 h. Oliguria was found in 60, bleeding tendencies in 64, haemodynamic instability noted - tachycardia in 86. Systolic blood pressure (BP) was <120 mm Hg in 68 and BP was not recordable in four patients. Twelve patients were in stage III kidney disease and needed haemodialysis. Of the 100 cases of snakebite-induced acute kidney failure, 86 recovered and six died. On follow up, after six months eight patients developed chronic kidney failure.Interpretation & conclusions:A cascade of events tends to occur in severe haemotoxic envenomation such as bleeding disorders, hypotension/circulatory shock, intravascular haemolysis, disseminated intravascular coagulation and acute respiratory disease syndrome (ARDS). The findings of this study showed that early hospitalization, quick antisnake venom administration and adequate supporting care provided promising results.

BIOMARKERS OF COAGULATION ACTIVATION IN CHILDREN WITH SICKLE CELL DISEASE

Sickle cell disease (SCD) is a multisystem disease, characterized by its multi-phenotypic diversity although being a disease caused by a single nucleotide substitution.In the present study, we measured biomarkers of coagulation activation in children with SCD. The study was performed on 50 Egyptian children with SCD and 41 age- and sex-matched controls. Complete blood picture (CBC), International normalized ratio (INR)and Partial thromboplastin time (PTT) levels were measured. Thrombin-antithrombin (TAT) plasma levels was estimated by enzyme-linked immunosorbent assay (ELISA). A statically significant increase in all of INR, PTT and TAT plasma levels were detected. We agree with the previous studies that children with SCD exhibit a hypercoagulable state.