Complete Blood Picture Research Articles

Inosine Triphosphate Pyrophosphatase Gene Polymorphisms and Ribavirin-Induced Anemia in HCV Patients

In spite of the interferon (INF) redundancy in treating HCV, ribavirin (RBV) is still included with the new direct antiviral therapies. Ribavirin-induced hematological alterations had been referred to ITPA gene polymorphisms. Objective: Evaluate ITPA gene polymorphisms (rs1127354 and rs7270101) with development of anemia in chronic hepatitis C (CHC) Egyptian patients during treatment with pegylated-interferon (Peg-IFN) plus ribavirin (RBV). Methods: 100 Egyptian CHC patients treated with PEG-IFN/RBV were recruited, 55 patients developed anemia (Hb decline>2 g/dl), and other 45 would not developed anemia (Hb decline ≤ 2 g/dl) at week 12 throughout the treatment course. Routine laboratory investigations were done for all participates (HCV-Abs, HBs Ag, HCV-RNA levels, complete blood picture, liver and kidney function tests. Single nucleotide polymorphism (SNP) was done by ABI TaqMan allelic discrimination kit for ITPA polymorphisms (rs1127354 and rs7270101). Results: CC and AA were the most prevalent genotypes of SNPs rs1127354 and rs7270101 respectively among two studied groups. rs1127354 polymorphism was associated with Hb-decline at week 12 of treatment and with rs7270101 polymorphism for predicting platelet decline during treatment. Lower levels of platelet decline were detected with CC rs1127354 and AA rs7270101. Conclusion: While ITPA polymorphisms rs1127354 CC genotype carried a predilection of anemia occurrence in PEG-IFN/RBV HCV treated subjects, the minor allele rs1127354 AA plays a crucial role in their protection. Platelet decline was reported in both ITPA rs1127354 and rs7270101 polymorphisms. Screening for ITPA polymorphisms in Egyptian HCV patients would be of value in avoiding hematological disturbances and dose modulations in RBVbased therapies.

Assessment of immune response to hepatitis B virus vaccine in chronic hemodialysis patients

Objective This study aimed to assess the immune response to hepatitis B virus (HBV) vaccine in chronic hemodialysis (HD) patients. Background HBV is an important public health problem in humans. Currently available HB vaccines have an excellent safety and immunogenicity profile. Anti-HBs are the only easily measurable correlate of vaccine-induced protection. Dialyzed patients have impaired immune response and lower seroconversion rates compared with the general population. Patients and methods This study was conducted on 50 patients with chronic renal failure on hemodialysis (HD) and 30 healthy persons. These patients were subjected to full history taking, complete clinical examination, complete blood picture, liver function tests, renal function tests, serum Na, K, and Ca, abdominal and pelvic ultrasound, HBsAg, anti-HBs, anti-HBc, and HCV-Ab by ELISA. Results There was a highly significant decrease in the mean value of anti-HBs titer in the HD group when compared with the control group. In addition, there was a highly significant decrease in the mean value of inadequate anti-HBs titer and a significant decrease in the mean value of adequate anti-HBs titer in the HD group when compared with the control group. A significant negative correlation between anti-HBs titer and age was found. There was a highly significant negative correlation between anti-HBs titer and serum creatinine levels and blood urea. A significant positive correlation between anti-HBs titer and serum albumin levels was found. Conclusion Response of HD patients to HB vaccine is inadequate, with significant negative correlation with serum creatinine, blood urea levels, and age, and a significant positive correlation with serum albumin.

Clinical and Haematobiochemical Evaluation of Pneumonia in Calves with Special Reference to Oxidant/Antioxidant Indices

Pneumonia and pneumoenteritis are the major problems affect health and performance of calves and induce many losses even with treatment. Thirty calves were subjected to study; fifteen calves (group 1) showed fever, cough, bilateral mucopurulent nasal discharges with abnormal lung sound on auscultation. The remained fifteen calves were apparently clinically healthy and kept as control group (group 2). Clinical observation had been done and complete blood picture, oxidant/antioxidant profile and serum sodium, potassium and chloride were evaluated. Results of hematological analysis of group 1 showed a significant reduction in the RBCs count, Hb content, PCV and MCV indicating microcytic hypochromic anemia associated with a non-significant increase in the MCH and significant increase in both of MCHC and WBCs indicating leukocytosis. Results of oxidant/antioxidant profile of group 1 showed a significant reduction in the activity of CAT, SOD, GSH, GSH-Px and TAC values associated with a significant increase in the MDA level. While levels of serum electrolytes of group 1 showed a significant reduction in Na and Cl with a significant increase in K.

Blood parameters, carcass and meat quality of slaughter pigs with and without liver milk spots

The aim of this study was to determine the influence of liver milk spots on hematological, carcass and meat quality parameters in slaughter pigs. A total of 120 pigs with a live weight of approximately 115 kg and six months old were examined. Any signs of liver milk spots were recorded as present or absent according to Welfare Quality? protocol (2009). A complete blood picture was investigated. The following carcass quality parameters were measured: live, hot and cold carcass weights, dressing percentage, backfat thickness and meatiness. pH and temperature measurements were performed 45 minutes postmortem. Pork quality classes (PSE - pale, soft and exudative, normal, DFD - dark, firm and dry meat) were determined according to Adzitey and Nurul (2011) using pH45 value. Pigs with liver milk spots had significantly higher middle-sized cell count (monocytes, eosinophils, and basophils) and neutrophils count, but significantly lower red blood cell count, hemoglobin concentration, hematocrit and MCV than unaffected pigs. The same group of pigs had significantly lower live weight, hot carcass weight, cold carcass weight, dressing percentage and meatiness compared to the pigs free of milk spot lesions. Pigs showing liver milk spots had significantly higher pH45 value and incidence of DFD meat than pigs without pathological lesions in the livers. In conclusion, assessment of liver milk spots at slaughter line has potential to serve not only as an indirect measure of pig health and welfare, but also for the carcass and pork quality.

Study of biochemical and nutritional indicators in severe acute malnutrition: A prospective observational study

Background: Malnutrition in children is widely prevalent in developing countries including India. More than 33% of the deaths in 0-5 years are associated with malnutrition. Children with severe acute malnutrition (SAM) are in danger of death from hypoglycemia, hypothermia, fluid overload, electrolyte mismanagement, and undetected infections. Hence, biochemical and nutritional indicators in these children are important for management. Objectives: To study the biochemical and nutritional indicators in children with SAM. Methods: This hospital based prospective study was conducted on children aged 6-59 months admitted at Nutrition Rehabilitation Center attached to a tertiary care teaching institution. 100 consecutive SAM children admitted during 2013-2015 were studied. Children were tested for biochemical and nutritional status like complete blood picture with peripheral smear, liver function tests, renal function tests, serum electrolytes, calcium, phosphorus, and alkaline phosphatase. Results: A total of 100 cases were included, of these 57 were male and female were 43. Mean age of presentation was 18.45±2.37 months. A lack of exclusive breastfeeding was seen in 67% of these children and in 78% children complimentary feeds were initiated either early or later than 6 months. Hypoglycemia was seen in 15% cases, hypokalemia in 22%, and hypocalcemia in 35% of cases. Hyponatremia was seen in 14% and hypernatremia in 19% of the children. The most common type of anemia was microcytic hypochromic type (55%). Conclusion: The observations in this study confirm a significant association between SAM and faulty feeding and early introduction of complementary feeds. It was observed that these children have significant alterations in nutritional indicators at admission.

Study the Oxidative Stress, Some Biochemical and Hematological Parameters in patients with agout at AL-Ramadi city

This study aims to study the effect of gout disease on complete blood picture and biochemical parameters and some non-enzymatic antioxidants, some tracing elements and lipid peroxidation ,in outpatients with gout disease at Al-Ramadi Teaching-Hospital ,Al-Razi Hospital and the study duration from Octo.2013-to May 2014.(50) blood samples were collected from patients with age groups (30-80 years) from both sexes (28 males,22 females),a (30) blood samples (15 males,15 females) were collected from normal individuals as a control group with age groups (27-75 years). Hematological measurement showed no significant differences in size compressed blood cells, the percentages in ( 45.15 +4.99 and 46.87+6.30) % in patient and control groups respectively, hemoglobin concentrations were ( 14.04+1.66 and 14.30+1.93) g/l in patient and control groups respectively, total number of red blood cells ( 5.21+0.43 and 5.12 +0.58) 106/mm3 in patient and control groups respectively with(P?0.05) in ESR (21.06+13.47 and 13.37 +7.45) mm/hr in patient and control groups respectively with (P?0.05), the total number of WBCs were recorded (8.96+2.04 and 7.50+1.69)in patient and control groups respectively. Results showed also significant differences (P?0.05) in uric acid levels (7.42+0.76 and 5.62+0.88) mg/dl,malondialdehyde levels were recorded (4.45+0.64 and 3.21+0.86) in patient and control groups

Peroxidative stress and antioxidant enzymes in children with β-thalassemia major

Objective The objective of this study was to evaluate the extent of lipid peroxidation and to study the state of antioxidant enzymes in thalassemic children, as well as to assess the oxidative status in β-thalassemia major patients. Patients and methods This is a case–control study conducted on 40 patients previously diagnosed with β-thalassemia major and 40 healthy age-matched and sex-matched children as the control group. The following investigations were done for all children: complete blood picture, reticulocyte count, serum ferritin level, and hepatitis B and C markers. Measurement of lipoperoxides; instead of, malondialdehyde (MDA), analysis of antioxidant enzymes; instead of, superoxide dismutase, glutathione peroxidase, and vitamin E levels were also performed. Results There were significant differences in oxidative status values between cases and controls. Increased MDA level ranged from 2.3 to 4.6 nmol/ml in thalassemia patients compared with the controls (P<0.001). Significantly lower activity of superoxide dismutase was 50–78 U/ml in thalassemic patients as compared with controls (P<0.001). In addition, the glutathione peroxidase level ranging from 2.85 to 5.85 U/l was significantly lower in thalassemic patients (P<0.001). Vitamin E was significantly lower among patients with β-thalassemia (0.1–0.5 mg/dl) compared with controls (P<0.001). Conclusion An increased level of the lipid peroxidation product MDA was detected in β-thalassemia major patients accompanied by significantly lower activity level of antioxidant enzymes and vitamin E.

Screening for viral infection and anemia among pregnant women with bad pregnancy outcome in Egyptian population

Hepatitis C virus (HCV) is a major public health concern worldwide and in Egypt. Viral hepatitis during pregnancy is closely related to high risks of maternal complications Human Cytomegalovirus (CMV) is considered the most common cause of congenital malformation that results from viral intrauterine infection in developed countries. Anemia is one of the common complications that is associated with increased risk of bad pregnancy outcome including low birth weight and preterm birth. The aim of this study was to screen for HCV, CMV and anemia among pregnant women in Egyptian population. This prospective study was conducted at the Prenatal Diagnosis clinic in the National Research Centre between April 2013 and August 2015 and a total of 200 pregnant women during their second trimester of pregnancy were enrolled and divided into case group (150/200) with current or history of bad pregnancy outcome and control group (50/200) with no previous history of bad pregnancy outcome. All blood samples were tested for complete blood picture and liver enzyme tests and were screened by ELISA for Anti-HCV and CMV-IgG and IgM. After all investigations including medical and family history for all pregnant women included in the study, all data was statistically analyzed using spss version 19. Anemia was diagnosed in pregnant women with hemoglobin level below 11 g/dl and it was detected in 24 % (48/200) of the total pregnant females included in the study. Five cases tested positive for Anti-HCV antibody among all cases enrolled in the study and was found in the cases group 3.33% (5/150) while all pregnant women in the control group showed negative results. Screening for CMV showed 100 % CMV-IgG while we found 0 % CMV-IgM. Screening for anemia and serological screening for CMV and HCV antibodies should be routine tests especially among pregnant women.

Haematological values of apparently healthy indigenousgoats in Malaysia: A comparative study

Objective of this study was to understand the changes that occur among several strains of goats in Malaysia by investigating the haematological values under the tropical climate to stand on the health level and immune system. Sixty adult goats were used. These goats comprised three indigenous breeds, namely, Kambing Katjang, Boer, and Jamnapari. Blood samples (n=618) were withdrawn for every 2 weeks. Complete blood picture was determined immediately after collection. ANOVA, (P less than 0.05), was used to analyze data for the effects of sex and breed. Several of the analyzed parameters seem to be affected at the sex and breed.

Prevalence of concealed and overt chronic renal failure in patients with COPD

AimTo assess the prevalence of chronic renal failure (concealed and overt) in patients with COPD. Patients and methodsThis study was conducted on 150 patients who were classified into three groups: Group I: 67 patients with COPD, Group II: 33 COPD patients with co morbidities (diabetes mellitus, hypertension and or ischemic heart disease). Group III: (control group): 50 patients with other diseases such as diabetes mellitus, ischemic heart disease and or hypertension. All patients were subjected to: (1) Full history taking. (2) Complete clinical examination. (3) Anthropometric measurements (weight, height and body mass index). (4) Arterial oxygen saturation. (5) Radiological examination (Plain chest X-ray posterior–anterior view and Pelvi-abdominal ultrasound). (6) ECG and Echocardiography. (7) Spirometry. (8) Laboratory investigations (complete blood picture, erythrocyte sedimentation rate, Liver function tests, serum creatinine, blood urea and uric acid and GFR, total cholesterol, sodium, potassium and chloride concentration). ResultsIn group I, there were 8 patients who had CRF (11.94%), 5 patients had overt CRF (7.46%) and 3 patients had concealed CRF (4.48%). In group II, there were 11 patients with CRF (33.33%), 6 patients had overt CRF (18.18%) and 5 patients had concealed CRF (15.15%). In group III, there were 9 patients having CRF (18%), 6 patients had overt CRF (12%) and 3patients had concealed CRF (6%). In COPD (group I and II) the overall prevalence of CRF was 19%. ConclusionCRF either concealed or overt may be associated with COPD patients and should be screened, not only by serum creatinine level but also by the estimated GFR to recognize the cases of concealed CRF who have low GFR despite normal serum creatinine level.

Plasma free amino acid profile changes in hepatocellular carcinoma patients

Objective The aim of this study was to investigate plasma amino acid profile as a possible diagnostic/prognostic method in patients with hepatocellular carcinoma. Background Many previous reports have shown that metabolism is notably altered in cancer cells. Thus, various methods for cancer diagnosis and prognosis have been developed based on metabolite analysis. Among whole metabolites, amino acids were proposed as suitable candidates for focused metabolomics as they are either ingested or synthesized endogenously and they play an essential physiological role both as basic metabolites and metabolic regulators. Patients and methods This study included 71 hepatocellular carcinoma patients (60 male and 11 female) and 30 chronic hepatitis C virus patients (20 male and 10 female) in addition to 30 healthy controls (25 male and 5 female). Laboratory investigations including complete blood picture, liver function tests, serum α-fetoprotein, hepatitis viral markers (HBsAg and anti-HCVAb) were carried out for all participants. Amino acid assay was carried out using ultra performance liquid chromatography–electrospray ionization-mass spectrometry. Results The study showed a statistically significant increase in methionine, tyrosine, ornithine, citrulline, glycine, phenylalanine, alanine, glutamate, proline, and arginine and a decrease in valine, aspartate, leucine/isoleucine, branched tyrosine ratio (BTR), and Fischer's ratio in hepatocellular carcinoma compared with the control group. Moreover, the study indicated that there was a statistically significant correlation between BTR and platelets, alanine transaminase, albumin, bilirubin, and α-fetoprotein and significant differences in BTR among Child-Pugh A, B, and C. Conclusion Our results suggested that the plasma free amino acid profile is considered valuable for diagnosis and nutritional care in cancer patients. Furthermore, BTR reflects the pathological liver background with a high degree of correlation with other liver functional markers.

Comparative study for adding some medical plants powders to the rasion with Amprolium on hematology, serology and productive properties of broiler chickens Rose 308

The purpose of the study is to mix some medicinal plant powders with the food diet and to compare them with the Amberolium antibiotic and to study their effect as dietary aids in improving the hematological , serological, and productive characteristics of the broiler chickens (Rose 308).The four types of medicinal plants were added to the Rose308 broiler Rosemary ,peel of pomegranate, pine and willow plants, and treatment of amberolium was added to water at a concentration of 0.5 g / L. our research includes studies the following : complete blood pictures, biochemical blood parameters ,and all the results oversoften to SSD statistic programs.The results of the study showed that the cumulative performance characteristics of the period (1-42 days) showed significant differences (P< 0.05) For the treatment of control compared with other treatments. It was found that the best treatment in improving the performance characteristics when mixed with the diet and calculating the length of time of breeding period and the body's resistance to diseases and the percentage of losses is the treatment to which the pomegranate powder was added compared with the production characteristics of the other treatments and compared with the control , And the treatment was reduced from the loss rate. The efficiency of the pomegranate peel powder to the type of active ingredient may have been widely used in commercial medical treatments, and the blood parameters ratios of this treatment were closely correlated with the control ratios. As it had an active role in increasing the amount of( Hb , RBC and Platelate) and lower the levels of ESR compared with control and the rest of the other transactions, either serological factors which include: (Total serum protein, albumins, uric acid, creatinine)& (Lipid TC, TG, HDL).It was also found that giving some natural extracts of plants has led to a significant stability of the serological factors. (lipid TC, TG, HDL), and some natural extracts of plants have resulted in significant stability in the results, The final results of our study found that peel of pomegranate powder was the best treatment in terms of improvement of the performance traits and the indicators of the hemolytic , serological and ionic characteristics, while the lowest of the above indicators was in the powder of rosemary leave.

A Cross Sectional Study on Morphological Pattern of Anemia

Background:Anemia is a global health problem of immense health significance, affecting persons of all ages and economic groups. Anemia is functionally defined as an insufficient RBC mass to adequately deliver oxygen to peripheral tissue. Developing countries like India; it is more common in pregnant women and in adolescent girls.Objectives:The present study was to emphasize various morphological patterns of anemia and its prevalence in various age groups. Materials and methods: This was a cross sectional study on 920 complete blood pictures (CBPs), over a period of 2 years from 2010 to 2012 at department of pathology,S.V.R.R.G.G.H &Sri Venkateswara Medical College, Tirupati, a tertiary health care center. The results wereanalyzed andinterpreted statically. Results:Of the total 920 hemograms that were studied, 685 were anemic with prevalence of 74.5%. Females were 419 (61.2%) and Males were 266 (38.8%), was showing Female preponderancewith Male Female ratio 1:1.6. Most common age group in females was 21-30 years and in males was 51-60 years. Commonest pattern of anemia was observed Microcytic Hypochromicfollowed by Dimorphic and Macrocytic anemia respectively. Conclusions:The introduction of automated cell counters has initiated a rethink on the conventional classification of routinely encountered conditions such as anemia. Iron deficiency anemia (IDA) is the most common anemia with microcytic hypochromic picture. It occurs in all age groups especially in woman in the reproductive age group.Diagnosing anemia and knowing its pattern is important since it help in directing further investigation, identifying the etiology and most importantly helps in treatment.

Incidence of anemia in type 2 diabetic mellitus and its prognostic index

Objective: To identify the incidence of anemia in type 2 diabetic mellitus in a rural population and its prognostic value. Methodology: This is prospective observational study conducted at RMMCH, Chidambaram; the study comprises of 250 patients diagnosed with type 2 diabetic mellitus. Age of greater than 18 years, Risk factor such us hypertension and CAD were included in the study. Age of less than 18 years, anemia due to chronic blood loss, anemia due to other secondary causes and patient on treatment for anemia is excluded from the study. In patients with diabetic mellitus, HbA1c, Complete Blood Picture, Smear study, were done after obtaining consent detail from patients. Result: In the present study out of 250 populations females was dominated by 160/250(64%) with mean age group of 60±13 were mean duration of diabetes being 4.1±3 years and mean hemoglobin level was 11.3 ±2%, the comorbid condition such us CAD and Hypertension was present in 90 and 110 patients respectively. Mean HbA1c value was 8.4±2.1. Normocytic Normochromic anemia was present in 25% of anemic patients; Microcytic Hypochromic anemia was found in 35%, Macrocytic Hyperchromic is 32% and Dimorphic anemia was present in 8%. Conclusion: Anemia is present in 74% of the study population which point towards the need of hematological evaluations and care needed for the diabetic patients for better outcome in rural population.

Insight on Bone Morphogenetic Protein 7 in Ankylosing Spondylitis and its association with disease activity and radiographic damage.

IntroductionFusion of joints as well as intervertebral spaces by the formation of bony spurs appearing as syndesmophytes and osteophytes are the hallmark of spondyloarthropathies which accounts for disability. The aim of this study was to assess the serum level of bone morphogenetic protein (BMP)-7 in ankylosing spondylitis and its relationship with disease activity and the radiographic damage.MethodsThis longitudinal case control study was conducted in Ain Shams University Hospitals (Egypt). A total of 55 subjects were included in two case groups and one control group. Group I included 20 patients with Ankylosing Spondylitis (AS) assessed at baseline (defined as Ia and after 18 months defined as Ib). Group II included 20 patients with Rheumatoid Arthritis (RA) and Group III included 15 healthy subjects as controls. Patients with other forms of seronegative spondyloarthropathies, bone forming diseases were excluded from the study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Metrology Index (BASMI) were used to assess disease activity in AS patients. RA disease activity was assessed using the disease activity score 28 (DAS28). Radiographic changes were assessed using the Bath AS Radiographic Index (BASRI) in AS and Larsen scores in RA. Laboratory investigations included: Complete blood picture (CBC), Erythrocyte sedimentation rate (ESR), quantitative CRP, serum calcium, phosphorus and alkaline phosphatase. Determination of serum bone morphogenetic protein-7 level (BMP-7) was done using enzyme linked immunosorbent assay (ELISA). Sample collections, clinical and radiological assessments were performed at baseline for all groups and after a mean follow-up of 18 months for Group I. Data were analyzed by SPSS 17, using t-test, Kruskal-Wallis, Mann-Whitney, Fischer exact test, Chi square, and Pearson Product-Moment Correlation Coefficient.ResultsThere were statistically significant differences between the 3 groups as regard baseline BMP-7 levels; the mean BMP-7 level of AS patients was significantly higher than that of RA patients and controls and significantly higher in the RA group than that of controls. BMP-7 levels were not associated with any of the clinical or drug related variables either in AS or RA. In AS BMP-7 levels showed significant increase after follow up and significant positive correlation with serum alkaline phosphatase (both at baseline and after follow up) and BASDAI score (after follow up) respectively. Despite the parallel increase of BMP7 and BASRI score during the follow-up period no statistically significant correlation was detected. There were no significant correlations between BMP7 level and patient’s age or any disease related characteristics in the RA group.ConclusionA significant progressive increase in serum BMP-7 was noted in AS patients that correlated with serum markers of bone formation. Such a biomarker measurement may not only act as a surrogate marker for the disease but has the potential to contribute to the pathogenesis of AS that may provide a complementary or alternative therapeutic approach.

Beneficial Effects of Omega-3 Supplement to the Enteral Feeding in Children With Mild to Moderate Sepsis.

The objective was to investigate the benefits of supplementing enteral feeding with omega-3 fatty acids in children with mild to moderate sepsis and its effects on acute-phase reactants and interleukin 6 (IL-6) level. The study was a prospective randomized, double-blind, placebo-controlled study from January 2012 to June 2014, which included 2 groups of children with mild to moderate sepsis tolerating enteral feeding. Group A included 60 children supplemented with omega-3 fatty acids, whereas group B included 60 children who received enteral feeding without omega-3 supplementation. Both groups had complete blood pictures, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum albumin, and IL-6 before and after 7 days from supplementation. There was a significant improvement in hemoglobin percentage ( P < .0001), total white blood cell (WBC) count ( P < .0001), and platelet count ( P < .0001) and significant decrease in CRP ( P < .0001), ESR ( P < .0001), IL-6 ( P < .0001), and albumin level ( P < .001) in the supplemented group than the nonsupplemented group. The supplemented group also had a significantly shorter duration of stay in pediatric intensive care unit (PICU; P < .01) and decreased death rate than the nonsupplemented group. Children with mild to moderate sepsis showed significant improvement in inflammatory markers and had shorter PICU admission when enteral feeding was supplemented with omega-3 essential fatty acids.

Assessment of the radioprotective effect of propolis in breast cancer patients undergoing radiotherapy. New perspective for an old honey bee product

BackgroundIonizing radiation is widely used for treatment of cancer. However, one of the limitations of using radiation is its toxic effects on normal tissue. Radiation damage to normal tissue can be partially reduced by the use of radio-protectors that scavenge free radicals produced during radiation. Recently, interest has increased in the development of potential drug of plant origin for the modification of radiation effects and has an advantage over the synthetic compounds in term of low or no toxicity and with minimum side effects. Propolis is apicultural product which is composed of nutritionally valuable substances and contains considerable amounts of polyphenol substances. Flavonoids and phenolic acids are the major classes of polyphenolic compounds. Because of its broad spectrum biological properties, the interest in propolis as harmless medicine has been increased. Aim of the workThe present study has been undertaken to evaluate the radio-protective effect of propolis supplementation in breast cancer (BC) patients undergoing radiotherapy. Subjects and methodsThis study included 135 subjects divided into three main groups: Group I: 45 healthy females served as control group of matched age and menopausal status with the next malignant groups. Group II: 45 chemotherapy received breast cancer patients followed by radiation therapy only. Group III: 45 chemotherapy received breast cancer patients followed by radiation therapy plus propolis supplements. Two venous blood samples were collected from both breast cancer patients groups (Before and after radiotherapy) and one blood sample from matched controls. DNA damage in mononuclear cells was assessed by alkaline Comet assay. Serum was separated to measure ribonucleotide reductase M2 subunit (RRM2) by enzyme linked immunossorbent assay (ELISA). Malonaldhyde (MDA), total antioxidant capacity (TAC) and iron were assayed by colorimetric method. One ml blood sample was collected into EDTA tubes for complete blood picture analysis. ResultsThe present study showed that radiotherapy is accompanied by significant increase in Comet tail parameters (Tail length, % Tail DNA, Tail moment) in peripheral blood mononuclear cells of BC patients. While in the group of patients supplemented with propolis plus radiotherapy, propolis have the ability to reduce significantly the radiation induced DNA damage. Concerning RRM2 subunit, it was found that, although radiotherapy significantly down regulate RRM2 protein but still significantly higher than normal control value. On the other hand, the supplementation of propolis during radiotherapy caused a significant down regulation of RRM2 level and became within the normal control level. Furthermore, radiotherapy is accompanied by significant increase in serum MDA and significant decrease in serum TAC while after propolis supplementation plus radiotherapy, serum MDA and serum TAC significantly improved. Regarding serum iron and hematological parameters including hemoglobin (HB) concentration, white blood cells (WBCs) and platelets counts were significantly decreased after radiotherapy treatment alone while after radiotherapy plus propolis, these parameters significantly increased and became within the normal control level. ConclusionsSupplementation of propolis with radiotherapy treatment offers a quite measurable protection against DNA damage caused by ionizing radiation in BC patients leukocytes and inhibits RRM2 overexpression. Moreover, propolis has beneficial effects on the serum antioxidant capacity and improves the digestive utilization of iron and the regeneration efficiency of hemoglobin. Larger prospective studies are required to confirm our findings.

Clinical presentations and outcome of severe community-acquired pneumonia

BackgroundSevere community-acquired pneumonia (SCAP) represents a frequent and potentially life-threatening condition. About 10% of all hospitalized patients with CAP require admission to the intensive care unit (ICU), and the mortality of these patients reaches 20–50%. ObjectiveTo evaluate the clinical presentation, bacteriological profile and outcome of severe community-acquired pneumonia (SCAP). Patients and methods54 patients presented by symptoms and sign of severe community acquired pneumonia who were admitted to respiratory care unit of Alhussein, Al-Azhar University Hospital from August 2015 to March 2016 were subjected to full clinical examination, chest X ray, complete blood picture, sputum and blood culture, PCR for suspected cases of Influenza H1N1 and MERS-COV, treatment, follow up, data collections and statistical analysis. ResultsThe present study included 54 patients 26 males and 28 females with SCAP who were admitted to respiratory care unit of Alhussein, Al-Azhar University Hospital. The most common comorbidities were diabetes mellitus and hypertension. The most common presentations were fever, cough, dyspnea and hypoxemia. Two patients developed renal failure and 4 patients developed septic shock. The most common isolated organism was Streptococcus pneumoniae, Influenza H1N1, and Staphylococcus aureus. Mortality was 24% and it was common in patients with comorbidity than in patients without comorbidities. ConclusionSCAP occurs more frequently in those with comorbidities. The most frequent isolated causative organism of SCAP is S. pneumoniae, Influenza H1N1 and S. aureus. SCAP is associated with significant mortality, early recognition and prompt treatment may improve outcome.

The relation between mean platelet volume/platelet count ratio and prognostic factors in patients with advanced non-small cell lung cancer

Background: Identifying simple and reliable prognostic indicators in non-small cell lung cancer (NSCLC) is important to optimize its management. The mean platelet volume/platelet count (MPV/PC) ratio may be of prognostic value in some clinical conditions including NSCLC.Aim: To investigate the relationship between MPV/PC ratio and some important prognostic factors in Egyptian NSCLC patients.Methods: Retrospective study that included 69 patients with stage III/IV NSCLC in the period from January 2010 to December 2012. The complete blood picture done before starting treatment was the one considered for the calculation of MPV/PC. The relation between MPV/PC ratio and patients and disease characteristics was studied.Results: More advanced stage was associated with lower average MPV/PC ratio. The average MPV/PC ratio was 0.45963 (95%CI: 0.38829- 0.53098) in patients with stage IIIA, 0.33873 (95%CI: 0.2854-0.39208) in stage IIIB and 0.32752 (95%CI: 0.28642- 0.36862) in stage IV (p=0.015).Similarly, higher Eastern Cooperative Oncology Group performance status score was associated with lower MPV/PC ratio. The average MPV/PC ratio was 0.40949 (95%CI: 0.34959 – 0.46939) in patients with ECOG 1, 0.36369 (95%CI: 0.31009- 0.41724) in ECOG 2 and 0.28378 (95%CI: 0.24898 -0.31857) in ECOG 3 (p=0.004). Older patients had a significantly lower MPV/PC ratio (p=0.043).Conclusion: Low MPV/PC is associated with poor prognostic factors in NSCLC such as advanced stage and poor performance status. Future clinical studies to evaluate the prognostic value of MPV/PC ration in NSCLC are warranted.

Diagnostic value of platelet parameters versus interleukin-6 in children with urinary tract infection

BackgroundUrinary tract infection (UTI) is a common problem that is frequently encountered by pediatric healthcare providers. Diagnosis of UTI is often difficult, particularly in critically ill patient and in patients with nonspecific and mild symptoms. Testing for platelet parameters is inexpensive, easily accessible and routinely performed that had been recognized as a hallmark in the diagnosis of platelet activation during infection and inflammatory disorders. AimTo evaluate the value of platelet parameters in the diagnosis of UTI in children in comparison to interleukin-6. MethodThis case–control study included 88 children; 44 of them had culture proved UTI. In addition 44 age and sex matched healthy children served as a control group. Complete blood picture with emphasis on platelet parameters (mean platelet volume (MPV), platelet distribution width (PDW) and platelet count), C-reactive protein, erythrocyte sedimentation rate and interleukin-6 serum levels were done for both groups. We investigated the correlation between platelet parameters, inflammatory biomarkers and the type of organism in children with UTI. ResultsPlatelet parameters were significantly higher in children with UTI in comparison to those of the control group. There was a significant positive correlation between platelet parameters, ESR, CRP and interleukin-6 in children with UTI. MPV & PDW have 90.1% & 88.6% sensitivity and 86.3% & 84.1% specificity respectively for diagnosis of UTI. Platelet parameters are significantly higher in children with gram positive infection. ConclusionPlatelet indices could be used as an indicator of UTI in children. It could predict the type of causative organism. Further researches are needed to evaluate its role for detection of recurrence of UTI in high risk children.